Restriction in blood supply to tissues
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Jay Gunkelman has read more than half a million brain scans. In this episode he and host Pete Jansons open a real before-and-after case and walk it frame by frame — eyes open and eyes closed, pre-treatment and post-treatment — so you can watch what changed. Going in: fast alpha racing at 11.5 Hz, 23 Hz beta spindling at the vertex driving insomnia, a slow edge of alpha buried in the left temporal lobe pointing at local ischemia and possible old head injury, and right-frontal beta carrying a depressive signature. Coming out: alpha stabilized toward 10 Hz, frontal beta down, left-temporal function dramatically improved. Then the bigger story — the refractory-psychiatry work Jay did with Ron Swatzyna and Nash Boutros, where roughly half of medication failures turned out to have a focal EEG biomarker that no pill could fix. As Jay puts it: you can't give soup to the whole brain.
Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net.Today on the emDOCs cast with Brit Long (@long_brit), we cover how to evaluate and manage acute limb ischemia. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play Send us Fan Mail
With Edoardo Conte and Daniele Andreini, Galeazzi-Sant'Ambrogio Hospital IRCCS, Milan - Italy and Gal Tsaban, Mayo Clinic, Rochester - USA. Link to paper Link to editorial
SURGICAL EDUCATOR'S ACADEMY Advanced Online Surgery Masterclass Upper Limb Ischemia Overview ✔️Upper limb ischemia is significantly less common than lower limb ischemia with a ratio of approximately one to nine due to rich collateral networks and a lower workload. ✔️The vast majority of cases involve small vessel occlusive diseases affecting palmar and digital arteries while only ten percent involve large vessel occlusive disease.✔️ Common etiologies include Raynaud phenomenon and thoracic outlet syndrome plus thromboangiitis obliterans which is also known as Buerger disease. ✔️Diagnosis is primarily based on history and physical examination supported by non invasive imaging such as duplex scans and computed tomography angiography.Raynaud Phenomenon ✔️This is a dynamic vasospastic disorder of the small arteries and arterioles triggered by cold exposure or emotional stress. ✔️It is characterized by a pathognomonic triphasic color change where the digits turn white due to ischemia then blue due to deoxygenated blood and finally red due to reactive hyperemia. ✔️Primary Raynaud or Raynaud disease is idiopathic and symmetric and benign typically affecting young women without causing tissue loss. ✔️Secondary Raynaud or Raynaud syndrome is associated with underlying connective tissue diseases like scleroderma and carries a high risk of digital ulcers or gangrene. ✔️Management focuses on patient education and warmth and smoking cessation with calcium channel blockers like nifedipine as the first line pharmacotherapy for moderate to severe cases.Thoracic Outlet Syndrome ✔️This condition involves the compression of the neurovascular bundle as it exits the chest through the scalene triangle. ✔️It is classified into three types including neurogenic which accounts for ninety five percent of cases and venous and arterial. ✔️Arterial thoracic outlet syndrome is rare and often caused by mechanical compression from a cervical rib or an anomalous fibromuscular band. ✔️The most sensitive provocative maneuver is the EAST or Wright test where the patient abducts the arm to ninety degrees with external rotation to check for blanching or radial pulse weakening. ✔️Initial treatment for most patients is physiotherapy to improve posture while surgical decompression via rib resection and scalenectomy is reserved for refractory symptoms or significant arterial compromise.Thromboangiitis Obliterans or Buerger Disease✔️ This is a non atherosclerotic and segmental inflammatory occlusive disease of the small and medium sized arteries in the distal limbs. ✔️It predominantly affects young male smokers under the age of fifty. ✔️Diagnostic criteria include a history of tobacco use and onset before age fifty and distal arterial occlusion in the absence of atherosclerotic risk factors or proximal embolic sources. ✔️Arteriography typically reveals a characteristic corkscrew appearance of collateral vessels around the occlusions. ✔️The only definitive treatment that stops the progression of the disease and prevents amputation is absolute and permanent smoking cessation. ✔️Supportive therapies include intravenous iloprost for ulcer healing and sympathectomy to reduce vasospasm and manage refractory pain.Diagnostic and Management Pathways ✔️The diagnostic pathway begins with functional and non invasive tests such as bilateral segmental arm pressures and digital pulse volume recordings. ✔️Duplex ultrasound is essential for dynamic testing in suspected thoracic outlet syndrome while computed tomography angiography or magnetic resonance angiography provides anatomical mapping for surgical planning. ✔️Revascularization is generally successful for large vessel disease whereas small vessel vasospastic diseases are managed with supportive care and risk factor modification. ✔️Selective arteriography remains the gold standard for invasive imaging when planning complex interventions.
CLTI- Chronic Limb Threatening IschemiaDefinition and Clinical Presentation ✔️Chronic Limb Threatening Ischemia is a clinical diagnosis defined by severe peripheral arterial disease causing ischemic rest pain or tissue loss such as non healing ulcers and gangrene that has persisted for more than two weeks. ✔️The hallmark symptom is nocturnal rest pain which is severe forefoot or toe pain that is worse when lying flat and is uniquely relieved by dangling the foot over the side of the bed. This position of dependency uses gravity to increase hydrostatic pressure and meet basic metabolic demands of the tissues. ✔️Physical examination signs include cool and shiny hairless skin with thick nails plus the presence of punched out distal ulcers or black dry gangrene.Classification and Risk ✔️Assessment Clinical severity is traditionally measured by the Rutherford system where category four indicates rest pain and categories five or six involve varying degrees of tissue loss. ✔️The modern gold standard for predicting amputation risk is the WIfI system which stands for Wound Ischemia and foot Infection. Each category in this system is graded from zero to three to determine the urgency of intervention. Patients with high WIfI scores are at a significantly increased risk of major limb loss within six months and require urgent evaluation.Diagnostic Evaluation ✔️The Ankle Brachial Index is the initial first line test but it is often falsely elevated above one point three zero in patients with diabetes or chronic kidney disease because of calcified and noncompressible vessels. ✔️In these instances a Toe Brachial Index of less than zero point seven zero or a toe pressure below thirty to forty millimeters of mercury is required to confirm the diagnosis. ✔️Computed Tomography Angiography is considered the gold standard imaging study to map the arterial anatomy and provide the necessary information for planning revascularization.Treatment and Revascularization Strategies ✔️Management of this condition requires urgent revascularization typically within days to weeks. ✔️Treatment options include endovascular techniques like balloon angioplasty and stenting which are less invasive and preferred for focal lesions or frail patients with high surgical risk. ✔️Open surgical bypass is indicated for fit patients with long segment arterial occlusions. The great saphenous vein is the gold standard conduit for bypass and must be preserved for leg salvage rather than being used for other procedures. After surgery a multidisciplinary team is essential for wound healing which can take three to six months.Medical Therapy and Long Term Prognosis ✔️Aggressive medical management is necessary to save the life of the patient even after the limb has been successfully salvaged. ✔️This includes high intensity statins and antiplatelet medications plus strict smoking cessation and diabetes optimization. Without this intensive therapy approximately fifty percent of patients will die from cardiovascular causes such as heart attack or stroke within five years. Additionally up to thirty percent of patients may still require a major amputation within five years highlighting the severe nature of the underlying systemic disease.
