Podcasts about iatrogenic

The Bug - YouTubeDire Straits - The Bug (Official Music Video) - YouTubeFood Safety Talk 318: Head Grime And The Lice — Food Safety TalkRecognizing Botulism: New Insights from Old Narratives: Talkington, Dr. J.A., Cook, Cherity, Eldridge, Makenzie: 9781952966170: Amazon.com: BooksPeoria's resident botulism historian is out with a new book on the rare illness | WCBU PeoriaJane Talkington | Staff | About | Turner School of Entrepreneurship and Innovation | Academics | Bradley UniversityHistorical Newspapers from the 1700's-2000sMunicipality of Port HopeUnit 731 - WikipediaVichyssoise: A sad food safety story - Produce Blue BookFoodborne Botulism – IllinoisBotulism Outbreak Lawsuits | Marler ClarkBotulism Victim Settles With Castleberry After… | Marler ClarkTurn back the clock to 1977 botulism outbreak: Improper processing of canned foods can be deadly | barfblogBotulinum Neurotoxin-Producing Bacteria. Isn't It Time that We Called a Species a Species? - PMCNOTES ON BACILLUS BOTULINUS | Journal of BacteriologyFoodborne Botulism Outbreak Associated With Commercial Nacho Cheese Sauce From a Gas Station Market - PubMedNotes from the Field: Large Outbreak of Botulism Associated with a Church Potluck Meal — Ohio, 2015Jane Talkington, PhD | PatreonThe International Outbreak Museum |Canned Ripe California Olives Spread Botulism in 1919 | Food Safety NewsFoodborne Illness - Causes, Symptoms and Prevention | STOPStop Foodborne Illness Announces Sandra Eskin as New CEOThe recent outbreak of Iatrogenic botulism: point of view from the present world: editorial - PMCPtomaine poisoning - The LancetLaboratory Diagnostics of Botulism - PMCFoodborne Illness Acquired in the United States—Major Pathogens - PMCA Fallen Marionette: I Was A Prisoner Inside My Own Body: Walsh, Geo: 9781723815560: Amazon.com: BooksWilliam Schaffner, MD – NFID

Hey listeners! I know it's been a while but I'm back. I have been working with clients and getting more insights. You may be wondering, what is Iatrogenic Injury? How does it occur ? What does it do to the original trauma? I have noticed that clients have been working on their issues for months or even years , but the problem is not being resolved, in fact, it might be a little worse with an added layer of emotional complexity. In this episode, we're going to take a look at the concept of iatrogenic injury—unintentional harm caused by efforts to heal, particularly in talk therapy. Many people who've faced traumatic experiences find themselves stuck, not only with the original issue but also with new layers of anxiety and frustration created by repeated attempts to fix the original problem.his episode explores the concept of iatrogenic injury, the unintended harm that can occur when efforts to heal a problem make it worse. Many people with unresolved trauma find themselves burdened not only by the original issue but also by added layers of anxiety and frustration created through repeated attempts at resolution. Through the lens of neuroscience and observing hundreds of my clients who have experienced emotional healing, I discuss why traditional methods like talk therapy and mindfulness sometimes fail to address the deeper, emotional roots of persistent issues. Discover how Accelerated Hypnotherapy bypasses these barriers by working with the subconscious mind to create profound and lasting shifts, even for problems that have lingered for years. This episode provides insight into why healing might require a different approach when logic and understanding alone aren't working. Accelerated Hypnotherapy⁠ | Rapid Results blog #iatrogenicinjury #iatrogenicharm #traumahealing #emotionalresilience #subconsciousmind #acceleratedhypnotherapy #iatrogeneiceffects #mentalhealthsolutions #unblockingemotions #therapyalternatives #neuroscienceoftrauma #emotionalfreedom #hypnotherapyinsights #healingpastwounds #subconscioustransformation #overcominganxiety #advancedtherapytechniques

Show notes at pharmacyjoe.com/episode981. In this episode, I'll discuss tranexamic acid for controlling iatrogenic bleeding during flexible bronchoscopy. The post 981: Tranexamic Acid to Control Iatrogenic Bleeding During Flexible Bronchoscopy appeared first on Pharmacy Joe.

Last month, Alpha Genesis made headlines after 43 rhesus macaque primates escaped from the Yemassee facility because an employee failed to secure a door during routine feeding and health checks. Two weeks after the incident, four of the monkeys remained unaccounted for. Alpha Genesis specializes in non-human primate health and testing, focusing on the study of prions, a type of infectious protein responsible for neurodegenerative diseases. Congruently, the authors of the new and alarming report said there appears to be a relationship between COVID-19 infection and prion disease after numerous independent lab tests were conducted. When compounded with the biological component of a vaccine, we get future diseases that are part of an Iatrogenic result. Are we heading for another pandemic but with a much greater death toll? Tonight on Ground Zero (7-10 pm, pacific time) Clyde Lewis talks with Dr. Kevin McCairn and Charles Rixey about MONKEY ME MONKEY YOU. Listen Live: https://groundzero.radio Archived Shows: https://aftermath.media

 "Ever wondered how to perfect your dental extractions while safeguarding against iatrogenic jaw fractures in canine patients? In this episode, we dive deep into best practices, essential techniques, and expert tips to enhance your veterinary dental procedures!" The focus is on specific procedures such as canine extractions, jaw fracture risks, the Chevron effect in radiographs, and much more. Dr. Beckman answers real-world questions from practitioners, sharing expert advice that can be immediately applied in your clinic.       Guest & Host: Host: Dr. Brett Beckman, Board-Certified Veterinary Dentist Sponsor: Veterinary Dental Practitioner Program (IVDI)       Main Talking Points: Envelope Flaps in Canine Extractions: How and when to use envelope flaps. Expected healing time and the importance of post-surgical care, including the use of Elizabethan collars. Avoiding Jaw Fractures in Canine Patients: Risk of iatrogenic jaw fractures during extraction, particularly in smaller dogs. Importance of correct technique and bone preservation. Chevron Effect in Radiographs: Explanation of Chevron effects, and how to discern them in mandibular and maxillary teeth. Dental Composites and Longevity: How long dental composites last and how to monitor their effectiveness over time.       Interesting Quotes: "It literally takes just days for the gingiva to reattach, but it's crucial to prevent the patient from disturbing the surgical site." "A Chevron effect can sometimes be mistaken for a more severe lucency, so it's important to be discerning in your interpretation."       Timestamps: 0:00 – Introduction to the show and sponsor. 2:00 – Understanding envelope flaps in canine extractions. 6:30 – Risks of iatrogenic jaw fractures in small dogs. 10:45 – How to identify and interpret the Chevron effect in radiographs. 16:30 – Dental composites: When and how to use them, and their longevity.         [Veterinary dentistry, canine extraction techniques, iatrogenic jaw fracture, Chevron effect in radiographs, veterinary dental composites, dental radiography, veterinary dental training]       Affiliate & Sponsor Links: For more information on enhancing your skills in veterinary dentistry, submit a request for the Veterinary Dental Practitioners Program at ivdi.org/inv. 

This is a free preview of a paid episode. To hear more, visit www.widerlenspod.comIn this bonus episode for premium subscribers, Jesper Rasmussen emphasizes a strategic approach to effecting change in public policy and societal perceptions. His comprehensive strategy balances direct political action with broader efforts to sway public opinion and leverage media influence. His efforts in Denmark involved relentless conversations about the hidden truths behind gender affirming care for minors, much like the iatrogenic effects. His persistence in securing meetings and fostering alliances significantly impacting the debate in the Danish Parliament. Jesper highlights the importance of engaging public perception in shaping political decisions and leveraging media and strategic messaging to change societal views.----The iatrogenic effect refers to any adverse condition or complication that results from medical treatment or intervention rather than from the underlying disease or condition itself. In the context of pediatric sex changes, iatrogenic concerns revolve around the potentially harmful outcomes that result from early social and medical interventions. These effects may lock a child into a transition process that they might not have chosen if left to develop naturally, leading to irreversible and life-altering consequences.Iatrogenic effects are generally a significant concern in medicine because they underscore the importance of weighing the risks and benefits of any medical intervention. Medical professionals strive to minimize these effects through careful planning, informed consent, and adherence to best practices. So why are they being entirely disregarded with respect to pediatric gender medical treatments? ----Watch our full length episode with Jesper Rasmussen: https://www.widerlenspod.com/p/episode-177For instructions on setting up a private feed to listen to our premium content in your favorite podcast app, visit https://www.widerlenspod.com/p/how-to-listen-to-our-full-premium.

