Podcasts about medical update

Medical Update and Major Announcement. Monday's Travel and Cruise Industry Podcast; February 24, 2025, brought to you by Whill_US, owner of Scootaround and Chillies Cruises. #fMondaytravelandcruiseindustrypodcast #travelandcruiseindustrynews #podcast #cruisenews #travelnews #cruise #travel #chilliescruises #chilliefalls #whill_us Thanks for visiting my channel. NYTimes The Daily, the flagship NYT podcast with a massive audience. "Vacationing In The Time Of Covid" https://nyti.ms/3QuRwOS To access the Travel and Cruise Industry News Podcast; https://cms.megaphone.fm/channel/trav... or go to https://accessadventure.net/ To subscribe: http://bit.ly/chi-fal I appreciate super chats or any other donation to support my channel. For your convenience, please visit: https://paypal.me/chillie9264?locale.... Chillie's Cruise Schedule: https://www.accessadventure.net/chillies-trip-calendar/ For your mobility needs, contact me, Whill.inc/US, at (844) 699-4455 use SRN 11137 or call Scootaround at 1.888.441.7575. Use SRN 11137. YouTube: https://www.youtube.com/ChilliesCruises Facebook: https://www.facebook.com/chillie.falls X: https://x.com/ChillieFalls Learn more about your ad choices. Visit megaphone.fm/adchoices

Today on show: A frontline medical update on the Gaza genocide, as Trump continues to advocate for the complete ethnic cleansing of Gaza. Also, Poet Anita barrows returns as she continues to keep track of the Gaza slaughter poem by poem, and day after murderous day. Today she documents the 23rd day of the ceasefire. We'll feature A commentary by Caitlan johnstone, “The Gaza Ceasefire Is Being Sabotaged By Israel, By Trump, and The Media:”.  And Gavin Newsom turns his back on solar energy The post A Frontline Medical Update on The Genocide in Gaza appeared first on KPFA.

Health care leaders answer questions about rising cases of flu and Covid-19, as well as other public health concerns

The Fat One closes out the first FULL week of 2025 with an update on Garry with 2 Rs, gentlemen callers, Ubering Vader to the aeropuerto (which we all know is Mexican for, Aeropuerto), a trip to the Sam's Club and the Wednesday coupon. Happy National Bittersweet Chocolate Day.

In this episode I discuss an update of an emergency medical incident that occurred yesterday for one of my long-term clients.

It's always great to connect with old friends. In this case, the positive power of social media helped a breast cancer patient find specialized care.

Treating breast cancer isn't just about the disease--it's about the whole person. Meet the cosmetologists helping women regain their confidence.

~The Sunday Morning MEDICAL UPDATE Message "AUDIO" Podcast On *preaker+-P.S.T.-Always Uploaded & Available 24/7 On All Major PodCast Channels & Platforms-Coast To Coast-WorldWide & iNTERNATIOANL)-The Opening Prayer-Scriptures-Notes & More!-In The Torah/K.J.V./Orthodox Study Bible/N.L.T./Amplified Bible+-Blessings & Thank You ~Become a supporter of this podcast: https://www.spreaker.com/podcast/ch-1-live-in-studio-a-you-re-on-air-w-pstr-rik-coast-to-coast-worldwide-internationa--2973438/support.

Severe food allergies can make each meal a challenge– and expensive. Meet a mom whose own fight to feed her daughters has led to better access for Medicaid patients everywhere. Visit our website, www.kansashealthsystem.com or findadoctor.kansashealthsystem.com.

After last week's electrocution incident, I update the Glade Plugins medical department on my recent doctor's visit and receive some startling disinformation vis-à-vis which of their products is safe to heat up on the stove.

Hey there, buttercup! In this episode Chalene dives into the ongoing medical mystery—spoiler alert, it's still a mystery! She stresses again hormone replacement therapy and why it's essential for women over 40. Plus, get Chalene's thoughts on a Netflix docu-series about the Dallas Cowboys Cheerleaders that serves up a shocking dose of '90s-style body shaming. Tune in for all the juicy details and more!  Join the all-new Phase It!! A Personalized Plan to Fit Your Life

Human excrement used as a treatment?! Meet someone who needed a fecal microbiota transplant to reset her gut's microbiome.

