Podcasts about jul sep

Send us a textE45 Long Neglect Has Worn Away by Emily Bronte Description: An immersive reading of Long Neglect Has Worn Away by Emily Bronte with reflection on transience and permeance, tuberculosis and facial maladies. Website:https://anauscultation.wordpress.comWork:[Long Neglect Has Worn Away] by Emily BronteLong neglect has worn awayHalf the sweet enchanting smile;Time has turned the bloom to gray;Mold and damp the face defile.But that lock of silky hair,Still beneath the picture twined,Tells what once those features were,Paints their image on the mind.Fair the hand that traced that line,“Dearest, ever deem me true”;Swiftly flew the fingers fineWhen the pen that motto drew.References:Emily Bronte: https://www.poetryfoundation.org/poets/emily-bronte Bansal R, Jain A, Mittal S. Orofacial tuberculosis: Clinical manifestations, diagnosis and management. J Family Med Prim Care. 2015 Jul-Sep;4(3):335-41.Quaranta N, Petrone P, Michailidou A, Miragliotta L, Santantonio M, Del Prete R, Mosca A, Miragliotta G. Tuberculous otitis media with facial paralysis: a clinical and microbiological diagnosis-a case report. Case Rep Infect Dis. 2011;2011:932608.

Palau in July: Stroll Around Kayangel : https://youtu.be/X2_dsX_ebVg?si=QNnkc-pJy8wUyGMM Speed Boat (state boat) ride to Kayangel: https://youtu.be/2WKGioP5mXc?si=1lrKVPUuijaXXMY9 BRO! Ride (in the truck) around Kayangel island with the next generation. Learning what matters most. So much Joy! : https://youtu.be/sspeoSVAxEs?si=8cl_N5paaDzSYnGJ Morning Stroll in Malakal + Visiting King's Market & Surangels Mall: https://youtu.be/f7Ddwl27vAk?si=LRHHeGkWEb-7EzO6 Sunday Morning Kayangel Evangelical Church : https://youtu.be/-xucC-6xOJc?si=yVzNR_NHn7IvIM6G Snorkeling in Kayangel, Palau :https://youtu.be/_iBkx9PZVqg?si=_ItgH1YGeiWNv7a3 Tandem Kayaking in Palau : https://youtu.be/3cGw-aRoKrU?si=gH1-yYW6rc6dluK1 Year three of Invited Back begins - August: Year Three of the Invited Back Journey Has Begun: https://youtu.be/6hGPb0trg2E?si=demK-WcK-1rd-5Hg Remembering and Moving into Q4 with Small, Specific, Intentional Choices https://youtu.be/qSW61Deys3k?si=zvcPduPYGUhfYBhC Heartbreaking and Groundbreaking Seasons of Sisterhood: Suicide and Getting Surrounded: https://youtu.be/lUAo8VOxrzY?si=VKt2yhCD839baBDk San Antonio, Texas Women's Assembly - September: Day 0 : https://www.instagram.com/reel/C_zY2gqO8xE/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA== Day 1: https://www.instagram.com/reel/C_18FfjOyLq/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA== Day 2: The photos skim the surface of the deep well from which @womensassembly 002 has given me to draw from. Day two, with this crew is done and I am extremely thankful for another day that I GET TO do this! Through the days, month, years, and generations ahead we will tell the stories, we will remain disciplined, we will have the courage in the face of hard things, and we will adventure into a world that is desperate for us to OWN IT ALL. Reflections: https://www.instagram.com/p/C_4pgErO8GF/?utm_source=ig_web_copy_link WA 003 October 1-3, 2025 Phoenix, AZ. https://echelonfront.com/events/#assembly

The Big Beatles Sort Out Presents: The Big 60s Sort Out! Yes, for season 4 we are taking a look at the decade that made (or was made?) by The Beatles, by ranking every UK number one, looking for sneaky Beatles links, and generally putting ourselves in the world where they crafted their legacy. Please joins us as we try and sort out, the 60s! Songs this episode: Chris Farlowe - Out Of Time The Troggs - With A Girl Like You The Beatles - Yellow Submarine The Beatles - Eleanor Rigby The Small Faces - All Or Nothing If you want to view the chart up to the latest episode, you can do so⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ here! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Paul has a new music biopic Instagram feed you can check out here: ⁠⁠⁠⁠https://www.instagram.com/Music_Biopic/⁠⁠⁠⁠ Below are links to our respective music projects! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Smiles On Lonely Souls | Garry Abbott (bandcamp.com)⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://goodgriefliverpool.bandcamp.com/⁠⁠⁠⁠⁠

Singapore shares began the day trading nearly flat despite weekend gains in markets abroad.   In early trade, the Straits Times Index (STI) dipped 0.04 per cent to 3,638.6 points after 40.1 million securities changed hands in the broader market.  In terms of companies to watch, we have City Developments Ltd, after the developer said late yesterday that its residential project Norwood Grand sold 292 or 84 per cent of its 348 units over its launch weekend at an average selling price of S$2,067 per square foot.  Elsewhere, from Bitcoin pushing higher today amid a spurt of inflows into exchange-traded funds (ETFs) for the largest digital asset as well as optimism about the outlook for US regulations to earnings to watch out for in the US and Singapore this week, more international and corporate headlines remain in focus. On Market View, The Evening Runway's finance presenter Chua Tian Tian unpacked the developments with David Kuo, Co-founder, The Smart Investor.See omnystudio.com/listener for privacy information.

Dr. Rosenblum reviews the benefits of Scrambler Therapy for CRPS and Neuropathic Pain State.  What is Scrambler Therapy? Efficacy of Scrambler Therapy for Neuropathic Pain  Mechanism of action of Scrambler Therapy Regenerative Pain Management Course PainExam Board Prep NRAP Academy Private Tutorials for Ultrasound Guidance and Regenerative Medicine ST was introduced as a chronic pain relief method in 2003. That same year, Giuseppe Marineo published findings from a small clinical trial involving 11 terminal cancer patients suffering from drug-resistant chronic visceral pain, with all participants showing positive responses and significant reductions in pain scores. In a subsequent trial involving 226 patients with neuropathic pain, 80% reported a 50% reduction in pain. Since then, numerous case reports and studies have documented the use of ST for various pain types. Evidence from these reports suggests that ST is effective for managing both acute and chronic pain from different causes. For instance, a child with acute mixed pain, resistant to pharmacological treatment, experienced significant relief after four ST sessions, with pain levels dropping from 5/10 to 0/10. Additionally, a 52-year-old woman with burning pain from her foot to knee, stemming from a right medullary acute hemorrhage and suffering for 12 years, reported immediate relief after ST. Her pain score decreased from 9/10 to 3/10 on the first day, and to 0/10 by the second day, remaining below 1 on the Visual Analog Scale (VAS) throughout the 10-day treatment period. In terms of chronic pain, literature includes a case where a patient with shoulder joint pain and limited range of motion saw significant pain reduction and increased mobility after 10 sessions of ST. ST has shown considerable promise in treating severe pain conditions that are typically difficult to manage, such as complex regional pain syndrome and pain related to HIV. Despite the encouraging results from these case studies, higher-quality evidence is necessary to establish the efficacy of ST, which could be obtained through extensive clinical trials, particularly focusing on chronic pain. Besides the aforementioned studies by Marineo and Sabato et al, additional trials have indicated that ST is an effective treatment for various chronic pain conditions, including low back pain, postherpetic pain, and neuropathic pain. For instance, a prospective study on chronic low back pain patients showed a significant decrease in VAS scores from 8.12 to 3.63 after six treatment days. Another trial involving 10 patients with postherpetic pain reported a drop in the average Numeric Rating Scale (NRS-11) score from 7.64 to 1.46 at baseline and 0.42 to 0.89 after one month, with benefits persisting at two and three months. ST has also demonstrated significant potential in treating neuropathic pain. In a prospective study of 45 patients with neuropathic pain lasting over three months, 28 experienced a decrease in Douleur Neuropathique en 4 questions (DN4) pain scores, with four patients stopping treatment early due to complete pain resolution. The mean baseline DN4 score dropped from 5.67 to 2.82 by the end of treatment. A pilot randomized trial involving 52 patients found that 21 out of 26 in the intervention group achieved complete pain relief. While the findings from these studies, along with others that have been systematically analyzed, suggest strong evidence for the efficacy of ST, a definitive conclusion regarding its effectiveness has not yet been reached. A systematic review by Majithia et al concluded that while studies generally indicate ST results in pain reduction with lasting benefits, there are still gaps in the evidence. This article aims to evaluate the research needs surrounding ST for cancer pain management. While Majithia et al focused on chronic pain across various conditions and noted specific evidence limitations, this study will concentrate on the effectiveness of ST for cancer-related pain. The objective is to identify gaps in the existing literature and provide recommendations for future research through a systematic review. We will specifically analyze the types and levels of evidence supporting the use of ST in managing cancer pain and determine what studies are necessary to enhance the evidence base. References  Majithia, N., Smith, T.J., Coyne, P.J. et al. Scrambler Therapy for the management of chronic pain. Support Care Cancer 24, 2807–2814 (2016). https://doi.org/10.1007/s00520-016-3177-3 Mohamed, Mohamed S. I.1; Alkahlout, Lama1; Elgamal, Salma1; Mohiuddin, Amna1; Al-sayed, Talal1; Al-Marri, Hamad1; Zahid, Fatima1; Martínez-Magallanes, Daniela2; Fregni, Felipe2; Doi, Suhail A. R.1; Abdallah, Abdallah M.3; Musa, Omran A.H.1,4; Khan, Muhammad Naseem1; Babu, Giridhara R.1,*. Efficacy of scrambler therapy in chronic neuropathic pain: pairwise and dose-response meta-analysis. Brain Network and Modulation 3(3):p 63-70, Jul–Sep 2024. | DOI: 10.4103/BNM.BNM_20_24 Kashyap, Komal, and Sushma Bhatnagar. "Evidence for the efficacy of scrambler therapy for cancer pain: a systematic review." Pain Physician 23.4 (2020): 349.