Take a sneak peek at this month's Fertility and Sterility! Articles discussed this month are:  6:24 Iatrogenic and demographic determinants of the national plural birth increase 18:10 Comparison of outcomes between intracytoplasmic sperm injection and in vitro fertilization inseminations with preimplantation genetic testing for aneuploidy, analysis of Society for Assisted Reproductive Technology Clinic Outcome Reporting System data 24:54 Retrospective cohort study comparing the success of medical management of early pregnancy loss in pregnancies conceived with and without medical assistance 33:31 Association of duration of embryo culture with risk of large for gestational age delivery in cryopreserved embryo transfer cycles 38:32 Endometriosis diagnosed by ultrasound is associated with lower live birth rates in women undergoing their first in vitro fertilization/intracytoplasmic sperm injection treatment 47:29 Quantitative ultrasound measurement of uterine contractility in adenomyotic vs. normal uteri: a multicenter prospective study 53:13 Unhealthy air quality secondary to wildfires is associated with lower blastocyst yield 1:03:22 The American Society for Reproductive Medicine's new and more inclusive definition of infertility may conflict with traditional and conservative religious-cultural values  View Fertility and Sterility May 2024, Volume 121, Issue 5: https://www.fertstert.org/issue/S0015-0282(24)X0004-7 View Fertility and Sterility at https://www.fertstert.org/  

The public rightly expects high quality dignified care for all, including older people and persons living with dementia who require care in an institutional care setting such as a hospital or care home. However, in many countries, care quality within these institutions falls far below the public's expectations.The speakers for this podcast draw on their own research and broader research to draw attention to institutional structures and processes of care that are risk factors for iatrogenic incontinence. Professor Joan Ostaszkiewicz advocates for continence care that foregrounds the person's dignity in everyday care interactions. Professor Katie Featherstone describes how her ethnographic research illuminated practices in hospitals that systematically fail to recognise and meet the basic hygiene needs of older people and people living with dementia. Dr Tiina Vaittinnen argues that iatrogenic incontinence is a form of harm and injustice that is deeply imbued in the present cultures of care in institutionalised care settings and that it is caused by dysfunctional health systems. Collectively, they articulate the system-level, long-term economic and environmental impacts of the lack of attention to incontinence and continence caregiving in public health and policy.Joan Ostaszkiewicz, NurseKatie Featherstone, Social ScientistTiina Vaittinen Vaittinen, Health Services ResearcherPiers Gibbon, Journalist Early registration for ICS 2024 Madrid is now open at www.ics.org/2024The ICS annual meeting is the must-attend, multidisciplinary event for clinical and research scientists interested in: Urology Urogynaecology Female and functional urology Gynaecology Bowel dysfunction Neurourology Pure and applied science Physiotherapy Nursing Geriatrics The ICS 2024 Madrid conference fosters collaboration between all disciplines involved in continence care.

On this episode, Nate is joined by philosopher and educator Zak Stein to discuss the current state of education and development for children during a time of converging crises and societal transformation. As the pace of life continues to accelerate - including world-shaking technological developments - our schools struggle to keep pace with changes in cultural expectations. What qualities are we encouraging in a system centered on competition and with no emphasis on creating agency or community participation? How is unfettered technology and artificial intelligence influencing youth - and what should parents, adults, and teachers be doing in response? What could the future of education look like if guided by true teacherly authority with the aim to create well-rounded, stable young humans with a sense of belonging and purpose in their communities?  About Zak Stein:  Dr. Zak Stein is a philosopher of education, as well as a Co-founder of the Center for World Philosophy and Religion. He is also the Co-founder of Civilization Research Institute, the Consilience Project, and Lectica, Inc. He is the author of dozens of published papers and two books, including Education in a Time Between Worlds.  PDF Transcript Show Notes 00:00 - Zak Stein works + Info, Civilization Research Institute, Education in a Time Between Worlds, Center for World Philosophy and Religion, First Principles and First Values  03:24 - No Child Left Behind 03:56 - Joseph Tainter + TGS episode 03:53 - Iatrogenic  05:30 - Daniel Schmachtenberger (TGS Episodes), Ken Wilbur, Marc Gafney 16:01 - Effects of screens and social media on teen mental health 16:54 - Marshall McLuhan 17:20 - The importance of adult boundary and limit setting for children 18:17 - How social media affects the brain 19:06 - The rise of ADHD in the 90s and effects on education - a timeline 19:58 - Hypercompetitive primary education systems 20:20 - High level of stress and cheating in primary education 22:28 - Scandinavian school systems 26:27 - Cold war effects on the education system 26:35 - Sputnik 27:25 - Tech elites don't give their kids tech 28:35 - Elite overproduction, Peter Turchin 34:10 - Your Unique Self  37:28 - Iain McGilchrist + TGS Episode 38:02 - Moral Relativism 43:27 - Foundations of advertising  47:07 - Negatives of standardized testing 47:22 - Donald T. Cambell - Campbell's law 48:57 - Nature vs Nurture Debate 49:20 - Cooperation and competition 52:10 - Effects of a competitive school environment 55:02 - The effects of an above-and-beyond teacher 55:42 - Legitimate teacherly authority 59:55 - Importance of the environment in the first 5 years of life 1:02:20 - John Dewey 1:10:31 - The best way to learn is to teach 1:11:40 - David Graeber, Bullshit Jobs 1:15:25 - How standardized testing increased high education access 1:16:08 - Civilian Conservation Corp, Lawrence A. Cremin 1:17:02 - New Deal 1:22:07 - Risks around artificial intelligence 1:24:58 - Rise of relationships with AI 1:28:41 - First Chatbot ELIZA 1:30:01 - Electricity use of AI 1:37:30 - The Future of Human Nature 1:41:19 - Peak Oil 1:42:29 - Mental Health Crisis 1:46:35 - Correlation of COVID with IQ loss Watch this video episode on YouTube

Dr Carrie Tamarelli joins Ethics Talk to discuss her article, coauthored with Angela Cao and Dr Rebecca Grossman-Kahn: “Should Patients' Boredom in Locked Patient Psychiatric Units Be Considered Iatrogenic Harm?”  Recorded December 7, 2023.  Read the full article for free at JournalOfEthics.org

Neurology Today Editor-in-Chief Joseph E. Safdieh, MD, FAAN, highlights new stories reporting on the use of AI in EMS systems for stroke detection, the association between human growth hormone and iatrogenic Alzheimer's, and seizure dogs for refractory epilepsy.

We respond to listener comments about independent media co-ops, the disappearance of tween fashion, posting disease, influencer voice, mourning online, and human height throughout history.--This conversation contains a single, brief mention of suicide.--☎️ Call us at 651 615 5007 to leave a voice mail

During today's episode I tackle something I've been thinking about for years, the ever difficult question of iatrogenic factors in clinical practice.  An iatrogenic side effect is an illness or symptom, caused by a medical procedure, intervention and/or provider.  I discuss how I see this topic, the things I am paying attention to in my own practice as I try to achieve the best results for the people that I see.  Thank you for listening to my jumbled thoughts on this topic! Is this something you've considered before? Comment below. --- Send in a voice message: https://podcasters.spotify.com/pod/show/concast/message

Empowering Holistic Healers: Unveiling the 8 Steps to Holistic Health Certification with Mayim Vega | Arukah Holistic Healer Program Join Mayim Vega, founder of arukah.com, as she unveils the transformative 8-step certification program to empower individuals on the journey to becoming holistic healers. Explore the foundational Module 1, focusing on health principles and toxin identification, inspired by a herbalist teacher's 20 Steps to a Healthier Life. Dive into critical topics such as pure water, live foods, natural cleaning, and the dangers of modern living. Discover the holistic approach to health, unmasking hidden threats like GMOs, Iatrogenic errors, MSG, and more. Break free from mainstream health disinformation and embark on a path to true holistic healing at www.arukah.com. #HolisticHealing #CertificationProgram #HolisticHealth #ArukahHolisticHealer" --- Send in a voice message: https://podcasters.spotify.com/pod/show/arukah/message

Why is the public discourse around vaccination either 100% good or 100% evil?  Ikoi along with our two guests, both of whom have suffered significant vaccine injuries but remain pro-vaccination, share their stories, experiences and nuanced opinions. -- Support us on Patreon: https://www.patreon.com/itsnotjustinyourhead Email us with feedback, questions, suggestions at itsnotjustinyourhead@gmail.com. -- Harriet's other shows: WBAI Interpersonal Update (Wednesdays): https://wbai.org/program.php?program=431 Capitalism Hits Home: https://www.youtube.com/playlist?list=PLPJpiw1WYdTNYvke-gNRdml1Z2lwz0iEH -- ATTENTION! This is a Boring Dystopia/Obligatory 'don't sue us' message: This podcast provides numerous different perspectives and criticisms of the mental health space, however, it should not be considered medical advice. Please consult your medical professional with regards to any health decisions or management. --- Send in a voice message: https://podcasters.spotify.com/pod/show/itsnotjustinyourhead/message

Go online to PeerView.com/NYY860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, experts in fibrodysplasia ossificans progressiva (FOP) discuss the pathophysiology, prevalence, and burden of the disease, as well as the disease's manifestations and common misdiagnoses. With a focus on improving patient care and quality of life, the activity also includes a patient interview and 3D animation and is part of a larger education collection on FOP. Upon completion of this activity, participants should be better able to: Describe the mechanism of disease of FOP, including the underlying genetic pathophysiology; Summarize the spectrum of FOP disease manifestations, understanding the holistic burden on the patient and impact on quality of life; and Avoid iatrogenic harm caused by diagnostic errors by correctly identifying patients with the clinical hallmarks of FOP