Summer heat comes with health concerns, and it doesn't even need to be sweltering hot before your body reacts. From the danger of hot cars to the medications that put us at higher risk of heat illness. Today we're focused on giving you valuable information to keep you and your loved ones safe this summer.

Seeing a doctor doesn't mean you're weak. Seeking help has nothing to do with masculinity. Join us for an important discussion aimed at ending the stigma surrounding men's health.

Skin cancer is rarely "one-and-done". Patient Kevin Shea needed surgery, more than a decade after his original diagnosis! Surviving melanoma, how doctors keep tabs on where the cancer may spread.

Gestational diabetes, a condition that often has no symptoms, catching pregnant women by surprise, and putting their babies at risk. We look at the danger for both mother and baby. Plus, how experts teach expecting moms to protect their metabolic health.

It's tough to talk about Alzheimer's, but we shouldn't shy away from such important conversations. We hear from a caregiver, and get and update on the newest Alzheimer's drugs.

4 years into the COVID Pandemic and this shared traumatic experience has changed us. The deaths, the division and the uncertainty are still taking a toll mental health. Experts call it a collective trauma facing society.

Countless creams, gels and drugs promise to reverse the effects of menopause. Now doctors have a laser in their toolbox the five-minute treatment promising less dryness and pain.

Waiting for a new kidney sapped Amy Reinhardt's energy, but it never shook the 27-year-old's faith. How Amy connected to a community of patients just like her and learned to endure life on the transplant list.

Answers to your questions about Covid, vaccines, flu and other health matters

A party for a princess- 3-year-old Olivia is hoping to put cancer treatment behind her. The rare tumor that first showed up as a gut infection. And the urgent treatment giving her the best shot at a bright future.

A brother and sister's bond is amplified when he donates his bone marrow to save her life. Watch all episode - Morning Medical Update Cancer: Choices, Hope and Science   

in today's episode I give an update on what is going on with me and hopefully motivate some of my listeners to LISTEN to the signs your body is giving you. I break down overtraining syndrome and the different phases. If you have struggled with overtraining or you are struggling with living the high stress lifestyle that mimics it, I would love to have you on board in my road to recovery. If you have recovered from overtraining syndrome, I would love to hear your experience and how you managed to overcome it.Shoot me a message: IG @cherylnassoFB @cherylnassoEMAIL cheryl@myfitbodyrx.com Schedule a free nutrition strategy call below:https://formfaca.de/sm/8F3alRLhKJoin My Free Facebook Group: LIVE TRAININGS, SUPPORT, EDUCATION :https://www.facebook.com/groups/141933950164494

In this Medical Update, Buck talks about one quick thing you can do to significantly improve the quality of your sleep. It goes against what we've been told but everyone should do it. The data backs it!

Sponsored by www.betterhelp.com/TheBarnVulgar Display of Podcast: Instagram | Twitter | FacebookBetterHelp, Zymurgy Brewing, Black Bayou Coffee Roasters, Michael Haley Photography, Total Deathcore, Liquid DeathMoontooth is a name that resonates with the raw, unbridled energy of heavy rock. Hailing from New York City, this quartet has been forging a unique path in the world of modern rock music, offering a blend of hard-hitting riffs, intricate melodies, and emotive lyrics that captivate audiences and challenge genre boundaries.Formed in 2012, Moontooth consists of John Carbone (vocals/guitar), Nick Lee (lead guitar), Vincent Romanelli (bass), and Ray Marte (drums). From their early beginnings, they showcased a fearless approach to their music, combining elements of hard rock, metal, and progressive rock into a sound that defies easy categorization.One of Moontooth's defining features is their powerful and dynamic live performances. They bring an intensity to the stage that electrifies audiences, leaving them in awe of the band's musicianship and sheer sonic force. Whether they're headlining a show or supporting larger acts, Moontooth's stage presence is undeniable, and their performances are memorable experiences.In 2014, they released their self-titled EP, which served as a promising introduction to their sound. However, it was their 2016 full-length debut album, "Chromaparagon," that truly put them on the map. The album received critical acclaim and showcased the band's ability to craft songs that were simultaneously heavy and melodic, featuring intricate guitar work and Carbone's distinctive, emotive vocals.One of the standout tracks from "Chromaparagon" is "Queen Wolf," which exemplifies Moontooth's ability to create music that blurs the line between hard rock and progressive metal. The song's heavy riffing, time signature changes, and evocative lyrics are a testament to the band's songwriting prowess.Moontooth's evolution as a band continued with their 2019 release, "Violent Grief: Acoustic Selections." This EP demonstrated their versatility by presenting stripped-down, acoustic versions of their songs. It was a departure from their heavier sound but showcased their songwriting depth and Carbone's emotive vocals.In a music landscape where genres are constantly evolving, Moontooth stands as a beacon of innovation and fearless creativity. Their ability to merge heavy rock with intricate compositions and genuine emotion sets them apart and ensures their place in the future of modern rock. Whether on record or onstage, Moontooth continues to shape the future of heavy rock, and fans eagerly anticipate what they will deliver next.This episode is sponsored by www.betterhelp.com/TheBarn and presented to you by The Barn Media Group.