Dr. Rosenblum reviews the benefits of Scrambler Therapy for CRPS and Neuropathic Pain State.  What is Scrambler Therapy? Efficacy of Scrambler Therapy for Neuropathic Pain  Mechanism of action of Scrambler Therapy Regenerative Pain Management Course PainExam Board Prep NRAP Academy Private Tutorials for Ultrasound Guidance and Regenerative Medicine ST was introduced as a chronic pain relief method in 2003. That same year, Giuseppe Marineo published findings from a small clinical trial involving 11 terminal cancer patients suffering from drug-resistant chronic visceral pain, with all participants showing positive responses and significant reductions in pain scores. In a subsequent trial involving 226 patients with neuropathic pain, 80% reported a 50% reduction in pain. Since then, numerous case reports and studies have documented the use of ST for various pain types. Evidence from these reports suggests that ST is effective for managing both acute and chronic pain from different causes. For instance, a child with acute mixed pain, resistant to pharmacological treatment, experienced significant relief after four ST sessions, with pain levels dropping from 5/10 to 0/10. Additionally, a 52-year-old woman with burning pain from her foot to knee, stemming from a right medullary acute hemorrhage and suffering for 12 years, reported immediate relief after ST. Her pain score decreased from 9/10 to 3/10 on the first day, and to 0/10 by the second day, remaining below 1 on the Visual Analog Scale (VAS) throughout the 10-day treatment period. In terms of chronic pain, literature includes a case where a patient with shoulder joint pain and limited range of motion saw significant pain reduction and increased mobility after 10 sessions of ST. ST has shown considerable promise in treating severe pain conditions that are typically difficult to manage, such as complex regional pain syndrome and pain related to HIV. Despite the encouraging results from these case studies, higher-quality evidence is necessary to establish the efficacy of ST, which could be obtained through extensive clinical trials, particularly focusing on chronic pain. Besides the aforementioned studies by Marineo and Sabato et al, additional trials have indicated that ST is an effective treatment for various chronic pain conditions, including low back pain, postherpetic pain, and neuropathic pain. For instance, a prospective study on chronic low back pain patients showed a significant decrease in VAS scores from 8.12 to 3.63 after six treatment days. Another trial involving 10 patients with postherpetic pain reported a drop in the average Numeric Rating Scale (NRS-11) score from 7.64 to 1.46 at baseline and 0.42 to 0.89 after one month, with benefits persisting at two and three months. ST has also demonstrated significant potential in treating neuropathic pain. In a prospective study of 45 patients with neuropathic pain lasting over three months, 28 experienced a decrease in Douleur Neuropathique en 4 questions (DN4) pain scores, with four patients stopping treatment early due to complete pain resolution. The mean baseline DN4 score dropped from 5.67 to 2.82 by the end of treatment. A pilot randomized trial involving 52 patients found that 21 out of 26 in the intervention group achieved complete pain relief. While the findings from these studies, along with others that have been systematically analyzed, suggest strong evidence for the efficacy of ST, a definitive conclusion regarding its effectiveness has not yet been reached. A systematic review by Majithia et al concluded that while studies generally indicate ST results in pain reduction with lasting benefits, there are still gaps in the evidence. This article aims to evaluate the research needs surrounding ST for cancer pain management. While Majithia et al focused on chronic pain across various conditions and noted specific evidence limitations, this study will concentrate on the effectiveness of ST for cancer-related pain. The objective is to identify gaps in the existing literature and provide recommendations for future research through a systematic review. We will specifically analyze the types and levels of evidence supporting the use of ST in managing cancer pain and determine what studies are necessary to enhance the evidence base. References  Majithia, N., Smith, T.J., Coyne, P.J. et al. Scrambler Therapy for the management of chronic pain. Support Care Cancer 24, 2807–2814 (2016). https://doi.org/10.1007/s00520-016-3177-3 Mohamed, Mohamed S. I.1; Alkahlout, Lama1; Elgamal, Salma1; Mohiuddin, Amna1; Al-sayed, Talal1; Al-Marri, Hamad1; Zahid, Fatima1; Martínez-Magallanes, Daniela2; Fregni, Felipe2; Doi, Suhail A. R.1; Abdallah, Abdallah M.3; Musa, Omran A.H.1,4; Khan, Muhammad Naseem1; Babu, Giridhara R.1,*. Efficacy of scrambler therapy in chronic neuropathic pain: pairwise and dose-response meta-analysis. Brain Network and Modulation 3(3):p 63-70, Jul–Sep 2024. | DOI: 10.4103/BNM.BNM_20_24 Kashyap, Komal, and Sushma Bhatnagar. "Evidence for the efficacy of scrambler therapy for cancer pain: a systematic review." Pain Physician 23.4 (2020): 349.

References FEMS Microbiol Rev.1998. Oct;22(4):255-75 Discoveries(Craiova). 2017 Jul-Sep; 5(3): e77. J Cell Mol Med. 2015 Jul; 19(7): 1427–1440. Oncogene. 2017 Mar 23; 36(12): 1607–1618. Bach, JS. 1742. Kunst der Fuge , BWV 1080; Marta Czech https://youtu.be/p1Sq1HOYglU?si=2GMF7kf3dLW4rr2O Lennon and MCartney.1968. "Martha my Dear" https://youtu.be/RXawa90YU2s?si=dUPDtTdm4UqrgWit --- Send in a voice message: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/message Support this podcast: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/support

BRASH es un acrónimo relativamente nuevo que describe un síndrome de bradicardias con hipotensión severa en el contexto de fallo renal e hiperkalemia. Usted está atendiendo a un masculino de 62 años de edad con debilidad general y desorientación progresivamente peor desde hace varias horas. Mantiene su propia vía aérea y respira espontáneamente, pero no tiene pulsos periféricos palpables. Los signos vitales son 28, 20, 86%, 82/38. Usted coloca al paciente en el monitor cardiaco y observa un bloqueo AV de 3er grado sin ondas P y con un complejo de escape ventricular. De inmediato le coloca oxígeno al paciente mediante mascarilla de no-reinhalación, obtiene dos accesos vasculares, administra 1 mg de atropina y se prepara para realizar intervenciones de segunda línea para aumentar la frecuencia cardiaca, entre ellas, la administración de una infusión de adrenalina y la colocación de un marcapasos externo. Los algoritmos están hechos para evitar desastres. No necesariamente representan el mejor cuidado posible. En este caso, el algoritmo de bradicardia nos dice qué acciones debemos hacer de inicio para mantener al paciente vivo. Sin embargo, no está funcionando. ¿Por qué? Debido a la hiperkalemia. Los medicamentos que causan bloqueo de la conducción a través del nodo atrioventricular (AV) pueden provocar episodios de hipotensión severa y refractaria en el contexto de fallo renal agudo. Bloqueo AV + fallo renal agudo El fallo renal puede ocurrir por cualquier causa no relacionada. El fallo renal pre-renal puede ocurrir, por ejemplo, por deshidratación severa o cualquier otra causa de pobre perfusión sistémica. El fallo renal produce hiperkalemia. La hiperkalemia y el bloqueo del nodo AV por los bloqueadores beta y/o por los bloqueadores de canales de calcio produce la hipotensión. BRASH: un acrónimo a recordar cuando se trata bradicardias sintomáticas Bradicardia Fallo Renal Bloqueo AV Shock Hiperkalemia Cada una de estas condiciones presenta un problema por sí mismo. Cuando se combinan, tienen un efecto sinergístico. Es decir, tiene un efecto más potente que la suma de sus partes individuales. BRASH no es un diagnóstico por separado, sino una descripción de los signos y síntomas asociados al ciclo vicioso de bradicardia, shock, fallo renal e hiperkalemia. Ciclo vicioso de bradicadia, shock, fallo renal e hiperkalemia La bradicardia puede venir por los medicamentos y/o por la hiperkalemia. En el paciente que ya toma estos medicamentos de forma continua, es posible que un deterioro súbito en la función renal de paso a la hiperkalemia. La causa del deterioro súbito de la función renal puede ser por cualquier causa pre-renal, renal o pos-renal. Una causa común de fallo renal pre-renal es cualquier causa de shock que provoque un episodio sostenido de pobre perfusión renal. El resultado es un aumento en los niveles de potasio debido a la pobre eliminación renal. La hiperkalemia produce bloqueo AV y bradicardia, lo que puede agravar aún más la bradicardia y agravar aún más la pobre perfusión renal, lo que provoca a su vez una peor hiperkalemia. SAMPLE El historial clínico del paciente es fundamental para entender el problema. Signos y síntomas Alergias Medicamentos Padecimientos Última ingesta ("last meal") Evento que precedió la emergencia Pistas importantes del historial El historial puede dar a relucir el hecho de que el paciente esté tomando medicamentos que bloquean el nodo AV. Quizás un cambio reciente en la dosis, o la introducción de otro medicamento que tenga un efecto en los niveles de potasio puede ser el detonante reciente. El historial puede dar a relucir el hecho de que el paciente ya padezca de una condición renal previa. El historial puede dar a relucir algún evento reciente que haya provocado el deterioro agudo en la función renal. Trate la bradicardia, la hiperkalemia y la causa de la pobre perfusión El manejo de la bradicardia puede no ser suficiente para lograr estabilizar hemodinámicamente al paciente con BRASH. Es importante reconocer rápidamente y tratar de inmediato de la hiperkalemia. Aunque las ondas T picudas e hiperagudas son signos clásicos de la hiperkalemia, son signos demasiado tempranos. La evolución natural de la condición va a producir bloqueo AV y prolongamiento del complejo QRS. Es decir, es la propia bradicardia y bloqueo AV el mejor signo de que el paciente puede tener una hiperkalemia. Simultáneo al manejo de la bradicardia y de la hiperkalemia, es esencial tratar la causa que está provocando la pobre perfusión renal (por ejemplo, fallo pre-renal por pobre perfusión). Si esto no se corrige, el escenario va a volver a repetirse. Pequeños estímulos con grandes efectos Como mencionado anteriormente, el efecto de esta combinación es sinergístico. Es decir, el efecto combinado es más grande que la suma de sus efectos individuales. No tiene que haber ocurrido un cambio en la dosis que el paciente está tomando del medicamento que bloquea el nodo AV, ni tiene que ser una dosis especialmente alta. Puede ser la misma dosis que ha tomado por largo tiempo sin efectos adversos. Un episodio reciente de deshidratación no tiene que llevar a fallo renal pre-renal. Sin embargo, en presencia del efecto del medicamento que bloquea el nodo AV, tiene un efecto dramático en el riñón. La hiperkalemia no tiene que ser de inicio muy alta. Es decir, no hay una correlación entre niveles específicos de potasio en sangre y los efectos observados. Peor aún, los cambios en el EKG no necesariamente van a progresar de la misma manera que siempre se habla de la hiperkalemia (primero ondas T hiperagudas). Como mencioné anteriormente, la bradicardia quizás es el único indicio. Entonces, cada uno de los estímulos no tiene que ser muy significativo: una dosis normal del medicamento que siempre ha tomado, un episodio relativamente benigno de deshidratación (por ejemplo), un nivel de potasio levemente elevado... pero la combinación produce una bradicardia severa, con fallo renal, bloqueo AV, shock e hiperkalemia... mejor conocido como BRASH. Referencias Arif AW, Khan MS, Masri A, Mba B, Talha Ayub M, Doukky R. BRASH Syndrome with Hyperkalemia: An Under-Recognized Clinical Condition. Methodist Debakey Cardiovasc J. 2020 Jul-Sep;16(3):241-244. doi: 10.14797/mdcj-16-3-241. PMID: 33133361; PMCID: PMC7587309. Farkas JD, Long B, Koyfman A, Menson K. BRASH Syndrome: Bradycardia, Renal Failure, AV Blockade, Shock, and Hyperkalemia. J Emerg Med. 2020 Aug;59(2):216-223. doi: 10.1016/j.jemermed.2020.05.001. Epub 2020 Jun 18. PMID: 32565167. Lizyness K, Dewald O. BRASH Syndrome. [Updated 2023 Mar 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK570643/ https://emcrit.org/ibcc/brash/ https://litfl.com/brash-syndrome/

