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Who's the best coach in Wolves history? Headlines and plenty of Wolves chat
Who's the best coach in Wolves history? Headlines and plenty of Wolves chatSee omnystudio.com/listener for privacy information.
Who's the best coach in Wolves history? Headlines and plenty of Wolves chat
Leber and Muss join the show, they talk Vikes schedule, Muss has a new favorite NBA player, Sauce talks about his favorite new snack
Leber and Muss join the show, they talk Vikes schedule, Muss has a new favorite NBA player, Sauce talks about his favorite new snackSee omnystudio.com/listener for privacy information.
Leber and Muss join the show, they talk Vikes schedule, Muss has a new favorite NBA player, Sauce talks about his favorite new snack
➤ Eine gesunde Leber ist mehr als nur ein Entgiftungsorgan. Sie ist der Schlüssel zu körperlicher Kraft, mentaler Klarheit und innerem Gleichgewicht. etzt exklusiv bei FAIR TALK 15% Rabatt mit dem Code „FAIRTALK15“ https://evolution-international.com/leber-gesundheit/ ➤ Unsere Gäste trinken Wasser gefiltert mit AQUOSS Filteranlagen. AQUOSS Lichtwasser erhellt die Sinne und bringt den Bewohnern der Erde Vitalität und Wohlergehen. https://aquoss.com/ ➤ Entdecke flexgold! Investiere in physisches Gold und sichere Deine Werte. Außerdem unterstützt Du Fair Talk bei Deinem nächsten Goldkauf über diesen Link: https://www.fairtalk.tv/flexgold
In dieser Folge spreche ich offen und ehrlich über ein Thema, das viele betrifft, aber über das kaum jemand gerne spricht: ständiger Durchfall und schnelle Verdauung.Vielleicht kennst du das Gefühl, dass das Essen buchstäblich "durchrauscht"? Dass dein Körper scheinbar alles direkt wieder loswerden will? Ich verrate dir heute, warum das kein Zufall ist – und vor allem, was wirklich dahinterstecken kann.Das erwartet dich in dieser Folge:Warum Durchfall kein Zufall, sondern ein Warnsignal deines Körpers istDie häufigsten Ursachen: von Darmflora-Ungleichgewicht über SIBO bis hin zu Stress und NahrungsmittelunverträglichkeitenWas Blähbauch, Krämpfe und Fettstuhl über deine Verdauung verratenWie du erste eigene Zusammenhänge erkennen kannst – z. B. durch ein ErnährungstagebuchWarum es wichtig ist, sich nicht mit einer Reizdarm-Diagnose abzufindenWie du erkennst, ob deine Leber, Galle oder Hormone mit reinspielenUnd: Wann es an der Zeit ist, dir Unterstützung zu holenIch teile mit dir meine ganzheitliche Sichtweise als Ernährungscoach und gebe dir praktische Impulse, um deinem Körper endlich wieder mehr Ruhe und Energie zu schenken.———————————————————Im Podcast erwähnt:Hier kannst du dein kostenloses Erstgespräch buchenEmbelly SIBO Test - Rabattcode: Hannah10 ——————————————————Du möchtest keine Folge verpassen und zusätzliche Tipps direkt in Dein E-Mail Postfach bekommen? Dann melde Dich für meinen Newsletter an und erhalte meine 11 darmfreundlichen Rezepte, die auch Meal Prep geeignet sind.Newsletter & FreebieDeine Gedanken zu meinem Podcastfolge kannst Du mir gerne auf Instagram unter dem Post mitteilen oder auch per Mail zusenden: info@hannah-willemsen.com.Du würdest mir einen riesen Gefallen tun, wenn Du meinen Podcast auf iTunes mit 5 Sternen bewertest. So finden andere diesen Podcast auch und erhalten ebenfalls wertvolle Tipps zum Thema gesunde Ernährung.Alles LiebeDeine Hannah
mit Miriam zusammenarbeiten:https://miriamwechner.com/Gesunde Rezepte für den Mai – easy, schnell & voller Lebendigkeit (Eat the Rainbow Edition)Du weißt nicht, was du im Mai essen sollst – aber du willst deinem Körper etwas richtig Gutes tun?In dieser Quickie-Folge teile ich mit dir 8 gesunde, einfache & bunte Rezepte, die nicht nur köstlich schmecken, sondern auch deinen Körper und Geist unterstützen.Mit dabei: Spargel, Rhabarber, Wildkräuter, Radieschen, Himbeeren, Lauch, Sprossen & Co. – echte Gamechanger für deine Lebendigkeit.Ich spreche darüber:
Evolution Radio Show - Alles was du über Keto, Low Carb und Paleo wissen musst
Schau dir das Video auf YouTube an: und YouTube Kanal gleich abonnieren und keine neue Folge mehr verpassen.ZusammenfassungIst Keto schlecht für die Schilddrüse? Dieser Mythos wird in der Episode entlarvt. Julia erklärt, warum niedrigere FT3-Werte unter Keto oft kein Grund zur Sorge sind. Erfahre mehr über die Grundlagen der Schilddrüsenfunktion, die Hormone TSH, FT3, FT4 und ihre richtige Interpretation bei Keto. Die Schilddrüse, unsere Stoffwechselzentrale, wird vom Gehirn via TSH gesteuert. TSH allein ist aber nicht aussagekräftig. Die Umwandlung von T4 zu aktivem T3 ist essenziell und braucht eine gesunde Leber sowie Co-Faktoren (Eisen, Selen, Jod, Zink, Magnesium). Sinkende FT3-Spiegel in Ketose haben oft physiologische Gründe: Der Körper wird effizienter, benötigt weniger Hormon, Rezeptoren werden empfindlicher (ähnlich verbesserter Insulinsensitivität). Das zeigt Stoffwechsel-Effizienz, nicht zwingend eine Schilddrüsenunterfunktion, solange keine Symptome (Frieren, Haarausfall, Müdigkeit, Verstopfung) da sind. Bei Symptomen müssen andere Ursachen (Mängel, Kalorienrestriktion, unerkannte Erkrankungen) geprüft werden, die unabhängig von Keto sein können. Die ketogene Ernährung kann bei Hashimoto durch Entzündungsmodulation positiv wirken. Julia gibt praktische Tipps für eine schilddrüsenfreundliche Keto-Ernährung und betont: Laborwerte immer im Kontext des Wohlbefindens und Körpergefühls sehen!
