Podcasts about evd

In this episode, we discuss the case of a 15-year-old girl who presents with progressive headache, nausea, vomiting, and difficulty ambulating. Her condition rapidly evolves into altered mental status and severe hydrocephalus, leading to a compelling discussion about the evaluation, diagnosis, and management of hydrocephalus in pediatric patients.We break down the case into key elements:A comprehensive look at acute hydrocephalus, including its pathophysiology and causesEpidemiological insights, clinical presentation, and diagnostic approachesManagement strategies, including temporary and permanent CSF diversion techniquesA review of complications related to shunts and endoscopic third ventriculostomyKey Case Highlights:Patient Presentation:A 15-year-old girl with a 3-day history of worsening headaches, nausea, vomiting, and difficulty walkingAltered mental status and bradycardia upon PICU admissionCT scan revealed severe hydrocephalus without a clear mass lesionManagement Steps in the PICU:Hypertonic saline bolus improved her mental status and pupillary reactionsNeurosurgery consultation recommended MRI and close neuro checksInitial management included dexamethasone, keeping the patient NPO, and hourly neuro assessmentsDifferential Diagnosis:Obstructive (non-communicating) vs. non-obstructive (communicating) hydrocephalusConsideration of alternative diagnoses like intracranial hemorrhage and idiopathic intracranial hypertensionEpisode Learning Points:Hydrocephalus Overview:Abnormal CSF buildup in the ventricles leading to increased intracranial pressure (ICP)Key distinctions between obstructive and non-obstructive typesEpidemiology and Risk Factors:Congenital causes include genetic syndromes, neural tube defects, and Chiari malformationsAcquired causes: post-hemorrhagic hydrocephalus (e.g., from IVH in preemies), infections like TB meningitis, and brain tumorsClinical Presentation:Infants: Bulging fontanelles, sunsetting eyes, irritabilityOlder children: Headaches, vomiting, papilledema, and gait disturbancesManagement Framework:Temporary CSF diversion via external ventricular drains (EVD) or lumbar cathetersPermanent interventions include VP shunts and endoscopic third ventriculostomy (ETV)Complications of Shunts and ETV:Shunt infections, malfunctions, over-drainage, and migrationETV-specific risks, including delayed failure years post-procedureClinical Pearl:Communicating hydrocephalus involves symmetric ventricular enlargement and is often linked to inflammatory or post-treatment changes affecting CSF reabsorption.Hosts' Takeaway Points:Dr. Pradip Kamat emphasizes the importance of timely recognition and intervention in hydrocephalus to prevent complications like brain herniation.Dr. Rahul Damania highlights the need for meticulous neurological checks in PICU patients and an individualized approach to treatment.Resources Mentioned:Hydrocephalus Clinical Research Network guidelines.Recent studies on ETV outcomes in pediatric populations.Call to Action:If you enjoyed this discussion, please subscribe to PICU Doc On Call and leave a review. Have a topic you'd like us to cover? Reach out to us via email or on social media!Follow Us:Twitter: @PICUDocOnCallEmail:

Unlock the secrets to enhancing patient safety with our comprehensive discussion on the External Ventricular Drain (EVD) Safety Campaign. Ever wondered how to drastically reduce complications like ventriculitis? We promise you'll walk away with actionable insights, from the critical use of antimicrobial EVDs to the meticulous setup of devices by trained personnel under sterile conditions. We'll delve into essential preoperative steps such as patient history, neurological exams, and intracranial pressure (ICP) monitoring to ensure you're equipped with the best practices for patient care.Our episode doesn't stop there. We go further to unravel the intricacies of correctly leveling an EVD and the importance of monitoring ICP waveforms, especially during patient transport. Should you travel with the EVD clamped or open? We've got you covered with practical guidelines and key considerations for continuous monitoring. Don't miss out on this treasure trove of knowledge tailored for healthcare professionals committed to elevating patient safety. For more details and resources, visit APSF.org, and feel free to reach out to us with your questions at podcast@APSF.org.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/222-best-practices-for-external-ventricular-drain-management/© 2024, The Anesthesia Patient Safety Foundation

Curious about how to enhance patient safety with external ventricular drains or EVDs? Join us as we unravel the intricacies of EVDs and their pivotal role in perioperative care. With over 25,000 EVD placements annually in the United States, it's crucial for anesthesia and critical care professionals to master the management of these devices to prevent serious complications. We delve into the fundamentals of EVDs, covering their function, placement, and the common risks associated with their use.This episode features the launch of the EVD Safety Campaign, a collaboration between the Anesthesia Patient Safety Foundation (APSF) and the Society for Neuroscience in Anesthesiology and Critical Care (SNACC). We'll discuss the campaign's objectives, which include raising awareness, providing education, promoting standardized guidelines, and enhancing clinical proficiency. Discover the wealth of resources available in the EVD Knowledge Hub, designed to equip healthcare professionals with the skills needed to ensure optimal patient outcomes. Tune in for a comprehensive guide on safeguarding patients with EVDs and elevating your clinical practice.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/220-enhancing-patient-safety-with-external-ventricular-drains-launching-the-evd-safety-campaign/© 2024, The Anesthesia Patient Safety Foundation

Alaina Martini, a flight nurse at Allegheny Life Flight, shares her expertise on transporting patients with external ventricular drains (EVDs). She explains the indications for EVD insertion, such as aneurysmal subarachnoid hemorrhage and obstructive hydrocephalus. Alaina discusses the importance of assessing the color and texture of the cerebrospinal fluid (CSF) to detect changes and potential rebleeding. She also explains the process of inserting the EVD and how it is guided by CT scans to avoid damaging important brain tissue. Alaina emphasizes the need to know if the aneurysm is secure before adjusting the EVD drain level, as opening it too low can increase the risk of rebleeding. She also discusses the use of hypertonic saline and osmotic therapy to manage increased intracranial pressure. Tyler and Alaina discuss various aspects of managing patients with external ventricular drains (EVDs) during transport in this conversation. They cover topics such as the clamping of EVDs, positioning the patient's head, troubleshooting common issues, and securing the EVD during transport. Alaina provides insights and recommendations based on her experience as a neurocritical care nurse.