In dieser Folge spreche ich mit Prof. Dr. med. Uwe Nixdorff, Internist, Kardiologe, Sportmediziner und Gründer des European Prevention Center (EPC) in Düsseldorf, über die Todesursache Nummer 1 in Europa: Herz-Kreislauf-Erkrankungen. Allein in Deutschland sterben jedes Jahr rund 345.000 Menschen am Herzinfarkt, und 60 bis 80 Prozent davon, bevor sie überhaupt im Krankenhaus ankommen. Gleichzeitig zeigen große Studien wie die Inter Heart Trial, dass sich rund 80 Prozent dieser Infarkte vermeiden ließen. Wir sprechen darüber, warum das klassische Belastungs-EKG für die Früherkennung längst nicht mehr ausreicht, was es mit der gefährlichen vulnerablen Plaque auf sich hat und warum nur moderne Bildgebung sie sichtbar macht. Prof. Nixdorff erklärt seinen evidenzbasierten Algorithmus, von der sorgfältigen Risikofaktoren-Anamnese über Pulswellenanalyse, Funduskopie und Age-Scan bis zum Herz-CT, das seit Kurzem auch von der Kasse für die Früherkennung anerkannt ist. Wir sprechen über Blutdruck-Zielwerte, die drei Säulen Bewegung, Ernährung und Entspannung, sinnvolle Wearables wie Continuous Glucose Monitoring und über die Frage, warum Selbstverantwortung in der Prävention so entscheidend ist. In dieser Folge sprechen wir u.a. über folgende Themen: - Warum die Letalität bei Herzinfarkt zurückgeht, die Morbidität aber steigt, und was das für den Healthspan bedeutet? - Was ist eine vulnerable Plaque, warum ist sie so tückisch und weshalb erkennt sie ein klassisches Belastungs-EKG nicht? - Wie sich die Pathophysiologie eines Herzinfarkts in zwei Minuten verstehen lässt, von Noxen über LDL-Oxidation bis zur Ruptur der Deckplatte? - Warum rund 80 Prozent der Herzinfarkte vermeidbar wären und was das für unser Gesundheitssystem bedeuten würde? - Welche Risikofaktoren laut Framingham und Inter Heart Trial wirklich zählen und welche Rolle psychosozialer Stress dabei spielt? - Warum der Body Mass Index nicht ideal ist und der Taillenumfang die deutlich aussagekräftigere Messgröße darstellt? - Was Pulswellenanalyse, Augmentationsindex und Pulswellengeschwindigkeit über die Arteriensteifigkeit verraten und welche dieser Werte reversibel sind? - Wie der Age-Scan über die Maillard-Reaktion sichtbar macht, was die Verzuckerung von Proteinen mit Atherosklerose zu tun hat? - Weshalb der Augenhintergrund einen arteriellen Hypertonus oft schon ein bis zwei Jahre vor der Manifestation anzeigt? - Wie sich Calcium-Scoring und kontrastmittelgestütztes Herz-CT unterscheiden und warum Letzteres den diagnostischen Herzkatheter weitgehend ersetzen kann? - Warum Stentimplantationen im stabilen Fall laut Studien wie ISCHEMIA und ORBITA prognostisch oft keinen Vorteil bringen? - Welche drei Lebensstil-Säulen die kardiologische Prävention tragen und welche Rolle Wearables wie CGM und Aura Ring dabei spielen? Weitere Informationen zu Prof. Dr. med. Uwe Nixdorff findest du hier: - https://kardiologie-nixdorff.de/ - https://www.epccheckup.de/ Du interessierst dich für Gesunde Langlebigkeit (Longevity) und möchtest ein Leben lang gesund und fit bleiben, dann folge mir auch auf den sozialen Kanälen bei Instagram, TikTok, Facebook oder YouTube. https://www.instagram.com/nina.ruge.official https://www.tiktok.com/@nina.ruge.official https://www.facebook.com/NinaRugeOffiziell https://www.youtube.com/channel/UCOe2d1hLARB60z2hg039l9g Disclaimer: Ich bin keine Ärztin und meine Inhalte ersetzen keine medizinische Beratung. Bei gesundheitlichen Fragen wende dich bitte an deinen Arzt/deine Ärztin. STY- 289
Listen to an AI Collaborative Simulated Case Discussions on Chronic Lower Limb Ischemia - Lifestyle Limiting Ischemia.If you carefully listen to the episode you will have an immersive and transformational learning experience.
This episode includes two full, sample vascular scenarios pulled directly from our Vascular Surgery Oral Board Review Course. Listen in and test your clinical pathways in real-time as we walk through the perfect answers and provide high-yield commentary to help you pass the "hot seat."Sample Scenarios Included in This Episode: Case 22: Aortoenteric Fistula (AEF). A 78-year-old woman presents to the ER with a massive upper GI bleed and a history of an open AAA repair 10 years ago. We walk you through the immediate stabilization, CTA evaluation, and the definitive operative management—including axillobifemoral bypass, aortic stump closure, and duodenal repair. Case 27: Acute Mesenteric Ischemia. A 79-year-old woman with a history of atrial fibrillation presents with abdominal pain out of proportion to her physical exam. Test your decision-making on systemic heparinization, SMA embolectomy versus stenting (ROMS), and how to appropriately evaluate bowel viability with a second-look laparotomy. About our Vascular Surgery Oral Board Review Course: 72 High-Yield Scenarios: Covering everything from carotid stump syndrome to a AAA with a horseshoe kidney. Dual-Format Learning: Each case includes "Part A" (a straight run-through of the perfect exam response) and "Part B" (the same scenario packed with expert tips, tricks, and commentary). Free Simulator Access: Every purchase of the course includes access to our new AI-powered Oral Board Simulator, allowing you to practice your verbal responses under pressure. Resources: Vascular Surgery Oral Board Review Course: https://app.behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Oral Board Simulator: https://app.behindtheknife.org/oral-board-simulator Download the BTK App on iOS and Android for on-the-go studying. DOMINATE THE DAY!
Dr Tanveer Hossain, a post-CCT robotic surgery fellow in upper gastrointestinal surgery and endoscopy at Southampton Hospital. Dr Hussain has extensive experience in the management of complex gastrointestinal conditions and advanced minimally invasive surgical techniques.In today's episode, he will be sharing his expertise on acute mesenteric ischemia, helping us understand how to recognise it early and how it is managed from a surgical perspective.