Go online to PeerView.com/NYY860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, experts in fibrodysplasia ossificans progressiva (FOP) discuss the pathophysiology, prevalence, and burden of the disease, as well as the disease's manifestations and common misdiagnoses. With a focus on improving patient care and quality of life, the activity also includes a patient interview and 3D animation and is part of a larger education collection on FOP. Upon completion of this activity, participants should be better able to: Describe the mechanism of disease of FOP, including the underlying genetic pathophysiology; Summarize the spectrum of FOP disease manifestations, understanding the holistic burden on the patient and impact on quality of life; and Avoid iatrogenic harm caused by diagnostic errors by correctly identifying patients with the clinical hallmarks of FOP

Go online to PeerView.com/NYY860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. In this activity, experts in fibrodysplasia ossificans progressiva (FOP) discuss the pathophysiology, prevalence, and burden of the disease, as well as the disease's manifestations and common misdiagnoses. With a focus on improving patient care and quality of life, the activity also includes a patient interview and 3D animation and is part of a larger education collection on FOP. Upon completion of this activity, participants should be better able to: Describe the mechanism of disease of FOP, including the underlying genetic pathophysiology; Summarize the spectrum of FOP disease manifestations, understanding the holistic burden on the patient and impact on quality of life; and Avoid iatrogenic harm caused by diagnostic errors by correctly identifying patients with the clinical hallmarks of FOP

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/NYY865. CME credit will be available until August 30, 2024.Can YOU Avoid Iatrogenic Harm? Understanding and Identifying Fibrodysplasia Ossificans ProgressivaIn support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and International Fibrodysplasia Ossificans Progressiva Association ,Progressive Osseous & Heteroplasia Association ,The American Society for Bone and Mineral Research. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresCo-Chair/PlannerRichard Keen, PhD, FRCP, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; Regeneron Pharmaceuticals Inc.; and UCB, Inc.Grant/Research Support from Incyte; Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; and Regeneron Pharmaceuticals Inc.Speaker for Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; Regeneron Pharmaceuticals Inc.; and UCB, Inc.Co-Chair/PlannerEdna E. Mancilla, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Ipsen Biopharmaceuticals, Inc./Clementia Pharmaceuticals.Grant/Research Support from Incyte.Patient/PlannerErin Danzer has no financial interests/relationships or affiliations in relation to this activity.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/NYY865. CME credit will be available until August 30, 2024.Can YOU Avoid Iatrogenic Harm? Understanding and Identifying Fibrodysplasia Ossificans ProgressivaIn support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and International Fibrodysplasia Ossificans Progressiva Association ,Progressive Osseous & Heteroplasia Association ,The American Society for Bone and Mineral Research. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresCo-Chair/PlannerRichard Keen, PhD, FRCP, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; Regeneron Pharmaceuticals Inc.; and UCB, Inc.Grant/Research Support from Incyte; Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; and Regeneron Pharmaceuticals Inc.Speaker for Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; Regeneron Pharmaceuticals Inc.; and UCB, Inc.Co-Chair/PlannerEdna E. Mancilla, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Ipsen Biopharmaceuticals, Inc./Clementia Pharmaceuticals.Grant/Research Support from Incyte.Patient/PlannerErin Danzer has no financial interests/relationships or affiliations in relation to this activity.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/NYY865. CME credit will be available until August 30, 2024.Can YOU Avoid Iatrogenic Harm? Understanding and Identifying Fibrodysplasia Ossificans ProgressivaIn support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and International Fibrodysplasia Ossificans Progressiva Association ,Progressive Osseous & Heteroplasia Association ,The American Society for Bone and Mineral Research. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresCo-Chair/PlannerRichard Keen, PhD, FRCP, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; Regeneron Pharmaceuticals Inc.; and UCB, Inc.Grant/Research Support from Incyte; Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; and Regeneron Pharmaceuticals Inc.Speaker for Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; Regeneron Pharmaceuticals Inc.; and UCB, Inc.Co-Chair/PlannerEdna E. Mancilla, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Ipsen Biopharmaceuticals, Inc./Clementia Pharmaceuticals.Grant/Research Support from Incyte.Patient/PlannerErin Danzer has no financial interests/relationships or affiliations in relation to this activity.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/NYY865. CME credit will be available until August 30, 2024.Can YOU Avoid Iatrogenic Harm? Understanding and Identifying Fibrodysplasia Ossificans ProgressivaIn support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and International Fibrodysplasia Ossificans Progressiva Association ,Progressive Osseous & Heteroplasia Association ,The American Society for Bone and Mineral Research. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresCo-Chair/PlannerRichard Keen, PhD, FRCP, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; Regeneron Pharmaceuticals Inc.; and UCB, Inc.Grant/Research Support from Incyte; Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; and Regeneron Pharmaceuticals Inc.Speaker for Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; Regeneron Pharmaceuticals Inc.; and UCB, Inc.Co-Chair/PlannerEdna E. Mancilla, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Ipsen Biopharmaceuticals, Inc./Clementia Pharmaceuticals.Grant/Research Support from Incyte.Patient/PlannerErin Danzer has no financial interests/relationships or affiliations in relation to this activity.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/NYY865. CME credit will be available until August 30, 2024.Can YOU Avoid Iatrogenic Harm? Understanding and Identifying Fibrodysplasia Ossificans ProgressivaIn support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and International Fibrodysplasia Ossificans Progressiva Association ,Progressive Osseous & Heteroplasia Association ,The American Society for Bone and Mineral Research. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresCo-Chair/PlannerRichard Keen, PhD, FRCP, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; Regeneron Pharmaceuticals Inc.; and UCB, Inc.Grant/Research Support from Incyte; Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; and Regeneron Pharmaceuticals Inc.Speaker for Ipsen Biopharmaceuticals, Inc.; Kyowa Kirin Co., Ltd; Regeneron Pharmaceuticals Inc.; and UCB, Inc.Co-Chair/PlannerEdna E. Mancilla, MD, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Ipsen Biopharmaceuticals, Inc./Clementia Pharmaceuticals.Grant/Research Support from Incyte.Patient/PlannerErin Danzer has no financial interests/relationships or affiliations in relation to this activity.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

Bill Rice Jr is a professional journalist, whose frustration with the COVID narrative led him to break free and ply his trade on Substack. His regular newsletter now attracts thousands of readers. I came across Bill's work when preparing the Measuring the Mandates report, as he has specialised in documenting the evidence for early spread of the virus. Although we'd approached this question from different angles, we'd both realised the implications of this: that COVID couldn't be the thing driving the excess mortality. This is the biggest scandal of our time. In this interview I ask Bill all about that. We also discuss some of his writing and insights into how ‘The Narrative' insulates and protects itself, and what we can do to break through.  Follow Bill on Substack: https://billricejr.substack.com/ Read Measuring the Mandates, Questioning the States Response to COVID-19: https://www.deepstateconsciousness.com/measuring-the-mandates

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In the latest episode of The Flip N' Shift Podcast, my guest is Dr. Tawny Kross. Dr. Tawny Kross, Pain Specialist of Kross Centered Care. Dr. Kross is a Doctor of Physical Therapy and a Pain Specialist. She has nearly a decade of experience at a Veteran's hospital in North Carolina working with patients that have some of the most complex chronic pain cases. Dr. Kross  believes passionately in our brain and body's innate ability to heal. She is SO excited to be able to share her knowledge with you now as a Pain and Wellness Coach.  Website:  https://www.drtawnykross.com Facebook: https://www.facebook.com/tawny.kross Instagram:  https://www.instagram.com/dr.tawny.kross Link Tree:  https://journals.lww.com/pain/Abstract/2022/02000 https://uspainfoundation.org/news/the-financial-and-emotional-cost-of-chronic-pain https://pubmed.ncbi.nlm.nih.gov/16896359 https://www.nytimes.com/2017/06/23/science/john-sarno-dead-healing-back-pain-doctor.html   Article and Publication Cite Sourcing: eyo RA, Weinstein JN. Low back pain. N Engl J Med. 2001;344(5):363-370. doi:10.1056/NEJM200102013440508; Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society [published correction appears in Ann Intern Med. 2008 Feb 5;148(3):247-8]. Ann Intern Med. 2007;147(7):478-491. doi:10.7326/0003-4819-147-7-200710020-00006; Webster BS, Bauer AZ, Choi Y, Cifuentes M, Pransky GS. Iatrogenic consequences of early magnetic resonance imaging in acute, work-related, disabling low back pain. Spine (Phila Pa 1976). 2013;38(22):1939-1946. doi:10.1097/BRS.0b013e3182a42eb6 Koes BW, Van Tulder MW. Clinical Review, Diagnosis and treatment of low back pain.  Stewart M, Loftus S. Sticks and Stones: The Impact of Language in Musculoskeletal Rehabilitation. J Orthop Sports Phys Ther. 2018;48(7):519-522. doi:10.2519/jospt.2018.0610 Major NM, Helms CA. MR imaging of the knee: findings in asymptomatic collegiate basketball players. AJR Am J Roentgenol. 2002;179(3):641-644. doi:10.2214/ajr.179.3.1790641   Please subscribe to the Flip N' Shift Podcast Channels. Connect with us through The Flip N Shift website.   The Flip N Shift Self Healing Podcast is Now Available on ALL Podcast Platforms.   All audio formatted episodes will have corresponding visual/kinesthetic aides, tools and techniques available for download in our website.  (click on the link below)   https://www.flipnshift.com   The Instatie link will connect you to all of our social media platforms and podcast platforms.   https://www.instatie.com/FlipnShift-Podcast    