In this episode of The FARM Cast, we delve into the intricate world of Carpal Tunnel Syndrome (CTS) – a condition that affects millions worldwide. Join us as we unravel the complexities of CTS, exploring its causes, symptoms, and potential treatments. Dr. Beau sheds light on the anatomy of the wrist, explaining how the carpal tunnel, a narrow passageway in the wrist, can become a source of discomfort and pain. We discuss the common risk factors associated with CTS, including repetitive hand movements, poor ergonomics, and certain medical conditions. Listeners will gain valuable insights into recognizing the early warning signs of CTS, such as tingling, numbness, and weakness in the hand and fingers. Our guest shares practical tips on ergonomics and exercises that can help prevent and alleviate symptoms, making this episode a must-listen for anyone spending extended hours on keyboards or engaging in repetitive hand activities. -- Abdalbary SA, Abdel-Wahed M, Amr S, Mahmoud M, El-Shaarawy EAA, Salaheldin S, Fares A. The Myth of Median Nerve in Forearm and Its Role in Double Crush Syndrome: A Cadaveric Study. Front Surg. 2021 Sep 21;8:648779. doi: 10.3389/fsurg.2021.648779. PMID: 34621777; PMCID: PMC8490666. Karne SS, Bhalerao NS. Carpal Tunnel Syndrome in Hypothyroidism. J Clin Diagn Res. 2016 Feb;10(2):OC36-8. doi: 10.7860/JCDR/2016/16464.7316. Epub 2016 Feb 1. PMID: 27042500; PMCID: PMC4800566. Kong G, Brutus JP, Vo TT, Hagert E. The prevalence of double- and multiple crush syndromes in patients surgically treated for peripheral nerve compression in the upper limb. Hand Surg Rehabil. 2023 Dec;42(6):475-481. doi: 10.1016/j.hansur.2023.09.002. Epub 2023 Sep 14. PMID: 37714514. Louie D, Earp B, Blazar P. Long-term outcomes of carpal tunnel release: a critical review of the literature. Hand (N Y). 2012 Sep;7(3):242-6. doi: 10.1007/s11552-012-9429-x. PMID: 23997725; PMCID: PMC3418353. Mills ES, Mertz K, Fresquez Z, Ton A, Buser Z, Alluri RK, Hah RJ. The Incidence of Double Crush Syndrome in Surgically Treated Patients. Global Spine J. 2022 Nov 1:21925682221137530. doi: 10.1177/21925682221137530. Epub ahead of print. PMID: 36321208. Möllestam K, Rosales RS, Lyrén PE, Atroshi I. Measuring symptoms severity in carpal tunnel syndrome: score agreement and responsiveness of the Atroshi-Lyrén 6-item symptoms scale and the Boston symptom severity scale. Qual Life Res. 2022 May;31(5):1553-1560. doi: 10.1007/s11136-021-03039-1. Epub 2021 Nov 20. PMID: 34800220; PMCID: PMC9023404. Mondelli M, Farioli A, Mattioli S, Aretini A, Ginanneschi F, Greco G, Curti S. Severity of Carpal Tunnel Syndrome and Diagnostic Accuracy of Hand and Body Anthropometric Measures. PLoS One. 2016 Oct 21;11(10):e0164715. doi: 10.1371/journal.pone.0164715. PMID: 27768728; PMCID: PMC5074522. Pensy RA, Burke FD, Bradley MJ, Dubin NH, Wilgis EF. A 6-year outcome of patients who cancelled carpal tunnel surgery. J Hand Surg Eur Vol. 2011 Oct;36(8):642-7. doi: 10.1177/1753193411410155. Epub 2011 Jun 2. PMID: 21636619. Rozmaryn LM, Dovelle S, Rothman ER, Gorman K, Olvey KM, Bartko JJ. Nerve and tendon gliding exercises and the conservative management of carpal tunnel syndrome. J Hand Ther. 1998 Jul-Sep;11(3):171-9. doi: 10.1016/s0894-1130(98)80035-5. PMID: 9730093. Sangram, B.S.; Mayne, A.I.W.; Jariwala, A.C. Can we accurately predict nerve conduction study outcome using a carpal tunnel syndrome questionnaire? Surgeon 2019, 17, 156–159. --- Send in a voice message: https://podcasters.spotify.com/pod/show/thefarmcast/message

Mol Cell Biol. 2012 Jan;32(1):126-38 Mutat Res. 2013 Jul-Sep;753(1):24-40 Molecular Neurobiology 2022. volume 59, pages 4223–4241 --- Send in a voice message: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/message Support this podcast: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/support

In the third quarter of 2023 (Jul-Sep), I took 5 trips to Colombia, Boston and Atlanta, and attended Investfest and INBOUND. Show Notes: at https://kickinitwithdaree.com/episode/spring-life-update-2023 o

Mamileiros e mamiletes, o que inspira o Mamilos Cultura de hoje é o livro A Tirania do Mérito, de Michael J. Sandel. As democracias liberais estão em risco. E, de acordo com o filósofo Michael J. Sandel, o princípio do mérito, um de seus pilares básicos, é o responsável por esse cenário. A tirania do mérito propõe que para existir uma ética diferente e dignificadora, o sucesso deve ser compreendido em prol da coletividade. Indica que uma alternativa de pensamento guiado pela humildade, pela compreensão do papel do acaso na vida humana e pela criação real da oportunidade poderá ser, então, a melhor bússola para a democracia, para o bem comum. O livro foi publicado no Brasil pela editora Civilização Brasileira em 2020. Pra conversar sobre as reflexões inspiradas pelo livro, Ju Wallauer recebe o advogado e professor Thiago Amparo. Dá o play e vem com a gente! _____ NOVALGINA Se você estiver sentindo aquela dor forte intensa ou febre, não precisa ficar sofrendo esperando passar. Para esses momentos, vale ter Novalgina 1 grama em casa. Ela combate a dor intensa e a febre em minutos. Novalgina é um medicamento à base de dipirona de dupla ação, é analgésico e antitérmico. Além de ser uma marca de confiança, que há mais de 100 anos ajuda a cuidar das famílias brasileiras, é também a mais recomendada pelos médicos. É uma escolha certeira: vale o que custa, vale cada comprimido Acesse novalgina.com.br pra saber mais NOVALGINA® (dipirona monoidratada). Indicação: analgésico e antitérmico. M.S.: 1.8326.0351. O USO DO MEDICAMENTO PODE TRAZER ALGUNS RISCOS. Leia atentamente a bula. SE PERSISTIREM OS SINTOMAS, O MÉDICO DEVERÁ SER CONSULTADO. Junho/2023. MAT-BR-2303214. “combate a dor intensa e a febre em minutos”: 1- Bula Novalgina - profissional de saúde. *Início de ação de 30 a 60 minutos. 2- Ajgaonkar VS, Marathe SN, Virani AR. Dipyrone versus paracetamol: a double-blind study in typhoid fever. J Int Med Res. 1988 May-Jun;16(3):225-30. 3- Tulunay FC et al. The efficacy and safety of dipyrone (Novalgin) tablets in the treatment of acute migraine attacks: a double-blind, cross-over, randomized, placebo-controlled, multi-center study. Funct Neurol. 2004 Jul-Sep;19(3):197-202. “É também a mais recomendada pelos médicos: 4- IQVIA GPS FY'22 – Valores RX – Mercado de Analgésicos OTC _____ FALE CONOSCO . Email: mamilos@b9.com.br _____ CONTRIBUA COM O MAMILOS Quem apoia o Mamilos ajuda a manter o podcast no ar e ainda participa do nosso grupo especial no Telegram. É só R$9,90 por mês! Quem assina não abre mão. https://www.catarse.me/mamilos _____ Equipe Mamilos Mamilos é uma produção do B9 A apresentação é de Cris Bartis e Ju Wallauer. Pra ouvir todos episódios, assine nosso feed ou acesse mamilos.b9.com.br Quem coordenou essa produção foi Beatriz Souza. Com a estrutura de pauta e roteiro escrito por Cris Bartis e Ju Wallauer. A edição foi de Mariana Leão e as trilhas sonoras, de Angie Lopez. A coordenação digital é feita por Agê Barros. O B9 tem direção executiva de Cris Bartis, Ju Wallauer e Carlos Merigo. O atendimento e negócios é feito por Telma Zenaro.