Guest - Craig Libby Matthew 14

Hour 1: Tiki and Tommy talk about the Mets big win in Atlanta last night and if Mets fans should be buying into the recent success of the team. They also provide an update on Evan's sickness with an official word on his ailment(s). 

Welcome to another episode of The Monday Night Warfare Podcast, where JR Judy and Wade Skaggs take a look back at and review the weekly television wars between the WWF, WCW, and ECW! On this week's podcast: WCW Monday Nitro (11/27/1995) 3:43 World War 3 PPV Recap 8:45 WCW World Television Championship: Johnny B Badd (c) w/ The Diamond Doll Kimberly against DDP (Diamond Dallas Page) 12:05 Mean Gene Okerlund interviews The Taskmaster Kevin Sullivan and Jimmy Hart 14:22 Bull Nakano & Akira Hokuto w/Sonny Ohno vs. Cutie Suzuki & Mayumi Ozaki 17:47 Hugh Morrus vs. Hulk Hogan 21:54 Mean Gene Okerlund interviews the NEW WCW World Heavyweight Champion Macho Man Randy Savage 26:56 Arn Anderson & Flyin' Brian Pillman vs. Sting & Lex Luger 31:38 Preview for Next Week on Nitro and Starrcade 1995 Updates involving New Japan Pro Wrestling WWF Monday Night Raw (11/27/1995) 36:32 Recap of Shawn Michaels' collapsing last week on RAW 38:45 Rad Radford vs. Ahmed Johnson 41:05 Medical Update on Shawn Michaels 43:19 Aja Kong & Tomoko Watanabe vs. Alundra Blayze & Kioko Innoue 49:29 The Brother Love Show with NEW WWF Champion Bret The Hitman Hart 54:11 Triple H vs. John Crystal 58:18 The Undertaker w/Paul Bearer vs. Kama w/Ted DiBiase ECW Hardcore TV (11/28/1995) 1:04:50 Sabu Returns To ECW 1:06:38 Jason vs. Konnan (Special Guest Referee: Taz) 1:07:45 ECW World Heavyweight Championship: Mikey Whipwreck (c) vs. Rey Mysterio Jr. 1:09:22 Lance Wright calls Superstar Steve Austin 1:11:18 Todd Gordon vs. Bill Alfonso (Special Guest Referee: Beulah McGillicutty ) 1:18:03 ECW Promo Montage featuring Mick Foley/Cactus Jack Listen on Apple Podcast or Spotify, OR watch on YouTube! Stay up to date with all things Monday Night Warfare Podcast: Facebook: @MondayNightWarfarePodcast Twitter: @MonNightWarfare Instagram: @MondayNightWarfarePodcast YouTube: The Monday Night Warfare Podcast This video is not produced or endorsed by WWE entertainment. This video is not intended to devalue or tarnish WWE's quality of work. This video does not represent WWE's corporate views. This video has been created with the purpose to educate, review, and critique on works within professional wrestling. Any images used in this video are to assist with these outlined purposes. Images are used with section 197 of the copyright act in mind. This section states that allowance is made for fair use purposes such as criticism, comment, reporting, teaching, and research. Fair use is a use permitted by copyright statute that might otherwise be infringing. Any and all images used in the following video have been presented under faith that the images fall under fair use. --- Support this podcast: https://podcasters.spotify.com/pod/show/mondaynightwarfarepod/support