Dr. Kim Brockenbrough: https://www.cardiavision.com/https://www.linkedin.com/in/kimberly-brockenbrough-md-1b321a123/https://www.instagram.com/kimbromd?ighsh=YjVpcDcwdHA3ejVvYour calcium score came back zero. You're in the clear, right? Not so fast.In this episode, Optispan Clinical Director Dr. Nicki Byrne sits down with Dr. Kim Brockenbrough, board-certified cardiovascular radiologist, 25-year veteran of vascular imaging, and CEO of CardiaVision, for a conversation that challenges one of the most common assumptions in preventive cardiology.If you care about cardiovascular longevity, and you should, because heart disease remains the leading killer, this is the imaging conversation you didn't know you needed.Timestamps:00:00 — Cold open: The 48-year-old runner with an 80% blockage and a zero calcium score00:54 — Dr. Nicki Byrne introduces Dr. Kim Brockenbrough & CardiaVision01:45 — Dr. Brockenbrough's background: 25 years of vascular imaging02:35 — Cardiovascular disease through a longevity lens: imaging vs. labs vs. functional testing03:24 — The lifecycle of plaque: from fatty deposits to rupture and heart attack04:21 — Why soft plaque is more dangerous than calcified plaque (SCOT-HEART 2020)05:14 — How calcium scores are used in clinical practice — and where they fall short06:18 — The only way to see soft plaque non-invasively: coronary CT angiography (CCTA)07:08 — Which populations are most at risk of a false sense of security from calcium scoring08:03 — What a CCTA can tell you that a calcium score can't09:43 — How often should patients follow up with repeat scans?10:28 — Higher vs. lower dose radiation protocols — and why Dr. Brockenbrough chooses higher dose11:17 — Risks of CCTA: contrast reactions, kidney considerations12:15 — Stress tests vs. CCTA: why a negative stress test is a very low bar13:21 — Soft plaque that isn't flow-limiting: small emboli, dementia, and congestive heart failure15:36 — Medications that reverse plaque: statins, PCSK9 inhibitors, and the LOCATE trial16:23 — LDL reduction and plaque regression: what the data shows17:08 — High-intensity statins vs. Repatha — tolerability, efficacy, and the price drop18:27 — When OptiSpan reaches for PCSK9 inhibitors: ApoB, LDL, Lp(a), ApoE4, and significant disease19:22 — Why a rising calcium score on a statin is exactly what you want to see20:25 — AI plaque quantification tools: promise, limitations, and validation concerns22:54 — Has AI ever changed Dr. Brockenbrough's read? A real-world case23:40 — FFR-CT, the ISCHEMIA trial, and why stenting asymptomatic patients is no longer standard of care25:25 — The future of cardiac imaging and the case for universal CCTA screening26:52 — The patient experience: what to expect at a CardiaVision CCTA appointment28:18 — Why seeing soft plaque changes patient behavior — the power of treating disease, not numbers29:49 — Bridging the gap between longevity medicine and traditional cardiology33:11 — Testosterone, the TRAVERSE trial, and what you should know about your coronaries first35:41 — What causes coronary artery disease beyond cholesterol: sugar, inflammation, gum disease37:07 — Image walkthrough: soft plaque vs. calcified plaque on a real CCTA41:36 — Where to find Dr. Brockenbrough and CardiaVision
In this episode, we review the high-yield topic of Acute Limb Ischemia from the Cardiovascular section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
Enlace del curso: https://app.behindtheknife.org/premium/repaso-para-el-examen-de-certificaci-n-en-cirug-a-general Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General. Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios. El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito. La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen. Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web (behindtheknife.org). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a hello@behindtheknife.org y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material. Este contenido incluye 97 descripciones operatorias para todos los procedimientos comunes —y la mayoría de los poco comunes— incluidos en el Currículo de Cirugía General SCORE. Cada descripción está diseñada para ayudar a los candidatos a prepararse de manera eficaz para el Examen de Certificación en Cirugía General. presentadores de podcast: - Auri P. Garcia Gonzalez, MD PhD nació en San Juan, Puerto Rico, y se trasladó a los Estados Unidos en el 2012 para sus estudios graduados. Actualmente, es estudiante de post-grado en cirugía general en Duke University. - Diego Schaps, MD, MPH es un residente de cirugía general en Duke y nació en Miami, en el estado de la Florida. Sus padres nacieron en El Salvador. Disclaimer: Los productos de contenido de Behind the Knife son únicamente para fines educativos. No diagnosticamos, tratamos ni ofrecemos consejos específicos para pacientes. ------ Behind the Knife is the world's leading surgical podcast and surgical education platform. Our mission is to create innovative surgical education content that is accessible to all. We are very excited to expand into the spanish audience and bring you 4 sample episodes of our General Surgery Oral Board Review Course which will be released over the course of the next week. Today, you'll hear a sample scenario from this comprehensive audio review course which includes 100 scenarios. The course has an exciting and entirely unique format. Each of the 100 scenarios includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are five to seven minutes long and include a variety of tactics and styles. If you're able to achieve this level of performance in your preparation, you are sure to pass the oral exam with flying colors. The second part introduces high yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy to understand teaching that covers the most confusing topics that we face as general surgeons. We are confident you will find this unique dual format approach a highly effective way to prepare for the test. The course contains crisp, concise operative descriptions that cover all SCORE common topics and and most SCORE uncommon topics. Our content is available on our iOS and Android apps and website (behindtheknife.org). Please check the show notes for more information. We would love to hear your feedback by emailing hello@behindtheknife.org and appreciate your help spreading the word to your colleagues if you enjoy the material. Hosts: - Auri P. Garcia Gonzalez, MD PhD was born and raised in San Juan, Puerto Rico and moved to the US in 2012 for graduate studies. At present, she is a surgical resident at Duke University. - Diego Schaps, MD, MPH is a general surgery resident at Duke and was born in Miami, Florida. His parents were born in El Salvador. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
Every leg saved has a story behind it — and this week on The Heart of Innovation, you'll meet the nurse practitioners who live those stories every day. Kym McNicholas and Dr. John Phillips chat with four remarkable OhioHealth NPs — Chelsea Jones, Elizabeth Murray, Brittany Byce, and Rebecca Lawler — to share what it's really like to help patients fight peripheral artery disease (PAD) and critical limb ischemia inside a large hospital system. They open up about: The split-second decisions that can mean the difference between amputation and recovery The emotional moments that stay with them long after a shift ends The gaps in care they're constantly trying to close for PAD patients And yes… the hilarious "Nonsense Board" where they log the wild moments that keep them sane It's raw. It's real. It's the life of a limb-saving NP — equal parts heart, grit, urgency, and humor. If you or someone you love is living with PAD, struggling to navigate the system, or wondering what limb-saving care actually looks like behind the scenes, this episode will give you clarity, encouragement, and a whole new appreciation for the clinicians fighting for patients every single day. #TheHeartOfInnovation #PAD #LimbSavingCare #PeripheralArteryDisease #NursePractitioner #OhioHealth #VascularHealth #AmputationPrevention #LifeAndLimb #KymMcNicholas #DrJohnPhillips #PatientAdvocacy #ChronicDiseaseCare #FrontlineMedicine #HealthcareHeroes
In this industry-sponsored episode, host Praveen Ranganath, MD is joined by returning guest, Amir Ahmadi, MD, FSCCT to discuss the paradigm shift from an ischemia-driven to an atheroma-driven approach to cardiovascular disease. Tune in and enjoy!This episode is sponsored by Elucid.References to a specific product, process, or service by speakers in this podcast episode do not constitute or imply an endorsement by the Society of Cardiovascular Computed Tomography. The views and opinions expressed in do not necessarily reflect those of the Society of Cardiovascular Computed Tomography.