Mamileiros e mamiletes, o que inspira o Mamilos Cultura de hoje é o documentário Alma Imoral, disponível no Canal Curta, no YouTube. O documentário “Alma Imoral”, dirigido pelo cineasta Silvio Tendler, reflete sobre os conceitos de corpo e alma, tradição e transcendência, obediência e ruptura, através do livro “A Alma Imoral”, publicado pelo rabino Nilton Bonder. O filme questiona o que acontece quando o “corpo moral” - normalmente apontado como instrumento importante para a preservação da espécie humana - se torna estreito e passa a ser um obstáculo ao futuro da humanidade. Como se dá esse processo imoral de transcendência, de transgressão, para que fronteiras sejam ampliadas? O documentário busca estabelecer pontes entre histórias de personagens da Bíblia que romperam com as tradições em busca de uma nova ordem - como Eva, Abraão, Moisés - e transgressores do nosso tempo em vários campos, como comportamento, ciência e política. Ali podemos ver israelenses que lutam pela paz ao lado de palestinos, rabinos gays, cientistas que defendem teorias controversas, entre outras histórias que expandem as fronteiras da nossa consciência e produzem a possibilidade de evolução. Dá o play e vem com a gente! _____ NOVALGINA Se você estiver sentindo aquela dor forte intensa ou febre, não precisa ficar sofrendo esperando passar. Para esses momentos, vale ter Novalgina 1 grama em casa. Ela combate a dor intensa e a febre em minutos. Novalgina é um medicamento à base de dipirona de dupla ação, é analgésico e antitérmico. Além de ser uma marca de confiança, que há mais de 100 anos ajuda a cuidar das famílias brasileiras, é também a mais recomendada pelos médicos. É uma escolha certeira: vale o que custa, vale cada comprimido Acesse novalgina.com.br pra saber mais NOVALGINA® (dipirona monoidratada). Indicação: analgésico e antitérmico. M.S.: 1.8326.0351. O USO DO MEDICAMENTO PODE TRAZER ALGUNS RISCOS. Leia atentamente a bula. SE PERSISTIREM OS SINTOMAS, O MÉDICO DEVERÁ SER CONSULTADO. Junho/2023. MAT-BR-2303214. “combate a dor intensa e a febre em minutos”: 1- Bula Novalgina - profissional de saúde. *Início de ação de 30 a 60 minutos. 2- Ajgaonkar VS, Marathe SN, Virani AR. Dipyrone versus paracetamol: a double-blind study in typhoid fever. J Int Med Res. 1988 May-Jun;16(3):225-30. 3- Tulunay FC et al. The efficacy and safety of dipyrone (Novalgin) tablets in the treatment of acute migraine attacks: a double-blind, cross-over, randomized, placebo-controlled, multi-center study. Funct Neurol. 2004 Jul-Sep;19(3):197-202. “É também a mais recomendada pelos médicos: 4- IQVIA GPS FY'22 – Valores RX – Mercado de Analgésicos OTC _____ FALE CONOSCO . Email: mamilos@b9.com.br _____ CONTRIBUA COM O MAMILOS Quem apoia o Mamilos ajuda a manter o podcast no ar e ainda participa do nosso grupo especial no Telegram. É só R$9,90 por mês! Quem assina não abre mão. https://www.catarse.me/mamilos _____ Equipe Mamilos Mamilos é uma produção do B9 A apresentação é de Cris Bartis e Ju Wallauer. Pra ouvir todos episódios, assine nosso feed ou acesse mamilos.b9.com.br Quem coordenou essa produção foi Beatriz Souza. Com a estrutura de pauta e roteiro escrito por Cris Bartis e Ju Wallauer. A edição foi de Mariana Leão e as trilhas sonoras, de Angie Lopez. A coordenação digital é feita por Agê Barros. O B9 tem direção executiva de Cris Bartis, Ju Wallauer e Carlos Merigo. O atendimento e negócios é feito por Telma Zenaro.

Mamileiros e mamiletes, o que inspira o Mamilos Cultura de hoje é a série “Xuxa, o documentário”, disponível no Globoplay. A série documental percorre a trajetória de Xuxa, com acervo exclusivo, entrevistas inéditas e reencontros significativos. Com todos os seus episódios já disponíveis, a série sobre Xuxa Meneghel conquistou um recorde de público para a Globo e se transformou no documentário mais visto no Globoplay. Dá o play e vem com a gente! _____ NOVALGINA Se você estiver sentindo aquela dor forte intensa ou febre, não precisa ficar sofrendo esperando passar. Para esses momentos, vale ter Novalgina 1 grama em casa. Ela combate a dor intensa e a febre em minutos. Novalgina é um medicamento à base de dipirona de dupla ação, é analgésico e antitérmico. Além de ser uma marca de confiança, que há mais de 100 anos ajuda a cuidar das famílias brasileiras, é também a mais recomendada pelos médicos. É uma escolha certeira: vale o que custa, vale cada comprimido. Acesse novalgina.com.br pra saber mais NOVALGINA® (dipirona monoidratada). Indicação: analgésico e antitérmico. M.S.: 1.8326.0351. O USO DO MEDICAMENTO PODE TRAZER ALGUNS RISCOS. Leia atentamente a bula. SE PERSISTIREM OS SINTOMAS, O MÉDICO DEVERÁ SER CONSULTADO. Junho/2023. MAT-BR-2303214. “combate a dor intensa e a febre em minutos”: 1- Bula Novalgina - profissional de saúde. *Início de ação de 30 a 60 minutos. 2- Ajgaonkar VS, Marathe SN, Virani AR. Dipyrone versus paracetamol: a double-blind study in typhoid fever. J Int Med Res. 1988 May-Jun;16(3):225-30. 3- Tulunay FC et al. The efficacy and safety of dipyrone (Novalgin) tablets in the treatment of acute migraine attacks: a double-blind, cross-over, randomized, placebo-controlled, multi-center study. Funct Neurol. 2004 Jul-Sep;19(3):197-202. “É também a mais recomendada pelos médicos: 4- IQVIA GPS FY'22 – Valores RX – Mercado de Analgésicos OTC _____ FALE CONOSCO . Email: mamilos@b9.com.br _____ CONTRIBUA COM O MAMILOS Quem apoia o Mamilos ajuda a manter o podcast no ar e ainda participa do nosso grupo especial no Telegram. É só R$9,90 por mês! Quem assina não abre mão. https://www.catarse.me/mamilos _____ Equipe Mamilos Mamilos é uma produção do B9 A apresentação é de Cris Bartis e Ju Wallauer. Pra ouvir todos episódios, assine nosso feed ou acesse mamilos.b9.com.br Quem coordenou essa produção foi Beatriz Souza. Com a estrutura de pauta e roteiro escrito por Cris Bartis e Ju Wallauer. A edição foi de Mariana Leão e as trilhas sonoras, de Angie Lopez. A coordenação digital é feita por Agê Barros. O B9 tem direção executiva de Cris Bartis, Ju Wallauer e Carlos Merigo. O atendimento e negócios é feito por Telma Zenaro.

Mamileiros e mamiletes, o que inspira o Mamilos Cultura é o filme Oppenheimer, dirigido por Christopher Nolan e baseado no livro biográfico vencedor do Prêmio Pulitzer, Prometeu Americano: O Triunfo e a Tragédia de J. Robert Oppenheimer, escrito por Kai Bird e Martin J. Sherwin. Ambientado na Segunda Guerra Mundial, o longa acompanha a vida de J. Robert Oppenheimer (Cillian Murphy), físico teórico da Universidade da Califórnia e diretor do Laboratório de Los Alamos durante o Projeto Manhattan - que tinha a missão de projetar e construir as primeiras bombas atômicas. Pra conversar sobre as reflexões que o filme inspira, Ju Wallauer recebe Bianca Dias, psicanalista, escritora, ensaísta e crítica de arte. Aperta o play e vamos juntos! _____ NOVALGINA Se você estiver sentindo aquela dor forte intensa ou febre, não precisa ficar sofrendo esperando passar. Para esses momentos, vale ter Novalgina 1 grama em casa. Ela combate a dor intensa e a febre em minutos. Novalgina é um medicamento à base de dipirona de dupla ação, é analgésico e antitérmico. Além de ser uma marca de confiança, que há mais de 100 anos ajuda a cuidar das famílias brasileiras, é também a mais recomendada pelos médicos. É uma escolha certeira: vale o que custa, vale cada comprimido Acesse novalgina.com.br pra saber mais NOVALGINA® (dipirona monoidratada). Indicação: analgésico e antitérmico. M.S.: 1.8326.0351. O USO DO MEDICAMENTO PODE TRAZER ALGUNS RISCOS. Leia atentamente a bula. SE PERSISTIREM OS SINTOMAS, O MÉDICO DEVERÁ SER CONSULTADO. Junho/2023. MAT-BR-2303214. “combate a dor intensa e a febre em minutos”: 1- Bula Novalgina - profissional de saúde. *Início de ação de 30 a 60 minutos. 2- Ajgaonkar VS, Marathe SN, Virani AR. Dipyrone versus paracetamol: a double-blind study in typhoid fever. J Int Med Res. 1988 May-Jun;16(3):225-30. 3- Tulunay FC et al. The efficacy and safety of dipyrone (Novalgin) tablets in the treatment of acute migraine attacks: a double-blind, cross-over, randomized, placebo-controlled, multi-center study. Funct Neurol. 2004 Jul-Sep;19(3):197-202. “É também a mais recomendada pelos médicos: 4- IQVIA GPS FY'22 – Valores RX – Mercado de Analgésicos OTC _____ FALE CONOSCO . Email: mamilos@b9.com.br _____ CONTRIBUA COM O MAMILOS Quem apoia o Mamilos ajuda a manter o podcast no ar e ainda participa do nosso grupo especial no Telegram. É só R$9,90 por mês! Quem assina não abre mão. https://www.catarse.me/mamilos _____ Equipe Mamilos Mamilos é uma produção do B9 A apresentação é de Cris Bartis e Ju Wallauer. Pra ouvir todos episódios, assine nosso feed ou acesse mamilos.b9.com.br Quem coordenou essa produção foi Beatriz Souza. Com a estrutura de pauta e roteiro escrito por Cris Bartis e Ju Wallauer. A edição foi de Mariana Leão e as trilhas sonoras, de Angie Lopez. A coordenação digital é feita por Agê Barros. O B9 tem direção executiva de Cris Bartis, Ju Wallauer e Carlos Merigo. O atendimento e negócios é feito por Telma Zenaro.

Contributor: Aaron Lessen, MD Educational Pearls: What is thrombolysis? Thrombolysis is performed by administration of a medication that promotes the body's natural ability to break up clots. These medications include Alteplase (tPA) and Tenecteplase (TNK). The main side effect of using such an agent is bleeding which typically occurs at puncture sites but can also occur internally. However, an unusual side effect of thrombolytic agents, which occurs in about 1-5% of cases, is angioedema. What is angioedema? Angioedema is a medical condition that causes swelling beneath the surface of the skin, typically in the face, lips, and throat (orolingual angioedema). Fluid leaks from blood vessels and accumulates in the deeper layers of the skin. How are these two connected? The mechanism by which angioedema occurs after thrombolysis is not well understood, but it is likely connected to how tPA can increase levels of bradykinin and histamine. Swelling can appear suddenly but can also occur up to 24 hours after thrombolysis, and may last for a few hours or several days. In some cases, angioedema can affect the airways, leading to difficulty breathing. What can be done? If this side effect occurs the provider can stop the medication or infusion and treat the patient with anti-histamines, steroids, epinephrine, and airway monitoring. Medications such as Berinert or Icatibant, typically used in hereditary angioedema or ACE-i-induced angioedema, can also be used but have limited evidence for their efficacy. Fun fact tPA-related angioedema is about 4 times more likely in patients on ACE inhibitors. This is likely related to how ACE inhibitors also increase bradykinin and histamine in a patient's body. References Zhu A, Rajendram P, Tseng E, Coutts SB, Yu AYX. Alteplase or tenecteplase for thrombolysis in ischemic stroke: An illustrated review. Res Pract Thromb Haemost. 2022 Sep 20;6(6):e12795. doi: 10.1002/rth2.12795. PMID: 36186106; PMCID: PMC9487449. Pahs L, Droege C, Kneale H, Pancioli A. A Novel Approach to the Treatment of Orolingual Angioedema After Tissue Plasminogen Activator Administration. Ann Emerg Med. 2016 Sep;68(3):345-8. doi: 10.1016/j.annemergmed.2016.02.019. Epub 2016 May 10. PMID: 27174372. Burd M, McPheeters C, Scherrer LA. Orolingual Angioedema After Tissue Plasminogen Activator Administration in Patients Taking Angiotensin-Converting Enzyme Inhibitors. Adv Emerg Nurs J. 2019 Jul/Sep;41(3):204-214. doi: 10.1097/TME.0000000000000250. PMID: 31356244. Sczepanski M, Bozyk P. Institutional Incidence of Severe tPA-Induced Angioedema in Ischemic Cerebral Vascular Accidents. Crit Care Res Pract. 2018 Sep 27;2018:9360918. doi: 10.1155/2018/9360918. PMID: 30363665; PMCID: PMC6180929. Summarized by Jeffrey Olson, MS1 | Edited by Meg Joyce & Jorge Chalit, OMS1