A study released in February 2023 offered some critique of NoFap as a community. The study name is Iatrogenic effects of Reboot/NoFap on public health: A preregistered survey study. Let me respond to some of the ideas from the study.   → “Pornography addiction” is an unrecognized diagnosis. I will reply with a comment Dorian made on my blog: “I've also been consuming porn for 15 years, now starting my journey. I recognized it as a problem a few years ago, but I'm just now realizing how bad it really is. Until now I've made excuses or just pretended it isn't a problem even though I knew the truth. I'm totally lethargic and demotivated.”   → Qualitative studies have consistently suggested that “Reboots” paradoxically cause more distress. The distress appears to occur in response to (1) the abstinence goal, which recasts common sexual behaviors as personal “failures.” Honestly, I don't think this distress is that bad. In fact, it's okay to feel distress when you are pushing yourself to improve yourself to get rid of a bad habit. You are getting out of your comfort zone, after all. I'd recommend decreasing the distress by getting support, though. Part of that distress is indeed unhealthy. You might feel shamed or bullied. You might feel something is wrong with you. But that's not true. You are a good person. It's just that PMO addiction is getting the best of you. Then, it's key to see the distinction between porn and masturbation. Masturbation is not bad. It's a natural way to release sexually when you can't have sex. Sex should be a priority, though. Excessive masturbation becomes a problem when it's a waste of time and energy. And a coping mechanism. And an excuse not to be social and seek real sex. Finally, porn is poison. Kill me, hang me but porn is poison to guys. Porn is bad to your brain just like weed is. You can consume it and convince yourself it's helping you but on the backend, it's killing you.   → (2) problematic and inaccurate Reboot/NoFap forum messaging regarding sexuality and addiction. Participants reported that their most recent relapse was followed by feeling shameful, worthless, sad, a desire to commit suicide, and other negative emotions. More engagement in NoFap online forums was associated with worse symptoms of erectile dysfunction, depression, anxiety, and more sex negativity.   Well, I felt porn-watching was wrong for me way before NoFap became a thing. The problem is not about NoFap as a particular community. I think that overall, they have a positive message. But are there still particular people in a community who are toxic ❓For sure. And that's normal. Now if you feel your self-improvement goal is not supported by this community, don't go there. Or filter what they write.   → Results support and expand previously documented harms and problems with Reboot/NoFap claims of treating pornography addiction from qualitative research. This is a controversial topic. See some of the studies above that talk about the dangers of porn for sexual confidence in men and the stability of relationships. Whenever someone takes PMO to an extreme, it's easy to attack them. Perhaps, the answer is common sense and moderation. Study link: https://journals.sagepub.com/doi/10.1177/13634607231157070 ---------------------------------------------- TAKE MY FREE PORN DETOX COURSE: Sick of empty promises to yourself ❓ I am going to show you how to hack willpower for No PMO.  Step by step. For a better future. You achieving the success that you want. If you are interested, CLICK THE LINK BELOW NOW: https://romanmironov.com/free If not, fine — just keep lying to yourself that you'll quit someday. ---------------------------------------------- OTHER VIDEOS YOU MIGHT LIKE:

Dr Katherine Pumphrey joins Ethics Talk to discuss her article, coauthored with Dr Jessica Hart: “What the COVID-19 Pandemic Teaches Us About Pediatric Iatrogenic Risk.”  Recorded December 9, 2022. Read the full article at JournalofEthics.org

Drs Andrea Asnes and Sundes Kazmir join Ethics Talk to discuss medical child abuse, sites of pediatric neglect, and how clinicians can best carry out their responsibilities as mandatory reporters. Recorded November 3, 2022.  Read the full February 2023 issue for free at JournalofEthics.org.

Dr Kevin Shulman joins Ethics Talk to discuss his article, coauthored with Dr Barak Richman: “Informed Consent as a Means of Acknowledging and Avoiding Financial Toxicity as Iatrogenic Harm”  Recorded August 22, 2022.

Show notes at pharmacyjoe.com/episode760. In this episode, I'll discuss tranexamic acid for controlling iatrogenic bleeding during flexible bronchoscopy. The post 760: Can You Use Tranexamic Acid For Controlling Iatrogenic Bleeding During Flexible Bronchoscopy? appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode760. In this episode, I ll discuss tranexamic acid for controlling iatrogenic bleeding during flexible bronchoscopy. The post 760: Can You Use Tranexamic Acid For Controlling Iatrogenic Bleeding During Flexible Bronchoscopy? appeared first on Pharmacy Joe.

Visit D'Artagnan: https://www.dartagnan.com/ Paul was diagnosed 5 years ago with type 1 diabetes in a pretty severe crisis. Through very low carb (less than 30 TOTAL carbs per day), often zero, he has managed blood glucose in the normal range. The last 3 A1c readings have been right around 5.0%.  Timestamps 00:00 Introduction 01:49 Type 1 diabetes diagnosis in old age 05:06 Coaching type 1 diabetics 06:06 ADA type 1 diabetic self-care handbook 07:54 Dr. Bernstein 08:43 Blood sugar rollercoaster 10:49 Discovering being type 1 diabetic 12:53 Type 1 vs type 2 diabetes 14:06 Trying carnivore diet for type 1 diabetes 15:57 Self-experimenting 18:04 Current diabetic routine 19:28 Using insulin on type 1 diabetes 22:21 Meal size 24:18 Negative effects of carnivore diet 25:11 Blood sugar and dementia 26:22 Carnivore diet resolves retinopathy 28:28 Carnivore diet & peripheral neuropathy 31:10 Diabetes and infections 32:49 Over-the-counter insulin 34:22 CGM for diabetes 36:33 CGMs and women 37:54 Carnivore diet and family 41:09 Carnivore diet and heart disease risk 44:55 Mastering Diabetes 45:46 Vegans and diabetes 47:01 Literature vs patient experience 48:16 Iatrogenic causes 50:23 Corrective doses of insulin See open positions at Revero: https://jobs.lever.co/Revero/ Join Carnivore Diet for a free 30 day trial: https://carnivore.diet/join/ Book a Carnivore Coach: https://carnivore.diet/book-a-coach/ Carnivore Shirts: https://merch.carnivore.diet Subscribe to our Newsletter: https://carnivore.diet/subscribe/ . ‪#revero #shawnbaker #Carnivorediet #MeatHeals #HealthCreation   #humanfood #AnimalBased #ZeroCarb #DietCoach  #FatAdapted #Carnivore #sugarfree  ‪

We have realized how much words matter when it comes to patient's and client's recovery and pain experience. Our words can change the way someone thinks, feels, and acts and our words have the capacity to heal or the potential to cause harm. Tune in, as we discuss why words matter in health care and fitness and what some solutions are to help our patients get better results by changing how we communicate with them.In this episode, we are joined by Dr. Rachel Heller, Physical Therapist and Yoga Instructor here at Made2Move.Follow her on IG:@thebalancedrach Welcome to the Healthy Charleston Podcast, where we help you take ownership of your health and fitness. We are here to be your source of accurate health and fitness information while spreading awareness about the health and fitness resources available to you in the Charleston area. Be sure you are subscribed so you never miss an episode, we hope you enjoy the show.Follow Hannah and Made2Move:@hannahbreal_dpt @made2movept DONT spend another day in pain! Sign up for an appointment at made2movept.com and get 10% off your first visit when you mention the podcast.Articles we reference in this episodeBarsky AJ. The Iatrogenic Potential of the Physician's Words. JAMA. 2017 Dec 26;318(24):2425-2426. doi: 10.1001/jama.2017.16216. Erratum in: JAMA. 2018 Feb 27;319(8):833. PMID: 29090307.Colloca L. Nocebo effects can make you feel pain. Science. 2017 Oct 6;358(6359):44. doi: 10.1126/science.aap8488. PMID: 28983038; PMCID: PMC5754642.Darlow, Ben, et al. "The enduring impact of what clinicians say to people with low back pain." The Annals of Family Medicine 11.6 (2013): 527-534.Friedman, Daniel Jonah, Louise Tulloh, and Karim M. Khan. "Peeling off musculoskeletal labels: sticks and stones may break my bones, but diagnostic labels can hamstring me forever." British Journal of Sports Medicine 55.21 (2021): 1184-1185.Stewart, Michael, and Stephen Loftus. "Sticks and stones: the impact of language in musculoskeletal rehabilitation." journal of orthopaedic & sports physical therapy 48.7 (2018): 519-522.Webster BS, Bauer AZ, Choi Y, Cifuentes M, Pransky GS. Iatrogenic consequences of early magnetic resonance imaging in acute, work-related, disabling low back pain. Spine (Phila Pa 1976). 2013 Oct 15;38(22):1939-46. doi: 10.1097/BRS.0b013e3182a42eb6. PMID: 23883826; PMCID: PMC4235393.