Auf die Couch mit Jana, der Coaching Quickie für zwischendurch
Worüber keiner redet, die Leber und die Wechseljahre. Gibt es vielleicht gar keine Wechseljahre, sondern nur eine Überlastung der Leber, sind viele Beschwerden einfach Leberhitze? Betrachten wir das Thema doch mal aus einer anderen Perspektive und lassen uns überraschen von den Möglichkeiten.
Welche Unterschiede gibt es zwischen Männern und Frauen bei Krebstherapien? Die Forschung hat darauf bisher nur wenige Antworten. Daher ist Genderforschung auch in der Onkologie von grosser Bedeutung. Claudia S., Anfang 40 und Mutter von zwei Kindern, bekam letztes Jahr die Diagnose schwarzer Hautkrebs. Die zielgerichtete Therapie nach der Operation musste sie aufgrund heftiger Nebenwirkungen abbrechen. Dies sei exemplarisch für die Geschlechterunterschiede bei Krebstherapien, sagt Berna Özdemir. Sie ist Genderforscherin und Onkologin am Berner Inselspital. Frauen haben im Schnitt weniger Muskelmasse, hormonelle Schwankungen und einen anderen Stoffwechsel als Männer – insbesondere bei der Entgiftung über Leber und Nieren. Daher bauen sie Medikamente langsamer ab, was zu mehr Nebenwirkungen führen kann. Auch die Dosis von Chemotherapien wird oft noch mit veralteten Formeln berechnet; die Geschlechterunterschiede nicht berücksichtigt. Die Wissenschaftlerin macht sich deshalb dafür stark, den Faktor Geschlecht in Zukunft miteinzubeziehen.
Ben Leber in studio on the purple for two segments, before ESPN's Courtney Cronin joins to offer a breakdown on the Bears!See omnystudio.com/listener for privacy information.
Ben Leber in studio on the purple for two segments, before ESPN's Courtney Cronin joins to offer a breakdown on the Bears!
Ben Leber in studio on the purple for two segments, before ESPN's Courtney Cronin joins to offer a breakdown on the Bears!
Den ganzen Abend lang trinken und trotzdem keinen Kater haben? Immer mehr Menschen - insbesondere Jüngere - greifen bewusst zu alkoholfreien Alternativen zu Bier, Wein und Schnaps. Warum? Es liegt im Trend. Viele legen Wert auf einen gesunden Lifestyle und möchten weniger Kalorien zu sich nehmen. Sie verzichten bewusst auf Alkohol, um Schlaf, Leber und Blutwerte zu verbessern. Das beste Beispiel ist die Bierindustrie: Der Marktanteil alkoholfreier Biere liegt aktuell bei etwa 9 Prozent. Laut dem Deutschem Brauer-Bund sind 10 Prozent in Reichweite: Die Produktionsmenge hat sich in den letzten zehn Jahren mehr als verdoppelt. Auch Zero Labs aus München braut Bier mit 0,0 Prozent Alkohol, zuckerfrei und in pinkfarbenem Design. Sechs Wochen lang - dreimal so lange wie üblich - dauert die Herstellung. Das Bier ist ungefiltert, so soll es besonders intensiv schmecken. Hinter Zero Labs stehen Max Wittrock und Moritz Keller. Beide sind Seriengründer und keine Unbekannten in der Startup-Szene. Warum sie sich als neues Projekt alkoholfreies Bier ausgesucht haben, wie das pinke Design bei den Leuten ankommt und welche Rolle Social Media für ihr Startup spielt, verraten sie im Podcast."Startup - jetzt ganz ehrlich" - der Podcast mit Janna Linke. Auf RTL+ und überall, wo es Podcasts gibt: Amazon Music, Apple Podcasts, Spotify, RSS-Feed.Unsere allgemeinen Datenschutzrichtlinien finden Sie unter https://datenschutz.ad-alliance.de/podcast.htmlWir verarbeiten im Zusammenhang mit dem Angebot unserer Podcasts Daten. Wenn Sie der automatischen Übermittlung der Daten widersprechen wollen, klicken Sie hier: https://datenschutz.ad-alliance.de/podcast.htmlUnsere allgemeinen Datenschutzrichtlinien finden Sie unter https://art19.com/privacy. Die Datenschutzrichtlinien für Kalifornien sind unter https://art19.com/privacy#do-not-sell-my-info abrufbar.
Detox ist in aller Munde – doch was steckt wirklich dahinter? In dieser Folge erfährst du, warum gerade der Frühling die perfekte Zeit ist, um deiner Leber etwas Gutes zu tun, wie echter Detox im Körper funktioniert und welche Detox-Produkte du getrost vergessen kannst. Wir schauen uns an, wie du deine Leber im Alltag natürlich unterstützen kannst und welche gesunden Gewohnheiten wirklich einen Unterschied machen.
Nach der "Stoffwechselformel" jetzt also der Diät-Shake "Sanamana": Jasper Caven, selbsternannter Abnehmexperte, vermarktet ein neues Produkt, das Fettverbrennung verspricht - über den Umweg der Leber. Doch was steckt wirklich dahinter? Max und Jonathan nehmen die Rückkehr des Abnehm-Gurus unter die Lupe: Was steckt wirklich drin im Shake? Gibt es Studien zur Wirkung? Und hat Jasper Caven seit seiner letzten Festnahme irgendetwas dazugelernt? Wir sollen für euch ermitteln? → sciencecops@wdr.de Von Maximilian Doeckel und Jonathan Focke.