What about oral?? Lewis GD et al. Effect of oral iron repletion on exercise capacity in patients with heart failure with reduced ejection fraction and iron deficiency: The IRONOUT HF randomized clinical trial. JAMA 2017 May 16; 317:1958. (http://dx.doi.org/10.1001/jama.2017.5427. opens in new tab) randomized, 225 patients with symptomatic systolic HF for 16-weeks to either  oral iron polysaccharide 150 mg twice daily and placebo in 225 patients with symptomatic systolic HF (median left ventricular ejection fraction, 25%) At 16 weeks, the groups did not differ on the primary endpoint of peak oxygen consumption (VO2) or on secondary endpoints, including 6-minute walk distance and quality of life as measured with the Kansas City Cardiomyopathy Questionnaire. Thus as you mentioned not only is it not well tolerated it also doesn't appear to work which might be a better reason to not give it.https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0279166Vitamin D2 supplementation was associated with a 48.8% reduction in suicide/self-harm risks, and vitamin D3 with a 44.8% reduction, both highly significant (P < .001).   this sounds great but it is purely relative reduction not absolute because the absolute numbers wereUnadjusted suicide attempt/intentional self-harm rates in the D2 sample were 0.27% for those treated versus 0.52% for those untreated. The corresponding percentages for D3 were 0.20% versus 0.36%, respectively.Which equals a NNT of roughly 400 and 625 over 8 yrs, respectfully.IF this was true then that actually isn't too bad (not good or great but not terrible) but this was a retrospective observational trial so they just looked at a lot of people and said what can we find and publish.So what are other reasons that someone would not commit suicide??My first thought is ‘you only get put on vit d if you go to the doctor” (which is true)And typically the people that go to the doctor for their health care a little more about their health than someone who commits suicideClearly this isn't a universal answer but possibleAnother thought isthe vet that goes to the doctor and gets prescribed vit d feels like someone “cares for him/her” so maybe it has nothing to do with the vit d but just the sense of reassurance that someone cares about them?? Based on this I still wouldn't/wont write for vitamin d unless you need cheap placebo since we cant actually write for placeboD'Andrea E et al. Comparing effectiveness and safety of SGLT2 inhibitors vs DPP-4 inhibitors in patients with type 2 diabetes and varying baseline HbA1c levels. JAMA Intern Med 2023 Feb 6; [e-pub]. Sodium–glucose cotransporter-2 (SGLT-2) inhibitors are used to manage type 2 diabetes but also have protective cardiovascular and renal effects.  Do these benefits and adverse effects vary according to baseline level of hyperglycemia SGLT-2 inhibitors were compared with propensity-score–matched patients who initiated dipeptidyl peptidase-4 (DPP-4) inhibitors, within three categories of HbA1c: 9%. After mean follow-up of 8 months, initiation of SGLT-2 inhibitors was associated with significantly lower risks for major adverse cardiovascular events and hospitalization for heart failure, DUH we know this works in people that don't have diabetes why is it a surprise that it works in those with uncontrolled or controlled diabetes. To me this points to the problem that A1C is a number, it is not the problem, a bad A1C says there could be a problem in the future but in itself the A1C is a number!Buelt, Andrew | Apr 19, 2023, 3:25 PM | | to meTreat-to-Target or High-Intensity Statin in Patients With Coronary Artery Disease: A Randomized Clinical Trial | Cardiology | JAMA | JAMA Network JAMA. 2023;329(13):1078-1087. doi:10.1001/jama.2023.2487  randomized noninferiority trial 4400 patients Question  Is treatment to a goal low-density lipoprotein cholesterol (LDL-C) level between 50 and 70 mg/dL noninferior to a strategy using high-intensity statin therapy among patients with coronary artery disease? To assess whether a treat-to-target strategy is noninferior to a strategy of high-intensity statins for long-term clinical outcomes in patients with coronary artery disease.Patients were randomly assigned to receive either the LDL-C target strategy, with an LDL-C level between 50 and 70 mg/dL as the target, or high-intensity statin treatment, which consisted of rosuvastatin, 20 mg, or atorvastatin, 40 mg.  Which isn't HIGH in my book that that is fine.  