STUDIES REFERENCED   PATHOLOGY OF NON SCARRING AND SCARRING ALOPECIA   Amanda Araujo Dos Reis Botega et al. Scarring versus Non-Scarring Alopecia: An Interobserver Histopathological Reproducibility Study Skin Appendage Disord. 2023 Jan;9(1):34-41. doi: 10.1159/000526966. Epub 2022 Nov 25.     HYDROXYCHLOROQUINE AND RETINOPATHY RISK   Ronald B Melles RB et al. Hydroxychloroquine Dose and Risk for Incident Retinopathy : A Cohort Study. Ann Intern Med. 2023 Jan 17.   LOW DOSE NALTREXONE IN LICHEN PLANOPILARIS   Lajevardi et al. The efficacy and safety of oral low dose naltrexone versus placebo in the patients with lichen planopilaris: a randomized controlled trial. J Dermatol Treat. Jun 2020   Hamel RK et al. Oral Low-Dose Naltrexone in the Treatment of Frontal Fibrosing Alopecia and Lichen Planopilaris: An Uncontrolled Open-Label Prospective Study. Cureus Jan 2023.   Toledo-Pastrana et al. Perifollicular Erythema as a Trichoscopy Sign of Progression in Frontal Fibrosing Alopecia. Int J Trichology. 2013 Jul-Sep; 5(3): 151–153.     ACTINIC LICHEN PLANOPILARIS Lalagianni N et al. Actinic lichen planopilaris: a new variant of lichen planopilaris triggered by ultraviolet radiation. Clin Exp Dermatol. 2023 Feb 2;48(2):158-160.     FOLLICULITIS DECALVANS MICROBIOME STUDIES   Moreno-Arrones OM et al. Folliculitis decalvans has a heterogeneous microbiological signature and impaired immunological response. Dermatology. 2023 Jan 30.   Moreno-Arrones et al. Folliculitis decalvans microbiologic signature is specific for disease clinical phenotype. J Am Acad Dermatol. 2021 Nov;85(5):1355-1357.     TNF INHIBITORS IN DISSECTING CELLULITIS Alzahrani M et al. Treatment of dissecting cellulitis of the scalp with tumor necrosis factor inhibitors: a retrospective multicenter STUDY. Clin Exp Dermatol. 2023 Jan 26;llad036.

Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Cruxes for nuclear risk reduction efforts - A proposal, published by Sarah Weiler on November 16, 2022 on The Effective Altruism Forum. This is my attempt to give an overview of debates and arguments relevant to the question of how to mitigate nuclear risks effectively. I list a number of crucial questions that I think need to be answered by anyone (individual or group) seeking to find their role as a contributor to nuclear risk mitigation efforts. I give a high-level overview of the cruxes in Figure 1: These questions are based on my moderately extensive engagement with the nuclear risk field; they are likely not exhaustive and might well be phrased in a less-than-optimal way — I thus welcome any feedback for how to improve the list found below. I hope that this list can help people (and groups) reflect on the cause of nuclear risk reduction by highlighting relevant considerations and structuring the large amount of thinking that has gone into the topic already. I do not provide definitive answers to the questions listed, but try to outline competing responses to each question and flesh out my own current position on some of them in separate posts/write-ups (linked to below). The post consists of the following sections: Setting the stage: some background on my CERI research project Outline of my work on nuclear issues prior to the summer fellowship Summary of work by others with some similarity to mine A defense of the value of my project and the output presented here Main body: list of cruxes in the nuclear risk debate Substantive cruxes: questions to determine which nuclear risks to work on and how to do so Sub-cruxes: questions to help tackle the cruxes above Meta-level cruxes: methodological and epistemological questions Links and references Setting the stage For a couple of months, I have been engaged in an effort to disentangle the nuclear risk cause area, i.e., to figure out which specific risks it encompasses and to get a sense for what can and should be done about these risks. I took several stabs at the problem, and this is my latest attempt to make progress on this disentanglement goal. My previous attempts to disentangle nuclear risk While I had some exposure to nuclear affairs during my studies of global politics at uni (i.e., at least since 2018) and have been reading about the topic throughout the last few years, I've been engaging with the topic more seriously only since the beginning of this year (2022), when I did a part-time research fellowship in which I decided to focus on nuclear risks. For that fellowship, I started by brainstorming my thoughts and uncertainties about nuclear risk as a problem area that I might want to work on (resulting in a list of questions and my preliminary thoughts on them), did a limited survey of the academic literature on different intellectual approaches to the topic of nuclear weapons, and conducted a small-scale empirical investigation into how three different non-profits in the nuclear risk field (the Nuclear Threat Initiative, the International Campaign to Abolish Nuclear Weapons, and the RAND Corporation) conceptualize and justify their work on nuclear risk (resulting in a sketch of the theory of change. of each organization, constructed based on the information they provide on their websites). During ten weeks over this summer (Jul-Sep 2022), my participation in the Cambridge Existential Risk Initiative — a full-time, paid and mentored research fellowship — has allowed me to dedicate more time to this project and to test out a few more approaches to understanding the nuclear risk field. I spent around three weeks with the goal of compiling a list of organizations working on nuclear risk issues, collecting information on their self-described theory of change, and categorizing the organizations in a broad typolog...

There has been a steady rise in autoimmune disease throughout industrialised societies over the last 30 years. Almost 4.5% of the world's population is affected by one of more than 80 different autoimmune diseases.To add to these already alarming statistics, recent studies have revealed that the incidence of autoimmune diseases worldwide is increasing at a rate of 19% per year.While we know that numerous predisposing genetic risk factors have been identified, these only account for a fraction of the overall incidence of autoimmune diseases.There are studies pointing to a strong influence of environmental and lifestyle factors, but translating this into a meaningful therapeutic model is a challenge, especially under the current, prevailing medical paradigm.Nevertheless, there are those who have pioneered this field of research and, through their personal and professional endeavours, have made it all but impossible to ignore how profound an impact diet, lifestyle and mindset can have when faced with seemingly intractable conditions.Dr Terry Wahls is a clinical professor of medicine at the University of Iowa. In 2000, she was diagnosed with relapsing remitting multiple sclerosis and from that point, began to steadily decline. Because of her academic medical training, Terry began a research journey that eventually led her to investigate these under-explored factors and from this she developed a treatment plan that would help restore her health. Today, Dr Terry Wahls is a teacher and mentor to millions of people around the world who are seeking more effective ways to treat multiple sclerosis and other progressive health problems.Her story is truly inspirational and we are so fortunate to have Terry share this on the IMH Patient Journeys podcast. References:Jamka M, et.al. The Effect of the Paleolithic Diet vs. Healthy Diets on Glucose and Insulin Homeostasis. J Clin Med. 2020;9(2):296. Challa HJ, Bandlamudi M, Uppaluri KR. Paleolithic Diet. [Updated 2022 May 2]. Abbott RD, et.al. Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto's Thyroiditis. Cureus. 2019;11(4)Gauree G. et.al. Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease, Inflammatory Bowel Diseases, Volume 23, Issue 11, 1 November 2017, Pages 2054–2060Cecilio LA, et.al. The prevalence of HLA DQ2 and DQ8 in patients with celiac disease, in family and in general population. Arq Bras Cir Dig. 2015 Jul-Sep;28(3):183-5.Mangalam, Ashutosh et.al. (2009). HLA-DQ8 (DQB1*0302)-restricted Th17 cells exacerbate experimental autoimmune encephalomyelitis in HLA-DR3-transgenic mice. Journal of immunology.Santoro L, et.al. Looking for celiac disease in Italian women with endometriosis: a case control study. Biomed Res Int. 2014;2014 Małgorzata Królik, et.al. Possible effect of the HLA-DQ2/DQ8 polymorphism on autoimmune parameters and lymphocyte subpopulation in recurrent pregnancy losses, Journal of Reproductive Immunology, Volume 149, 2022,Garcia J, et.al. Social isolation and connectedness as determinants of well-being: Global evidence mapping focused on LGBTQ youth. Glob Public Health. 2020 Apr;15(4):497-519. doi: 10.1080/17441692.2019.1682028. Epub 2019 Oct 28. Rothman, Emily F.et.al. "The Prevalence of Sexual Assault Against People Who Identify as Gay, Lesbian, or Bisexual in the United States: A Systematic Review". Trauma, Violence, & Abuse. 12 (2): 55–66. Brenton JN, et al. Phase II study of ketogenic diets in relapsing multiple sclerosis: safety, tolerability and potential clinical benefits. J Neurol Neurosurg Psychiatry. 2022;93(6):637-644.

ANDROGENETIC ALOPECIA STUDIES Sanabria et al (starts at 4:40). Prospective cardiovascular evaluation with 24-h Holter and 24-h ambulatory blood pressure monitoring in men using 5 mg oral minoxidil for androgenetic alopecia. J Am Acad Dermatol. 2022 May 18; Klein E et al (starts at 13:40). Comparing combination low-dose oral minoxidil and topical minoxidil with oral minoxidil alone for the treatment of non-scarring alopecia; a retrospective chart review. J Cosmet Dermatol. 2022 Jun 1. Cao L et al (starts at 21:19). Nailfold capillaroscopy alterations in androgenetic alopecia: A cross-sectional study. Indian J Dermatol Venereol Leprol. 2022 Feb 28;1-7. doi: 10.25259/IJDVL_714_2021. Emmanuel Sánchez-Meza et al (starts at 28:17). Microneedling plus topical dutasteride solution for androgenetic alopecia: a randomized placebo-controlled study. J Eur Acad Dermatol Venereol. 2022 Jun 1. doi: 10.1111/jdv.18285.  David Saceda-Corralo et al. Mesotherapy with Dutasteride in the Treatment of Androgenetic Alopecia. Int J Trichology. 2017 Jul-Sep; 9(3): 143–145. Liamsombut S et al (starts at 34:45). Sleep quality in men with androgenetic alopecia. Sleep and Breathing. 2022 Apr 25.     ALOPECIA AREATA STUDIES Anna Waśkiel-Burnat et al (starts at 41:33). Patients with alopecia areata are at risk of endothelial dysfunction: results of a case-control study. Clin Exp Dermatol. 2022 Mar 31. Conic et al. Prevalence of cardiac and metabolic diseases among patients with alopecia areata.J Eur Acad Dermatol Venereol . 2021 Feb;35(2):e128-e129. Youssef S et al (starts at 48:28). Tofacitinib Therapy for Alopecia Areata is not Associated with Adverse Events during COVID-19 Infection. J Am Acad Dermatol. 2022 May 9;S0190-9622(22)00795-2. McKenzie P et al (starts at 53:32). Evaluation of the Prevalence and Incidence of Pediatric Alopecia Areata Using Electronic Health Record Data. JAMA Dermatol. 2022 May 1;158(5):547-551.