In neurocritical care, the initial evaluation is often fast paced, and assessment and management go hand in hand. History, clinical examination, and workup should be obtained while considering therapeutic implications and the need for lifesaving interventions. In this episode, Aaron Berkowitz, MD, PhD FAAN, speaks with Sarah Wahlster, MD, an author of the article “The Neurocritical Care Examination and Workup,” in the Continuum June 2024 Neurocritical Care issue. Dr. Berkowitz is a Continuum® Audio interviewer and professor of neurology at the University of California San Francisco, Department of Neurology and a neurohospitalist, general neurologist, and a clinician educator at the San Francisco VA Medical Center and San Francisco General Hospital in San Francisco, California. Dr. Wahlster is an associate professor of neurology in the departments of neurology, neurological surgery, and anesthesiology and pain medicine at Harborview Medical Center, University of Washington in Seattle, Washington. Additional Resources Read the article: The Neurocritical Care Examination and Workup Subscribe to Continuum: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @AaronLBerkowitz Guest: @SWahlster Full Episode Transcript Sarah Wahlster, MD   Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, a companion podcast to the journal. Continuum Audio features conversations with the guest editors and authors of Continuum, who are the leading experts in their fields. Subscribers to the Continuum journal can read the full article or listen to verbatim recordings of the article by clicking on the link in the Show Notes. Subscribers also have access to exclusive audio content not featured on the podcast. As an ad-free journal entirely supported by subscriptions, if you're not already a subscriber, we encourage you to become one. For more information on subscribing, please visit the link in the Show Notes. AAN members: stay tuned after the episode to hear how you can get CME for listening.  Dr Berkowitz: This is Dr Aaron Berkowitz, and today I'm interviewing Dr Sarah Wahlster about her article on examination and workup of the neurocritical care patient, which is part of the June 2024 Continuum issue on neurocritical care. Welcome to the podcast, Dr Wahlster. Can you please introduce yourself to the audience? Dr Wahlster: Thank you very much, Aaron. I'm Sarah Wahlster. I'm a neurologist and neurontensivist at Harborview Medical Center at the University of Washington. Dr Berkowitz: Well, Sarah and I know each other for many, many years. Sarah was my senior resident at Mass General and Brigham and Women's Hospital. Actually, Sarah was at my interview dinner for that program, and I remember meeting her and thinking, “If such brilliant, kind, talented people are in this program, I should try to see if I can find my way here so I can learn from them.” So, I learned a lot from Sarah as a resident, I learned a lot from this article, and excited for all of us to learn from Sarah, today, talking about this important topic. So, to start off, let's take a common scenario that we see often. We're called to the emergency room because a patient is found down, unresponsive, and neurology is called to see the patient. So, what's running through your mind? And then, walk us through your approach as you're getting to the bedside and as you're at the bedside. Dr Wahlster: Yeah, absolutely. This was a fun topic to write about because I think this initial kind of mystery of a patient and the initial approach is something that is one of the puzzles in neurology. And I think, especially if you're thinking about an emergency, the tricky part is that the evaluation and management go hand in hand. The thinking I've adapted as a neurointensivist is really thinking about “column A” (what is likely?) and “column B” (what are must-not-miss things?). It's actually something I learned from Steve Greenberg, who was a mutual mentor of us - but he always talked me through that. There's always things at the back of your head that you just want to rule out. I do think you evaluate the patient having in mind, “What are time-sensitive, critical interventions that this patient might need?” And so, I think that is usually my approach. Those things are usually anything with elevated intracranial pressure: Is the patient at risk of herniating imminently and would need a neurosurgical intervention, such as an EVD or decompression? Is there a neurovascular emergency, such as an acute ischemic stroke, a large-vessel occlusion, a subarachnoid hemorrhage that needs emergent intervention? And then other things you think about are seizures, convulsive/nonconvulsive status, CNS infection, spinal cord compression. But I think, just thinking about these pathologies somewhere and then really approaching the patient by just, very quickly, trying to gather as much possible information through a combination of exam and history. Dr Berkowitz: Great. So, you're thinking about all these not-to-miss diagnoses that would be life-threatening for the patient and you're getting to the bedside. So, how do you approach the exam? Often, this is a different scenario than usual, where the patient's not going to be able to give us a history or maybe necessarily even participate in the exam, and yet, as you said, the stakes are high to determine if there are neurologic conditions playing into this patient's status. So, how do you approach a patient at the bedside? Dr Wahlster: So, I think first step in an ICU setting (especially if the patient has a breathing tube) is you think about any confounders (especially sedation or metabolic confounders) - you want to remove as soon as possible, if able. I think as you do the exam, you try to kind of incorporate snippets of the history and really try to see - you know, localize the problem. And also kind of see, you know, what is the time course of the deterioration, what is the time course of the presentation. And that is something I actually learned from you. I know you've always had this framework of “what is it, where is it?” But I think in terms of just a clinical exam, I would look at localizing signs. I think, in the absence of being able to do the full head-to-toe neuro exam and interact with the patient, you really try to look at the brainstem findings. I always look at the eyes right away and look at, I think, just things like, you know, the gaze (how is it aligned? is there deviation? is there a skew? what do the pupils look like? [pupillary reactivity]). I think that's usually often a first step - that I just look at the patient's eyes. I think other objective findings, such as brainstem reflexes and motor responses, are also helpful. And then you just look whether there's any kind of focality in terms of - you know, is there any difference in size? But I think those are kind of the imminent things I look at quickly. Dr Berkowitz: Fantastic. Most of the time, this evaluation is happening kind of en route to the CT scanner or maybe a CT has already happened. So, let's say you're seeing a patient who's found down, the CT has either happened or you asked for it to happen somewhat quickly after you've done your exam, and let's say it's not particularly revealing early on. What are the sort things on your exam that would then push you to think about an MRI, a lumbar puncture, an EEG? You and I both spend time in large community hospitals, right, where “found down” is one of the most common chief concerns. In many cases, there isn't something to see on the CT or something obvious in the initial labs, and the question always comes up, “Who gets an MRI? Who gets an LP? Who gets an EEG?” - and I'm not sure I have a great framework for this. Obviously, you see focality on your exam, you know you need to look further. But, any factors in the history or exam that, even with a normal CT, raise your suspicion that you need to go further? Dr Wahlster: It's always a challenge, especially at a community hospital, because some of these patients come in at 1 AM where the EEG is not imminently available. But I think - let's say the CT scan is absolutely normal and doesn't give me a cause, but as an acute concerning deterioration, I think both EEG and LP would cross my mind. MRI I kind of see a little bit as a second-day test. I think there's very rare situation where an acute MRI would inform my imminent management. It's very informative, right, because you can see very small-vessel strokes. We had this patient that actually had this really bad vasculitis and we were able to see the small strokes everywhere on the MRI the day later, or sometimes helps you visualize acute brainstem pathology. But I think, even that - if you rule out a large-vessel occlusion on your CTA, there's brainstem pathology that is not imminently visible on the CT - it's nothing you need to go after. So, I do think the CT is a critical part of that initial eval, and whereas I always admire the neurological subspecialties, such as movements, where you just – like, your exam is everything. I think, to determine these acute time-sensitive interventions, the CT is key. And also, seeing a normal CT makes me a little less worried. You always look at these “four H” (they're big hypodensity, hyperdensity, any shift; is there hydrocephalus or herniation). I think if I don't have an explanation, my mind would imminently jump to seizure or CNS infection, or sometimes both. And I think then I would really kind of - to guide those decisions and whether I want to call in the EEG tech at 2 AM - I would, you know, again, look at the history and exam, see if there's any gaze deviation, tongue biting, incontinence - anything leading up towards seizure. I think, though, even if I didn't have any of those, those would strengthen my suspicion. If I really, absolutely don't have an explanation and the patient off sedation is just absolutely altered, I would still advocate for an EEG and maybe, in the meantime, do a small treatment trial. And I think with CNS infection - obviously, there are patients that are high risk for it - I would try to go back and get history about prodromes and, you know, look at things like the white count, fevers, and all of that. But again, I think if there's such a profound alteration in neurologic exam, there's nothing in the CT, and there's no other explanation, I would tend to do these things up front because, again, you don't want to miss them. Dr Berkowitz: Yeah, perfect. So many pearls in there, but one I just want to highlight because I'm not sure I've heard the mnemonic - can you tell us the four Hs again of sort of neurologic emergencies on CT? Dr Wahlster: Yeah. So, it's funny; for ages - I'm actually not sure where that's coming from, and I learned it from one of my fellows, one of our neurocritical care fellows - he's a fantastic teacher and he would teach our EM and anesthesia residents about it and his approach to CT. But yeah, the four H - he was always kind of like, “Look at the CT. Do you see any acute hypodensities, any hyperdensities?” And hypodensities would be involving infarct or edema; hyperdensities would be, most likely, hemorrhage (sometimes calcification or other things). Then, “Do you see hydrocephalus?” (because that needs an intervention). And, “Look at the midline structures and the ventricles.” And then, “Do you see any signs of herniation?” And he would go through the different types of herniation. But I thought that's a very good framework for looking at the “noncon” and just identifying critical pathology that needs some intervention. Dr Berkowitz: Yeah – so, hypodensity, hyperdensity, herniation, hydrocephalus. That's a good one – the four Hs; fantastic. Okay. So, a point that comes up a few times in your article - which I thought was very helpful to walk through and I'd love to pick your brain about a little bit – is, which patients need to be intubated for a neurologic indication? So, often we do consultations in medical, surgical ICUs; patients are intubated for medical respiratory reasons, but sometimes patients are intubated for neurologic reasons. So, can you walk us through your thinking on how to decide who needs to be intubated for the concern of depressed level of consciousness? Dr. Wahlster: It's an excellent question, and I think I would bet there's a lot of variation in practice and difference in opinion. There was actually the 2020 ESICM guidelines kind of commented on it, and those are great guidelines in terms of just intubation, mechanical ventilation of patients, and just acknowledging how there is a lack of really strong evidence. I would say the typical mantra (“GCS 8, intubate”) has been proposed in the trauma literature. And at some point, I actually dug into this to look behind the evidence, and there's actually not as much evidence as it's been put forth in guidelines and that kind of surprised me - that was just recently. I was like, “Actually, let me look this up.” I would say I didn't find a ton of strong evidence for it. I would say, as neurologist – you know, I'm amazed because GCS, I think is a - in some ways, a good tool to track things because it's so widely used across the board. But I would say, as neurologists, we all know that it sometimes doesn't account for some sort of nuances; you know, if a patient is aphasic, if a patient has an eyelid-opening apraxia - it can always be a little confounded. I'm amazed that GCS is still so widely used, to be frank. But I would say there is some literature - some school of thought - that maybe just blindly going by that mantra could be harmful or could not be ideal. I would say – I mean, I look at the two kind of functional things: oxygenation and ventilation. I think, in a neuro patient, you always think about airway protection or the decreased level of consciousness being a major issue (What is truly airway protection? Probably a mix of things). Then there's the issue of respiratory centers and respiratory drive - I think those are two issues you think about. But ultimately, if it leads to insufficient oxygenation - hypoxia early on is bad and that's been shown in several neurologic acute brain injuries. I think you also want to think about ventilation, especially if the mental status is poor to the point that the PCO2 elevates, that could also augment an ICP or exacerbate an ICP crisis. Or sometimes, I think there's just dysregulation of ventilation and there's hyperventilation to the point that the PCO2 is so low that I worry about cerebral vasoconstriction. So, I worry about these markers. I think, the oxygenation, I usually just kind of initially track on the sats. Sometimes, if the patient is profoundly altered, I do look at an arterial blood gas. And then there are things like breathing sounds (stridor, stertor [the work of breathing]). And I think something that also makes me have a lower threshold to intubate is if I'm worried and I want to scan, and I'm worried that the patient can't tolerate it - I want an imminent scan to just see why the patient is altered, or seizing, or presenting a certain way. Dr Berkowitz: All great pearls for how to think through this. Yeah - it's hard to think of hard and fast rules, and you can get to eight on the GCS in many different ways, as you said, some of which may not involve the respiratory mechanics at all. So, that's a helpful way of thinking about it that involves both the mental state, kind of the tracheal apparatus and how it's being managed by the neurologic system, and also the oxygen and carbon dioxide (sort of, respiratory parameters) – so, linking all those together; that's very helpful. And, related question – so, that's sort of for that patient with central nervous system pathology, who we're thinking about whether they need to be intubated for a primary neurologic indication. What about from the acute neuromuscular perspective (so, patients with Guillain-Barré syndrome or myasthenic crisis); how do you think about when to intubate those patients? Dr Wahlster: Yeah, absolutely - I think that's a really important one. And I think especially in a patient that is rapidly progressing, you always kind of think about that, and you want them in a supervised setting, either the ER or the ICU. I mean, there's some scores - I think there's the EGRIS score; there's some kind of models that predict it. I would say, the factors within that model, and based on my experience, often the pace of progression of reflex motor syndrome. I often see things like, kind of, changes in voice. You know, myasthenia, you look at things like head extension, flexion - those are the kind of factors. I would say there's this “20/30/40 rule” about various measures of, like, NIF and vital capacities, which is great. I would say in practice, I sometimes see that sometimes the participation in how the NIF is obtained is a little bit funky, so I wouldn't always blindly go by these numbers but sometimes it's helpful to track them. If you get a reliable kind of sixty and suddenly it drops to twenty, that makes me very concerned. But I would say, in general, it's really a little bit the work of breathing - looking at how the patient looks like. There's also (at some point) ABG abnormalities, but we always say, once those happen, you're kind of later in the game, so you should really - I think anyone that is in respiratory distress, you should think about it and have a low threshold to do it, and, at a minimum, monitor very closely. Dr Berkowitz: Yeah, we have those numbers, but so often, our patients who are weak, from a neuromuscular perspective, often have facial and other bulbar weakness and can't make a seal on the device that is used to check these numbers, and it can look very concerning when the patient may not, or can be a little bit difficult to interpret. So, I appreciate you giving us sort of the protocol and then the pearls of the caveats of how to interpret them and going sort of back to basics. So, just looking at the patient at the bedside and how hard they are working to breathe, or how difficult it is for them to clear their secretions from bulbar weakness. Moving on to another topic, you have a really wonderful section in your article on detecting clinical deterioration in patients in the neuro ICU. Many patients in the neuro ICU - for example, due to head trauma or large ischemic stroke or intracerebral hemorrhage, subarachnoid hemorrhage, or status epilepticus - they can't communicate with us to tell us something is getting worse, and they can't (in many cases) participate in the examination. They may be intubated, as you said, sedated or maybe even not sedated, and there's not necessarily much to follow on the exam to begin with if the GCS is very low. So, I'd love to hear your thoughts and your pearls, as someone who rounds in the neuro-ICU almost every day. What are you looking for at the bedside to try to detect sort of covert deterioration, if you will, in patients who already have major neurologic deficits, major neurologic injury or disease that we're aware of? I'm trying to see if there is some type of difference at the bedside that would lead you to be concerned for some underlying change and go back to the scanner or repeat EEG, LP, et cetera. Dr Wahlster: Yeah. I think that's an excellent question because that's a lot of what we do in the neuro ICU, right? And when you read your Clans, your residency, like, “Ah, QNR neuro checks, [IG1]  ” right? We often do that in many patients. But I think in the right patient, it can really be life or death a matter, and it is the exam that really then drives a whole cascade of changes in management and detects the need for lifesaving procedure. I would say it depends very much on the process and what you anticipate, right? If you have, for example, someone with a large ischemic stroke, large MCA stroke, especially, right, then there's sometimes conversations about doing a surgical procedure before they herniate. But let's say, kind of watch them and are worried that they will, you do worry about uncal herniation, and you pay attention to the pupil, because often, if the inferior division is infarcted, you know, you can see that kind of temporal tickling the uncus already. And so, I think those are patients that I torture with those NPi checks and checking the pupil very vigilantly. I would say, if it's a cerebellar stroke, for example, right, then you think about, you know, hydrocephalus. And often patients with cerebellar stroke - you know, the beauty of it is that if you detect it early, those patients can do so well, but they can die, and will die if they develop hydrocephalus start swelling. But I think, often something I always like to teach trainees is looking at the eye movements in upgaze and downgaze because, often, as the aqueduct, the third ventricle gets compressed and there's pressure on the colliculi – you kind of see vertical gaze get worse. But I would say I think it's always good to know what the process is and then what deterioration would look like. For example, in subarachnoid hemorrhage, where you talk about vasospasm - it's funny - I think a really good, experienced nurse is actually the best tool in this, but they will sometimes come to you and say, “I see this flavor,” and it's actually a constellation of symptoms, especially in the anterior ACA (ACom) aneurysms. You sometimes see patients suddenly, like, making funky jokes or saying really weird things. And then you see that in combination with, sometimes, a sodium drop, a little bit of subfebrile temperature; blood pressure shoot up sometimes, and that is a way the brain is sometimes regulating. But it's often a constellation of things, and I think it depends a little on the process that you're worried about. Dr Berkowitz: Yeah, that's very helpful. You just gave us some pearls for detecting deterioration related to vasospasm and subarachnoid hemorrhage; some pearls for detecting malignant edema in an MCA stroke or fourth ventricular compression in a large cerebellar stroke. Patients I find often very challenging to get a sense of what's going on and often get scanned over and over and back on EEG, not necessarily find something: patients with large intracerebral hemorrhage (particularly, in my experience, if the thalamus is involved) just can fluctuate a lot, and it's not clear to me actually what the fluctuation is. But you're looking for whether they're developing hydrocephalus from third ventricular compression with a thalamic hemorrhage (probably shouldn't be seizing from the thalamus, but if it's a large hemorrhage and cortical networks are disrupted and it's beyond sort of the subcortical gray matter, or has the hemorrhage expanded or ruptured it into the ventricular system?) And yet, you scan these patients over and over, sometimes, and just see it's the same thalamic hemorrhage and there's some, probably, just fluctuation level of arousal from the thalamic lesion. How do you, as someone who sees a lot of these patients, decide which patients with intracerebral hemorrhage - what are you looking for as far as deterioration? How do you decide who to keep scanning when you're seeing the same fluctuations? I find it so challenging - I'm curious to hear your perspective. Dr Wahlster: Yeah, no - that is a very tricky one. I mean, unfortunately, in patients with deeper hemorrhages or deeper lesions - you know, thalamic or then affecting brainstem - I think those are the ones that ultimately don't have good, consistent airway protection and do end up needing a trach, just because there's so much fluctuation. But I agree - it's so tricky, and I don't think I can give a perfect answer. I would say, a little bit I lean on the imaging. And for example - let's say there's a thalamic hemorrhage. We recently actually had a patient - I was on service last week - we had a thalamic hemorrhage with a fair amount of edema on it that was also kind of pressing on the aqueduct and didn't have a lot of IVH, right? But it was, like, from the outside pushing on it and where we ended up getting more scans. And I have to say, that patient actually just did fine and actually got the drain out and didn't need a shunt or anything, and actually never drained. We put an EVD and actually drained very little. So, I think we're still bad at gauging those. But I think, in general, my index of suspicion or threshold to scan would be lower if there was something, like, you know, a lot of IVH associated, if, you know, just kind of push on the aqueduct. It's very hard to say, I think. Sometimes, as you get to know your patients, you can get a little bit of a flavor of what is within normal fluctuation. I think it's probably true for every patient, right? - that there's always some fluctuation within the realm of like, “that's what he does,” and then there's something more profound. Yeah, sorry - I wish I could give a better answer, but I would say it's very tricky and requires experience and, ideally, you really taking the time to examine the patient yourself (ideally, several times). Sometimes, we see the patient - we get really worried. Or the typical thing we see the ICU is that the neurosurgeons walk around at 5 AM and say, like, “She's altered, she's different, she's changed.” And then the nurse will tell you at 8 AM, like, “No, they woke up and they ate their breakfast.” So, I think really working with your nurse and examining the patient yourself and just getting a flavor for what the realm of fluctuation is. Dr Berkowitz: Yeah - that's helpful to hear how challenging it is, even for a neurocritical care expert. I'm often taking care of these patients when they come out of the ICU and I'm thinking, “Am I scanning these patients too much?” Because I just don't sort of see the initial stage, and then, you know, you realize, “If I'm concerned and this is not fitting, then I should get a CT scan,” and sometimes you can't sort it out of the bedside. So, far from apologizing for your answer, it's reassuring, right, that sometimes you really can't tell at the bedside, as much as we value our exam. And the stakes are quite high if this patient's developed intraventricular hemorrhage or hydrocephalus, and these would change the management. Sometimes you have these patients the first few days in the ICU (for us, when they come out of the ICU) are getting scanned more often than you would like to. But then you get a sense of, “Oh, yeah - these times of day, they're hard to arouse,” or, “They're hard to arouse, but they are arousable this way,” and then, “When they are aroused, this is what they can do, and that's kind of what we saw yesterday.” And yet, as you said, if anyone on the team (the resident, the nurse, the student, our neurosurgery colleague) says, “I don't think this is how they were yesterday,” then, very low threshold to just go back and get a CT and make sure we're not missing something. Dr. Wahlster: Exactly. Yeah. I would say the other thing is also certain time intervals, right? If I'm seeing a patient that may be in vasospasm kind of around the days seven to ten, for the first fourteen day, I would be a little bit more nervous. Or with swelling - acute ischemic stroke says that could peak swelling, when knowing which [IG2]  , I would just be more anxious or have a lower threshold to scan. Yeah. Dr Berkowitz: Yeah - very helpful. Well, thank you so much for joining me today on Continuum Audio. Dr Wahlster: Thank you very much, Aaron. Dr Berkowitz: Again, today we've been interviewing Dr Sarah Wahlster, whose article, “Examination and Workup of the Neurocritical Care Patient” appears in the most recent issue of Continuum, on neurocritical care. Be sure to check out Continuum Audio episodes from this and other issues. And thank you so much to our listeners for joining us today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practice. And right now, during our Spring Special, all subscriptions are 15% off. Go to Continpub.com/Spring2024 or use the link in the episode notes to learn more and take advantage of this great discount. This offer ends June 30, 2024. AAN members: go to the link in the episode notes and complete the evaluation to get CME. Thank you for listening to Continuum Audio.