We have realized how much words matter when it comes to patient's and client's recovery and pain experience. Our words can change the way someone thinks, feels, and acts and our words have the capacity to heal or the potential to cause harm. Tune in, as we discuss why words matter in health care and fitness and what some solutions are to help our patients get better results by changing how we communicate with them.In this episode, we are joined by Dr. Rachel Heller, Physical Therapist and Yoga Instructor here at Made2Move.Follow her on IG:@thebalancedrach Welcome to the Healthy Charleston Podcast, where we help you take ownership of your health and fitness. We are here to be your source of accurate health and fitness information while spreading awareness about the health and fitness resources available to you in the Charleston area. Be sure you are subscribed so you never miss an episode, we hope you enjoy the show.Follow Hannah and Made2Move:@hannahbreal_dpt @made2movept DONT spend another day in pain! Sign up for an appointment at made2movept.com and get 10% off your first visit when you mention the podcast.Articles we reference in this episodeBarsky AJ. The Iatrogenic Potential of the Physician's Words. JAMA. 2017 Dec 26;318(24):2425-2426. doi: 10.1001/jama.2017.16216. Erratum in: JAMA. 2018 Feb 27;319(8):833. PMID: 29090307.Colloca L. Nocebo effects can make you feel pain. Science. 2017 Oct 6;358(6359):44. doi: 10.1126/science.aap8488. PMID: 28983038; PMCID: PMC5754642.Darlow, Ben, et al. "The enduring impact of what clinicians say to people with low back pain." The Annals of Family Medicine 11.6 (2013): 527-534.Friedman, Daniel Jonah, Louise Tulloh, and Karim M. Khan. "Peeling off musculoskeletal labels: sticks and stones may break my bones, but diagnostic labels can hamstring me forever." British Journal of Sports Medicine 55.21 (2021): 1184-1185.Stewart, Michael, and Stephen Loftus. "Sticks and stones: the impact of language in musculoskeletal rehabilitation." journal of orthopaedic & sports physical therapy 48.7 (2018): 519-522.Webster BS, Bauer AZ, Choi Y, Cifuentes M, Pransky GS. Iatrogenic consequences of early magnetic resonance imaging in acute, work-related, disabling low back pain. Spine (Phila Pa 1976). 2013 Oct 15;38(22):1939-46. doi: 10.1097/BRS.0b013e3182a42eb6. PMID: 23883826; PMCID: PMC4235393.

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Dr Chloë Atkins joins Ethics Talk to discuss her article, coauthored with Dr Sunit Das: “What Should Clinicians and Patients Know About the Clinical Gaze, Disability, and Iatrogenic Harm When Making Decisions?”  Recorded May 31, 2022 Read the full article here. 

Dr Liam McCoy joins Ethics Talk to discuss his article, coauthored with Drs Zainab Doleeb, Jazleen Dada, and Catherine Allaire: “Underrecognition of Dysmenorrhea Is an Iatrogenic Harm" Recorded June 6, 2022  Read the full article here. 

Ramya Sampath joins Ethics Talk to discuss her article: “When Is Iatrogenic Harm Negligent?”  Recorded May 20, 2022  Read the full article here. 

Dr Helen Chapple joins Ethics Talk to discuss the harms of poor-end-of-care life and how to avoid them.   Recorded March 28, 2022 

Dr Kristen Choi joins Ethics Talk to discuss her article, coauthored with Bantale Ayisire: “When Experiencing Inequitable Health Care Is a Patient's Norm, How Should Iatrogenic Harm Be Considered?”  Recorded May 18, 2022  Read the full article here. 

Dr Carmen Black joins Ethics Talk to discuss her article, coauthored with Dr Amanda Calhoun: “How Biased and Carceral Responses to Persons With Mental Illness in Acute Medical Care Settings Constitutes Iatrogenic Harms”  Recorded May 16, 2022 Read the full article here. 

When blood, or other fluids, accumulate in the sac around the heart it's called a pericardial tamponade.  As little as 50 ml of blood, or a little under 1/4 cup, can cause a pericardial tamponade. Pathophysiology of cardiac tamponade. Iatrogenic causes of tamponade. Signs & symptoms that we observe prior to a patient arresting. Differentiating between a cardiac tamponade and a tension pneumothorax; another H&T reversible cause with some shared signs. Emergency treatment of cardiac tamponade with pericardiocentesis. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Jennifer DeGuillio is a wife, mother of four and a health coach, who specializes in ketogenic living, nutrition, health and wellness. She has coached hundreds of women, who have successfully sustained a healthy lifestyle. Jennifer loves sharing knowledge and helping others. She is a passionate person who will go the extra mile and over-deliver.When an Iatrogenic illness to benzodiazepines took her by surprise, she used this same healthy lifestyle and positive attitude to approach her taper.  She is proof, not everyone has to suffer when tapering a benzodiazepine.https://linktr.ee/JenniferDeguilio 