For paramedics, click here for CE credits.  Brought to you by Urgent Admin which is an intuitive one-touch solution that connects in-field clinicians and medical directors in real-time, this episode covers the complex nature of traumatic arrests. ,  Do we treat it the same as a medical arrest?  Do we have different treatment and decision priorities for these traumatic patients?  What makes caring for these patients in the prehospital environment so unique and how does that affect our care of these patients?  We discuss these questions and more with our special guest: Dr.  Rawan Safa @rawansafa93 Emergency Medicine Resident at Washington University Click here to check it out today! Thank you for listening! Hawnwan Philip Moy MD  Gina Pellerito EMT-P John Reagan EMT-P Noah Bernhardson MD References Millin MG, Galvagno SM, Khandker SR, Malki A, Bulger EM, Standards and Clinical Practice Committee of the National Association of EMS Physicians (NAEMSP)., Subcommittee on Emergency Services–Prehospital of the American College of Surgeons' Committee on Trauma (ACSCOT). J Trauma Acute Care Surg. 2013 Sep; 75(3):459-67. Lockey, D, Crewdson, K, Davies, G. Traumatic cardiac arrest: who are the survivors? Ann Emerg Med 2006; 48:240-244. Russell, RJ, Hodgetts, TJ, McLeod, J, Starkey, K, Mahoney, P, Harrison, K. The role of trauma scoring in developing trauma clinical governance in the Defense Medical Services. Phil Trans R Soc B 2011; 366:171-191. Morrison, JJ, Poon, H, Rasmussen, TE, Khan, MA, Midwinter, MJ, Blackbourne, LH. Resuscitative thoracotomy following wartime injury. J Trauma 2013; 74: 825- 829. Kouwenhoven, WB, Jude, JR, Knickerbocker, GG. Closed-chest cardiac massage. JAMA 1960; 173: 1065-1067. Luna, GK, Pavlin, EG, Kirkman, T, Copass, MK, Rice, CL. Hemodynamic effects of external cardiac massage in trauma shock. J Trauma 1989; 29:1430-1433. Leis C. Traumatic cardiac arrest: should advanced life support be initiated?. Journal of Acute Care Surgery. 2013;74:634-638. Keith J Roberts. The role for surgery in pre-hospital care. 2015; 18(2): 92-100. Escott ME, Gleisberg GR, Kimmel K, Karrer A, Cosper J, Monroe BJ. Simple thoracostomy. Moving beyond needle decompression in traumatic cardiac arrest. 2014 Apr; 39(4): 26-32. Martin M, Satterly S, Inaba K, Blair K. Does needle thoracostomy provide adequate and effective decompression of tension pneumothorax? Journal of Trauma and Acute Care Surgery. 2012; 73(6): 1412-1417. Stevens RL, Rochester AA, Busko J, et al. Needle Thoracostomy for Tension Pneumothorax: Failure Predicted by Chest Computed Tomography. Prehospital Emergency Care. 2009; 13(1): 14-17. Inaba K, Ives C, McClure K, et al. Radiologic evaluation of alternative sites for needle decompression of tension pneumothorax. Arch Surg. 2012 Sep; 147(9): 813-8. Ball CG, Wyrzykowski AD, Kirkpatrick AW, et al. Thoracic needle decompression for tension pneumothorax: clinical correlation with catheter length. Can J Surg. 2010 Jun; 53(3): 184-8. Brian Wernick, Heidi H Hon, Ronnie N Mubang, et al. Complications of needle thoracostomy: A comprehensive clinical review. Int J Crit Illn Inj Sci. 2015 Jul-Sep; 5(3): 160–169. Smith JE, Rickard A, Wise D. Traumatic cardiac arrest. J R Soc Med. 2015;108(1):11-16. Leis CC, Hernández CC, Blanco MJ, et al. Traumatic cardiac arrest: Should advanced life support be initiated? J Trauma Acute Care Surg. 2013;74(2):634-638. Jørgensen H, Jensen CH, Dirks J. Does prehospital ultrasound improve treatment of the trauma patient? A systematic review. Eur J Emerg Med. 2010;17(5):249-253.  

Join the EMGuideWire Crew from CMC EM Residency Program as they discuss Ludwig's Angina and the management Priorities!!! BACKGROUND Angina = “Strangling” Bilateral infection of submental, submandibular, and sublingual spaces 70-85% of cases arise from odontogenic source Periapical abscesses of mandibular molars Piercings (frenulum) URI more common cause in children Source of infection often polymicrobial Most commonly viridans; also Staphylococcus and Bacteroides species Patients usually 20-60 years-old; more common in males1 Mortality in treated Ludwig’s Angina = 8%7 ***Airway compromise = leading cause of death8 Who Is At Risk? Diabetes mellitus Chronic alcohol abuse IVDA HIV/AIDS Malnutrition Poor oral hygiene Smokers Anatomy & Pathophysiology Mylohyoid subdivides submandibular space: Sublingual space Submaxillary (submylohyoid) space Infection extends posteriorly and superiorly, elevating tongue against hypopharynx If left untreated, can extend inferiorly to retropharyngeal space and into superior mediastinum3 Clinical Signs & Symptoms Dysphagia Odynophagia Trismus Edema of upper midline neck and floor of mouth Raised tongue "Woody" or brawny texture to floor of mouth with visible swelling and erythema Late Findings Drooling Tongue protrusion Trismus Dysphonia Cyanosis Acute laryngospasm Stridor Patients may demonstrate signs of systemic toxicity → fever, tachycardia, and hypotension How Do I Make the Diagnosis? Clinically! Consider CT head/neck Can help evaluate extent of infection if clinical situation persists CBC Chemistry Lactate Blood Cultures Management Emergent ENT/OMFS consult for I&D in OR and extraction of dentition if source is dental abscess Airway Management Intubation will be VERY difficult due to trismus and posterior pharyngeal extension Ideal situation = awake fiberoptic intubation in OR ALWAYS have a surgical airway ready as your back up plan Blind insertion devices (e.g. intubating LMA) are NOT recommended Management - Antibiotics Must cover typical polymicrobial oral flora Immunocompetent 3rd-generation Cephalosporin + (Clindamycin or Metronidazole) Ampicillin/Sulbactam Penicillin G + Metronidazole Clindamycin (allergic to penicillin) Immunocompromised → *Need MRSA and GNR coverage!3 Cefepime + Metronidazole Meropenem Piperacillin-tazobactam Add Vancomycin if concern for MRSA risk factors Steroids Dexamethasone 10 mg IV Thought to chemically decompress for airway protection and increase antibiotic penetration6 Nebulized epinephrine Resuscitation and pain control Complications Intracranial infections (e.g. CST, brain abscess) IJ thrombophlebitis (Lemirre’s Syndrome) Mediastinitis Mandibular osteomyelitis Empyema Pearls Three characteristics of Ludwig’s angina can be remembered as the 3 Fs: Feared Often Fatal Rarely Fluctuant ABCs—Sit upright Early notification of ENT/OMFS and anesthesia to facilitate definitive airway management Arrange for the patient to be admitted to ICU Priorities!!! Secure the airway EARLY! Prepare and be ready for a difficult airway — expect that the patient will require a surgical airway Prevent the development of septic shock and multi-organ failure — give antibiotics early References Lin HW, O’Neil A, Cunningham MJ. Ludwig’s Angina in the Pediatric Population. Clin Pediatr (Phila) 2009;48:583-7. Baez-Pravia, Orville V. et al. “Should We Consider IgG Hypogammaglobulinemia a Risk Factor for Severe Complications of Ludwig Angina?: A Case Report and Review of the Literature.” Medicine. 2017;96(47):e8708. Pandey M, Kaur M, Sanwal M, Jain A, Sinha SK. Ludwig’s Angina in children anesthesiologist’s nightmare: Case series and review of literature. J Anaesthesiol Clin Pharmacol. 2017 Jul-Sep;33(3):406-409. Botha A, Jacobs F, Postma C. Retrospective analysis of etiology and comorbid diseases associated with Ludwig’s Angina Ann Maxillofac Surg. 2015 Jul-Dec;5(2):168-73. Parhiscar A, Har-El G. Deep neck abscess: a retrospective review of 210 cases. Ann Otol Rhinol Laryngol 110: 1051, 2001. Saifeldeen K, R Evans. Ludwig’s Angina. Emerg Med J 2004; 21: 242-243 Nanda N, Zalzal HG, Borah Gl. Negative-Pressure Wound Therapy for Ludwig’s Angina: A Case Series.Plast Reconstr Surg Glob Open2017 Nov 7;5(11):e1561. Pak S, Cha D, Meyer C, Dee C, Fershko A.Ludwig’s Angina. Cureus. 2017 Aug 21;9(8):e1588.  