Primary end point was a 3-year composite of death, myocardial infarction, stroke, or coronary revascularization with a noninferiority margin of 3.0 percentage points. The primary end point occurred in (8.1%) in the treat-to-target group and (8.7%) in the high-intensity statin group  Worst conclusion ever“Conclusions and Relevance  Among patients with coronary artery disease, a treat-to-target LDL-C strategy of 50 to 70 mg/dL as the goal was noninferior to a high-intensity statin therapy for the 3-year composite of death, myocardial infarction, stroke, or coronary revascularization. These findings provide additional evidence supporting the suitability of a treat-to-target strategy that may allow a tailored approach with consideration for individual variability in drug response to statin therapy.” Let's see if something that's much more difficult and costly and more blood draws and more work and more office appointments is non inferior to something that's easier such as take this medication and that it………………………………... Then why it is, we recommend the much more difficult thing.     Treat-to-Target or High-Intensity Statin in Patients With Coronary Artery Disease: A Randomized Clinical Trial | Cardiology | JAMA | JAMA Network JAMA. 2023;329(13):1078-1087. doi:10.1001/jama.2023.2487  randomized noninferiority trial 4400 patients Question  Is treatment to a goal low-density lipoprotein cholesterol (LDL-C) level between 50 and 70 mg/dL noninferior to a strategy using high-intensity statin therapy among patients with coronary artery disease? To assess whether a treat-to-target strategy is noninferior to a strategy of high-intensity statins for long-term clinical outcomes in patients with coronary artery disease.Patients were randomly assigned to receive either the LDL-C target strategy, with an LDL-C level between 50 and 70 mg/dL as the target, or high-intensity statin treatment, which consisted of rosuvastatin, 20 mg, or atorvastatin, 40 mg.  Which isn't HIGH in my book that that is fine.  Primary end point was a 3-year composite of death, myocardial infarction, stroke, or coronary revascularization with a noninferiority margin of 3.0 percentage points. The primary end point occurred in (8.1%) in the treat-to-target group and (8.7%) in the high-intensity statin group  Worst conclusion ever“Conclusions and Relevance  Among patients with coronary artery disease, a treat-to-target LDL-C strategy of 50 to 70 mg/dL as the goal was noninferior to a high-intensity statin therapy for the 3-year composite of death, myocardial infarction, stroke, or coronary revascularization. These findings provide additional evidence supporting the suitability of a treat-to-target strategy that may allow a tailored approach with consideration for individual variability in drug response to statin therapy.” Let's see if something that's much more difficult and costly and more blood draws and more work and more office appointments is non inferior to something that's easier such as take this medication and that it………………………………... Then why it is, we recommend the much more difficult thing.        Hydrochlorothiazide and Prevention of Kidney-Stone Recurrence | NEJMN Engl J Med 2023; 388:781-791  Thiazide diuretic agents are widely used for prevention of the recurrence of kidney stones, but data regarding the efficacy of such agents as compared with placebo are limited.  double-blind RCT  patients with recurrent calcium-containing kidney stones were randomized to hctz 12.5 mg, 25 mg, or 50 mg once daily or placebo once daily.  primary end point, a composite of symptomatic or radiologic recurrence of kidney stones. Symptomatic= The visible passage of a stone and radiologic =Appearance of new stones on CT 416 patients were randomized and followed for almost 3yrs primary end-point event occurred in (59%) in the placebo group (59%) in the 12.5-mg hydrochlorothiazide group (56%) in the 25-mg group(49%) in the 50-mg group  (rate ratio, 0.92; 95% CI, 0.63 to 1.36) No difference in any of the subgroups that was looked at there was no difference in the stone composition if it was calcium oxalate or calcium phosphate there was no difference Some women and people of race were underrepresented in this study but when you have a well done study that is the best we have the burden of proof now falls on you to prove there is benefit… for me this goes against board questions and what I thought was true and will lead me to stopping HCTZ if I am using it for prevention of kidney stones. 