Episode 103: Caring for LGBTQ+ Patients. Salwa, Pat, and Dr. Arreaza explain how to care for patients who identify themselves as LGBTQ+. Answered questions include, what screenings are needed? Any special needs? Introduction: LGBTQ+ Information.  By Hector Arreaza, MD. Recently the media has been flooded with information about LGBTQ+. If you wonder what LGBTQ+ means, it means lesbian, gay, bisexual, transgender, queer or questioning, and the “+” sign acknowledges other orientations such as asexual, intersex, and more. June was designated as “pride month”. I think we have received more information within the last year than in the previous century. Many people consider this an overrepresentation of the calculated 3.5% to 8% of the population who identify themselves as LGBTQ+, many others consider this a revolution to promote equality in our society by reaffirming gay rights, while others consider this a part of an agenda to destroy the “American way of living” or even the US Armed Forces. You can come to your own conclusion about the origin and validity of this movement, but as medical providers, especially as family medicine providers, we must be prepared to care for any patient we encounter, including members of the LGBTQ+ community, and treat them with the same respect and compassion as any other patient. This episode was done to increase your awareness of this topic and motivate you to keep learning about it. By the way, there are now specific fellowships you can take to become more specialized on this topic, and you can find more information on the American Medical Association website.[3] This is the Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.___________________________Caring for LGBTQ+ patients. By Salwa Sadiq-Ali, MS IV Ross University School of Medicine, and Pattamestrige Perera, MS IV, American University of the Caribbean. Comments by Hector Arreaza, MD. Salwa: So, I was browsing the internet as we all do these days and I came across a short film, The Clinic, by a Canada-based organization, the Get REAL movement. Have you heard about this Dr. Arreaza? Arreaza: No, I haven't, but this sounds interesting. What was the film about? Salwa: Essentially, it's about LGBTQ+ patients and how healthcare is not inclusive. The film shows two patients with the same concern, one of which is from the LGBTQ+ community. It goes on to show how they are treated differently by the physician. Arreaza: That's not how it should be. Unfortunately, healthcare disparity is very real, especially in minority groups like the LGBTQ+. One study found that 3.5% of Americans identify as lesbian, gay, or bisexual and 0.3% identify as transgender. They also found that these individuals are more likely to get poor care because of stigma and lack of awareness. Salwa: Exactly! And since June is PRIDE month, I thought this would be a great topic! Especially because we as students or healthcare providers don't learn too much about this in school or training. Arreaza: I think that's a great idea. I've heard a lot about PRIDE celebrations and the memorials that are held. How about we start with what exactly is PRIDE?Pat: PRIDE is a celebration, a movement. It's celebrated to commemorate the 1969 Stonewall Riots or Uprising. The riots began after the police raided a gay club in New York City leading to almost a week of violent clashes. This event marked the beginning of the gay rights movement as we know it today. Arreaza: And today PRIDE is celebrated with parades and many hold memorials for members of the community who were victims of hate crimes. By the way, you can listen to our episode 14, “Gender Diversity”, to learn about the definitions of gender, sexual orientation, and more.Pat: As you said earlier, LGBTQ+ individuals are part of a minority group and face discrimination. Arreaza: Let's talk about the health care gaps the “community” faces. Tell us more. Salwa: Yes absolutely! Let's get into it! Did you know that LGBTQ+ youth are at a higher risk for substance abuse, STDs, cancers, cardiovascular disease, obesity, bullying, isolation, rejection, anxiety, depression, and suicide in comparison to the general population? Arreaza: The AAFP says suicide rates are 4 times higher among LGBTQ+ and even higher among trans youth compared to heterosexual youths. Also, members of the community, specifically men who have sex with men, are at a much higher risk of being affected by HIV/AIDS.Pat: In fact, family physicians, and all primary care providers, are key to providing care for the LGBTQ+ community and the special needs of the community including gender-affirming care. Arreaza: So, what should primary care providers do?Salwa: That's a great question! First, let's go back to the basics. Bedside manners are key. Being open and welcoming will open the door for you to find relevant health information. Having open conversations and being empathetic and mindful will help you build that patient-doctor relationship you want to have with your patients. I'll share a story from when I was rotating in surgery. I had a transgender patient in the clinic, male to female. That's what is called a transgender woman. When I was reviewing the chart, I couldn't tell what pronouns the patient used. The first thing I did when I got into the room was to ask, “What pronouns would you like me to use?”. Even though she was wearing a mask I could tell that her face lit up just by looking at her eyes, and she said, “Thank you, that was very kind of you to ask.” Small things like this can really make a difference. Arreaza: And that's becoming a routine question when our medical assistants encounter a patient for the first time. Their preferred pronoun is listed next to the patient's name. What about the other health issues for LGBTQ+ patients? What should we do for that?Salwa: For the other concerns – depression, anxiety, suicide, and more – follow the current guidelines for cisgender patients (cisgender patients are those who identify themselves with their gender assigned at birth). The AAFP and USPSTF have screening guidelines in place that can be utilized to help determine what someone may need further management for. Pat: The PHQ9 – a screening questionnaire for depression – will help you determine if you need to start treatment for depression or refer to behavioral health. There's a similar questionnaire for anxiety – the GAD 7. Salwa: When I was doing my psychiatry rotation, I had a transgender male patient who didn't have a support system. His family had essentially rejected him, and he was so isolated that he became depressed and suicidal. So, I'd say ask your patients about bullying, their support system, ask them about their friends. Maybe even talk to their parents if the patient is a minor, if they consent you to do so, or refer to family therapy. Pat: And of course, there is STD testing, HPV vaccination, obesity and related comorbidity screening, PAP smears for anyone with a cervix, maybe even consider an anal PAP smear when appropriate.Arreaza: Beverly Hills rotation: A gynecologist for men.People at increased risk of anal cancer:-Men who have sex with men-Iatrogenic immunosuppression (e.g., solid organ transplant recipients, long-term oral corticosteroids)-Women with a history of cervical, vulvar, or vaginal SIL (also termed intraepithelial neoplasia) or cancer-Women with a history of cervical HPV 16 infection-Individuals with a history of anogenital wartsPat: Depression is important to detect on time given the higher rate of suicide in this population, aside from following current guidelines, are there any unique health-related questions we should ask our LGBTQ+ patients? I hope you guys said yes! two common health topics are gender-affirming care and complications related to chest binding. Dr. Arreaza, have you had any patient encounters for gender-affirming care?Arreaza: Yes actually. I've had a few patients who requested gender-affirming care. It requires a multi-disciplinary care team. You must consider hormone replacement, mental health, and surgeries. At the primary care level, you are there as the patient's support system to help them navigate through everything and provide them with all the information. Hormone replacement is generally done by an endocrinologist or by a primary care provider who has been trained to do it. Of course, when appropriate, we will refer the patients to surgeons for certain procedures. Salwa: Exactly! Individuals who, from my understanding, are transgender or non-binary, as in they identify as males but tend to have female sexual characteristics such as breasts, may do something called chest binding. It involves compressing the breast tissue with a wrap to have a more masculine gender expression. Usually, individuals will use commercial binders, elastic bandages, duct tape, or plastic wrap. When you have a patient who practices chest binding, it's important to address safe practices. They commonly develop dermatological conditions like acne, scarring, fungal infections. But they can also develop other complications like chronic pain, restrictive respiration, rib fractures, syncope, lightheadedness, and heartburn. Pat: A study showed that 88.9% of participants experienced a negative side effect of binding, but only 15% sought care. Cleveland Clinic suggests that individuals use a commercial, breathable binder or a sports bra. It's also important to stay hydrated, have at least one day a week when a binder is not used, and avoid using a binder while sleeping. Most importantly, if you experienced any side effects, to get help from a doctor. Arreaza: Asylum seekers due to sexual orientation is possible. People in different parts of the world suffer persecution due to their sexual orientation. LGBTQ+ individuals are target for “killings, sexual and gender-based violence, physical attacks, torture, arbitrary detention, accusations of immoral or aberrant behavior, denial of the rights to assembly, expression and information, and discrimination in employment, health, and education in all regions around the world.Pat: So, I think we covered most of it. Do you two think we mentioned the important parts? Salwa: On that note, we want to end this podcast with a small message to LGBTQ+ individualslistening in. We want you to know that you are not alone and that you matter.And if you're listening right now and know someone who is LGBTQ+, check in on them and letthem know how much they mean to you. Pat: We encourage you to go to your PCP and talk to them about your concerns and how you're doing. And we encourage all PCPs, all healthcare providers even, to implement these principles when encountering their LGBTQ+ patients. Arreaza: If you do not feel comfortable caring for LGBTQ+ patients, you can refer them to a provider with the knowledge and skills to care for them. Available Resources:The Center for Sexuality and Gender Diversity in Kern CountyPFLAG Bakersfield ChapterBakersfield LGBTQ+The Trevor Project (have crisis counselors available to help)National Suicide Hotline (1-800-273-8255)National LGBTQ TaskforceSAGE - Services and Advocacy for LGBTQ+ EldersTransgender Law Center ____________________________Conclusion: Now we conclude our episode number 103 “Caring for LGBTQ+ Patients.” Remember to screen your patients for conditions related to their gender assigned at birth but take into consideration the effects of hormones in those who have changed their gender. While caring for LGBTQ+ patients, remember to apply the same ethical principles you apply to the rest of your patients: beneficence, non-maleficence, autonomy, and justice. Even without trying, every night you go to bed being a little wiser.This week we thank Hector Arreaza, Salwa Sadiq-Ali, and Pat Perera.Thanks for listening to Rio Bravo qWeek Podcast. If you have any feedback, contact us by email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. Audio edition: Suraj Amrutia. See you next week! _____________________References:Powell, Lauren. We Are Here: LGBTQ+ Adult Population in United States Reaches At Least 20 Million, According to Human Rights Campaign Foundation Report, December 9, 2021, Human Rights Campaign, hrc.org, https://www.hrc.org/press-releases/we-are-here-lgbtq-adult-population-in-united-states-reaches-at-least-20-million-according-to-human-rights-campaign-foundation-report, accessed on June 30, 2022.  How Many People are Lesbian, Gay, Bisexual, and Transgender? UCLA School of Law Williams Institute, April 2011, https://williamsinstitute.law.ucla.edu/publications/how-many-people-lgbt/ National LGBTQ+ Fellowship Program, American Medical Association Foundation, https://amafoundation.org/programs/lgbtq-fellowship/ Guidelines on International Protection No. 9, United Nations High Commission for Refugees, unhcr.org, published on October 23, 2012, online at: https://www.unhcr.org/509136ca9.pdf, accessed on June 30, 2022.  The Clinic, short film. The Get Real Movement, thegetrealmovement.com, https://www.thegetrealmovement.com/theclinicfilm. Accessed on June 30, 2022.  June is LGBT Pride Month, Youth.Gov, https://youth.gov/feature-article/june-lgbt-pride-month, accessed on June 30, 2022. Stonewall Riots, The History Channel, history.com, https://www.history.com/topics/gay-rights/the-stonewall-riots, Accessed on June 30, 2022.  Hafeez H, Zeshan M, Tahir MA, Jahan N, Naveed S. Health Care Disparities Among Lesbian, Gay, Bisexual, and Transgender Youth: A Literature Review. Cureus. 2017 Apr 20;9(4):e1184. doi: 10.7759/cureus.1184. PMID: 28638747; PMCID: PMC5478215. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478215/ Lesbian, Gay, Bisexual, Transgender, and Queer or Questioning (LGBTQ+) Health, American Academy of Family Physicians, accessed on June 30, 2022. https://www.aafp.org/dam/AAFP/documents/advocacy/prevention/equality/BKG-LGBTQ+Health.pdf. Creating a welcoming clinical environment for lesbian, gay, bisexual, and transgender (LGBT) patients, rainbowwelcome.org, https://www.rainbowwelcome.org/uploads/pdfs/Creating%20a%20Welcome%20Clinical%20Environment%20for%20LGBT%20Patients.pdf Peitzmeier S, Gardner I, Weinand J, Corbet A, Acevedo K. Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study. Cult Health Sex. 2017 Jan;19(1):64-75. doi: 10.1080/13691058.2016.1191675. Epub 2016 Jun 14. PMID: 27300085. https://pubmed.ncbi.nlm.nih.gov/27300085/ Moffa, Jamie. Chest Binding: A Physician's Guide, Pride in Practice, April 6, 2019. https://www.prideinpractice.org/articles/chest-binding-physician-guide/ Cleveland Clinic Health Essentials, How to Bind Your Chest Safely, July 26, 2021, https://health.clevelandclinic.org/safe-chest-binding/ 