GETTIN' SALTY EXPERIENCE PODCAST Ep. 194Be sure and join us on our YouTube channel. Our special guest 29 Year Veteran of the Baltimore City F.D. EVD Ray Lockett. In 1972 he entered the BCFD riding with 4 Truck on Saturdays After 8 weeks of Fire School and was Assigned to Engine 25. 1974 Transferred to E-13 – 6 blocks down the street from E-25 1981 Promoted to EVD assigned to T-25 as a floater. 1982 Long term detail to T-15 1985 Transferred to T-10 – Back in West Baltimore 1990 his son Ray joined the Baltimore City Fire Department 1995 his son Steve joined the Baltimore City Fire Department 2001 Retired out of T-10 2015 He Wrote his book "Into The Heat" We will get the whole skinny... You don't want to miss this one. Join us at the kitchen table on the BEST FIREFIGHTER PODCAST ON THE INTERNET. You can also Listen to our podcast ...we are on all the players #lovethisjob #GiveBackMoreThanYouTake #Oldschool #baltimorecity www.youtube.com/gettinsaltyexperience.Become a supporter of this podcast: https://www.spreaker.com/podcast/gettin-salty-experience-firefighter-podcast--4218265/support.

We're still digging down into the Erich von Daniken rabbit hole, touching on some other authors who have followed EvD's lead in speculating about the extrarrestrial origins of the stories underpinning Judaism and Christianity. In other words, you're about to learn why Jesus isn't just your co-pilot--he's in charge of the whole goddanged UFO. Also, we'll learn why a trained Christian minister has spent the past fifty years or so explaining how a hidden UFO performed all of the miracles of the Exodus. Including the big special effects moment with the sea parting, the Jews passing, and the Egyptians drowning. It's a hoot. See you in a couple of weeks. Hosted on Acast. See acast.com/privacy for more information.

Introductions done, we dive into our first subject in this grand UFO series--that is, Ancient Aliens and the man most responsible for bringing them to us, Erich Von Daniken. In addition to being a hilariously self-regarding fabulist, EVD is also just a very weird dude with quite a checkered legal past. We get into all of that, as well von Daniken's extremely weird inter-stellar sex orgy theory of space exploration. It's nice to be back. Hosted on Acast. See acast.com/privacy for more information.

"Meqapolis adamı"nda qonaq əl işi sabunların hazırlanması üzrə mütəxəssis Şükufə Musayeva oldu.Əl işi sabunlar necə hazırlanır?Əl işi sabunların hazır sabunlardan fərqi nədir?Evdə özümüz dekorativ sabun hazırlaya bilərik?Əl işi sabunların qoxusunun qalıcılıq müddəti nə qədər olur? və s. kimi daha çox sualları qonağımız cavabladı.