The Check-In Tuesday 5/30/23

Lindholt JS, Søgaard R, Rasmussen LM, et al. Five-year outcomes of the Danish cardiovascular screening (DANCAVAS) trial. N Engl J Med 2022;387(15):1385-1394.     Study design: Randomized controlled trial (nonblinded) Looking to see if intensive screening protocol for cardiovascular disease reduce cardiovascular events or mortality in older men? Danish study, 46,611 men aged 65 to 74 years were randomly assigned to receive an invitation to screening or usual careThe screening program included non-contrast electrocardiographically gated CT to measure coronary artery calcium, look for aneurysms, and detect atrial fibrillation; ankle-brachial index measurements for peripheral arterial disease (PAD) and hypertension; and blood tests for diabetes and hyperlipidemiaThose who accepted screening were more educated, more likely to be employed, and had a somewhat lower rate of hospitalization for cardiovascular events in the previous 5 years. (the rich white gullible ceo male)The screened group was more likely to be given lipid-lowering drugs and antithrombotics, and they were more likely to have repair of an aortic aneurysm.In the entire population, stroke was less likely (HR 0.93; 0.86 - 0.99) but there were no significant differences in myocardial infarction, aortic dissection, or aortic rupture. The authors estimated that 97.4% of men who received preventive therapy of some kind as a result of screening experienced no mortality benefit after almost 6 yrs of follow up. This is basically a really small absolute benefit which we could also see in just placing a pt on a statin. We don't need vip medicine we need pcp that have time to calculate risk and place pt on statin when indicated.     Goldberg RB, Orchard TJ, Crandall JP, et al, for the Diabetes Prevention Program Research Group. Effects of long-term metformin and lifestyle interventions on cardiovascular events in the diabetes prevention program and its outcome study. Circulation 2022;145(22):1632-1641. Study design: Randomized controlled trial (nonblinded) What is the long-term impact of treating prediabetes on mortality and cardiovascular outcomes? Go way back original Diabetes Prevention Program study randomized 3234 overweight or obese adults with impaired glucose tolerance ("prediabetes") to receive metformin 850 mg twice daily, an intensive exercise program, or placebo and followed them for 3 years Patients were invited to participate in a long-term open-label follow-up study This article reports long-term cardiovascular and mortality outcomes for each group. Patients in the intervention groups were less likely to have been given a diagnosis of T2DM (55% for metformin and 53% for lifestyle vs 60% for placebo; P = .001; number needed to treat [NNT] = 17) There was no difference between either intervention group and placebo with regard to the risk of cardiovascular death, nonfatal stroke, or nonfatal myocardial infarction. There was also no significant difference in the composite of all 3 outcomes for the original metformin group versus the placebo group (hazard ratio [HR] 1.03; 95% CI 0.78 - 1.37) or for those in the original lifestyle group versus the placebo group (HR 1.14; 0.87 - 1.50). More is less or rather more meds is less diagnosis but no difference in things we actually care about     Skjerven HO, Lie A, Vettukattil R, et al. Early food intervention and skin emollients to prevent food allergy in young children (PreventADALL): a factorial, multicentre, cluster-randomised trial. Lancet 2022;399(10344):2398-2411. Study design: Randomized controlled trial (single-blinded) Does the early introduction of allergenic foods prevent the development of food allergy? investigators randomized healthy newborns, singletons or twins, with at least 35 weeks' gestational age (concealed allocation) to receive no intervention (n = 597), a skin intervention (n = 575), a food intervention (n = 642), or a combined intervention (n = 583). The skin intervention consisted of 5- to 10-minute baths with added petrolatum-based emulsified oil followed by topical cetirizine cream applied to the face. This intervention was to occur at least 4 days per week from age 2 weeks to 8 months, The food allergy intervention consisted of sequentially adding allergenic foods (peanuts, cow's milk, wheat, then eggs) to the infants' regular diet at weekly intervals starting at age 3 months. Overall, 95% of the infants in each group were breastfed at 3 months The researchers had final data on 99.9% of the participants!   based on structured parental interviews, skin testing, and oral challenges  The researchers classified the development of food allergy at 36 months as probable, none, or unclear.  There was no significant difference, however, between the infants who were exposed to skin interventions and those who were not exposed (2.1% vs 1.6%). BUT BUT BUT Food allergy occurred in 1.1% of infants in the interventions using food (food intervention and combination intervention) compared with 2.6% in not using food (no intervention and skin intervention; number needed to treat = 63; 95% CI 37-196).   Lewis E, Merghani K, Robertson I, et al. The effectiveness of leucocyte-poor platelet-rich plasma injections on symptomatic early osteoarthritis of the knee: the PEAK randomized controlled trial. Bone Joint J 2022;104-B(6):663-671. Study design: Randomized controlled trial (double-blinded) Allocation: Concealed recruited adults with at least 4 months of knee pain (with or without swelling) who had mild degeneration on their x-rays (if plain x-rays found no signs of degeneration, they used magnetic resonance imaging to confirm the diagnosis). The participants were randomized to receive 3 weekly saline injections (n = 28), or a single PRP injection followed by 2 weekly saline injections (n = 47), or 3 weekly PRP injections (n = 27). . The clinician performing the injections was unmasked but had no other involvement in the study procedures. the participants were evaluated at 6 weeks, 12 weeks, 6 months, and 12 months after enrollment Using intention-to-treat analysis looking at pain, function, and quality of life, at no point in the study were PRP injections, singly or serially, superior to saline injections.