Fühlst du dich oft müde, hast Heißhunger oder kämpfst mit hartnäckigem Bauchfett, obwohl du dich eigentlich gesund ernährst? Dann könnte deine Leber die stille Ursache sein. In dieser Folge sprechen wir über die nicht-alkoholische Fettleber, welche durch einen zu großen Zuckerkonsum verursacht wird. Du erfährst, wie Zucker deinen Körper aus dem Gleichgewicht bringt, warum deine Leber so wichtig für deine Hormon- und Energie-Balance ist und was du ganz konkret im Alltag tun kannst, um sie zu entlasten. Kleine Schritte bringen eine große Wirkung: Von bewusster Ernährung über leberfreundliche Lebensmittel bis hin zu einfachen Bewegungstipps. Hol dir dein Wohlgefühl zurück – und starte mit neuer Energie durch! Du erfährst: ✨ Wie Zucker deinem Körper schaden kann ✨ Was du gegen eine nicht-alkoholische Fettleber tun kannst ✨ Was du tun kannst, um deine Leber gesund zu halten ✨ Simple Tipps für den Alltag, um wieder in deine Balance zu finden
Aromatherapie für die Ohren mit Eliane Zimmermann & Sabrina Herber
FCF: Das ist kein Fußballverein, sondern die Bezeichnung für ein ätherisches Öl, dem ein ganz wichtiger Bestandteil entfernt wurde. Die Furocumarine in Zitrusfruchtschalen werden vom Gesetzgeber als "bösartig" betrachtet und sollen darum verschwinden. Sie wurden in Kosmetik so gut wie verboten, nur noch Spuren sind erlaubt. Denn unter Sonnen- und Solariumlicht können sie – über 1%ig aufgetragen – Verbrennungen verursachen (Beloque Dermatitis) und bei regelmäßiger unkorrekter Anwendung sogar zu DNA-Schäden in der Haut und gar zu Hautkrebs führen. Jedoch gibt es in diversen Gewebe-Studien auch Hinweise, dass diese besonderen Moleküle eindeutig antitumoral wirken. Wir fragen uns, ob das Eingreifen des Menschen in natürliche Prozesse wirklich sinnvoll ist, denn diese Moleküle tragen vermutlich zur deutlich stimmungsaufhellenden Wirkung der Zitrusöle bei. Auch die enthaltenen Stickstoff-Verbindungen helfen bei emotionalen Themen, denn sie können den körpereigenen Neurotransmittern, also den "Happy-Botenstoffen", auf die Sprünge helfen.Zudem wirken die Fruchtschalenöle aus Zitrone, Zedrat, Limette und Yuzu ausgleichend bis erfrischend (ohne anzuregen), wenn uns Gehirnnebel und Zeitumstellung plagen. Wer manche Zitrusbäume aufmerksam anschaut, wird riesige Dornen sehen, die Abwehrkraft ist also in der Signatur der Pflanze zu erkennen. Blutorangen erhalten ihre Pigmente durch den "Nachtschreck", also durch das Abfallen der nächtlichen Temperatur, Orangenschalenöle sind gut untersuchte Helfer bei Anspannung und Angst-Symptomen. Wir sprechen über etliche Besonderheiten dieser Powerpakete und auch über die wintermüde Leber, die sich über diese ätherischen Öle freut.Dieser Podcast kostet DICH nichts: Wir freuen uns, wenn du uns mit dem Kauf deiner Bio-Düfte in unserem Shop (klick!) UNTERSTÜTZT! Hier geht's zu den Seelen-Duftmischungen. Feedback und Anregungen (bitte keine Anfragen Beschwerden betreffend!): feedback@aromatherapie-fuer-die-ohren.de5erlei Petit Grain, Entspannung pur!Im Set günstiger: Zitrone, Zedrat-Zitrone und Yuzu Zitronen 3erleiSeelentrost, wenn das Leben zu viel Gegenwind bereit hält NeroliErste Hilfe bei Schreck, Trauma, wenn mieses Karma anklopft: Hydrolat OrangenblüteBesonderes Blutorangenöl von sizilianischen Kleinbauern, als Lebensmittel zertifiziertEau de Cologne Mandarine von FarfallaArtikel Frühjahrsmüdigkeit (und mehr im Archiv)Leberpflege im Frühling: Kruut, feine BitterprodukteArtikel zur Studie: Yuzu bei PMSInformationen rund um Yuzu sowie Rezepte zB Raumspray mit YuzuFotos & Text im Öle-Lexikon Petit GrainKorrekte Abbildung und Infos zur Combava-Limette im Öle-LexikonOnline-Live-Seminar Hydrolate am 13. April 2023 (mit Vorab-Duftpaket)Online-Live-Seminar Fette Öle mit Heilwirkung am 25. April 2023 (mit Vorab-Duftpaket)Ästhetisch-informatives Poster A2 Zitrusöle und ihre feinen WirkungenwebSeminar Frühjahrskur & Insektenschutz (Aufzeichnung)Kurzausbildung für LaienBlog-Artikel von Eliane Zimmermann (v. a. Studien): AromapraxisBlog-Artikel mit vielen Rezepten von Sabrina Herber: Vivere-AromapflegeAufzeichnungen unserer über 40 webSeminare:: HAFTUNGSAUSSCHLUSS :: Alle Informationen in unseren Podcasts beruhen auf unserer langjährigen Erfahrung, auf traditionellen Anwendungen, sowie – sofern bereits durchgeführt – auf wissenschaftlichen Arbeiten. Unsere Tipps dienen ausschließlich Ihrer Information und ersetzen niemals eine gründliche Beratung, Untersuchung oder Diagnose bei einer gut ausgebildeten Heilpraktikerin oder beim qualifizierten Arzt. Ganzheitlich verstandene Aromatherapie berücksichtigt vorrangig individuellen Besonderheiten, dies ist nur in einem persönliche Gespräch möglich. Unsere zur Verfügung gestellten Inhalte können und dürfen nicht zur Erstellung eigenständiger Diagnosen verwendet werden. Das vollständige Impressum befindet sich jeweils auf den beiden Websites der Autorinnen, jede Haftung wird ausgeschlossen.