Commentary by Dr. Jian'an Wang.
Commentary by Dr. Taku Kato.
Ischemia with No Obstructive Arteries (INOCA) in 2024 Guest: Claire Raphael, M.B.B.S., Ph.D. Host: Sharonne Hayes, M.D. INOCA is a common condition. It is an acronym that stands for ischemia with non-obstructive coronary artery disease. We discuss when to consider a diagnosis of INOCA, how to diagnose it and how to treat patients. Topics Discussed: What is INOCA? Who is at risk for INOCA? How do we manage INOCA? Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode. Podcast episode transcript found here.
This week please join author Chetan Huded as he discusses the article "Health Status Outcomes with Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting in ISCHEMIA." For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20250922.194514
In this episode, Dr. Harlan Krumholz introduces the September 16, 2025 issue of JACC, which features studies that challenge conventional clinical thinking, including a detailed ECMO physiology study showing that higher ECMO flow does not uniformly raise pulmonary capillary wedge pressure, suggesting the need for individualized management. A novel analysis of the ISCHEMIA trial revealed distinct angina symptom trajectories, emphasizing that recovery is not binary and supporting a more personalized approach to treatment and monitoring. A landmark target trial emulation found that statins significantly reduce cardiovascular risk in patients with type 1 diabetes—filling a key evidence gap. Additional highlights include a call to redefine early cardiogenic shock, a nuanced review of moderate secondary mitral regurgitation, and an editorial reaffirming JACC's commitment to independent, transparent science in alignment with new "Gold Standard Science" principles.
Join Jay Gunkelman, QEEGD (the man who has analyzed over 500,000 brain scans), and host Pete Jansons for another engaging NeuroNoodle Neurofeedback Podcast episode discussing neuroscience, psychology, mental health, and brain training.✅ Topic 1 Explained: Cold feet during neurofeedback might be linked to sympathetic overarousal or circulation issues—Jay explores temperature training, HRV, and even vascular screenings.✅ Topic 2 Deep Dive: SMR's effect on blood flow and how precise frequency training can improve perfusion, reduce ischemia, and support conditions like migraines and traumatic brain injury.✅ Topic 3 Insights: Restless leg syndrome is examined as a sleep disorder treated with dopamine-based meds and SMR neurofeedback—plus how frontal beta balance prevents underarousal.✅ Additional Topics:
In this episode, we review the high-yield topic Mesenteric Ischemia from the Gastrointestinal section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
Let's start your week strong with a quick tip you can incorporate right away. In this Mo's Monday Minute shortie episode, I'm talking about the six key signs that your patient is suffering limb ischemia. You don't want to miss this episode, because seconds can count when blood flow is lost! ___________________ FREE CLASS - If all you've heard are nursing school horror stories, then you need this class! Join me in this on-demand session where I dispel all those nursing school myths and show you that YES...you can thrive in nursing school without it taking over your life! 20 Secrets of Successful Nursing Students – Learn key strategies that will help you be a successful nursing student with this FREE guide! All Straight A Nursing Resources - Check out everything Straight A Nursing has to offer, including free resources and online courses to help you succeed!
Primary and Secondary Outcomes of the Women's Ischemia Trial to Reduce Events in Non-Obstructive Coronary Artery Disease
In this episode, we review the high-yield topic Mesenteric Ischemia from the Gastrointestinal section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
What is the role of ferroptosis, programmed cell death characterized by intracellular iron accumulation and lipid peroxidation, in the context of ischemic injury related to heart transplantation? In this episode, Associate Editor Dr. Amanda LeBlanc (University of Louisville) interviews authors Dr. Kenneth Liao and Dr. Nandan Mondal (both at Baylor College of Medicine), along with expert Dr. Zachary Kiernan (Virginia Commonwealth University) about the latest study by Li et al. The authors found that prolonged cold storage increases the susceptibility of hearts donated after brain death (DBD) to ferroptotic cell death. In contrast, however, the authors found that warm ischemic injury increased the risk for ferroptotic cell death in hearts donated after circulatory death (DCD). Li et al. found that targeting ferroptosis could be beneficial for optimizing cold preservation for DBD hearts, while interventions for DCD hearts should focus on the early phase of warm ischemia. Heart transplantation is the gold standard therapy for patients with medically refractory advanced heart failure. However, demand greatly exceeds supply of donor hearts. Listen as we discuss the current state of the heart transplantation field and the many challenges it faces. Shiyi Li, Katherine V. Nordick, Abdussalam E. Elsenousi, Rishav Bhattacharya, Randall P. Kirby, Adel M. Hassan, Camila Hochman-Mendez, Todd K. Rosengart, Kenneth K. Liao, and Nandan K. Mondal Warm-ischemia and Cold Storage Induced Modulation of Ferroptosis Observed in Human Hearts Donated After Circulatory Death and Brain Death Am J Physiol Heart Circ Physiol, published March 28, 2025. DOI: 10.1152/ajpheart.00806.2024
When Jae's mother faced amputation due to Critical Limb Ischemia (CLI) an advanced stage of Peripheral Artery Disease (PAD) in rural Louisiana, she refused to accept it as the only option. Despite being told there were no alternatives, Jae discovered the truth: not all PAD specialists have the skills to treat advanced cases. This episode comes at a crucial time. A May 2025 study from @SCAI reveals Black patients with CLI face a 46% higher chance of amputation and are 10% less likely to see vascular specialists before treatment. CLI is more deadly than breast, colon, and prostate cancer COMBINED—and outcomes worsen dramatically after amputation. Listen as Jae shares how she: • Fought against medical gaslighting • Found help through the @GlobalPADAssociation's Leg Saver Hotline (1-833-PAD-LEGS) • Connected with CLI specialist Dr. Amit Amin who successfully opened her mother's arteries This story could save someone's leg—or life. Share widely. #SaveALeg #PADAwareness #HealthcareEquity #CLI #PeripheralArteryDisease #PatientAdvocacy
In this podcast, Dr. Valentin Fuster discusses a groundbreaking study from the Orbiter 2 trial, which explores how dobutamine stress echocardiography (DSE) can predict the efficacy of percutaneous coronary intervention (PCI) in relieving angina in patients with stable coronary artery disease. The study reveals that the degree of ischemia, as measured by DSE, is strongly correlated with improvement in symptoms, offering new insights into patient selection for PCI treatment.