Pathogens in Pop Culture: Jack Ryan, The Hot Zone, and EbolaIn episode two of the Pathogens in Pop Culture series, hosts Lauren Sauer and Rachel Lookadoo welcome guest Dr. Billy Fischer to discuss the portrayal of Ebola Virus Disease in the 2018 Jack Ryan TV series and Richard Preston's 1994 novel, The Hot Zone: A Terrifying True Story. Together, they will explore the science behind the virus, including its transmission, approaches to treatment and care, and the accuracy of its portrayal in the TV series and the book. Join us for an in-depth analysis of the science and myths surrounding Ebola in popular culture.Questions or comments for NETEC? Contact us at info@netec.org.Visit Transmission Interrupted on the web at netec.org/podcast.GuestWilliam A. Fischer II, MDWilliam A Fischer, II, MD, serves as an Associate Professor of Medicine in the Division of Pulmonary Diseases and Critical Care Medicine at The University of North Carolina at Chapel Hill School of Medicine. He is a Pulmonary and Critical Care physician at the University of North Carolina School of Medicine with expertise in severe emerging viral infections, clinical research, and international health. Dr Fischer graduated from the University of North Carolina at Chapel Hill School of Medicine and completed a residency in Internal Medicine and a fellowship in Pulmonary and Critical Care Medicine at the Johns Hopkins Hospital where he was an Assistant Chief of Service. Dr Fischer has extensive field experience providing medical care in resource limited settings and was deployed as a WHO critical care physician to care for Ebola-infected patients in Gueckedou, Guinea, the epicenter of the 2014-2016 Ebola outbreak, N'zerekore in response to a resurgence of Ebola virus disease (EVD) and the Democratic Republic of Congo for outbreaks in 2018 and 2019 where he helped launch the use of novel therapeutics and optimized supportive care. Dr Fischer has active research programs exploring the clinical complications of Ebola virus disease, the prevalence, pathogenesis, and persistence of Lassa Fever (PREPARE study), and serves as one of the principal investigators for an NIH study (PREVAIL IV) evaluating a novel antiviral compound for efficacy in reducing or eliminating Ebola virus shedding in male survivors of EVD. He also has research programs exploring respiratory viral infections in high-risk populations including the elderly and HIV-infected individuals. Dr Fischer serves as the Director of Emerging Pathogens for the Institute for Global Health and Infectious Diseases at the University of North Carolina School of Medicine. He is also a member of the WHO Epidemic Clinical Management Team, the WHO Antiviral Working Group, the WHO Personal Protective Equipment End-User's Advisory Council, the WHO Advisory Committee on Infection, Prevention, and Control, and was a member of the CDC Ebola Response Team.HostsLauren Sauer, MScLauren is an Associate Professor in the College of Public Health, Department of Environmental, Agricultural, and Occupational Health, at the University of Nebraska Medical Center and Core Faculty of the UNMC Global Center for Health Security. She is an Adjunct Associate Professor of Emergency Medicine in the Johns Hopkins School of Medicine, and the director of the Special Pathogens Research Network.She previously served as Director of Operations for the Johns Hopkins Office of Critical Event Preparedness where she ran the inpatient COVID19 biobank and served on the COVID-19 research steering committee for JHU. Lauren's research focuses on human subjects research in bio-emergencies and disasters, in particular, ethical implementation of research and navigating the regulatory environment. The goal of her research is to provide health care...

Music: Spark Of Inspiration by Shane Ivers - https://www.silvermansound.comLicensed under Creative Commons Attribution 4.0 International Licensehttps://creativecommons.org/licenses/by/4.0/Music promoted by https://www.chosic.com

In 2020, William Kyler Lewis, 15, was riding in the car with his mom in College Station, Texas, when he suddenly turned to her confused. His head hurt, he was sick to his stomach and his vision was blurred. Soon, he couldn't remember anything for more than a few seconds. After his mom rushed him to the pediatrician, he got a shot and was told to go home. Instead, his mom drove 1½ hours to a children's hospital in Houston. Nurses there thought Kyler had taken drugs, but his mom insisted no, he was not that type of kid, and something was very wrong. A CT scan revealed Kyler had an acute spontaneous intracranial hemorrhage from a brain arteriovenous malformation (AVM) that he unknowingly had when he was born. A brain AVM is a condition that is not inherited. AVMs are a random occurrence due to a gene malfunction in utero where a mass of arteries connect directly to veins. Kyler received lifesaving external ventricular drain (EVD) surgery to control the fluid build-up in his brain. After the stroke, memory and neuro fatigue became a big problem. Kyler has undergone radiation and chemotherapy and takes medication for epilepsy, headaches, dizziness, weakness and tremors. Yet, Kyler is inspiring many. He uses local news, community functions and social media to educate the public that a child can have a stroke, too. He also organizes walks to highlight the importance of recognizing the symptoms of a pediatric stroke. Kyler's Facebook group, “A Cure for Kyler,” his CaringBridge page and YouTube channel educate and inspire pediatric stroke survivors by documenting his recovery. His video, “Being You after an Aneurysm/AVM Rupture,” and his family's Facebook page, “AVM Alliance: A Cure for Kyler and Friends,” share stories of other hemorrhagic stroke survivors and educate people about symptoms and conditions. Links: Cxnadvisory.com https://www.f3metro.com/ Freed to Lead   CONTACT INFO: https://www.linkedin.com/in/tim-whitmire-7955145/ Twitter: @trwhitmire_OBT Show Credits: Music intro credit to Jake Dansereau, connect at JAKEEZo on Soundcloud @user-257386777. Our intro welcome is the voice of Caroline Goggin, a stroke survivor and our first podcast guest! Please listen to her inspiring story on Episode 2 of the podcast. Thank you Caroline! Until next time, be sure to give the show a like and share, +follow and connect with us on social or contact us to support us as a show sponsor or become a guest on the Know Stroke Podcast. Visit our new website to apply here: https://www.knowstrokepod.com/ Connect with Us and Share our Show on Social: Website | Linkedin | Twitter | YouTube Watch this episode on YouTube: https://youtu.be/pSYVCzUGZXs

Approach to Pediatric Trauma Welcome to PICU Doc On Call, A Podcast Dedicated to Current and Aspiring Intensivists.I'm Pradip Kamat coming to you from Children's Healthcare of Atlanta/Emory University School of Medicine and I'm Rahul Damania, from Cleveland Clinic Children's Hospital. We are two Pediatric ICU physicians passionate about all things MED-ED in the PICU. PICU Doc on Call focuses on interesting PICU cases & management in the acute care pediatric setting so let's get into our episode.Welcome to our Episode today of a 7 yo M who presents to the PICU after a severe Motor Vehicle Accident.Here is the case presented by RahulA 7-year-old male child is admitted to the PICU after sustaining severe trauma. The patient was brought to the emergency department after a motor vehicle accident that involved an 18-wheeler truck & the family's car; in this severe accident the 7 yo was noted to be restrained however upon impact was ejected from the vehicle. He was unconscious and had multiple injuries, including a laceration on the head and bruising on the chest. The EMS was activated and the patient presented to the ED for acute stabilization. Upon examination, the patient was found to have a Glasgow Coma Scale score of 8, indicating a serious head injury. He had multiple bruises and abrasions on the chest and arms, and his pulse was rapid and weak. The patient was resuscitated with colloid and blood products, intubated, and transferred to the pediatric intensive care unit for further management.Notably, a CT scan of the head showed a skull fracture and a subdural hematoma. A chest X-ray showed multiple rib fractures and bilateral pulmonary opacities with no evidence of pneumothorax. The patient was also found to have a grade 2 liver laceration and a splenic injury. Pelvic x-ray and cardiac FAST exam were unrevealing.To summarize key elements from this case, this patient has:A traumatic brain injuryPulmonary contusions and is at risk for PARDSLiver and spleen injuryAnemiaPertinent negative includes: No pelvic injuries or injuries to great vessels in the chestRahul, let's approach the PICU medical management of this case based on a culmination of various guidelines published in the Pediatric Critical Care literature. Namely, let's use this case to dive deep into guidelines for:Traumatic brain injury (TBI)****Transfusion and Anemia Expertise Initiative (****TAXI)pediatric blunt liver and spleen injury management, are also known as the ATOMAC protocol, as well as general PICU management of acute trauma.As we take the management of this pediatric trauma patient in a systems-based fashion let's first go into the Management of Pediatric Traumatic Brain Injuries, can you start us off with some key management considerations?Based on the March 2019 TBI guidelines published in Pediatric Critical Care Medicine in 2019 (PCCM20(3S):p S1-S82, March 2019)This patient should have an ICP monitor or even an EVD placed for CSF diversion in consultation with the NS and trauma team. A CPP of at least >50 in our 7 yo patient and ICP < 20 mm Hg has been shown to improve outcomes and reduce mortality.Just as a quick review, CPP stands for cerebral perfusion pressure, which is the pressure that maintains blood flow to the brain. The formula for CPP is:CPP = MAP (mean arterial pressure) - ICP (intracranial pressure)Monitoring does not affect outcomes directly; rather the information from monitoring can be used to direct treatment decisions. Treatment informed by data from monitoring may result in better outcomes than treatment informed solely by data from clinical assessment. In short, it is important to have qualitative and quantitative data to optimize your decision-making.As we talked about ICP control is so crucial for

Joining us today in our CO2 Mondays is Timo Kaufhold. Timo will share with us what CAREL offers on their CO2 electronic valves and controller product lines. We will dive into the different types of controllers like the EVD evolution and electronic valves We will also touch on facility management controllers like the pRack and boss system.   In this episode, you'll learn: Installing and troubleshooting CAREL CO2 electronic valves How to properly size a Subcritical and Transcritical CO2 electronic valve Overview of pRack and CO2 chill booster   CAREL sizing software - https://cpq.carel.com/ Download Everything For CO2 booklet  Learn more about Timo Kaufhold:  Linkedin: Tim Kaufhold ============================ All Access to Refrigeration Mentor Content:  Learn More Compressor Masterclass: Learn More Supermarket Learning Program: Learn More Free System & Compressor Troubleshooting Guide Subscribe to the Refrigeration Mentors video newsletter and get your Free Compressor Guide Youtube Channel : https://www.youtube.com/c/refrigerationmentor Connect with the Refrigeration Mentor IG: @RefrigerationMentor

Dr. Brandmeir, a neurosurgeon from WVU Hospital and the WVU Rockefeller Neuroscience Institute, presents his early experience utilizing IRRAlfow and demonstrates the positive clinical outcomes seen with his case reviews. Presentation Outline: - Why do we need a better EVD? - What is IRRAflow, and how does it work? - How he uses IRRAflow in the ICU? - What are some outcomes that you can expect with IRRAflow? Case Reviews: - cSDH treated with IRRAflow - IVH treated with EVD - IVH treated with IRRAflow and tPA - IVH with IPH treated with IRRAflow and tPA - IVH treated with IRRAflow and tPA with endoscopic photos - Abscess treated with IRRAflow with antibiotic

Since Richmond wants to be a big player in the transfer market, Yogi and Matt took some time to talk about what EVD looks like in a Kickers and how this transfer came to be. We look at what does a positive season looks like and the chance of him playing this upcoming week!