Sauce refuses to say hi to Ben's wifeSee omnystudio.com/listener for privacy information.
Ben Leber in studio for most of middle hour on the Vikings and the Draft! Some news follows!
Ben Leber in studio for most of middle hour on the Vikings and the Draft! Some news follows!See omnystudio.com/listener for privacy information.
In today's episode, host Dr. Amanda Redfern invites Dr. Nancy Newman to share updates in the treatment of Leber hereditary optic neuropathy (LHON), covering several clinical trials underway that involve idebenone and gene therapy. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.
In the final episode of this four-part series, Dr. Justin Abbatemarco and Dr. Nancy Newman discuss the abstract she presented at the AAN Annual Meeting and details on the upcoming gene therapy trial. Show reference: https://www.neurology.org/doi/10.1212/WNL.0000000000208987
Ben Leber in studio on the Vikings and NFL draft for most of the hour! Some light news to finish!See omnystudio.com/listener for privacy information.
Ben Leber in studio on the Vikings and NFL draft for most of the hour! Some light news to finish!
In part two of this four-part series, Dr. Justin Abbatemarco and Dr. Nancy Newman discuss current treatment options for Leber hereditary optic neuropathy (LHON). Show reference: https://index.mirasmart.com/AAN2025/PDFfiles/AAN2025-002206.html
Diagnosing and differentiating among the many possible localizations and causes of vision loss is an essential skill for neurologists. The approach to vision loss should include a history and examination geared toward localization, followed by a differential diagnosis based on the likely location of the pathophysiologic process. In this episode, Aaron Berkowitz, MD, PhD, FAAN speaks with Nancy J. Newman, MD, FAAN, author of the article “Approach to Vision Loss” in the Continuum® April 2025 Neuro-ophthalmology issue. Dr. Berkowitz is a Continuum® Audio interviewer and a professor of neurology at the University of California San Francisco in the Department of Neurology and a neurohospitalist, general neurologist, and clinician educator at the San Francisco VA Medical Center at the San Francisco General Hospital in San Francisco, California. Dr. Newman is a professor of ophthalmology and neurology at the Emory University School of Medicine in Atlanta, Georgia. Additional Resources Read the article: Approach to Vision Loss Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @AaronLBerkowitz Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Berkowitz: This is Dr Aaron Berkowitz, and today I'm interviewing Dr Nancy Newman about her article on the approach to visual loss, which she wrote with Dr Valerie Biousse. This article appears in the April 2025 Continuum issue on neuro-ophthalmology. Welcome to the podcast, Dr Newman. I know you need no introduction, but if you wouldn't mind introducing yourself to our listeners. Dr Newman: Sure. My name's Nancy Newman. I am a neurologist and neuro-ophthalmologist, professor of ophthalmology and neurology at the Emory University School of Medicine in Atlanta, Georgia. Dr Berkowitz: You and your colleague Dr Biousse have written a comprehensive and practical article on the approach to visual loss here. It's fantastic to have this article by two of the world's leading experts and best-known teachers in neuro-ophthalmology. And so, readers of this article will find extremely helpful flow charts, tables and very nuanced clinical discussion about how to make a bedside diagnosis of the cause of visual loss based on the history exam and ancillary testing. We'll talk today about that important topic, and excited to learn from you and for our listeners to learn from you. To begin, let's start broad. Let's say you have a patient presenting with visual loss. What's your framework for the approach to this common chief concern that has such a broad differential diagnosis of localizations and of causes? Where do you start when you hear of visual loss? How do you think about this chief concern? Dr Newman: Well, it's very fun because this is the heart of being a neurologist, isn't it? Nowhere in the nervous system is localization as important as the complaint of vision loss. And so, the key, as any neurologist knows, is to first of all figure out where the problem is. And then you can figure out what it is based on the where, because that will limit the number of possibilities. So, the visual system is quite beautiful in that regard because you really can exquisitely localize based on figuring out where things are. And that starts with the history and then goes to the exam, in particular the first localization. So, you can whittle it down to the more power-for-your-buck question is, is the vision lost in one eye or in two eyes? Because if the vision loss clearly, whether it's transient or persistent, is in only one eye, then you only have to think about the eyeball and the optic nerve on that side. So, think about that. Why would you ever get a brain MRI? I know I'm jumping ahead here, but this is the importance of localization. Because what you really want to know, once you know for sure it's in one eye, is, is it an eyeball problem---which could be anything from the cornea, the lens, the vitreous, the retina---or is it an optic nerve problem? The only caveat is that every once in a while, although we trust our patients, a patient may insist that a homonymous hemianopia, especially when it's transient, is only in the eye with the temporal defect. So that's the only caveat. But if it's in only one eye, it has to be in that side eyeball or optic nerve. And if it's in two eyes, it's either in both eyeballs or optic nerves, or it's chiasmal or retrochiasmal. So that's the initial approach and everything about the history should first be guided by that. Then you can move on to the more nuanced questions that help you with the whats. Once you have your where, you can then figure out what the whats are that fit that particular where. Dr Berkowitz: Fantastic. And your article with Dr Biousse has this very helpful framework, which you alluded to there, that first we figure out, is it monocular or binocular? And we figure out if it's a transient or fixed or permanent deficit. So, you have transient monocular, transient binocular, fixed monocular, fixed binocular. And I encourage our listeners to seek out this article where you have a table for each of those, a flow chart for each of those, that are definitely things people want to have printed out and at their desk or on their phone to use at the bedside. Very helpful. So, we won't be able to go through all of those different clinical presentations in this interview, but let's focus on monocular visual loss. As you just mentioned, this can be an eye problem or an optic nerve problem. So, this could be an ophthalmologic problem or a neurologic problem, right? And sometimes this can be hard to distinguish. So, you mentioned the importance of the history. When you hear a monocular visual loss- and with the caveat, I said you're convinced that this is a monocular visual problem and not a visual field defect that may appear. So, the patient