This week on Heart Doc VIP, Dr. Joel Kahn explores new and historic data showing that heart disease can begin shockingly early—sometimes before age 30. A pivotal 1998 study revealed that up to one-third of young adults already show signs of atherosclerosis, emphasizing the urgent need for primordial prevention starting in childhood. Dr. Kahn outlines the key health screenings every parent should know: blood pressure checks, body weight monitoring, and essential lab work. Later in the episode, Dr. Kahn revisits new findings on the Paleo diet, showing it may have included more plant- and starch-based foods than often assumed. He also discusses concerning links between processed meats and dementia, plus a cautionary look at a recent study on a specific group following the KETO diet—don't buy into the hype just yet. Additional topics include: The ISCHEMIA trial's insights on blood pressure control New research on the risk of dementia in people diagnosed with atrial fibrillation (AFIB) before age 70 Thanks to our partner endur.com. Use code KahnMD10 for a discount on Endur-Thine.
In this episode, Dr. Valentin Fuster discusses a study from the ISCHEMIA trial, showing that achieving multiple guideline-directed medical therapy (GDMT) goals—especially blood pressure control—reduces cardiovascular events in chronic coronary artery disease patients. The study highlights the importance of early goal attainment and adherence, with the POLYPILL offering a potential solution to improve patient compliance.
In this episode, Dr. Valentin Fuster reviews the ischemia trial's findings on invasive versus conservative treatment strategies for patients with chronic total occlusions (CTOs). The trial revealed that while revascularization of CTOs improved quality of life for angina, the invasive approach did not significantly reduce heart-related deaths or heart attacks compared to conservative management.
In this episode of the Award-winning PRS Journal Club Podcast, 2025 Resident Ambassadors to the PRS Editorial Board – Christopher Kalmar, Ilana Margulies, and Amanda Sergesketter- and special guest, Brad Hill, MD, discuss the following articles from the March 2025 issue: “Effect of Tourniquet-Related Nerve Ischemia on Response to Handheld Nerve Stimulation in Ulnar Nerve Transposition” by Brogan, Lee, Beamer, and Dy. Read the article for FREE: https://bit.ly/IschemiaNerveStim Special guest, Brad Hill, MD, completed combined residency training in General Surgery and Plastic and Reconstructive Surgery at New York University, followed by a Fellowship in Hand and Upper Extremity Surgery at the Curtis National Hand Center. Dr Hill currently serves as the Director of Hand and Peripheral Nerve Surgery Education at Vanderbilt University Medical Center. He is an avid educator and guest on several other national medical podcasts. READ the articles discussed in this podcast as well as free related content: https://bit.ly/March25JCCollection
On this episode of JHLT: The Podcast, the Digital Media Editors invite lead author Jan Van Slambrouck, MD, to discuss the paper, “The effect of rewarming ischemia on tissue transcriptome and metabolome signatures: A clinical observational study in lung transplantation.” Dr. Van Slambrouck is a general surgeon who's just finished his PhD training at the KU Leuven lab of respiratory disease and thoracic surgery in Belgium. The episode explores: How rewarming ischemia time (RIT) affects donor lungs, especially on the molecular level The pace of rewarming and how prior literature prepared the team to track and evaluate it Clinical strategies to reduce RIT and directly address molecular changes For the latest studies from JHLT, visit www.jhltonline.org/current, or, if you're an ISHLT member, access your Journal membership at www.ishlt.org/jhlt. Those involved in the pulmonary vascular disease space should tune in again later this month for a study on the safety and efficacy of riociguat in patients with PAH. Don't already get the Journal and want to read along? Join the International Society of Heart and Lung Transplantation at www.ishlt.org for a free subscription, or subscribe today at www.jhltonline.org.
N Engl J Med 2013;369:1115-23Background: The COURAGE trial was published in 2007. It compared up-front PCI to medical therapy alone in patients with stable CAD. Preventive PCI did not reduce the chance of dying or having a heart attack over a median follow up time of 5 years. The results rocked the cardiology world because for years prior to the publication of COURAGE, the standard of care called for revascularization of obstructive coronary stenosis. Despite what we would consider minor criticisms of COURAGE, the results have held over time as a preventive PCI strategy has failed repeatedly to reduce death or MI compared to medicine alone in subsequent large trials (BARI 2D, FAME 2, ISCHEMIA and ISCHEMIA-CKD) involving patients with stable CAD. But what about patients with acute coronary syndromes who have, a clearly defined “culprit” lesion and stable coronary stenosis of a non-infarct vessel? On the surface, the answer might seem simple - treat the “culprit” lesion with PCI and leave the stable disease alone. Continue optimal medical treatment of stable CAD indefinitely with consideration of revascularization only if new symptoms arise. But what if a stable coronary stenosis behaves differently in a patient with an acute coronary syndrome than in patients without it? Are these patients predisposed or particularly susceptible to acute plaque rupture and thrombogenesis to such an extent that they would benefit from a preventive revascularization strategy? The Primary Angioplasty in Myocardial Infarction (PRAMI) trial sought to test the hypothesis that immediate preventive PCI of non-culprit vessels plus the culprit vessel compared to culprit vessel only PCI would improve outcomes in patients with a STEMI and coronary stenosis of a non-infarct related artery.