Lassa Fever: a Summary for CliniciansOn this episode of Transmission Interrupted, we welcome Dr. Jared Evans, Dr. Aneesh Mehta, and Dr. Vanessa Rabbe—members of NETEC's Special Pathogen Research Network—to discuss their recent manuscript entitled, “Lassa Virus Infection: a Summary for Clinicians.” Developed from a clinical perspective, this manuscript provides clinicians with a condensed, accessible understanding of the current literature on Lassa virus (LASV) infection and Lassa fever disease (LF). The topics discussed in this episode will provide basic information on Lassa virus and Lassa fever, and will highlight pathogenesis, clinical features, and medical countermeasures that have demonstrated potential value for use in clinical or research environments.Questions or comments for NETEC? Contact us at info@netec.org.Visit Transmission Interrupted on the web at netec.org/podcast.AuthorsDr. Jared Evans, PhDDr. Jared Evans is a senior staff scientist whose expertise in virology includes over twenty years of experience in basic and applied research. He currently focuses on applications and response to investigate high-priority pathogens, including dengue and influenza viruses, with an emphasis on single-cell assays, genomics, and novel molecular tools. His responsibilities include leading projects in virology, molecular biology, and genomics and coordinating with partners to reach technical goals. Dr. Evans is also an assistant professor in the Department of Emergency Medicine in the Johns Hopkins School of Medicine. Additional areas of expertise include microfluidics and molecular/synthetic biology.Dr. Aneesh Mehta, MD, FIDSA, FASTAneesh Mehta is a Professor of Medicine and of Surgery at Emory University School of Medicine, and also serves as the Chief of Infectious Diseases Services and Assistant Director of Transplant Infectious Diseases at Emory University Hospital. He is a board-certified infectious diseases physician, who received an MD from the University of Oklahoma and completed Internal Medicine and Infectious Diseases training at Emory University.Aneesh has been one of the core physicians of the Emory Serious Communicable Diseases Unit (SCDU) since 2009. He was admitted physician for Emory's first patient with Ebola Virus Disease and was highly involved in care of the four patients with EVD, one patient with Lassa Fever, and several PUIs cared for by the Emory SCDU. During the Ebola activation, Aneesh was involved in all aspects of unit management, patient care, laboratory handling, and research.Aneesh is a co-Principal Investigator at NETEC. He also has been involved in the development of the Special Pathogens Research Network Biorepository and evaluation of Medical Countermeasures.Vanessa N. Raabe, MDAdult and Pediatric Infectious Disease PhysicianNYU Grossman School of MedicineResourcesLassa Virus Infection: a Summary for Clinicians: https://www.ijidonline.com/article/S1201-9712(22)00205-3/fulltextNETEC Resource Library: https://repository.netecweb.orgAbout NETECA Partnership for PreparednessThe National Emerging Special Pathogens Training and Education Center's mission is to set the gold standard for special pathogen preparedness and response across health systems in the U.S. with the goals of driving best practices, closing knowledge gaps, and developing innovative resources.Our vision is a sustainable infrastructure and culture of readiness for managing suspected and confirmed special pathogen incidents across the United States public health and health care...

Merhabalar. Bu yazımızda Amerikan Kalp Derneği ve Amerikan İnme Derneği tarafından hazırlanan 2022 Spontan İntraserebral Hemoroji (ISH) Olan Hastaların Yönetimine İlişkin Kılavuzun​1​ 6. ve 7. bölümlerinden özet olarak bahsedeceğiz. İyi okumalar diliyorum. Kısaltmalar CLEAR III Pıhtı Lizizi: İntraventriküler Kanama Faz III'ün Hızlandırılmış Çözünürlüğünün DeğerlendirilmesiEVD: Extraventriküler drenajDNAR: Canlandırma girişiminde bulunulmazGCS: Glasgow Koma SkalasıICH-İSK: intraserebral kanamaICP: kafa içi basıncıIVH: intraventriküler kanamaIVT: intraventriküler trombolizLOE: Kanıt DüzeyiMIS: minimal invaziv stratejiMISTIE III: Minimal İnvaziv Cerrahi Artı İntraserebral için rt-PARCT: randomize kontrollü çalışmaSTICH: İntraserebral Kanamada Cerrahi Denemesi 6. Cerrahi Müdahaleler 6.1. Hematom Tahliyesi 6.1.1. İSK'nın Minimal İnvaziv Cerrahi ile Tahliyesi Supratentoryal İSK için MIS, hematom hacmini rahatlatma, perihematomal ödemi azaltma ve geleneksel kraniyotomi ile karşılaştırıldığında sağlıklı beyin dokusunun bozulmasını en aza indirme şansına sahiptir. Bu nedenle, akut faz sırasında orta ila büyük İSK'leri tedavi etmek için MIS teknikleri ilgi görmektedir. Bununla birlikte, büyük randomize klinik çalışmaların sonuçları kesin değildir.Birinci öneri, trombolitik kullanımı olsun veya olmasın endoskopik veya stereotaktik aspirasyon ile minimal invaziv hematom tahliyesi güvenlidir ve mortaliteyi azaltmak için faydalı olabilir. Fonksiyonel sonuçları iyileştirebilse de, bunun için kanıt düzeyi düşüktür. Kraniyotomi ile karşılaştırıldığında, MIS'in mortalite yararı belirsizdir, ancak literatür MIS'in geleneksel kraniyotomi ile karşılaştırıldığında fonksiyonel sonuçları iyileştirdiği düşünülebileceğini desteklemesine rağmen MIS müdahaleleri, bu tavsiyelerin temeli olarak cerrah ve merkezin beceri ve deneyimini gerektirir. 6.1.2. İSK'nın Minimal İnvaziv Cerrahi ile Tahliyesi İSK'nın intraventriküler yayılımı, hastaların %30 ila %50'sinde meydana gelir ve hastaların yaklaşık yarısında hidrosefali gelişimine yatkınlık oluşturur. IVH, artan IVH hacmine ve inflamatuar menenjit ve hidrosefaliyi destekleyen kan yıkım ürünlerine ikincil olarak daha kötü bir prognoz öngörür. Kafa içi hipertansiyonu tedavi etmek ve kan ürünlerini çıkarmak için bir EVD'nin yerleştirilmesi sağ kalımı iyileştirir. Alteplaz veya ürokinaz ile trombolitik irrigasyonun eklenmesi, intraventriküler pıhtı çıkarılmasını hızlandırır ve mortalitenin azalmasını sağlar. Mevcut öneriler (Şekil 1'te gösterilmiştir) -Birinci öneri, intraventriküler trombolizli EVD güvenlidir ve klinik hidrosefalisi olan ve bilinç düzeyi düşük hastalarda tek başına EVD'ye (veya salin irrigasyona) kıyasla sağ kalımı artırır. -Bununla birlikte, EVH'nin fonksiyonel sonuçları iyileştirmedeki yararı belirsizdir. -Büyük hacimli İSK'yı çıkarmak ve kalıcı şant bağımlılığını azaltmak için çalışılan diğer müdahaleler arasında, IVT ile birlikte kontrollü lomber drenaj ve hedeflenen intraventriküler nöroendoskopi yer alır. Şekil-1: IVH'nin cerrahi tedavisi mevcut öneriler 6.1.3. Supratentoryal Kanama için Kraniyotomi Çoğu hasta için, spontan İSK için kraniyotomi, tek başına tıbbi tedaviyle karşılaştırıldığında belirsiz bir yarar sağlar. Sınırlı veriler, durumu kötüleşen hastalarda kraniyotominin hayat kurtarıcı bir prosedür olarak kabul edilmesinin makul olduğunu düşündürmektedir. 6.1.4. Posterior Fossa Kanaması İçin Kraniyotomi Spontan serebellar kanama sıklıkla hidrosefali, beyin sapı kompresyonu ve posterior fossanın sınırlı alanında herniasyon ile ilişkilidir. Bu nedenle, randomize kanıt olmamasına rağmen sıklıkla hematom tahliyesi önerilir. Mevcut kılavuz öncelikle eğilim skoru eşleştirmesi,  sistematik inceleme  ve birkaç geriye dönük çalışma ile büyük bir bireysel hasta verisi meta-analizinden elde edilen verilere dayanmaktadır. Birinci öneri, nörolojik olarak kötüleşen,

Flurona and the Future of Respiratory Virus SeasonFlurona! What is it? Is it real? Is it the next superbug? Can someone be infected with the flu and COVID-19 at the same time? The term ‘flurona' has been making the rounds in the news recently and has caused some confusion. Join us for this episode of Transmission Interrupted as NETEC's Lauren Sauer and special guests Dr. Jared Evans and Dr. Aneesh Mehta discuss all things flurona. The discussion will touch on the impact Flurona has had this influenza season, current recombination events in the news, the future of respiratory virus season, and steps the healthcare community can take to help mitigate the impact of flurona during the ongoing pandemic.Questions or comments for NETEC? Contact us: info@netec.orgVisit Transmission Interrupted on the web at https://netec.org/podcast/GuestsDr. Jared Evans, PhDDr. Jared Evans is a senior staff scientist whose expertise in virology includes over twenty years of experience in basic and applied research. He currently focuses on applications and response to investigate high-priority pathogens, including dengue and influenza viruses, with an emphasis on single-cell assays, genomics, and novel molecular tools. His responsibilities include leading projects in virology, molecular biology, and genomics and coordinating with partners to reach technical goals. Dr. Evans is also an assistant professor in the Department of Emergency Medicine in the Johns Hopkins School of Medicine. Additional areas of expertise include microfluidics and molecular/synthetic biology.Dr. Aneesh Mehta, MD, FIDSA, FASTAneesh Mehta is a Professor of Medicine and of Surgery at Emory University School of Medicine, and also serves as the Chief of Infectious Diseases Services and Assistant Director of Transplant Infectious Diseases at Emory University Hospital. He is a board-certified infectious diseases physician, who received an MD from the University of Oklahoma and completed Internal Medicine and Infectious Diseases training at Emory University.Aneesh has been one of the core physicians of the Emory Serious Communicable Diseases Unit (SCDU) since 2009. He was admitted physician for Emory's first patient with Ebola Virus Disease and was highly involved in care of the four patients with EVD, one patient with Lassa Fever, and several PUIs cared for by the Emory SCDU. During the Ebola activation, Aneesh was involved in all aspects of unit management, patient care, laboratory handling, and research.Aneesh is a co-Principal Investigator at NETEC. He also has been involved in the development of the Special Pathogens Research Network Biorepository and evaluation of Medical Countermeasures.HostLauren Sauer, MScLauren is an Associate Professor in the College of Public Health, Department of Environmental, Agricultural, and Occupational Health, at the University of Nebraska Medical Center and Core Faculty of the UNMC Global Center for Health Security. She is an Adjunct Associate Professor of Emergency Medicine in the Johns Hopkins School of Medicine, and the director of the Special Pathogens Research Network.She previously served as Director of Operations for the Johns Hopkins Office of Critical Event Preparedness where she ran the inpatient COVID19 biobank and served on the COVID19 research steering committee for JHU. Lauren's research focuses on human subjects research in bio-emergencies and disasters, in particular, ethical implementation of research and navigating the regulatory environment. The goal of her research is to provide health care facilities with the tools needed to conduct a clinical and operational research response in emergencies. ResourcesNETEC COVID-19 Novel Coronavirus Resources:

Ramon Zürcher ist seit vielen Jahren als Freund und Assistent an der Seite von Erich von Däniken. Mit ihm sprachen wir über EVD und natürlich über eigene interessante Projekte! https://ramar.space/ --- Send in a voice message: https://anchor.fm/neugierigkontakt/message

Federal, State and local agencies regularly use exercises to prepare for natural disasters including pandemics. In 2019, many of these entities and private sector partners participated in the scenario Crimson Contagion, which was meant to test how the U.S. government would respond to a novel influence pandemic spreading through the U.S. Sound familiar? On this episode of CNA Talks, Chris Emory, the Bureau Chief of Health Emergency Management within in the New Mexico Department of Health, and Cynthia Holmes who served as the coordinator for New Mexico's Joint Information Center for the first 200 of the COVID response join CNA analysts Dawn Thomas and Eric Trabert. They discuss how lessons learned from Crimson Contagion shaped New Mexico's response to COVID-19. Dawn Thomas is the co-director of CNA's Center for Emergency Management Operations. Dawn has written, executed and evaluated more than 60 exercises, in the fields of health and medical operations, animal disease and public health. Eric Trabert is the Director of CNA's Center for Public Health Preparedness and Resilience. He has evaluated the public health responses to more than a dozen emergencies, including the 2014-2016 Ebola virus disease (EVD) epidemic, and the 2009 H1N1 influenza pandemic. Chris Emory is the Bureau Chief of the Bureau of Health Emergency Management within the New Mexico Department of Health. Cynthia Holmes is currently an instructor with NCBRT out of Louisiana State University. Before this position, she served as the training and exercise manager for the New Mexico Department of Homeland Security and Emergency Management. During this time, she served as the coordinator for the Joint Information Center for the first 200 days of the COVID Response.

"Evdə tək" filmi ilə məşhurlaşan amerikalı aktyor - Macaulay Culkin !

Music: Spark Of Inspiration by Shane Ivers - https://www.silvermansound.comLicensed under Creative Commons Attribution 4.0 International Licensehttps://creativecommons.org/licenses/by/4.0/Music promoted by https://www.chosic.com/

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by Anchor: The easiest way to make a podcast.https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.--- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Evelyn Lewis is the CEO of SBTS (Sierra Business Technology Systems) Group Inc., a global technology firm that helps governments understand and coordinate attention to economic organizational, technological innovation, and integrated enterprise. Evelyn talks about how his childhood curiosity with computers and technology led to the creation of the SBTS Group of companies to make an impact on people's lives, especially in Sierra Leone where he is from. He chronicles how he started and grew his business and how he got into youth training and creating job opportunities for youth, not just in Sierra Leone but also in other countries on the African continent. Some of his most important work was with using technology for contact tracing to help manage and defeat the Ebola Virus Disease (EVD) outbreak in Sierra Leone between 2013 - 2016 that killed 11,323 people. The SBTS Group developed the Health Outbreak Manager (HOM) software which consists of an app and a comprehensive suite of tools that help collect and manage data for users for EVD responders and have been updated for use with COVID-19 responders. To connect with Evelyn, you can find him on LinkedIn.

I've had a bit of a quandary in the past week and have done some soul searching in regard to the future of The EV Diaries. I know, I've done this in the past, but as most things in my life, I'm figuring it out as I go along. Today, I reveal some hard questions … Continue reading "The Future of EVD?"

Neurosurgeon Dr. Kurt Yaeger, from Mt. Sinai Hospital in New York, New York, shares insight to being a healthcare worker on the front lines of the COVID-19 pandemic and provides an overview of his recent publication in World Neurosurgery, Patterns of Health Care Costs Due to External Ventricular Drain Infections.Additional Information about this study can be found below.Background: External ventricular drain (EVD) infections are a significant cause of morbidity among neurosurgical patients and have been correlated with increased length of hospital stay and longer requirements for intensive care. To date, no studies have examined the financial impact of EVD infections.Methods: Patients who underwent EVD placement between December 2010 and January 2016 were included in the study. Clinical records were retrospectively reviewed and health care cost data were obtained from the hospital's finance department. Clinical information included patient demographics, details from the hospital course, and outcomes. Total costs, direct/indirect, and fixed/variable costs were analyzed for every patient.Results: Over the 5-year study period, 246 EVDs were placed in 243 patients with an overall infection rate of 9.9% (N = 24). The median EVD duration for infected versus noninfected patients was 19 and 9 days, respectively (P < 0.0001). Median length of intensive care unit stay also was increased for patients with EVD infection (30 days vs. 13 days, P < 0.0001). Total health care costs were significantly greater for infected patients (US$ 168,692 vs. US$ 83,919, P < 0.0001). This trend was comparable for all other cost subtypes, including fixed-direct costs, fixed-indirect costs, variable direct costs, and variable-indirect costs.Conclusions: EVD infection has a substantial effect on clinical morbidity and healthcare costs. These results demonstrate the imperative need to improve EVD infection prevention, particularly in the setting of a value-based health care system.

Congo reported a fresh Ebola outbreak in its northwest on  Monday, the latest health emergency for a country already  fighting an epidemic of the deadly fever in the east as well as  a surging number of coronavirus infections.  Zaire ebolavirus, more commonly known as Ebola virus is one of six known species within the genus Ebolavirus. Four of the six known ebolaviruses, including ... Ebola Virus Ecology and Transmission. Ebola virus disease (EVD) is a deadly disease with occasional outbreaks that occur primarily on the African continent. EVD most commonly affects people and nonhuman primates (such as monkeys, gorillas, and chimpanzees).   BGM : https://youtu.be/eTz6Qp7QE_c  Our Criss Cross Tamizh(CCT) social platform Join us and be more Educated... Instagram https://instagram.com/crisscrosstamizh?igshid=1ogeqeggzu05j Telegram https://t.me/crisscrosstamizh Facebook https://www.facebook.com/Criss-Cross-Tamizh-112198540487435/ Twitter https://twitter.com/CrissTamizh?s=09          Do follow us on Social media and also we have planned a Whole new Series of Videos comming up to Disscuss about the modern tech gaints and Market Influencers like Tesla, Google, Amazon, IBM, Tata Industries, WB, Disney and so on...  Follow me on social media platform(Arun) Twitter  https://twitter.com/Arunkum19151978?s=09 Instagram https://instagram.com/kumarunsandyigshid=2t3mnt3qm12f  Facebook https://www.facebook.com/profile.php?id=100014455428099  Follow me on social media platform(Karan) Twitter  https://twitter.com/DKaran18?s=09 Instagram https://instagram.com/karandharmalingam0807?igshid=1kfrwj6sbk6u Facebook https://www.facebook.com/karan.dharmaligam --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

"If You're Good At Something Make Sure You're Parent's Won't Like It" This week we discuss "Brink". We Have offensive commentary, EVD, greasy hair, soul skating, bad haircuts, and everyone being "totally kyle"

In this episode, Michael Watts interviews Professor Mariane C. Ferme, a sociocultural anthropologist whose current research focuses on the political imagination, violence, and conflict, and access to justice in West Africa, particularly Sierra Leone.   Ferme's latest book, "Out of War: Violence, Trauma, and the Political Imagination in Sierra Leone," draws on her three decades of ethnographic engagements to examine the physical and psychological aftereffects of the harms of Sierra Leone's civil war. Ferme received her PhD in Anthropology from the University of Chicago, after studying Political Science at the University of Milano, Italy, and majoring in anthropology at Wellesley College. Her research has long focused on Sierra Leone, and West Africa more generally. It encompasses gendered approaches to everyday practices and materiality in agrarian West African societies, and work on the political imagination in times of violence, particularly in relation to the 1991-2002 civil war in Sierra Leone. She has also done research on the ways in which international humanitarian legal institutions and jurisprudence shape that status in our collective imaginaries of figures of victimhood, criminality, and witnessing in times of war. The empirical focus of this work has been the Special Court for Sierra Leone, and the developing jurisprudence in that setting about the forced conscription of child soldiers and the crime of “forced marriage.” Her most recent fieldwork in Sierra Leone—carried out in 2015-16, with funding from the National Science Foundation—was an interdisciplinary research project on changing agrarian institutions and access to land in the country. The Ebola Virus Disease (EVD) epidemic in Sierra Leone, Liberia, and Guinea has made the contribution of anthropologists crucial to developing socio-culturally sensitive and acceptable strategies for public health interventions, and to understanding pathways of disease transmission. She has written on the ways in which understanding rural mobility, as well as healing and burial practices, in Sierra Leone and the neighboring countries sheds light on the patterns of EVD infection, and can help inform public health interventions to stem the spread of this disease.