has a monocular deficit, how do you approach the history at trying to get at whether this is an eye problem or an optic nerve problem and what the cause may be? Dr Newman: Absolutely. So, the history at that point tends not to be as helpful as the examination. My mentor used to say if you haven't figured out the answer to the problem after your history, you're in trouble, because that 90% of it is history and 10% is the exam. In the visual system, the exam actually may have even more importance than anywhere else in the neurologic examination. And we need as neurologists to not have too much hubris in this. Because there's a whole specialty on the eyeball. And the ophthalmologists, although a lot of their training is surgical training that that we don't need to have, they also have a lot of expertise in recognizing when it's not a neurologic problem, when it's not an optic neuropathy. And they have all sorts of toys and equipment that can very much help them with that. And as neurologists, we tend not to be as versed in what those toys are and how to use them. So, we have to do what we can do. Your directive thalmoscope, I wouldn't throw it in the garbage, because it's actually helpful to look at the eyeball itself, not just the back of the eye, the optic nerve and retina. And we'll come back to that, but we have in our armamentarium things we can do as neurologists without having an eye doctor's office. These include things like visual acuity and color vision, confrontation, visual fields. Although again, you have to be very humble. Sometimes you're lucky; 30% of the time it's going to show you a defect. It has to be pretty big to pick it up on confrontation fields. And then as we say, looking at the fundus. And you probably know that myself and Dr Biousse have been on somewhat of a crusade to allow the emperor's new clothes to be recognized, which is- most neurologists aren't very comfortable using the direct ophthalmoscope and aren't so comfortable, even if they can use it, seeing what they need to see. It's hard. It's really, really hard. And it's particularly hard without pupillary dilation. And technology has allowed us now with non-mydriatic cameras, cameras that are incredible, even through a small pupil can take magnificent pictures of the back of the eye. And who wouldn't rather have that? And as their cost and availability- the cost goes down and their availability goes up. These cameras should be part of every neurology office and every emergency department. And this isn't futuristic. This is happening already and will continue to happen. But over the next five years or so… well, we're transitioning into that. I think knowing what you can do with the direct ophthalmoscope is important. First of all, if you dial in plus lenses, you can't be an ophthalmologist, but you can see media opacities. If you can't see into the back of the eye, that may be the reason the patient can't see out. And then just seeing if someone has central vision loss in one eye, it's got to be localized either to the media in the axis of vision; or it's in the macula, the very center of the retina; or it's in the optic nerve. So, if you get good at looking at the optic nerve and then try to curb your excitement when you saw it and actually move a little temporally and take a look at the macula, you're looking at the two areas. Again, a lot of ophthalmologists these days don't do much looking with the naked eye. They actually do photography, and they do what's called OCT, optical coherence tomography, which especially for maculopathies, problems in the macula are showing us the pathology so beautifully, things that used to be considered subtle like central serous retinopathy and other macula. So, I think having a real healthy respect for what an eye care provider can do for you to help screen away the ophthalmic causes, it's very, very important to have a patient complaining of central vision loss, even if they have a diagnosis like multiple sclerosis, you expect that they might have an optic neuritis… they can have retinal detachments and other things also. And so, I think every one of these patients should be seen by an eye care provider as well. Dr Berkowitz: Thank you for that overview. And I feel certainly as guilty as charged here as one of many neurologists, I imagine, who wish we were much better and more comfortable with fundoscopy and being confident on what we see. But as you said, it's hard with the direct ophthalmoscope and a non-dilated exam. And it's great that, as you said, these fundus photography techniques and tools are becoming more widely available so that we can get a good look at the fundus. And then we're going to have to learn a lot more about how to interpret those images, right? If we haven't been so confident in our ability to see the fundus and analyze some of the subtle abnormalities that you and your colleagues and our ophthalmology colleagues are more familiar with. So, I appreciate you acknowledging that. And I'm glad to hear that coming down the pipeline, there are going to be some tools to help us there. So, you mentioned some of the things you do at the bedside to try to distinguish between eye and optic nerve. Could you go into those in a little bit more detail here? How do you check the visual fields? For example, some people count fingers, some people wiggle fingers, see when the patient can see. How should we be checking visual fields? And what are some of the other bedside tasks you use to decide this is probably going to end up being in the optic nerve or this seems more like an eye? Dr Newman: Of course. Again, central visual acuity is very important. If somebody is older than fifty, they clearly will need some form of reading glasses. So, keeping a set of plus three glasses from cheapo drugstore in your pocket is very helpful. Have them put on their glasses and have them read an ear card. It's one of the few things you can actually measure and examine. And so that's important. The strongest reflex in the body and I can have it duke it out with the peripheral neurologists if they want to, it's not the knee jerk, it's looking for a relative afferent pupillary defect. Extremely important for neurologists to feel comfortable with that. Remember, you cut an optic nerve, you're not going to have anisocoria. It's not going to cause a big pupil. The pupils are always equal because this is not an efferent problem, it's an afferent problem, an input problem. So basically, if the eye has been injured in the optic nerve and it can't get that information about light back into the brain, well, the endoresfol nuclei, both of them are going to reset at a bigger size. And then when you swing over and shine that light in the good optic nerve, the good eye, then the brain gets all this light and both endoresfol nuclei equally set those pupils back at a smaller size. So that's the test for the relative afferent pupillary defect. When you swing back and forth. Of course, when the light falls on the eye, that's not transmitting light as well to the brain, you're going to see the pupil dilate up. But it's not that that pupil is dilating alone. They