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Patients: From 2008 through 2013, patients were enrolled from 5 coronary care centers in the United Kingdom. Patients could be any age with acute STEMI and multivessel CAD detected at the time of emergency PCI. The trial was limited to patients with STEMI because ST-segment elevation, unlike ST-segment depression, localizes the area of ischemia in the myocardium and an “infarct-artery” is usually easy to distinguish. Clinically stable patients were considered for eligibility after undergoing PCI of the infarct artery while they were in the catheterization lab. They were eligible if successful PCI of infarct artery was performed and there was stenosis of 50% or more in one or more non-infarct arteries. Exclusion criteria included cardiogenic shock, previous CABG, had left main or significant disease in the ostia of both the LAD and circumflex vessels, or if the only non-infarct stenosis was a chronic total occlusion.Baseline characteristics: The trial screened 2,428 patients and randomized 465 patients (19%) with 234 to preventive PCI and 231 to no preventive-PCI. The majority of patients were excluded for single vessel disease (1122/1922 [58%]). The average age of patients was 62 years and more than 75% were men. Close to 50% were current smokers. The infarct artery was anterior in 35%, inferior in 60% and lateral in 5%. Approximately 65% of patients had 2 vessel disease and 35% had 3 vessel disease.Procedures: After completion of PCI in the infarct artery, eligible patients were randomized and those assigned to the preventive-PCI group underwent the procedure immediately in all non-infarct arteries with a coronary stenosis >50%. PCI was discouraged at a later date (sometimes this strategy is referred to as “staged PCI”) in the no preventive-PCI group unless it was symptom driven. Any patient in the trial with subsequent symptoms of angina that were not controlled with medicine was required to undergo objective assessment of ischemia to secure a diagnosis of refractory angina. Follow-up information was collected at 6 weeks and then yearly thereafter.Endpoints: The primary endpoint was a composite of death from cardiac causes, nonfatal MI, or refractory angina. Secondary outcomes included the individual components of the composite endpoint along with noncardiac death and repeat revascularization. Myocardial infarction was defined as symptoms of cardiac ischemia and a troponin level >99% URL. However, within 14 days after randomization, MI diagnosis also required ECG evidence of new STE or left bundle branch block and angiographic evidence of coronary artery occlusion (essentially this makes it so only in-stent thrombosis or spontaneous STEMI count and other causes of peri-procedural MI do not - this would bias the trial in favor of the preventive-PCI group).Refractory angina was defined as angina despite medical therapy and objective evidence of myocardial ischemia (i.e., ischemia on ECG during spontaneous episode of pain or abnormal results on functional testing).It was determined that 600 patients would be needed to achieve 80% power to detect a 30% relative reduction in the preventive-PCI group, at a 5% level of significance, assuming an annual rate of the primary outcome of 20% in the control group. Stopping criteria were prespecified if the results from the trial showed a primary outcome difference at the 0.001 level of significance. Results: The trial was stopped early based on a significant difference (P50%, preventive PCI significantly reduced a primary composite outcome of cardiac death, nonfatal MI and refractory angina in the PRAMI trial with an estimated NNT of 7 patients over 2 years. Individual components of the primary endpoint that were significantly reduced included nonfatal MI and refractory angina by similarly large margins. These results may seem impressive at first glance but we urge extreme caution in their interpretation. First, this is a relatively small trial with a historically large effect size, especially when considering hard endpoints like cardiac death and nonfatal MI were included. Such results are often later found to be falsely positive when larger, confirmatory studies are conducted. Second, the trial was stopped early and early stopping is prone to yield false positive and/or exaggerated results. Third, inclusion of refractory angina in the primary endpoint, an endpoint susceptible to bias in an unblinded study (see earlier discussion of “faith healing” and “subtraction anxiety” in FAME 2; consideration also must be given to nocebo effects in patients who know they have “untreated blockages”), clouds the main findings by inflating the effect size and making the trial susceptible to large differences in underpowered endpoints before sufficient data can be accumulated on hard outcomes. For example, if the trial had sought to detect a conservative difference of 30% in a primary composite endpoint that only included cardiac death or nonfatal MI, based on an event rate of 12% in the control group (the actual event rate in the trial), over 2,200 patients would be needed for 80% power at a 5% level of significance. The estimated number of actual events would be around 230. However, only 47 events occurred in PRAMI making the results highly susceptible to noise.While results of PRAMI suggest a beneficial role for preventive-PCI in patients with STEMI, more evidence is needed to confirm the results.Thanks for reading Cardiology Trial's Substack! This post is public so feel free to share it. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe
In this episode of the Award-winning PRS Journal Club Podcast, 2025 Resident Ambassadors to the PRS Editorial Board – Christopher Kalmar, Ilana Margulies, and Amanda Sergesketter- and special guest, Brad Hill, MD, discuss the following articles from the March 2025 issue: “Effect of Tourniquet-Related Nerve Ischemia on Response to Handheld Nerve Stimulation in Ulnar Nerve Transposition” by Brogan, Lee, Beamer, and Dy. “Eaton-Littler Ligament Reconstruction in Thumb Carpometacarpal Joint Instability: Outcomes and Prognostic Factors in 74 Patients” by Nieuwdrop, Jongen, Hundepool, et al. “Cost Comparison of Digital Nerve Repair Techniques” Hu, Williams, Kammien, et al. Special guest, Brad Hill, MD, completed combined residency training in General Surgery and Plastic and Reconstructive Surgery at New York University, followed by a Fellowship in Hand and Upper Extremity Surgery at the Curtis National Hand Center. Dr Hill currently serves as the Director of Hand and Peripheral Nerve Surgery Education at Vanderbilt University Medical Center. He is an avid educator and guest on several other national medical podcasts. READ the articles discussed in this podcast as well as free related content: https://bit.ly/March25JCCollection
In this Journal of Vascular and Interventional Radiology (JVIR) audio episode, JVIR blog Editor Peter Li, MD, MS, uses artificial intelligence (AI) platforms ChatGPT and DeScript to produce a podcast discussion on a Dec. 9 blog entry by Isabel Okinedo on the paper, "Primary Limb-Based Patency for Chronic Limb-Threatening Ischemia Treated with Endovascular Therapy Based on the Global Limb Anatomic Staging System."Related resources:Read the original article, "Primary Limb-Based Patency for Chronic Limb-Threatening Ischemia Treated with Endovascular Therapy Based on the Global Limb Anatomic Staging System," by Minyong Peng, MD, Chao Li, MMed, Chengli Nie, MMed, Jiangwei Chen, MMed, and Jincai Tan, MMedRead the blog entry, "GLASS Classification Correlates with Primary Patency in Chronic Limb-Threatening Ischemia Patients Treated Endovascularly"SIR thanks BD for its generous support of the Kinked Wire.Contact us with your ideas and questions, or read more about about interventional radiology in IR Quarterly magazine or SIR's Patient Center.(c) Society of Interventional Radiology.Support the show