I HAVE THE AUDIO FOLKS AND WE ARE GIVING IT TO YOU EXCLUSIVE!!!!The Grand Jury.........a GREAT American institution!!!!!Fatty Arbuckle our old fat Frenchy, MEDICAL UPDATE!NO HUMPING ANOTHER MAN'S BLOW UP DOLL!!!BOTOX USE AFTER 20 YEARS! The results are NOT KIND!Brooke Shields has been cut out by Tom CruiseRod Stewart is still alive and has a girlfriend who shouldn't be in a bikini!King Chuck's new HOUSE OF LORDS DRESS CODE!A quick new 'Dear Stan' about an old problem!local news! MORE SHOOTINGS IN OKLAHOMA!Animal Cruelty will get you thrown in jail no matter the age folks!THE GREATEST COMMERCIAL FOR FIRE MEDS CANNABIS I'VE EVER DONE!!!!Trumps Indictment is PATHETIC!

Efficacy and Safety of Intensive Versus Nonintensive Supplemental Insulin With a Basal-Bolus Insulin Regimen in Hospitalized Patients With Type 2 Diabetes: A Randomized Clinical Study | Diabetes Care | American Diabetes Association (diabetesjournals.org)   randomized noninferiority study from Emory University, 224 hospitalized patients with longstanding type 2 diabetes  Both groups received basal/bolus insulin; both the starting dose and subsequent changes were specified by the study protocol. Additional premeal SSI was added to scheduled premeal bolus doses.randomized to either intensive SSI (at BG >140 mg/dL) or nonintensive SSI (at BG >260 mg/dL) before meals and at bedtime.  Mean baseline glycosylated hemoglobin (HbA1c) was 9%, and 60% of patients were using insulin at home. Patients with a presenting glucose level of >400 mg/dL or diabetic ketoacidosis were excluded.  Outcome---Mean daily BG level, hypoglycemia, severe hyperglycemia, percent of BGs in the target range (70–180 mg/dL), and the amount of total, basal, or prandial insulin used did not differ between groups. However, significantly fewer patients in the nonintensive group than in the intensive group received SSI (34% vs. 91%).   COMMENTAlthough this is a single-center study, its results are persuasive and suggest that a less-intense SSI regimen can achieve similar glucose outcomes in hospitalized patients with type 2 diabetes who are receiving basal/bolus insulin. It also could decrease nursing treatment burden. As we move slowly toward more continuous glucose monitoring in hospitals, reducing use of SSI is another opportunity to achieve similar results with less staff burden and more patient comfort.  Comparative Effectiveness and Safety Between Apixaban, Dabigatran, Edoxaban, and Rivaroxaban Among Patients With Atrial Fibrillation: A Multinational Population-Based Cohort Study: Annals of Internal Medicine: Vol 175, No 11 (acpjournals.org) In a retrospective study, investigators accessed five electronic health databases from Europe and the U.S. to compare >500,000 new DOAC users with newly diagnosed atrial fibrillation. Follow up varied from 1.5 to 4.5 years.   In propensity score–adjusted analyses, patients who received apixaban had significantly less gastrointestinal (GI) bleeding did those who received any of the other three drugs (hazard ratios, 0.7–0.8). This result was consistent among older patients and those with chronic kidney disease (CKD). Risk for stroke or other systemic embolism, intracranial hemorrhage, and all-cause mortality did not differ significantly among DOACs.    COMMENTThis is the largest comparison of individual DOACs, and it demonstrates similar efficacy among all agents. Although apixaban was associated with less GI bleeding, absolute percentages of GI bleeds ranged from ≈2% to ≈3.5% for all DOACs; therefore, apixaban's statistically significant safety benefit might amount to marginal clinical benefit for any individual patient. I might turn to apixaban for patients at high risk for GI bleeding (and those with CKD), but all DOACs remain reasonable options for preventing thromboembolism in most patients with atrial fibrillation. Ellenbogen MI et al. Safety and effectiveness of apixaban versus warfarin for acute venous thromboembolism in patients with end-stage kidney disease: A national cohort study. J Hosp Med 2022 Oct; 17:809. (https://doi.org/10.1002/jhm.12926. opens in new tab)  . In an industry-funded retrospective study, investigators used a national database (years, 2014–2018) and propensity score–adjusted analysis to compare outcomes among >11,500 patients with ESRD and newly diagnosed VTE who received either apixaban or warfarin.Only 2% of patients received apixaban in 2014, but 47% received apixaban in 2018.during the 6 months following initiation of therapy, apixaban — compared with warfarin  associated with significantly lower incidence of major bleeding (10% vs. 14%), including intracranial bleeding (1.8% vs. 2.5%) and gastrointestinal bleeding (8.6% vs. 10.4%). Recurrent VTE and all-cause mortality were similar in the two groups.   VTE and creatine clearence less than 30 then I think apixaban is the drug of choice—I would like to see this study don't with afib and done with exclusively