both are getting bigger. It's an extremely powerful reflex for a unilateral or asymmetric bilateral optic neuropathy. But what you have to remember, extremely important, is, where does our optic nerve come from? Well, it comes from the retinal ganglion cells. It's the axons of the retinal ganglion cells, which is in the inner retina. And therefore inner retinal disorders such as central retinal artery occlusion, ophthalmic artery occlusion, branch retinal artery occlusion, they will also give a relative afferent pupillary defect because you're affecting the source. And this is extremely important. A retinal detachment will give a relative afferent pupillary defect. So, you can't just assume that it's optic nerve. Luckily for us, those things that also give a relative afferent pupillary defect from a retinal problem cause really bad-looking retinal disease. And you should be able to see it with your direct ophthalmoscope. And if you can't, you definitely will be able to see it with a picture, a photograph, or having an ophthalmologist or optometrist take a look for you. That's really the bedside. You mentioned confrontation visual fields. I still do them, but I am very, very aware that they are not very sensitive. And I have an extremely low threshold to- again, I have something in my office. But if I were a general neurologist, to partner with an eye care specialist who has an automated visual field perimeter in their office because it is much more likely to pick up a deficit. Confrontation fields. Just remember, one eye at a time. Never two eyes at the same time. They overlap with each other. You're going to miss something if you do two eyes open, so one eye at a time. You check their field against your field, so you better be sure your field in that eye is normal. You probably ought to have an automated perimetry test yourself at some point during your career if you're doing that. And remember that the central thirty degrees is subserved by 90% of our fibers neurologically, so really just testing in the four quadrants around fixation within the central 30% is sufficient. You can present fingers, you don't have to wiggle in the periphery unless you want to pick up a retinal detachment. Dr Berkowitz: You mentioned perimetry. You've also mentioned ocular coherence tomography, OCT, other tests. Sometimes we think about it in these cases, is MRI one of the orbits? When do you decide to pursue one or more of those tests based on your history and exam? Dr Newman: So again, it sort of depends on what's available to you, right? Most neurologists don't have a perimeter and don't have an OCT machine. I think if you're worried that you have an optic neuropathy, since we're just speaking about monocular vision loss at this point, again, these are tests that you should get at an office of an eye care specialist if you can. OCT is very helpful specifically in investigating for a macular cause of central vision loss as opposed to an optic nerve cause. It's very, very good at picking up macular problems that would be bad enough to cause a vision problem. In addition, it can give you a look at the thickness of the axons that are about to become the optic nerve. We call it the peripapillary retinal nerve fiber layer. And it actually can look at the thickness of the layer of the retinal ganglion cells without any axons on them in that central area because the axons, the nerve fiber layer, bends away from central vision. So, we can see the best we can see. And remember these are anatomical measurements. So, they will lag, for the ganglion cell layer, three to four weeks behind an injury, and for the retinal nerve fiber, layer usually about six weeks behind an entry. Whereas the functional measurements, such as visual acuity, color vision, visual fields, will be immediate on an injury. So, it's that combination of function and anatomy examination that makes you all-powerful. You're very much helped by the two together and understanding where one will be more helpful than the other. Dr Berkowitz: Let's say we've gotten to the optic nerve as our localization. Many people jump to the assumption it's the optic nerve, it's optic neuritis, because maybe that's the most common diagnosis we learn in medical school. And of course, we have to sometimes, when we're teaching our students or trainees, say, well, actually, not all optic nerve disease, optic neuritis, we have to remember there's a broader bucket of optic neuropathy. And I remember, probably I didn't hear that term until residency and thought, oh, that's right. I learned optic neuritis. Didn't really learn any of the other causes of optic nerve pathology in medical school. And so, you sort of assume that's the only one. And so you realize, no, optic neuropathy has a differential diagnosis beyond optic neuritis. Neuritis is a common cause. So how do you think about the “what” once you've localized to the optic nerve, how do you think about that? Figure out what the cause of the optic neuropathy is? Dr Newman: Absolutely. And we've been trying to convince neuro-radiologists when they see evidence of optic nerve T2 hyperintensity, that just means damage to the optic nerve from any cause. It's just old damage, and they should not put in their read consistent with optic neuritis. But that's a pet peeve. Anyway, yes, the piece of tissue called the optic nerve can be affected by any category of pathophysiology of disease. And I always suggest that you run your categories in your head so you don't leave one out. Some are going to be more common to be bilateral involvement like toxic or metabolic causes. Others will be more likely unilateral. And so, you just run those guys. So, in my mind, my categories always are compressive-slash-infiltrative, which can be neoplastic or non-neoplastic. For example, an ophthalmic artery aneurysm pressing on an optic nerve, or a thyroid, an enlarged thyroid eye muscle pressing on the optic nerve. So, I have compressive infiltrative, which could be neoplastic or not neoplastic. I have inflammatory, which can be infectious. Some of the ones that can involve the optic nerve are syphilis, cat scratch disease. Or noninfectious, and these are usually your autoimmune such as idiopathic optic neuritis associated with multiple sclerosis, or MOG, or NMO, or even sarcoidosis and inflammation. Next category for me would be vascular, and you can have arterial versus venous in the optic nerve, probably all arterial if we're talking about causes of optic neuropathy. Or you could have arteritic versus nonarteritic with the vascular, the arteritic usually being giant cell arteritis. And the way the optic nerve circulation is, you can have an anterior ischemic optic neuropathy or a posterior ischemic optic neuropathy defined by the presence of disc edema suggesting it's anterior, the front of the optic nerve, or not, suggesting that it's retrobulbar or posterior optic nerve. So what category am I- we mentioned toxic, metabolic nutritional. And there are many causes in those categories of optic neuropathy, usually bilateral. You can have degenerative or inherited. And there are causes of inherited optic neuropathies