Alcohol and cancer, GLP-1 trial representativeness, diagnosing CAD, changing stroke rates in patients with AF, blanking periods after AF ablation are the topics John Mandrola, MD, covers this week. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Surgeon General Causes Hoopla Regarding ETOH Warning Dry January: Should Doctors Make It Year-Round? https://www.medscape.com/viewarticle/dry-january-should-doctors-make-it-year-round-2025a100009t Surgeon General Warning https://www.hhs.gov/about/news/2025/01/03/us-surgeon-general-issues-new-advisory-link-alcohol-cancer-risk.html GBD 2016 Collaboration Lancet https://doi.org/10.1016/S0140-6736(18)31310-2 RCT Voskobonik and colleagues https://www.nejm.org/doi/full/10.1056/NEJMoa1817591 Marcus and colleagues; UCSF https://pubmed.ncbi.nlm.nih.gov/33516710/ Review of ETOH AF https://doi.org/10.1016/j.jacc.2016.08.074 II. GLP-1 Agonists for Obesity –Trial vs Real World Generalizability of Trial Results https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2826335 HRS Document ICD http://dx.doi.org/10.1016/j.hrthm.2014.03.041 III. Stress Testing and CAD Severity Reynolds and colleagues. Observational ISCHEMIA Sub-analysis https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.123.013743 Foy Meta-analysis https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2655243 ISCHEMIA https://www.nejm.org/doi/full/10.1056/NEJMoa1915922 IV. Changing Stroke Rates with AF Teppo and colleagues. Finnish Study https://doi.org/10.1016/j.jacep.2024.10.029 Quinn and colleagues. https://www.ahajournals.org/doi/10.1161/circulationaha.116.024057 V. Patients' Lives Don't Pause for Blanking Periods Ruzieh and colleagues. https://doi.org/10.1016/j.ahjo.2024.100497 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net
Contributor: Travis Barlock MD Educational Pearls: What is the ST segment? The ST segment on an ECG represents the interval between the end of ventricular depolarization (QRS) and the beginning of ventricular repolarization (T-wave). It should appear isoelectric (flat) in a normal ECG. What if the ST segment is elevated? This is evidence that there is an injury that goes all the way through the muscular wall of the heart (transmural) This is very concerning for a heart attack (STEMI) but can be occasionally caused by other pathology, such as pericarditis What if the ST segment is depressed? This is evidence that only the innermost part of the muscular wall of the heart is becoming ischemic This has a much broader differential and includes a partial occlusion of a coronary artery but also any other stress on the body that could cause a supply-and-demand mismatch between the oxygen the coronaries can deliver and the oxygen the heart needs This is called subendocardial ischemia What else should you look for in the ECG to identify subendocardial ischemia? The ST-depressions should be at least 1 mm The ST depressions should be present in leads I, II, V4-6 and a variable number of additional leads. There is often reciprocal ST elevation in aVR > 1 mm The most important thing to remember when you see subendocardial ischemia is…history Still, keep all cardiac causes on your differential, such as unstable angina, stable angina, Prinzmetal angina, etc. Also consider a wide array of non-cardiac causes such as severe anemia, severe hypertension, pulmonary embolism, COPD, severe pneumonia, sepsis, shock, thyrotoxicosis, stimulant use, DKA, or any other state that lead to reduced oxygen supply to the subendocardium and/or increased myocardial oxygen demand. References Birnbaum, Y., Wilson, J. M., Fiol, M., de Luna, A. B., Eskola, M., & Nikus, K. (2014). ECG diagnosis and classification of acute coronary syndromes. Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 19(1), 4–14. https://doi.org/10.1111/anec.12130 Buttà, C., Zappia, L., Laterra, G., & Roberto, M. (2020). Diagnostic and prognostic role of electrocardiogram in acute myocarditis: A comprehensive review. Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 25(3), e12726. https://doi.org/10.1111/anec.12726 Cadogan, E. B. a. M. (2024, October 8). Myocardial Ischaemia. Life in the Fast Lane • LITFL. Retrieved December 7, 2024, from https://litfl.com/myocardial-ischaemia-ecg-library/#:~:text=ST%20depression%20due%20to%20subendocardial,left%20main%20coronary%20artery%20occlusion. Summarized by Jeffrey Olson, MS3 | Edited by Meg Joyce & Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/
Broadcast from KSQD, Santa Cruz on 11-07-2024: Dr. Dawn opens with a guided deep breathing exercise to help listeners manage stress and maintain emotional balance in challenging times. She helps an emailer understand a stress test result for a 72-year-old patient, explaining ST changes, ischemia, and the importance of follow-up angiography tests for heart health evaluation. The show addresses another email from a listener asking for advice about managing alcohol use in an 85-year-old dementia patient. Dr. Dawn discusses medical detox options and medications like Naltrexone for treatment. Dr. Dawn explores the use of low-dose Naltrexone for chronic pain management, particularly in diabetic neuropathy and fibromyalgia. She discusses cataract formation risks associated with St. John's Wort and also mentions the adverse interaction between prostate medications and cataract surgery which increases the risk of complications. Make sure your ophthalmologist knows you are on prostate medications The show features an in-depth explanation of A1 versus A2 milk proteins, their digestive impacts, and potential inflammatory effects in the body. Dr. Dawn concludes with groundbreaking research on creating viable oocytes from stem cells in mice, discussing implications for future fertility treatments.
Broadcast from KSQD, Santa Cruz on 11-07-2024: Dr. Dawn opens with a guided deep breathing exercise to help listeners manage stress and maintain emotional balance in challenging times. She helps an emailer understand a stress test result for a 72-year-old patient, explaining ST changes, ischemia, and the importance of follow-up angiography tests for heart health evaluation. The show addresses another email from a listener asking for advice about managing alcohol use in an 85-year-old dementia patient. Dr. Dawn discusses medical detox options and medications like Naltrexone for treatment. Dr. Dawn explores the use of low-dose Naltrexone for chronic pain management, particularly in diabetic neuropathy and fibromyalgia. She discusses cataract formation risks associated with St. John's Wort and also mentions the adverse interaction between prostate medications and cataract surgery which increases the risk of complications. Make sure your ophthalmologist knows you are on prostate medications The show features an in-depth explanation of A1 versus A2 milk proteins, their digestive impacts, and potential inflammatory effects in the body. Dr. Dawn concludes with groundbreaking research on creating viable oocytes from stem cells in mice, discussing implications for future fertility treatments.
Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General. Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios. El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito. La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen. Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web (behindtheknife.org). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a hello@behindtheknife.org y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material. Si los comentarios son positivos, traduciremos todo nuestro curso al español. presentadores de podcast: - Auri P. Garcia Gonzalez, MD PhD nació en San Juan, Puerto Rico, y se trasladó a los Estados Unidos en el 2012 para sus estudios graduados. Actualmente, es estudiante de post-grado en cirugía general en Duke University. - Diego Schaps, MD, MPH es un residente de cirugía general en Duke y nació en Miami, en el estado de la Florida. Sus padres nacieron en El Salvador. Disclaimer: Los productos de contenido de Behind the Knife son únicamente para fines educativos. No diagnosticamos, tratamos ni ofrecemos consejos específicos para pacientes. ------ Behind the Knife is the world's leading surgical podcast and surgical education platform. Our mission is to create innovative surgical education content that is accessible to all. We are very excited to expand into the spanish audience and bring you 4 sample episodes of our General Surgery Oral Board Review Course which will be released over the course of the next week. Today, you'll hear a sample scenario from this comprehensive audio review course which includes 100 scenarios. The course has an exciting and entirely unique format. Each of the 100 scenarios includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are five to seven minutes long and include a variety of tactics and styles. If you're able to achieve this level of performance in your preparation, you are sure to pass the oral exam with flying colors. The second part introduces high yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy to understand teaching that covers the most confusing topics that we face as general surgeons. We are confident you will find this unique dual format approach a highly effective way to prepare for the test. Our content is available on our iOS and Android apps and website (behindtheknife.org). Please check the show notes for more information. We would love to hear your feedback by emailing hello@behindtheknife.org and appreciate your help spreading the word to your colleagues if you enjoy the material. If feedback is positive, we will translate our entire course to Spanish. Hosts: - Auri P. Garcia Gonzalez, MD PhD was born and raised in San Juan, Puerto Rico and moved to the US in 2012 for graduate studies. At present, she is a surgical resident at Duke University. - Diego Schaps, MD, MPH is a general surgery resident at Duke and was born in Miami, Florida. His parents were born in El Salvador. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
On this month's EM Quick Hits podcast: Ian Chernoff on the often elusive diagnosis of traumatic coronary artery dissection, Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia, Brit Long and Hans Rosenberg on mesenteric ischemia pearls and pitfalls in diagnosis and management, Dave Jerome on recognition and management exercise-associated hyponatremia and heat illness and Jesse McLaren on the Queen of Hearts AI model in helping identify occlusion MI on ECG... Help Support EM Cases by Giving a Donation here: https://emergencymedicinecases.com/donation/
When Michelle discovered her patient was paralyzed, it surprised the whole medical team. This patient who was previously mobile and recovering from septic shock was now paralyzed and ultimately diagnosed with spinal cord ischemia, but could early intervention have changed the outcome?In this episode, we discuss the causes, signs, diagnosis and treatment of spinal cord ischemia. Michelle shares powerful insights from her work in neurocritical care, including a technique for detecting easy-to-miss neurological changes.Tune in to find out how you can improve patient outcomes when managing spinal cord ischemia!Topics discussed in this episode:Michelle's passion for patient care and nurse advocacyCritical case study: discovering a spinal cord abscessHow the patient developed spinal cord ischemiaPathophysiology and signs of spinal cord ischemiaNeurological assessment tipsPeripheral versus central nervous system assessmentsDiagnostic criteria and the diagnostic processPrognosis and patient recoveryTreatment options and challengesThe role of the ABCDEF bundle in critical careConnect with Michelle:https://www.michellededeo.com/https://www.instagram.com/michellededeo/Listen to Michelle's podcasts, the SCRN Prep Podcast and Narrative Nurse Project Podcast!Get 20% off Michelle's Stroke Review Bootcamp with code RAPIDRN20!https://www.nicolekupchikconsulting.com/booksAndCourses/online-courses/61/stroke-review-bootcamp-case-studies-in-optimizing-careMentioned in this episode:Rapid Response and Rescue Intro CourseCONNECT
This week we delve into the world of heart failure and transplantation when we review a recent PHTS study assessing the impact of ischemic time on outcomes of pediatric heart transplantation. What is considered to be a long ischemic time and what is the impact on outcomes in the pediatric patient undergoing transplant? Why does it appear as the impact of a longer ischemic time is less associated with graft failure in the present era in comparison to the past? What might be the impact of newer heart perfusion devices used to transport organs for transplant? These are amongst the questions reviewed with Professor of Pediatrics at U. Colorado, Dr. Scott R. Auerbach. DOI: 10.1016/j.healun.2024.03.002
In this episode of the Dr Tyna Show, I explore the latest study linking vision loss to Ozempic. With my inbox flooded with inquiries, I'm joined by Naturopathic cardiology specialist, Dr. Lauren Lattanza. Together we meticulously examine the study's findings, exploring the intricate connections between Ozempic, metabolic health, and vascular integrity. From insights into microvasculature to implications for diabetic patients, join us as we unravel the complexities and implications of this research and unpack this using basic physiology. Ozempic Uncovered FREE 4 Part Video Series On This Episode We Cover: 01:43 - Study overview 04:12 - The retina and cardiovascular system & compromised metabolic health 07:07 - The endothelial lining 08:39 - Understanding microvasculature 09:38 - Diabetes and your vascular system 12:50 - Relative hypoglycemia 15:43 - Vascular spasms 17:27 - Breaking down the study 19:45 - Ischemia 20:59 - Increased platelet activation 22:36 - The importance of dosing 23:40 - Risks associated with obesity 25:55 - Fasting insulin range 26:30 - Obesity and adipose tissue 28:25 - Effects of burning fat & the Herxheimer reaction 30:36 - The SELECT trial 35:34 - Limitations on the study 36:38 - Ozempic done right 41:55 - Connecting with Dr. Lattanza Sponsored By: Timeline Nutrition Go to timelinenutrition.com/DRTYNA and use code DRTYNA for 10% off NutriSense Get $30 OFF with code DRTYNA at nutrisense.io/drtyna LMNT Get your free Sample Pack with any LMNT purchase at drinkLMNT.com/drtyna BIOptimizers Go to bioptimizers.com/drtyna and use code DRTYNA to save 10% and get a free gift with purchase Show Links Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide Ozempic Done Right University Further Listening EP. 46: Integrative Cardiology in a Time of COVID with Dr. Lattanza Check Our Dr. Lattanza: Instagram Website Disclaimer: Information provided in this podcast is for informational purposes only. This information is NOT intended as a substitute for the advice provided by your physician or other healthcare professional, or any information contained on or in any product. Do not use the information provided in this podcast for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or other supplement, or using any treatment for a health problem. Information provided in this blog/podcast and the use of any products or services related to this podcast by you does not create a doctor-patient relationship between you and Dr. Tyna Moore. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent ANY disease.
In this episode, we are going to dive into the medical condition known as Chronic Mesenteric Ischemia. This is a significant health issue characterized by a reduction in the blood flow to the intestines. As a result of this diminished blood supply, individuals suffering from this condition often experience a range of symptoms, most notably abdominal pain and a loss of weight. Throughout the course of our discussion, we'll be tackling the various causes of this complex condition, exploring the different methods of diagnosis, and examining the available treatment options. We will also be placing a heavy emphasis on early intervention in order to maximize the chances of a successful treatment and recovery. Join Dr. Niket Sonpal, who will guide us through this complex medical condition. June 17, 2024 — Do you work in primary care medicine? Primary Care Medicine Essentials is our brand new program specifically designed for primary care providers to increase their core medical knowledge & improve patient flow optimization. Learn more here: Primary Care Essentials —
In this episode, we will explore the complex and often misunderstood condition known as Acute Mesenteric Ischemia. This condition, which involves an interruption of the blood flow to the intestines, can lead to severe abdominal pain and require emergency treatment. We'll discuss the various causes, signs and symptoms, and treatment options for Acute Mesenteric Ischemia. We'll also delve into the importance of early detection and intervention in preventing serious complications. Join Dr. Niket Sonpal as he navigates us through this challenging medical condition. June 10, 2024 — Do you work in primary care medicine? Primary Care Medicine Essentials is our brand new program specifically designed for primary care providers to increase their core medical knowledge & improve patient flow optimization. Learn more here: Primary Care Essentials —