In 1495, a mysterious and deadly plague struck the city of Naples. Over the next 500 years, the medical attempts to understand and treat this new disease -- syphilis -- would mold and shape medicine in surprising ways. In this episode, Tony Breu and I will perform an historical and physiological biography of syphilis, covering the development of germ theory, epic poetry, mercury saunas, intentionally infecting patients with malaria, magic bullets, and lots and lots of experiments on poor rabbits. This presentation was performed live at the American College of Physicians’ national meeting in Philadelphia on April 11, 2019.   Sources (WARNING -- LONG LIST):   Swain, K. ‘Extraordinarily arduous and fraught with danger’: syphilis, Salvarsan, and general paresis of the insane. Lancet Psychiatry 5, (2018).   Kępa, M. et al. Analysis of mercury levels in historical bone material from syphilitic subjects – pilot studies (short report). Kępa Małgorzata 69, 367-377(11) (2012).   Forrai, J. Syphilis - Recognition, Description and Diagnosis. (2011). doi:10.5772/24205   Parascandola, J. From mercury to miracle drugs: syphilis therapy over the centuries. Pharm Hist 51, 14–23 (2009).   Eisler, C. Who Is Dürer’s ‘Syphilitic Man’? Perspect Biol Med 52, 48–60 (2009).   Rothschild, B. M. History of Syphilis. Clin Infect Dis 40, 1454–1463 (2005).   Schwartz, R. S. Paul Ehrlich’s Magic Bullets. New Engl J Medicine 350, 1079–1080 (2004).   Fee, E. The wages of sin. Lancet 354, SIV61 (1999).   O’Shea, J. ‘Two Minutes with Venus, Two Years with Mercury’-Mercury as an Antisyphilitic Chemotherapeutic Agent. J Roy Soc Med 83, 392–395 (1989).   Mahoney, J., Arnold, R., Sterner, B. L., Harris, A. & Zwally, M. Penicillin Treatment of Early Syphilis: II. Jama 251, 2005–2010 (1984).   Waugh, M. Role played by Italy in the history of syphilis. Sex Transm Infect 58, 92–95 (1982).   Thorburn, A. Fritz Richard Schaudinn, 1871-1906: protozoologist of syphilis. Sex Transm Infect 47, 459–461 (1971).   CROSBY, A. W. The Early History of Syphilis: A Reappraisal. Am Anthropol 71, 218–227 (1969).   Clark, E. G. & Danbolt, N. The Oslo study of the natural history of untreated syphilis An epidemiologic investigation based on a restudy of the Boeck-Bruusgaard material a review and appraisal. J Chron Dis 2, 311–344 (1955).   MUNGER, R. S. Guaiacum, the Holy Wood from the New World. J Hist Med All Sci IV, 196–229 (1949).   Thomas, E. & r, W. Rapid Treatment of Early Syphilis with Multiple Injections of Mapharsen. J Nerv Ment Dis 99, 88 (1944).   WIEDER, L., FOERSTER, O. & FOERSTER, H. MAPHARSEN IN THE TREATMENT OF SYPHILIS: FURTHER EXPERIENCES. Arch Dermatol Syph 35, 402–413 (1937).   THON, L. SHOULD THE INTERNIST KNOW SYPHILIS? J Amer Med Assoc 97, 994–996 (1931).   Sarton, G. The Earliest Printed Literature on Syphilis, being Ten Tractates from the Years 1495-1498. Karl Sudhoff , Charles Singer , Henry E. Sigerist. Isis 8, 351–354 (1926).   COLE, H., GERICKE, A. & SOLLMANN, T. THE TREATMENT OF SYPHILIS BY MERCURY INHALATIONS: HISTORY, METHOD AND RESULTS. Arch Dermatol Syph 5, 18–33 (1922).   Mason, U. Observation: Use and Abuse of Salvarsan. J Natl Med Assoc 3, 340–3 (1911).   Fleming, A. & Colebrook, L. ON THE USE OF SALVARSAN IN THE TREATMENT OF SYPHILIS. Lancet 177, 1631–1634 (1911).   Evans, A. The Treatment of Syphilis by Salvarsan (Dioxy-diamido-arseno-benzol). Brit Med J 1, 617 (1911).   Boeck, W. History, Theory and Practice of Syphilisation. New Engl J Medicine 73, 20–25 (1865).   Veale, H. Remarks on Syphilis and Its Treatment. Edinb Medical J 10, 10–26 (1864).   LaFond RE and Lukehart SA, Biological Basis for Syphilis. Clinical Microbiology Reviews 2006.   Secher L et al, Treponema pallidum in peripheral nerve tissue of syphilitic chancres. Acta dermato-venereologica 1982.  Hollander DH, Turner TB, The role of temperature in experimental treponemal infection. American journal of syphilis, gonorrhea, and venereal diseases, 1954   Eagle H, et al. The effect of hyperpyrexia on the therapeutic efficacy of penicillin in experimental syphilis. American journal of syphilis, gonorrhea, and venereal diseases, 1947.   Kampmeier RH, Syphilis therapy: an historical perspective. Journal of the American Venereal Disease Association 1976.   Pachner AR, Spirochetal Diseases of the CNS. Neurologic clinics, 1986.   Sell S et al, Experimental syphilitic orchitis in rabbits: ultrastructural appearance of Treponema pallidum during phagocytosis and dissolution by macrophages in vivo. Laboratory investigation; a journal of technical methods and pathology, 1982.   Taylor SH, Diuretics in cardiovascular therapy. Perusing the past, practising in the present, preparing for the future. Zeitschrift für Kardiologie, 1985.   Ovchinnikov NM, [Treponema pallidum in peripheral nerves of rabbit syphiloma]. Vestnik dermatologii i venerologii, 1975.   Cheek DB, Wu F, The Effect of Calomel on Plasma Epinephrine in the Rat and the Relationship to Mechanisms in Pink Disease, Archives of Disease in Childhood, 1959   Vogl A, The discovery of the organic mercurial diuretics, American Heart Journal, 1950   Schwemlein GX et al, Penicillin and fever therapy in early syphilis, Journal of the American Medical Association, 1948.   Stringham JS, On the Diuretic Effects of Mercury in a Case of Syphilis. The Medical and physical journal, 1807   Evanson RL et al, Effect of mercurial diuretics on tubular sodium and potassium transport in the dog. The American journal of physiology, 1972   Sell S and Salman J, Demonstration of Treponema pallidum in Axons of Cutaneous Nerves in Experimental Chancres of Rabbits, Sexually Transmitted Diseases, 1992   Penn CW, Avoidance of Host Defences by Treponema pallidum in Situ and on Extraction from Infected Rabbit Testes, Microbiology 1981.   Beutler B and Munford RS, Tumor Necrosis Factor and the Jarisch–Herxheimer Reaction, The New England Journal of Medicine 1996.   Radolf JD et al, Treponema pallidum: doing a remarkable job with what it's got. Trends in Microbiology, 1999   Tight RR, Perkins RL, Treponema pallidum infection in subcutaneous polyethylene chambers in rabbits. Infection and immunity, 1976   Salazar JC et al, Treponema pallidum Elicits Innate and Adaptive Cellular Immune Responses in Skin and Blood during Secondary Syphilis: A Flow-Cytometric Analysis. The Journal of Infectious Diseases, 2007   Azevedo BF et al, Toxic Effects of Mercury on the Cardiovascular and Central Nervous Systems. Journal of Biomedicine and Biotechnology 2012,   Clarkson TW and Magos L, The Toxicology of Mercury and Its Chemical Compounds, Critical Reviews in Toxicology 2008.   Fitzgerald TJ, The Th1/Th2-like switch in syphilitic infection: is it detrimental? Infection and immunity, 1992   Batterman RC et al, THE SUBCUTANEOUS ADMINISTRATION OF MERCAPTOMERIN (THIOMERIN®): Effective Mercurial Diuretic for the Treatment of Congestive Heart Failure. Journal of the American Medical Association, 1949   Batterman RC, The status of mercurial diuretics for the treatment of congestive heart failure. American Heart Journal, 1951   Bleich HL et al, The Role of Regional Body Temperature in the Pathogenesis of Disease, The New England Journal of Medicine, 1981   Vander Veer JB et al, The Prolonged Use of an Oral Mercurial Diuretic in Ambulatory Patients with Congestive Heart Failure. Circulation 1950   Cox DL et al, The outer membrane, not a coat of host proteins, limits antigenicity of virulent Treponema pallidum. Infection and immunity, 1992.   Fildes P, The Mechanism of the Anti-bacterial Action of Mercury. Br J Exp Pathol, 1940   Clarkson TW, THE MECHANISM OF ACTION OF MERCURIAL DIURETICS IN RATS; THE METABOLISM OF 203Hg‐LABELLED CHLORMERODRIN. British Journal of Pharmacology and Chemotherapy, 1965   Engelkens HJ et al, The localisation of treponemes and characterisation of the inflammatory infiltrate in skin biopsies from patients with primary or secondary syphilis, or early infectious yaws. Genitourinary Medicine, 1993   Belum GR et al, The Jarisch–Herxheimer reaction: Revisited. Travel Medicine and Infectious Disease, 2013   Arando M et al, The Jarisch–Herxheimer reaction in syphilis: could molecular typing help to understand it better? Journal of the European Academy of Dermatology and Venereology, 2018.   Butler T, The Jarisch–Herxheimer Reaction After Antibiotic Treatment of Spirochetal Infections: A Review of Recent Cases and Our Understanding of Pathogenesis. The American Journal of Tropical Medicine and Hygiene, 2016   Carlson JA et al, The Immunopathobiology of Syphilis: The Manifestations and Course of Syphilis Are Determined by the Level of Delayed-Type Hypersensitivity. The American Journal of Dermatopathology 2011.   Aronson IK and Soltani K, The enigma of the pathogenesis of the Jarisch-Herxheimer reaction. The British Journal of Venereal Diseases, 1976   Sellato TJ et al, The Cutaneous Response in Humans to Treponema pallidum Lipoprotein Analogues Involves Cellular Elements of Both Innate and Adaptive Immunity, The Journal of Immunology 2001   Spiller HA, Rethinking mercury: the role of selenium in the pathophysiology of mercury toxicity. Clinical Toxicology 2017   Sell S et al, Reinfection of chancre-immune rabbits with Treponema pallidum. I. Light and immunofluorescence studies. The American journal of pathology 1985.    Grant SS and Hung DT, Persistent bacterial infections, antibiotic tolerance, and the oxidative stress response, Virulence 2013   Lant AF, Modern diuretics and the kidney. Journal of Clinical Pathology, 1981   Kamath SU et al, Mercury-based traditional herbo-metallic preparations: a toxicological perspective, Archives of Toxicology 2012.   Yeter et al, Mercury Promotes Catecholamines Which Potentiate Mercurial Autoimmunity and Vasodilation: Implications for Inositol 1,4,5-Triphosphate 3-Kinase C Susceptibility in Kawasaki Syndrome. Korean Circulation Journal 2013   Wöβmann W et al, Mercury intoxication presenting with hypertension and tachycardia. Archives of Disease in Childhood, 1999   Giacani L et al, Identification of the Treponema pallidum subsp. pallidum TP0092 (RpoE) Regulon and Its Implications for Pathogen Persistence in the Host and Syphilis Pathogenesis. Journal of Bacteriology 2013.   Edwards AM, From tooth to hoof: treponemes in tissue‐destructive diseases. Journal of Applied Microbiology, 2003   Wolgemuth CW, Flagellar motility of the pathogenic spirochetes. Seminars in Cell & Developmental Biology 2015.   Solomon HC and Kopp I, Fever Therapy. The New England Journal of Medicine 1937.   Rice KM et al, Environmental Mercury and Its Toxic Effects. Journal of Preventive Medicine and Public Health 2014.   Drusin LM, Electron microscopy of Treponema pallidum occurring in a human primary lesion. Journal of bacteriology 1969.   McNeely MC et al, Cutaneous secondary syphilis: Preliminary immunohistopathologic support for a role for immune complexes in lesion pathogenesis. Journal of the American Academy of Dermatology 1986.   Borenstein LA et al, Contribution of rabbit leukocyte defensins to the host response in experimental syphilis. Infection and immunity 1991.   Cabot RC et al, Case 51-1976 — Bicentennial CPC — Syphilis, Diarrhea and Death in the 1820's. The New England Journal of Medicine 1976.   Hobman JL and Crossman LC, Bacterial antimicrobial metal ion resistance. Journal of Medical Microbiology 2015   Gelpi A and Tucker JD, After Venus, mercury: syphilis treatment in the UK before Salvarsan. Sexually Transmitted Infections 2015.   MacHaffie et al, A study of the effectiveness of mercurial diuretics in treatment of cardiac decompensation. The American Journal of Cardiology 1958   Aberer W et al, Ammoniated mercury ointment: outdated but still in use. Contact Dermatitis 1990   Farhi D, Dupin N, Origins of syphilis and management in the immunocompetent patient: Facts and controversies. Clinics in Dermatology (2010) 28, 533–538   Frith J, “Syphilis – Its early history and Treatment until Penicillin and the Debate on its Origins,” Journal of Military and Veterans’ Health, 20(4), retrieved online at: http://jmvh.org/article/syphilis-its-early-history-and-treatment-until-penicillin-and-the-debate-on-its-origins/   Howes OD et al, “Julius Wagner-Jauregg, 1857-1940,” American Journal of Psychiatry, April 2009 Volume 166 Number 4, Volume 166, Issue 4, April, 2009, pp. 409-409.   Karamanou M et al, “Julius Wagner-Jauregg (1857-1940): Introducing fever therapy in the treatment of neurosyphilis.” Psychiatriki. 2013 Jul-Sep;24(3):208-12.   Simpson WM, “Artificial fever therapy of syphilis,” JAMA. 1935;105(26):2132-2140.   Tsay CJ, “Julius Wagner-Jauregg and the Legacy of Malarial Therapy for the Treatment of General Paresis of the Insane,” Yale J Biol Med. 2013;86(2): 245–254   Wagner-Jauregg J, “The history of malaria treatment of general paralysis.” Am J Psychiatry. 1946;02: 577-582   Shafer JK et al, Untreated syphilis in the male Negro: A prospective study of the effect on life expectancy. Public Health Rep. 1954 Jul; 69(7): 684–690.   Abara WE et al, Syphilis Trends among Men Who Have Sex with Men in the United States and Western Europe: A Systematic Review of Trend Studies Published between 2004 and 2015. PLoS One. 2016; 11(7): e0159309.   Nutton V, The Reception of Fracastoro's Theory of Contagion: The Seed That Fell among Thorns? Osiris, Vol. 6, Renaissance Medical Learning: Evolution of a Tradition (1990)   Tsaraklis A, Preventing syphilis in the 16th century: the distinguished Italian anatomist Gabriele Falloppio (1523-1562)  and the invention of the condom. Le Infezioni in Medicina, n. 4, 395-398, 2017.