such as Leber hereditary optic neuropathy and dominant optic atrophy. And then there's a group I call the mechanical optic neuropathies. The obvious one is traumatic, and that can happen in any piece of tissue. And then the other two relate to the particular anatomy of the eyeball and the optic nerve, and the fact that the optic nerve is a card-carrying member of the central nervous system. So, it's not really a nerve by the way, it's a tract. Think about it. Anyway, white matter tract. It is covered by the same fluid and meninges that the rest of the brain. So, what mechanically can happen? Well, you could have an elevated intraocular pressure where that nerve inserts. That's called glaucoma, and that would affect the front of the optic nerve. Or you can have elevated intracranial pressure. And if that's transmitted along the optic nerve, it can make the front of the optic nerve swell. And we call that specifically papilledema, optic disk edema due specifically to raised intracranial pressure. We actually even can have low intraocular pressure cause something called hypotony, and that can actually even give an optic neuropathy the swelling of the optic nerve. So, these are the mechanical. And if you were to just take that list and use it for any piece of tissue anywhere, like the heart or the kidney, you can come up with your own mechanical categories for those, like pericarditis or something like that. And then all those other categories would fit. But of course, the specific causes within that pathophysiology are going to be different based on the piece of tissue that you have. In this case, the optic nerve. Dr Berkowitz: In our final moments here, we've talked a lot about the approach to monocular visual loss. I think most neurologists, once we find a visual field defect, we breathe a sigh of relief that we know we're in our home territory here, somewhere in the visual task base that we've studied very well. I'm not trying to distinguish ocular causes amongst themselves or ocular from optic nerve, which can be very challenging at the bedside. But one topic you cover in your article, which I realized I don't really have a great approach to, is transient binocular visual loss. Briefly here, since we're running out of time, what's your approach to transient binocular visual loss? Dr Newman: We assume with transient binocular vision loss that we are not dealing with a different experience in each eye, because if you have a different experience in each eye, then you're dealing with bilateral eyeball or optic nerve. But if you're having the same experience in the two eyes, it's equal in the two eyes, then you're located. You're located, usually, retro chiasmally, or even chiasm if you have pituitary apoplexy or something. So, all of these things require imaging, and I want to take one minute to talk about that. If you are sure that you have monocular vision loss, please don't get a brain MRI without contrast. It's really useless. Get a orbital MRI with contrast and fat suppression techniques if you really want to look at the optic nerve. Now, let's say you you're convinced that this is chiasmal or retrochiasmal. Well then, we all know we want to get a brain MRI---again, with and without contrast---to look specifically where we could see something. And so, if it's persistent and you have a homonymous hemianopia, it's easy, you know where to look. Be careful though, optic track can fool you. It's such a small little piece, you may miss it on the MRI, especially in someone with MS. So really look hard. There's very few things that are homonymous hemianopias MRI negative. It may just be that you didn't look carefully enough. And as far as the transient binocular vision loss, again, remember, even if it's persistent, it has to be equal vision in the two eyes. If there's inequality, then you have a superimposed anterior visual pathway problem, meaning in front of the chiasm on the side that's worse. The most common cause of transient binocular vision loss would be a form of migraine. The visual aura of migraine usually is a positive phenomenon, but sometimes you can have a homonymous hemianopic persistent defect that then ebbs and flows and goes away. Usually there's buildup, lasts maybe fifteen minutes and then it goes away, not always followed by a headache. Other things to think of would be transient ischemic attack in the vertebra Basler system, either a homonymous hemianopia or cerebral blindness, what we call cortical blindness. It can be any degree of vision loss, complete or any degree, as long as the two eyes are equal. That should last only minutes. It should be maximum at onset. There should be no buildup the way migraine has it. And it should be gone within less than ten minutes, typically. After fifteen, that's really pushing it. And then you could have seizures. Seizures can actually be the aura of a seizure, the actual ictal phenomenon of a seizure, or a postictal, almost like a todd's paralysis after a seizure. These events are typically bright colors and flashing, and they last usually seconds or just a couple of minutes at most. So, you can probably differentiate them. And then there are the more- less common but more interesting things like hyperglycemia, non-ketonic hyperglycemia can give you transient vision loss from cerebral origin, and other less common things like that. Dr Berkowitz: Fantastic. Although we've talked about many pearls of clinical wisdom here with you today, Dr Newman, this is only a fraction of what we can find in your article with Dr Biousse. We focused here on monocular visual loss and a little bit at the end here on binocular visual loss, transient binocular visual loss. But thank you very much for your article, and thank you very much for taking the time to speak with us today. Again, today I've been interviewing Dr Nancy Newman about her article with Dr Valerie Biousse on the approach to visual loss, which appears in the most recent issue of Continuum on neuro-ophthalmology. Be sure to check out Continuum audio episodes from this and other issues. Thank you so much to our listeners for joining us today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.
In part two of this four-part series, Dr. Justin Abbatemarco and Dr. Nancy Newman discuss current treatment options for Leber hereditary optic neuropathy (LHON). Show reference: https://index.mirasmart.com/AAN2025/PDFfiles/AAN2025-002206.html
In part one of this four-part series, Dr. Justin Abbatemarco and Dr. Nancy Newman discuss how Leber hereditary optic neuropathy (LHON) typically presents and outline the steps for diagnosing LHON in a clinical setting. Show reference: https://index.mirasmart.com/AAN2025/PDFfiles/AAN2025-002206.html
20 Jahre Tagfalter-Monitoring - der Bestand der Schmetterlingsarten ; Wie hilft Bewegung beim Lernen? ; Zeitenwende an Hochschulen? - Wissenschaft und Zivilklausel ; Textilrecycling - Was tun mit alten Textilien? ; Fliegen ohne schlechtes Gewissen - CO-2 Kompensation okay? ; Lebertransplantation als Baby - Droht Marie (11) die Organ-Abstoßung? ; Was werdende Großeltern wissen sollten ; Moderation: Marija Bakker. Von WDR 5.