Healthy Indoors Show, 3/19/20, Part 3: Practical Anti-Virus Measures for BuildingsPart-3 focuses on the management of the physical indoor environment, and the practical building-related strategies that can be implemented to reduce occupants’ exposure to viruses. It will include a thorough overview of effective anti-viral cleaning and disinfecting practices to reduce viruses on surfaces.  And it will review prudent measures facilities personnel and building owners can take to maximize the efficacy of their building systems to reduce viral exposure risk.While the session focuses primarily on larger buildings and work spaces, several of the basic strategies for effective cleaning and improved ventilation apply to home management as well.Participants:Cole Stanton – Frequently engaged with catastrophe restoration, and as a key liason to organizations providing tens of thousands of volunteers in the aftermath of fire, flooding and hurricanes (such as SendRelief), Cole has put boots on the ground to support efforts in more than 30 disaster zones since 2003. Past experience with outbreaks include response strategy development to bird & swine flu, EVD-68 and Ebola, and surface disinfection procedural and policy development for these potential pandemics, as well as numerous regional and local epidemics (norovirus etc) As of Spring 2020, Cole Stanton is Director of Education and AED Specification for the Building Solutions Group (BSG) of ICP (Innovative Chemical Products).  In building out a more structured and robust training, knowledge, and specification capability, Cole continues to engage and serve all 24 brands and over 12,000 construction projects in the BSG portfolio.  These product areas include building envelope, environmental restoration & remediation, waterproofing, aesthetic finishes, industrial performance coatings, paint removers, marine applications, cementitious technologies, and recreational/athletic surfaces.  ICP is the 10th largest coatings company in North America.   For 22 years prior, Cole served in leadership, technical and field sales roles for ICP’s Fiberlock’s  products for remediation of asbestos, lead paint, mold, disaster recovery, and smoke/fire restoration. With ICP and Fiberlock for 25 years, Cole has provided multi-disciplinary expertise and service to various industries and agencies to develop remediation standards, augment state & provincial regulations.  He both presents and writes frequently for industry conferences and publications.   Every day, the most exciting challenges involve combining technology from across ICP to solve new challenges in emerging industries such as ICP’s research and provision of solutions for wildfire restoration & suppression, or for legalized cannabis Current standards development projects include development of the first international standard for Fire Damage Restoration, both in the RIA/IAQA program for four years ending 2018; and presently as a volunteer to the IICRC (Institute for Inspection, Cleaning and Restoration Certification)drafting of the S760 Wildfire Damage Restoration Standard.  During the RIA (Restoration Industries Association) development phase, Cole was Chair of the Tools, Equipment and Materials Committee; as well as providing early leadership to the HVAC Committee.  He served the Consensus Body for this fire damage document for nearly four years. Also with IICRC, Cole continues to serve the Consensus Body (CB) on the IICRC S520 Standard for Professional Mold Remediation.  Past service includes service on the CB of the IICRC S540 Trauma Cleanup document, as a Reviewer for the IICRC S500 standard for Water Damage Restoration, and as a Subject-Matter-Expert for exam development for the MRS (Mold Remediation Specialist). Kristofer Anderson, PE – Kris is the founder and President of K.G. ANDERSON, a Maine consulting engineering firm since 2002, which offers industrial, commercial, healthcare, and residential customers independent assistance regarding building energy, HVAC design and diagnostics, envelope design and forensics, retro-commissioning, and indoor air quality. Kris has a diverse background in the building and construction industry spanning 37 years. Kris holds a B.S. in Mechanical Engineering from Norwich, and is a Maine Licensed Professional Engineer, Certified Indoor Air Quality Professional, and Certified Energy Manager. He is a member of the American Society of Mechanical Engineers, the American Society of Heating, Refrigeration and Air-conditioning Engineers (ASHRAE), the Building Commissioning Association (BCA), the Association of Energy Engineers (AEE), and Member of the Maine Indoor Air Quality Council (MIAQC). Kris is a frequent speaker at conferences on the subjects of indoor air quality, HVAC, building forensics & science, and retro-commissioning. He is also a Volunteer Firefighter.Corbett LunsfordScott ArmourDr. David Krause

Healthy Indoors Show, 3/19/20, Part 3: Practical Anti-Virus Measures for BuildingsPart-3 focuses on the management of the physical indoor environment, and the practical building-related strategies that can be implemented to reduce occupants’ exposure to viruses. It will include a thorough overview of effective anti-viral cleaning and disinfecting practices to reduce viruses on surfaces.  And it will review prudent measures facilities personnel and building owners can take to maximize the efficacy of their building systems to reduce viral exposure risk.While the session focuses primarily on larger buildings and work spaces, several of the basic strategies for effective cleaning and improved ventilation apply to home management as well.Participants:Cole Stanton – Frequently engaged with catastrophe restoration, and as a key liason to organizations providing tens of thousands of volunteers in the aftermath of fire, flooding and hurricanes (such as SendRelief), Cole has put boots on the ground to support efforts in more than 30 disaster zones since 2003. Past experience with outbreaks include response strategy development to bird & swine flu, EVD-68 and Ebola, and surface disinfection procedural and policy development for these potential pandemics, as well as numerous regional and local epidemics (norovirus etc) As of Spring 2020, Cole Stanton is Director of Education and AED Specification for the Building Solutions Group (BSG) of ICP (Innovative Chemical Products).  In building out a more structured and robust training, knowledge, and specification capability, Cole continues to engage and serve all 24 brands and over 12,000 construction projects in the BSG portfolio.  These product areas include building envelope, environmental restoration & remediation, waterproofing, aesthetic finishes, industrial performance coatings, paint removers, marine applications, cementitious technologies, and recreational/athletic surfaces.  ICP is the 10th largest coatings company in North America.   For 22 years prior, Cole served in leadership, technical and field sales roles for ICP’s Fiberlock’s  products for remediation of asbestos, lead paint, mold, disaster recovery, and smoke/fire restoration. With ICP and Fiberlock for 25 years, Cole has provided multi-disciplinary expertise and service to various industries and agencies to develop remediation standards, augment state & provincial regulations.  He both presents and writes frequently for industry conferences and publications.   Every day, the most exciting challenges involve combining technology from across ICP to solve new challenges in emerging industries such as ICP’s research and provision of solutions for wildfire restoration & suppression, or for legalized cannabis Current standards development projects include development of the first international standard for Fire Damage Restoration, both in the RIA/IAQA program for four years ending 2018; and presently as a volunteer to the IICRC (Institute for Inspection, Cleaning and Restoration Certification)drafting of the S760 Wildfire Damage Restoration Standard.  During the RIA (Restoration Industries Association) development phase, Cole was Chair of the Tools, Equipment and Materials Committee; as well as providing early leadership to the HVAC Committee.  He served the Consensus Body for this fire damage document for nearly four years. Also with IICRC, Cole continues to serve the Consensus Body (CB) on the IICRC S520 Standard for Professional Mold Remediation.  Past service includes service on the CB of the IICRC S540 Trauma Cleanup document, as a Reviewer for the IICRC S500 standard for Water Damage Restoration, and as a Subject-Matter-Expert for exam development for the MRS (Mold Remediation Specialist). Kristofer Anderson, PE – Kris is the founder and President of K.G. ANDERSON, a Maine consulting engineering firm since 2002, which offers industrial, commercial, healthcare, and residential customers independent assistance regarding building energy, HVAC design and diagnostics, envelope design and forensics, retro-commissioning, and indoor air quality. Kris has a diverse background in the building and construction industry spanning 37 years. Kris holds a B.S. in Mechanical Engineering from Norwich, and is a Maine Licensed Professional Engineer, Certified Indoor Air Quality Professional, and Certified Energy Manager. He is a member of the American Society of Mechanical Engineers, the American Society of Heating, Refrigeration and Air-conditioning Engineers (ASHRAE), the Building Commissioning Association (BCA), the Association of Energy Engineers (AEE), and Member of the Maine Indoor Air Quality Council (MIAQC). Kris is a frequent speaker at conferences on the subjects of indoor air quality, HVAC, building forensics & science, and retro-commissioning. He is also a Volunteer Firefighter.Corbett LunsfordScott ArmourDr. David Krause

One of the central things we do for neuro patients in control their ICP. But, does tight control of ICP improve outcomes? Is ICP the best thing for us to be optimizing, especially if brain ischemia is what we're trying to avoid? What about brain tissue oxygenation? I'll quickly review the evidence, and you decide. Lundberg demonstrating ICP measured from an EVD in TBI patients. Lundberg, N., Troupp, H., Lorin, H. (1965). Continuous Recording of the Ventricular-Fluid Pressure in Patients with Severe Acute Traumatic Brain Injury Journal of Neurosurgery 22(6), 581-590. https://dx.doi.org/10.3171/jns.1965.22.6.0581 Model showing independent effects of ICP and blood pressure on TBI outcomes. Marmarou, A., Anderson, R., Ward, J., Choi, S., Young, H., Eisenberg, H., Foulkes, M., Marshall, L., Jane, J. (1991). Impact of ICP instability and hypotension on outcome in patients with severe head trauma Journal of Neurosurgery 75(Supplement), S59-S66. https://dx.doi.org/10.3171/sup.1991.75.1s.0s59 Mortality in TBI over the past 150 years (note the large decrease through the 70s and 80s). Stein, S., Georgoff, P., Meghan, S., Mizra, K., Sonnad, S. (2010). 150 Years of Treating Severe Traumatic Brain Injury: A Systematic Review of Progress in Mortality Journal of Neurotrauma 27(7), 1343-1353. https://dx.doi.org/10.1089/neu.2009.1206 BEST-TRIP trial comparing invasive ICP monitoring to clinical exam and CT. No difference in outcomes in severe TBI patients. Chesnut, R., Temkin, N., Carney, N., Dikmen, S., Rondina, C., Videtta, W., Petroni, G., Lujan, S., Pridgeon, J., Barber, J., Machamer, J., Chaddock, K., Celix, J., Cherner, M., Hendrix, T. (2012). A Trial of Intracranial-Pressure Monitoring in Traumatic Brain Injury The New England Journal of Medicine 367(26), 2471-2481. https://dx.doi.org/10.1056/NEJMoa1207363 Meta-analysis of invasive ICP studies. Observational studies consistently show a benefit to ICP monitoring. Shen, L., Wang, Z., Su, Z., Qiu, S., Xu, J., Zhou, Y., Yan, A., Yin, R., Lu, B., Nie, X., Zhao, S., Yan, R. (2016). Effects of Intracranial Pressure Monitoring on Mortality in Patients with Severe Traumatic Brain Injury: A Meta-Analysis PLOS ONE 11(12), e0168901. https://dx.doi.org/10.1371/journal.pone.0168901 Original Lancet article discussing secondary injury from ischemia in TBI. Graham, D., Adams, J. (1971). ISCHÆMIC BRAIN DAMAGE IN FATAL HEAD INJURIES The Lancet 297(7693), 265-266. https://dx.doi.org/10.1016/s0140-6736(71)91003-8 First studies to look at outcome in TBI patients using Licox Santbrink, H., Maas, A., Avezaat, C. (1996). Continuous Monitoring of Partial Pressure of Brain Tissue Oxygen in Patients with Severe Head Injury Neurosurgery 38(1), 21-31. https://dx.doi.org/10.1097/00006123-199601000-00007 Valadka, A., Gopinath, S., Contant, C., Uzura, M., Robertson, C. (1998). Relationship of brain tissue PO2 to outcome after severe head injury Critical Care Medicine 26(9), 1576-1581. https://dx.doi.org/10.1097/00003246-199809000-00029 BOOST-II trial. Respiratory interventions were able to improve PbO2 in TBI patients, and that group showed an improved outcome, including disability and mortality. Okonkwo, D., Shutter, L., Moore, C., Temkin, N., Puccio, A., Madden, C., Andaluz, N., Chesnut, R., Bullock, M., Grant, G., McGregor, J., Weaver, M., Jallo, J., LeRoux, P., Moberg, D., Barber, J., Lazaridis, C., Diaz-Arrastia, R. (2017). Brain Oxygen Optimization in Severe Traumatic Brain Injury Phase-II Critical Care Medicine 45(11), 1907. https://dx.doi.org/10.1097/CCM.0000000000002619

Isaiah 58.1-12 & Matthew 5.13-20 -- We continue our series of REVIVAL: to be restored to life/consciousness--to be awakened! Our word is Ev-ed (EVD = עבד) and it means a number of things: labor, work; to serve...and... worship. What a loaded word! We will look at how this word is used as a theme in the Hebrew Bible (and the Christian Scriptures--see Paul's work on being a slave to God and others) to understand how it can impact how we live our every day lives. Let's revisit the words of the prophet Isaiah for the people, Israel, and hear it with fresh ears. Let's revisit Jesus' words to the disciples and crowds upon the mount to understand the life to which we are called. Are you ready?