-----Criador_do_Podcast----- Prof. Nilton Vivacqua Gomes ----------------------------------------- -----Cursos----- Curso VIP: http://bit.ly/vivacquavip Aperf. e Imersões: http://bit.ly/aperfeic Especializações: http://bit.ly/especializ Dentalbox Conceito (85) 98180-9804 ----------------------------------------- -----Apoio----- Você pode apoiar essa iniciativa, para incentivá-la a continuar indefinidamente. É só acessar www.apoia.se/ENDOdontoCast e escolher o valor com o qual deseja apoiar mensalmente. Vale até mesmo 1 real. Quanto maior o valor, maior o benefício. -----Apoiadores----- Categoria Prata: Sandro Rodrigues Pinheiro Ana Paula Santos Flavia Darius Vivacqua ----------------------------------------- -----Podcast_Apps----- Podcasts (Nativo), Overcast, Breaker (IOS), Google Podcasts (Android), Ivoox, Wecast, Spotify, PocketCasts (IOS/Android). Instale o app e na aba busca e procure pelo ENDOdonto Cast. Inscreva-se clicando no botão destinado a isso. Selecione a config. p/ baixar novos episódios automaticamente. ----------------------------------------- -----Referências_Científicas----- -Pirâmide de Evidências The "architect analogy" of evidence-based practice: Reconsidering the role of clinical expertise and clinician experience in evidence-based health care. Paez A. J Evid Based Med. 2018 Nov;11(4):219-226. Self-Perceived Knowledge, Skills, Attitudes, and Use of Evidence-Based Dentistry Among Practitioners Transitioning to Dental Educators. Ciancio MJ, Lee MM, Krumdick ND, Lencioni C, Kanjirath PP. J Dent Educ. 2017 Mar;81(3):271-277. -Irrigação e Substâncias Químicas Irrigation in endodontics. Haapasalo M, Shen Y, Wang Z, Gao Y. Br Dent J. 2014 Mar;216(6):299-303. Sodium hypochlorite and its use as an endodontic irrigant. Clarkson RM1, Moule AJ. Aust Dent J. 1998 Aug;43(4):250-6. A Review Over Benefits and Drawbacks of Combining Sodium Hypochlorite with Other Endodontic Materials. Mohammadi Z, Shalavi S, Moeintaghavi A, Jafarzadeh H. Open Dent J. 2017 Dec 26;11:661-669. Sodium Hypochlorite Accident: A Systematic Review. Guivarc'h M, Ordioni U, Ahmed HM, Cohen S, Catherine JH, Bukiet F. J Endod. 2017 Jan;43(1):16-24. Newer Root Canal Irrigants in Horizon: A Review Sushma Jaju and Prashant P. Jaju. Int J Dent. 2011. Antimicrobial efficacy of chlorhexidine as a root canal irrigant: a literature review. Mohammadi Z, Jafarzadeh H, Shalavi S. J Oral Sci. 2014 Jun;56(2):99-103. Antimicrobial substantivity of root canal irrigants and medicaments: a review. Mohammadi Z, Abbott PV. Aust Endod J. 2009 Dec;35(3):131-9. Endodontic irrigants: Different methods to improve efficacy and related problems. Dioguardi M, Di Gioia G, Illuzzi G, Laneve E, Cocco A, Troiano G. Eur J Dent. 2018 Jul-Sep;12(3):459-466. ----------------------------------------- -----Site_e_Contatos----- EndodontiaAvancada.com EndodontiaAvancada.com@gmail.com -----Redes_Sociais----- Instagram/Facebook: NiltonVivacqua Página do Facebook: EndodontiaAvancada.com --- Send in a voice message: https://anchor.fm/endodontiaavancada/message

Qual a relação entre a erupção dos dentes decíduos e a febre? Nesse episódio, o professor Felipe Bravo comenta um artigo recente sobre o tema! Artigo: Association between Fever and Primary Tooth Eruption: A Systematic Review and Meta-analysis. [Int J Clin Pediatr Dent. 2017 Jul-Sep;10(3):293-298. doi: 10.5005/jp-journals-10005-1453. Epub 2017 Feb 27.] ------------------------------------ Se você ainda não ouve no Iphone ou Android, veja como fazer: IPHONE 1-Clicar no ícone do aplicativo Podcast (já vem instalado no IPHONE) 2-Clicar em “Buscar” 3-Digitar “Odontologia Cast” 4- Clicar em “Assinar” ANDROID 1- Baixar o aplicativo gratuito “Podcast Addict” 2- Procurar por “Odontologia Cast” 3- Assinar o podcast ------------------------------------

Malariotherapy -- infecting comatose syphilis patients with malaria to cure them of the disease -- was once the cutting edge of medicine, and earned its inventor Julius Wagner-Jauregg the Nobel Prize in Medicine or Physiology in 1927. In this episode, we’re going to talk about the fascinating story behind this remarkable treatment, from the murky beginnings of syphilis through its sordid sexual connotations, to the birth of modern psychiatry and Nazi experiments. Plus, there’s a brand new #AdamAnswers about whether or not ancient doctors thought hair served to store semen (seriously).  Listen to all this and more in Episode 31 of Bedside Rounds, a tiny podcast about fascinating stories in clinical medicine. Sources: Crellato E et al, “The Hippocratic treatise ‘On glands’: the first document on lymphoid tissue on lymph nodes,” Leukemia. Retrieved online at https://www.nature.com/articles/2404618 Farhi D, Dupin N, Origins of syphilis and management in theimmunocompetent patient: Facts and controversies. Clinics in Dermatology (2010) 28, 533–538 Frith J, “Syphilis – Its early history and Treatment until Penicillin and the Debate on its Origins,” Journal of Military and Veterans’ Health, 20(4), retrieved online at: http://jmvh.org/article/syphilis-its-early-history-and-treatment-until-penicillin-and-the-debate-on-its-origins/ Gelder MG, “Biological Psychiatry in Perspective,” British Medical Bulletin. 1996;2 (No. 3H01-4G7) Howes OD et al, “Julius Wagner-Jauregg, 1857-1940,” American Journal of Psychiatry, April 2009 Volume 166 Number 4, Volume 166, Issue 4, April, 2009, pp. 409-409. Karamanou M et al, “Julius Wagner-Jauregg (1857-1940): Introducing fever therapy in the treatment of neurosyphilis.” Psychiatriki. 2013 Jul-Sep;24(3):208-12. Kent, ME and Romanelli F. Reexamining Syphilis: An Update on Epidemiology, ClinicalManifestations, and Management, The Annals of Pharmacotherapy. 2008 February, Volume 42 Kreston R, “Pyromania! On Neurosyphilis and Fighting Fire with Fire,” Body Horrors blog on Discover. Retrieved online at: http://blogs.discovermagazine.com/bodyhorrors/2014/05/31/pyromania-syphilis-malaria/#.WnTvHKinE2x Martin TW, “Paul’s argument from Nature for the Veil in 1 Corinthians 11:13-15: A Testicle Instead of a Head Covering,” Journal of Biblical Literature, Vol. 123, No. 1 pp 75-84. Rothschild, BM, “History of Syphilis Clinical Infectious Diseases.” 2005; 40:1454–63 Simpson WM, “Artificial fever therapy of syphilis,” JAMA. 1935;105(26):2132-2140. Tampa M et al, “Brief History of Syphilis.” J Med Life. 2014 Mar 15; 7(1): 4–10. Tsay CJ, “Julius Wagner-Jauregg and the Legacy of Malarial Therapy for the Treatment of General Paresis of the Insane,” Yale J Biol Med. 2013;86(2): 245–254 Wagner-Jauregg J, “The history of malaria treatment of general paralysis.” Am J Psychiatry. 1946;02: 577-582