How safe are the food dyes found in many of the products we consume daily? Are concerns about their effects based on scientific evidence or misinformation? With government agencies and researchers continuously evaluating these additives, what changes might we see if more regulations and bans are put in place? As food products evolve in response to shifting policies, how can consumers stay informed and make the best choices for themselves? Tune into this episode to learn about: ● What types of foods/beverages contain food colors and why ● Artificial vs. natural food dyes ● What the research shows about the safety of food dyes ● Common myths and misconceptions about food dyes ● Challenges in making food color changes or product reformulations ● The California food dye acts ● Red dye number 3 ● The differences and similarities between the US and EU approach to risk management ● The truth about the differences between what the EU has banned compared to the US ● The difference between hazard and risk and why it is important ● A new food additives toolkit from IFT ● Takeaways and resources for the public and health professionals Full shownotes, transcript and resources: https://soundbitesrd.com/283
The charity Retina UK are seeking feedback from people with inherited sight loss conditions to learn how they can best support this community and feed into medical research. The charity primarily supports people who are living with genetic conditions, often with a progressive decline in sight. Some of these conditions are well known, such as Retinitis Pigmentosa, Usher Syndrome and Stargardt Disease and others are more rare, such as Leber congenital amaurosis. To participate in Retina UK's Sight Loss Survey, you can call their Helpline: 01280 821334. Or you can complete the survey online: surveymonkey.com/r/SightLossSurvey2025. The link to the survey can also be found on the Retina UK website. The CSUN Assistive Technology Conference is an annual showcase of the latest developments in assistive technology. The BBC's Senior North America Correspondent, Gary O'Donoghue and Emma Tracey, presenter of the BBC's disability and mental health podcast Access All, were there and they provide In Touch with an overview of the latest bits of tech that piqued their interest.Presenter: Peter White Producer: Beth Hemmings Production Coordinator: Liz PooleWebsite image description: Peter White sits smiling in the centre of the image and he is wearing a dark green jumper. Above Peter's head is the BBC logo (three separate white squares house each of the three letters). Bottom centre and overlaying the image are the words "In Touch" and the Radio 4 logo (the word ‘radio' in a bold white font, with the number 4 inside of a white circle). The background is a bright mid-blue with two rectangles angled diagonally to the right. Both are behind Peter, one is a darker blue and the other is a lighter blue.
Ben Leber in studio with PA for almost the entire hour!See omnystudio.com/listener for privacy information.
Ben Leber in studio with PA for almost the entire hour!
March 21, 2025. Professor Michel Michaelides, a world-renowned clinical researcher for inherited retinal diseases at Moorfields Eye Hospital and University College London, talks to host Ben Shaberman about the extraordinary vision improvements for young blind children receiving gene therapy for Leber congenital amaurosis 4 (LCA4). Professor also talks about emerging therapies in clinical trials for X-linked retinitis pigmentosa and Stargardt disease.
Chad Greenway and Ben Leber both in studio with PA for a Friday Feast!See omnystudio.com/listener for privacy information.
Chad Greenway and Ben Leber both in studio with PA for a Friday Feast!
Chad Greenway and Ben Leber both in studio with PA for a Friday Feast!
Der Lebergott (https://lebergott.com) ist Experte für Lebergesundheit und Ernährung.Er begleitet seit Jahren Menschen raus aus chronischen Beschwerden und zurück ins Leben. Über 5000 Menschen haben dank seiner Methode ihre Ernährung umgestellt und dabei etwas erreicht, wovon viele nur träumen: Sie haben ihren Körper regeneriert, ihre Gesundheit zurückgewonnen und leben heute die beste Version ihres Lebens. Im Podcast sprechen wir darüber, warum genau die Leber so eine zentrale Rolle spielt und weshalb der wichtigste Treibstoff für sie Zucker ist. Während seit Jahrzehnten erzählt wird, dass Fruchtzucker schädlich sei, zeigt der Lebergott, warum das Gegenteil der Fall ist.Inhaltsverzeichnis:04:00 Hochwertige Lebensmittel für die Leber: Glucose08:00 Der Treibstoff für die Leber ist Zucker12:00 Krankheiten die nicht heilbar sind — durch Obst schon15:00 Keto-diät ist FAKE17:00 Wahrheit über fasten22:00 Fettleber30:00 Schnitzel + Salat35:00 Hashimoto38:00 Neurodermitis - nichts hilft auf Dauer - Viren✨Mehr vom Lebergott:Website ➡ https://lebergott.comInstagram ➡ https://www.instagram.com/lebergott_/✨Japanischer Grüner Tee: https://arigato-life.deCommunity Mitglied werden und Bio Leinöl geschenkt bekommenhttps://www.skool.com/mrbroccolis-group-9868/about✨ Mehr von Mr. Broccoli:Homepage: https://www.vegan-athletes.comAbonniere meinen YouTube Kanal: https://www.youtube.com/@mrbroccoliInstagram: https://www.instagram.com/mrbroccoli.official/Telegram (für besonders brisante Themen): https://t.me/mrbroccoli_veganNewsletter: https://www.vegan-athletes.com/newsletter-vegan-athletes/➤➤➤ Meine 10 Favoriten für mehr Gesundheit: https://www.vegan-athletes.com/empfehlungen/
Leber in studio for most of the middle stretch on Vikings and NFL free agency, before some News bits to finish!
Leber in studio for most of the middle stretch on Vikings and NFL free agency, before some News bits to finish!
Ben Leber in studio for most of the hour, followed by Wolves chat on their win last night in Phoenix and Chris Finch getting ejected for the first time in his career!
Ben Leber in studio for most of the hour, followed by Wolves chat on their win last night in Phoenix and Chris Finch getting ejected for the first time in his career!
Ben Leber is in studio for most of the middle stretch!
Ben Leber is in studio for most of the middle stretch!
Ben Leber is in studio for most of the hour, with some news bits to finish!
Ben Leber is in studio for most of the hour, with some news bits to finish!