There are many ways to skin a cat. Rhonda Cadena discusses management of intracranial hypertension, specifically substantial practice variation, what the evidence shows and what she does in reality.

Ebolaviren sind kleine RNA-Viren der Filovirus-Familie. Die Ebola-Viruserkrankung (EVD), seit 1976 bekannt, ist eine der für den Menschen tödlichsten bekannten Erkrankungen. EVD kommt V.a. in West- und Zentralafrika vor wo im bislang größten Ausbruch 2014 – 16 über 11.000 Menschen an Ebola starben und es auch aktuell wieder einen großen Ausbruch gibt. Zu Therapie und … „Infektiopod#12 – Ebola“ weiterlesen

This is a sample episode of our new show In reSearch Of, which I'm co-hosting with Jeb Card.  I hope you'll consider subscribing.  I'm planning to keep the regular IRO episodes free, but offer bonus content for Patreon supporters. This is the pilot episode of In reSearch Of, the show where we watch the original TV show IN SEARCH OF… and consider some of the explanations that the producers chose not to present. In our inaugural episode, we watch the TV Special In Search of Ancient Astronauts, a repackaged cut of a German documentary about Eric Von Daniken's book Chariots of the Gods.  We want to thank Rachel and Chris Lackey for the theme music (And Greig Johnson!). They host the excellent show Rachel Watches Star Trek.  Also, we want to credit Jason Colavito for his excellent research into this and many adjacent topics around the Ancient Astronauts and Ancient Aliens tropes of the past fifty years, including his book:  The Cult of Alien Gods: H. P. Lovecraft and Extraterrestrial Pop Culture (Seriously - check out this link to Jason's article. He gives some great contemporary detail on the impact of this TV special such as "... within 48 hours of the program’s broadcast, Bantam Books had sold 250,000 new copies of Chariots of the Gods."  Amazing.) Oh - so as Jeb mentions, EVD is directly mentioned in the brainstorming session with Lucas, Spielberg, and Kasdan! You can check that out here. Walter Conkrite's  UFO's Friend, Foe or Fantasy  UFO documentary Show Notes: Dr. Harold P. Klein worked for NASA and was a major figure in the Viking mission. The Baghdad Battery - no reason to believe this was ever used as a battery. More likely a scroll container. (Featured on Episode 16 - season 3 - of Mythbusters) Star Trek Into Darkness (you can watch the clip here)  Mesoamerican Sites: Olmec Heads Tula Teotihuacan Chichen Itza Tiwanaku Piri Reis map Wernher Von Braun  Stonehenge  How did the ancients move stones? Theme music (updated!) is by Rachel Lackey & Greig Johnson.  

Like Robin taking the mask from Batman, Nick assumes the role of 'Danny' to begin a new era of Two Cents Radio. Among the topics discussed: Survivor: Island of the Idols, streaming television, EVD, Trump's potential impeachment, underrated fast food chains, buried Nebraskan treasure and much much more.

This is the pilot episode of In Research Of, the show where we watch the original TV show IN SEARCH OF… and consider some of the explanations that the producers chose not to present. In our inaugural episode, we watch the TV Special In Search of Ancient Astronauts, a repackaged cut of a German documentary about Eric Von Daniken's book Chariots of the Gods.  We want to thank Rachel and Chris Lackey for the theme music. They host the excellent show Rachel Watches Star Trek.  Also, we want to credit Jason Colavito for his excellent research into this and many adjacent topics around the Ancient Astronauts and Ancient Aliens tropes of the past fifty years, including his book:  The Cult of Alien Gods: H. P. Lovecraft and Extraterrestrial Pop Culture (Seriously - check out this link to Jason's article. He gives some great contemporary detail on the impact of this TV special such as "... within 48 hours of the program’s broadcast, Bantam Books had sold 250,000 new copies of Chariots of the Gods."  Amazing.) Oh - so as Jeb mentions, EVD is directly mentioned in the brainstorming session with Lucas, Spielberg, and Kasdan! You can check that out here. Walter Conkrite's  UFO's Friend, Foe or Fantasy  UFO documentary Show Notes: Dr. Harold P. Klein worked for NASA and was a major figure in the Viking mission. The Baghdad Battery - no reason to believe this was ever used as a battery. More likely a scroll container. (Featured on Episode 16 - season 3 - of Mythbusters) Star Trek Into Darkness (you can watch the clip here)  Mesoamerican Sites/Artifacts Discussed: Olmec Heads Tula Teotihuacan Chichen Itza Tiwanaku Piri Reis map Wernher Von Braun Stonehenge How did the ancients move stones? Theme music (updated!) is by Rachel Lackey & Greig Johnson.   Keywords Ancient Aliens, Ancient Astronauts, Eric Von Daniken, Skeptic, Archaeology, Science, Rod Serling

Surprise! It’s time to dive in to Lords of Dogtown..For Tweens! We’re back with guests (Alexis Gay from way back in the day, and Michelle Morales from well...now!) We dive into our DCOM love and explore Alexis’ never-ending, abiding love of EVD (despite how much of a sociopath Brink can be). We talk about how Gabriela is the REAL hero of the movie (and Brink should not get off that easy…) and imagine the sequel set 20 years later, starring Brink and Val’s daughter...also wtf this was based off of a novel from 1865???!! Catch Alexis and Alison performing with Happy Medium Improv (happymediumimprov.com) Also catch Michelle performing with Classic Diane at Endgames on their Harold Nights! (endgamesimprov.com)

All episodes available at http://TheNeuroNerds.com. Follow @TheNeuroNerds on Twitter/Instagram and Like us at Facebook.com/TheNeuroNerds. Summary We're celebrating Mother's Day 2019 with bad ass independent woman, mother, stroke/AVM survivor and this episode's guest co-host Bridget Chiovari. Our host Joe, talks with Bridget about her experience surviving her brain injury while pregnant with her second child in her second trimester! Plus, they talk photography, Game Of Thrones and more about juggling brain injury recovery while being a mother. Do you know any amazing brain injury surviving and thriving moms? Share with us on on our socials! Links to Topics Mentioned Follow on Bridget on Instagram at https://www.instagram.com/bridgetclarice/ Additional info and resources used in this episode about the stroke risk of chiropractic adjustments - https://consumer.healthday.com/alternative-medicine-information-3/chiropractic-news-128/could-chiropractic-manipulation-of-your-neck-trigger-a-stroke-690593.html, https://www.ahajournals.org/doi/pdf/10.1161/STR.0000000000000016 Heat Stroke - https://en.wikipedia.org/wiki/Heat_stroke External ventricular drain (EVD) - https://en.wikipedia.org/wiki/External_ventricular_drain Credits Support The NeuroNerds podcast on Patreon and join our NeuroJedi High Council at www.Patreon.com/TheNeuroNerds. During April and May 2019, we are donating a portion of the proceeds to aneurysm and stroke survivor Amelia Clarke's nonprofit SameYou.org Co-hosted by Joe Borges and Lauren Manzano Find Joe at http://joesorocks.com and @joesorocks on Twitter/Instagram and submit your stroke/brain injury recovery story at https://www.joesorocks.com/submit-your-story Find Lauren at @laurenlmanzano on Instagram, @tankbbg on Twitter Produced by Joe Borges and Felice LaZae Edited by Felice LaZae, http://felicelazae.com, @felicelazae on Twitter/Instagram Assistant editor - Calvin Nichols Theme song produced by Sleep Deez, @sleepvision on Instagram, @sleepdeez on Twitter Local Elevator by Kevin MacLeod is licensed under a Creative Commons Attribution license (https://creativecommons.org/licenses/by/4.0/), Source: http://incompetech.com/music/royalty-free/index.html?isrc=USUAN1300012, Artist: http://incompetech.com/ Excerpt of Independent by Webbie ft Lil Phat & Lil Boosie

We start this episode with a SHOCKING UPDATE about our personal hero, EVD. What is a Tulpa? We sort of find out in this episode centered around a tiny, dickish, Judd Nelson with a super sad backstory. We learn that Roadhouse was based on Squatch’s life. Chatrooms! What are they? We finally reveal our true feeling about people with glasses. John Cho! So-weird-men! Believe people when they tell you about their Tulpas. White ladies overstepping! GHOST DAD?!! Join us as we discuss all of that and more. Don’t forget to subscribe and rate APT! While you’re there please @UCarlossus with any and all complaints. #JumpInaLakeBecauseYoureOnFire @JohnTheCho

Hi guys my name is Esther welcome to my podcast keeping up with Evd new episodes every Wednesday will be feature new guest motivation life love marriage family and money I can’t wait to see y’all next week --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Today, let’s talk about how little happiness we get from “getting” our goals and what we can focus on instead. I’m bringing the heat today folks so this is not a EvD you want to miss!

Equifax breach resulted in $100 Billion of Economic Value Destruction ("EVD") at the high-end of our estimate range. Here is a link to our report: https://drive.google.com/open?id=0BxzCwbwg_jmIbng0bEhiV1JkV1U

Listen to this special broadcast of the Pan-African Journal hosted by Abayomi Azikiwe, editor of the Pan-African Journal. This program will feature PANW reports on developments in Africa and throughout the world. Special guests Mr. Togba Porte of the West African community in New York City and Mr. Johnnie Stevens of the International Action Center, also based in NYC, will discuss the burgeoning response to the Ebola Virus Disease outbreak in the regions and worldwide. Excerpts from the United Nations hearings on the EVD outbreak and global response will be featured in the final hour.

The word "Ebola" is enough to summon feelings of fear, body horror and even xenophobia. But don't give in to paranoia. In this episode of Stuff to Blow Your Mind, Robert and Julie arm you with information about Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever. Learn more about your ad-choices at https://news.iheart.com/podcast-advertisers