The combination of hydrochloric acid, lipase, and pepsin combine to create the acidic gastric juices found in the stomach. These healthy stomach acid levels serve as a first line of defense for the gastrointestinal system, preventing infectious agents from reaching the intestines. A normal gastric pH is considered to be present with pH values >3, with values below 4 capable of killing bacterial invaders within 15 minutes. Gastric juices with a pH >3 mark the beginning stages of hypochlorhydria. As the pH increases above 4, there is an increased prevalence of bacterial overgrowth. Achlorhydria is defined as a pH >7. Betaine HCL Click here to learn more about the Hedberg Institute Membership. There are two main categories of hypochlorhydria: iatrogenic and acquired. Iatrogenic hypochlorhydria is the most common, resulting from the use of medications to reduce gastric acid secretions. Proton pump inhibitors (PPIs) are one of the top ten most prescribed drugs in the world, contributing to the rise in iatrogenic hypochlorhydria. Malnutrition is the leading cause of acquired hypochlorhydria. Individuals taking PPIs generally have a pH between 5-7. Individuals with hypochlorhydria are at an increased risk for infection and disease due to a loss of this protective barrier. Research conducted by Martinsen, Fossmark, and Waldum (2019) demonstrated that individuals with hypochlorhydria were at an increased risk of a variety of infections including bacterial, fungal, and parasitic infections. One study they reviewed reported a significant decrease in Shannon's diversity of the GI microbiome and changes in 20% of the bacterial taxa in PPI users versus non-users. The increased use of PPIs makes it necessary to review current medications, both prescribed and over the counter, at each patient encounter. Nutritional status should also be evaluated utilizing blood labs, anthropometrics, diet diaries, food allergies/sensitivities, etc. Other useful factors in screening a patient for gastric hypoacidity include assessing gender, age, stress levels/eating behaviors, geographic origin/nationality, testing of stomach acid levels, and labs to rule out concurrent diseases such as Helicobacter pylori, chronic gastritis, parietal cell autoantibodies, hypothyroidism, etc. Keep in mind that there can be discrepancies between different testing methods and cutoff values depending on the labs used. Malnutrition can be the cause of or the result of hypochlorhydria. Malnutrition that leads to a deficiency in the nutrients needed to make HCL can cause hypochlorhydria. These include chloride, sodium, potassium, zinc, and iodine. Malnutrition can also develop as a result of hypochlorhydria. Decreased gastric acidity impairs nutrient absorption resulting in possible nutrient deficiencies for most of the essential vitamins and minerals including protein, iron, calcium, magnesium, zinc, vitamins A and E, copper, and all of the B vitamins. The presence of both malnutrition and hypochlorhydria increases the risk of enteric infections. There is also an increased prevalence of food allergies in individuals with reduced gastric acidity as they lose the ability to sufficiently denature proteins. With hypochlorhydria, larger protein peptides remain which can trigger an immune system response, resulting in allergic symptoms. Therefore, screening for hypochlorhydria should be conducted in individuals that suffer from malnutrition and/or food sensitivities/allergies. There is also an increased prevalence of food allergies in individuals with reduced gastric acidity as they lose the ability to sufficiently denature proteins. With hypochlorhydria, larger protein peptides remain which can trigger an immune system response, resulting in allergic symptoms. Therefore, screening for hypochlorhydria should be conducted in individuals that suffer from malnutrition and/or food sensitivities/allergies. Stress management is also important in regulating gastric...

When faced with a medical condition, most people either pay someone else to improve their lives or develop a fatalistic or defeatist view. But you have the power to change your life and improve your health. You can reprogram your mind for a healthy body and fulfilling life. In this episode, Dr. Bruce Lipton discusses how conscious and subconscious programs dictate our health and how you can reprogram them to your advantage. He also touches on topics including the current healthcare crisis around the world and spirituality. If you'd like to learn about reprogramming your subconscious for your happiness and a healthy body, this episode is for you! Here are three reasons why you should listen to the full episode: Discover the power of epigenetic programming and how it works. Learn the three ways to reprogram your mind for a healthy body. Find out how the healthcare industry could be negatively affecting your health. Customised Guidance for Your Genetic Make-Up Our epigenetics health programme is all about aligning fitness, lifestyle, nutrition, and cognitive performance to an individual's particular genes. To learn more, visit https://www.lisatamati.com/page/epigenetics-and-health-coaching/. Customised Online Coaching for Runners CUSTOMISED COACHING PLANS FOR RUNNERS — How to Run Faster, Be Stronger, and Run Longer – Without Burnout & Injuries Have you struggled to fit training into your busy life? Maybe you don't know where to start, or perhaps you have done a few races but struggle with motivation or injuries. Do you want to beat your time from last year, or finish at the front of the pack? Do you want to run your first 5-km, or run a 100-miler? ​​Do you want a holistic programme that is personalised and customised to your ability, goals, and lifestyle?  Go to www.runninghotcoaching.com for our online run training coaching. Health Optimisation and Life Coaching Are you struggling with a health issue and need people to look outside the box – people who are connected to some of the greatest science and health minds in the world? Reach out to us at support@lisatamati.com. We can jump on a call to see if we are a good fit for you. If you are dealing with adversity, are facing a big challenge ahead, want to take your performance to the next level,or want to learn how to increase your mental toughness, emotional resilience, foundational health, and more, contact us at support@lisatamati.com. Order My Books My latest book, Relentless, chronicles how my mother and I defied the odds. After an aneurysm left my mum, Isobel, with massive brain damage at age 74, the medical professionals told me there was no hope for any quality of life again. I used every mindset tool, years of research and incredible tenacity to prove them wrong and bring my mother back to her full health within three years. Get your copy here: https://shop.lisatamati.com/collections/books/products/relentless. For my other two best-selling books Running Hot and Running to Extremes, chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books. Lisa's Anti-Ageing and Longevity Supplements  NMN: Nicotinamide Mononucleotide, an NAD+ precursor Feel Healthier and Younger* Nicotinamide Adenine Dinucleotide (or NAD+) is a molecule essential for the functionality of all human cells. It also regulates metabolism. What is NMN? NMN Bio offers a cutting edge Vitamin B3 derivative, NMN (beta Nicotinamide Mononucleotide), which can boost the levels of NAD+ in muscle tissue and in the liver. Take charge of your energy levels, focus, metabolism, and overall health to live a happy, fulfilling life. Founded by scientists, NMN Bio offers supplements of the highest purity and rigorously tested by an independent, third-party lab. Start your cellular rejuvenation journey today. Support Your Healthy Ageing We offer powerful third-party-tested NAD+ boosting supplements. Start your healthy ageing journey today. Shop now: https://nmnbio.nz/collections/all NMN (beta Nicotinamide Mononucleotide) 250mg | 30 capsules NMN (beta Nicotinamide Mononucleotide) 500mg | 30 capsules 6 Bottles | NMN (beta Nicotinamide Mononucleotide) 250mg | 30 Capsules 6 Bottles | NMN (beta Nicotinamide Mononucleotide) 500mg | 30 Capsules Quality You Can Trust — NMN Our premium range of anti-ageing nutraceuticals (supplements that combine Mother Nature with cutting edge science) combats the effects of ageing and is designed to boost NAD+ levels. Products are manufactured in an ISO9001 certified facility. Boost Your NAD+ Levels — Healthy Ageing: Redefined Cellular Health Energy & Focus Bone Density Skin Elasticity DNA Repair Cardiovascular Health Brain Health  Metabolic Health My ‘Fierce' Sports Jewellery Collection For my gorgeous and inspiring sportswear jewellery collection, 'Fierce,' visit https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection. Episode Highlights [04:24] Stem Cells and Epigenetics We lose millions of cells every minute. We get new cells from stem cells. Dr Bruce Lipton was cloning stem cells in 1967. Genetic determinism is false, as genes are merely blueprints. Your mind is the one that activates and modifies the genes. Genes do not cause diseases; instead, they correlate with them. [13:56] Genes vs. Consciousness Believing in genetic determinism can make you feel like a powerless victim. Epigenetics is about controlling your genes and knowing that consciousness is creating disease. Changing your biology and behaviour can change your life. Before you can control your genes, you need to learn how epigenetics works and how to do it. Our brains are computers; you need suitable programming. [19:35] The Power of Programs Remember that you have the power to exert control over your physiological systems and attain a healthy body. Thinking, which takes up 95% of your life, redirects the focus of consciousness inside your head and allows autopilot programming to take over. Your programs determine your life and mentality, so pay attention to them. [29:34] Three Ways to Reprogram For a Healthy Body Our two minds ⁠— the conscious and subconscious ⁠— function and learn differently. Putting your brain into theta using hypnosis can help you change a program. You need practice and repetition to create a solid program. Energy psychology is about looking at your life to find out your programs and changing the subconscious programs. [46:57] Spirituality Frequency If a television breaks, the broadcast still keeps going. Your body is the television, and you're the broadcast. In a sense, this means that you cannot die. Listen to the full episode for research on cellular electrical activity and its correlation with mothers and their children! [51:25] What Happens After Death We can keep our minds conscious about what happens in the world, but we can tune into intuition so that the deceased become part of the field of information. Communicating with the deceased at an intuitive level is possible. [52:25] How Fear Affects Programs The issues that plague the world, such as pollution and war, are created by programs. We make antibodies before we're even born. Antigens stimulate the immune response and are what our bodies use to identify pathogens. If you have a healthy body, stop looking for bad signs or symptoms. Looking or the symptoms of a disease can create them. Fear causes immune system shutdown, vulnerability, and conflict. [1:05:17] Negative Impacts of Corporations A corporation's first and foremost rule is to make money for shareholders. Pharmaceutical companies only care about making money, robbing people of their chance at a healthy body. Science has no more freedom because corporations control the flow of research. If you want to hear more about how big healthcare corporations and pharmaceutical companies exploit people for profit, listen to the full episode! [1:11:09] Does Medicine Cure or Kill? An article by Dr Barbara Starfield, published in the Journal of the American Medical Association in 2000, revealed that medicine is the third leading cause of death in the US. Iatrogenic illness refers to illness caused by medical treatment. A few years ago, an article in the British Medical Journal came up with the same results. Both prescription and illegal drugs kill people every year. We can't even trust vitamins because they're being regulated as drugs. 7 Powerful Quotes ‘Here's the point, most everybody out here has been programmed by the belief that genes provide the character of our lives, that they came from our parents and they determine our traits. And if we don't like our traits, you can't change the genes.'   ‘How you see the world will determine which version of protein will be created from a gene, like a wiser realm.'   ‘Then epigenetics says that my consciousness is creating this. And therefore if I change my consciousness, I change my biology, change my behaviour, I can do anything with it.'   ‘Consciousness is you. Your specific identity, your spiritual domain, you, here. The rest of the brain back here is called subconscious, below conscious.'   ‘You weren't there for most of the programming. It started even before you were born. And it went a whole year from zero to one — you weren't there. They went from one to two who are in therapy, you're getting programmed every day.'   ‘So when the TV breaks, did the broadcast stop? The answer's no. How do you know I said, we'll get another TV, plug it in, turn it on and tune it to the station back on again. And here comes apart because this is called reincarnation, you cannot die.'   ‘Evolution is community coming together in harmony. And today's world is the antithesis of evolution and evolution as one separate the world and then make polarised groups charging each other go well then there's no unity.'   Resources Gain exclusive access and bonuses to Pushing the Limits Podcast by becoming a patron!  Dopesick Is US Health Really the Best in the World? by Dr Barbara Starfield Check out Dr Bruce Lipton's books: The Biology of Belief The Honeymoon Effect Spontaneous Evolution Connect with Dr Bruce: Website About Dr Bruce  Dr Bruce Lipton is a renowned stem cell biologist and leader in bridging the gap between science and spirit. He received his PhD from the University of Virginia in Charlottesville and joined the Department of Anatomy at the University of Wisconsin's School of Medicine in 1973. His studies on stem cells gave rise to epigenetics. He is the bestselling author of The Biology of Belief and recipient of the 2009 Goi Peace Award. As a highly sought after keynote speaker and workshop presenter, he's been a guest speaker on hundreds of TV and radio shows and a keynote presenter for national and international conferences. Many people have transformed their lives by applying the principles he discusses in lectures. He is one of the leading voices of new biology.  Learn more about Dr Bruce's work on his website. Enjoyed This Podcast? If you did, subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends so they can know how to optimise their health and happiness by reprogramming their subconscious. Everyone can have a healthy body — it just takes the right programming. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa

CardioNerds (Amit Goyal and Daniel Ambinder) and guest host, Dr. Priya Kothapalli (UT Austin fellow and CardioNerds Ambassador), join SUNY Downstate cardiology fellows, Dr. Eric Kupferstein and Dr. Gautham Upadhya to discuss a case about a patient who had coronary artery bypass grafting that was complicated by a LIMA grafted to the great cardiac vein. Dr. Alan Feit (Professor of Medicine, SUNY Downstate) provides the E-CPR for this episode. Dr. Moritz Wyler von Ballmoos (Director, robotic cardiac and vascular surgery for Houston Methodist Cardiovascular Surgery Associates) provides a special perspective regarding coronary artery bypass grafting as it relates to this case. Episode introduction with CardioNerds Clinical Trialist Dr. Jana Lovell (Johns Hopkins). Left Internal Mammary Artery (LIMA) to Left Anterior Descending (LAD) artery anastomosis is the cornerstone of Coronary Artery Bypass Graft (CABG) surgery. Anastomosis of the LIMA to the Great Cardiac Vein (GCV) is a known but rare complication of the surgery. Currently there are no clear guidelines in regard to further management. We report a case of a LIMA to GCV anastomosis managed with a drug eluting stent (DES) to the mid LAD after ruling out a significant left to right heart shunt. Jump to: Case media - Case teaching - References CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Case Media - Coronary Artery Bypass Grafting: An Iatrogenic Left to Right Cardiac Shunt Angiography Episode Schematics & Teaching - Coronary Artery Bypass Grafting: An Iatrogenic Left to Right Cardiac Shunt Pearls - Coronary Artery Bypass Grafting: An Iatrogenic Left to Right Cardiac Shunt Listen to the patient's story. The patient determines when the angina is no longer stable angina.The placebo effect of our interventions should not be discounted.LIMA to GCV anastomosis creates a left to right cardiac shunt. A Qp:Qs greater than 1.5 signifies a significant shunt.Increasing the pressure in the coronary sinus may actually be beneficial to the patient.LIMA-LAD is remains the most efficacious and long lasting graft but why not other arterial grafts? Notes - Coronary Artery Bypass Grafting: An Iatrogenic Left to Right Cardiac Shunt Iatrogenic anastomosis of the LIMA to the GCV is a rare but noted complication of CABG surgery. Review of the literature has reported under 40 such cases of arteriovenous fistula formation in the coronary system. Detection of the anastomosis generally stems from recurrent angina which can be attributed to unresolved ischemia or coronary steal syndrome but also can be detected with new heart failure (namely right sided heart failure due to left to right shunting). Diagnosis is usually made with coronary angiography, but CT coronary angiography has also been reported. Due to the rarity of this complication, no clear guidelines are in place directing the management leaving it to the discretion of the various Heart Teams. Evaluating for signs of heart failure and/or ischemia, and measuring the Qp:Qs have been the most common signs directing management. Various options are available for closing the fistula and include coil or balloon embolization, vascular plugs, venous ligation or a covered stent. Redoing the surgery is also an option. Spontaneous closure of the fistula has also been reported. Lastly, if redo surgery is not performed then regardless of fistula closure, coronary intervention for the native diseased artery may be pursued to relieve symptoms. References Boden et al; COURAGE Trial Research Group. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007 Apr 12;356(15):1503-16. doi: 10.1056/NEJMoa070829. Epub 2007 Mar 26. PMID: 17387127.

EMplify - September 2021 Announcements: Be on the lookout for an announcement regarding the new EB Medicine app, coming to an App Store near you this month !! Also, this month use code SB25 and get a $25 Starbucks gift card when you subscribe at ebmedicine.net ! Abnormal Uterine Bleeding in the Emergency Department Authors: Tazeen Abbas, MD Abbas Husain, MD, FACEP Physiology review Terminology Differentiating Causes: PALM-COEIN Structural: Polyp, Adenomyosis, Leiomyoma, Malignancy/Hyperplasia Non-structural: Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not otherwise specified Other causes: thyroid disease, hyperprolactinemia, stress, weight loss and anorexia, heavy exercise Age Based Differential 12-18 Immaturity of the hypothalamic-pituitary- ovarian axis Sexually transmitted infections Coagulopathies, and bleeding disorders (von Willibrand disease) 19-39 polyps fibroids malignancy PCOS Age 40 and older endometrial atrophy malignancy History Physical Exam Diagnostic Studies Treatment Unstable Stable Special Cases DOACs Prepubescent girls genital injuries  

Whether psychedelic therapists should have their own experiences with these compounds as part of their training is a passionately debated subject. Dr. Elizabeth Nielson, cofounder of Fluence, one of the foremost organizations training psychedelic therapists, has been pondering this for sometime, including how we ask the question itself. Her recent paper in the Journal of Humanistic Psychology explores the ethical considerations in offering and providing such experiences and is the subject of today's podcast. Our conversation begins with the ethics of discussing personal psychedelic experiences. We talk about the work of Fluence from harm reduction to integration coaching. We discuss Dr. Nielson's article “Psychedelics as a Training Experience for Psychedelic Therapists: Drawing on History to Inform Current Practice.” We explore the paradigms of the shamanic and Western worldview. Finally, we review other kinds of altered states of consciousness that psychedelic therapists can explore, in a. Dr. Elizabeth Nielson is a co-founder of Fluence and a psychologist with a focus on developing psychedelic medicines as empirically supported treatments for PTSD, substance use problems, and mood disorders. Dr. Nielson is a Site Co-Principal Investigator and therapist for an FDA approved Phase 3 clinical trial of MDMA-assisted Psychotherapy for Post-Traumatic Stress Disorder, and has served as a therapist on FDA approved clinical trials of psilocybin-assisted treatment of alcohol use disorder, psilocybin-assisted treatment of treatment resistant depression, and earlier phase 2 and 3 trials of MDMA-assisted psychotherapy. Through Fluence, she provides continuing education and training programs for therapists who wish to engage in integration of psychedelic experiences in clinical settings. Links Fluence Dr. Elizabeth Neilson on Twitter “Psychedelics as a Training Experience for Psychedelic Therapists: Drawing on History to Inform Current Practice” (Journal of Humanistic Psychology) Timestamps :08 - The ethics of sharing a personal psychedelic experience :12 - The work of Fluence from harm reduction to integration coaching :26 - The value of psychedelic experiences for psychedelic-assisted therapist :29 - The paradigms of shamanic vs Western medical :35 - Iatrogenic addiction and need for caution and research :44 - How Fluence offers experiential training in lieu of offering psychedelics :42 - The value of a therapist's pervious psychedelic experiences 1:00 - Advice to therapists