coffee saves your life-- maybe, careful for confounders heart failure hospital admission is really hard to preventmoderate dose statin is most important..but ezetmibe and moderate dose is equal to high dose statinI think we should take out all kidney stones and the evidence says there will be lest hospitalizations if we do thatEHR can help us and remind us to check and PTHrobotic surgery is not all that is seems to be-- or at least not yetvit. D and fish oil dont help dry eyes....or much of anything for that matterstop injecting Hyaluronic acid into the knee

210 – “Medical Update”, Exercise Modalities So I had a little procedure done which gave me the heebie jeebies – listen to my dramatic retelling of the story here. And we have the physics lesson to end all physics lessons after that, at least with respect to gym equipment and why the type of equipment… Read More » The post 210 – “Medical Update”, Exercise Modalities appeared first on Five Starr Physique.

210 – “Medical Update”, Exercise Modalities So I had a little procedure done which gave me the heebie jeebies – listen to my dramatic retelling of the story here. And we have the physics lesson to end all physics lessons after that, at least with respect to gym equipment and why the type of equipment you use (free weights, machine, cable, etc) matter. Before that, a quick follow-up from an&hellip The post 210 – “Medical Update”, Exercise Modalities appeared first on Five Starr Physique.

Today on the show we have EMS physician Dr. Kasia Hampton back after her medical tour in Ukraine to assist doctors and facilities there. Dr. Hampton studied medical school in Belgium before moving to the U.S. for her medical training in emergency medicine and pediatric medicine. She worked in the U.S. Army for five years as a civil service physician before moving to St. Louis in June 2021, where she worked an EMS fellow with Washington University.

 skin exam, ddp4, IUD, oral hypertension medication

Join John Williams and Dr. Matt Holden with special guests Rob Silver and Joni Kamlet with Real Mushrooms.com for this weeks Medical Update for our pets. 

https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.122.059410?af=RThe Biomarkers say REDUCE-IT was a scamhttps://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2791663NO! Just NO-- stick with the calculator for nowhttps://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.059038start the SLGT-2 inhibitors early! maybe an early dischargehttps://pubmed.ncbi.nlm.nih.gov/35849407/If we could get the EMR to do it automatically else you cant expect providers tohttps://pubmed.ncbi.nlm.nih.gov/35727595/the head CT for psych stuff can probably be put on holdhttps://eprints.whiterose.ac.uk/180135/continue the disease modifying agents

196. Medical Update -- PICC lines, PRE-Diabetes, Sleep in the Hospital, Ortho Surgery!

It's been nearly a year since the introduction of the breakthrough drug Aducanumab. Dr. Monica gives us an update and discusses some new treatments on the horizon.

European Heart JournalBariatric surgery and cardiovascular disease: a systematic review and meta-analysisEur Heart J 2022 Mar 04;[EPub Ahead of Print], SL van Veldhuisen, TM Gorter, G van Woerden, RA de Boer, M Rienstra, EJ Hazebroek, DJ van Veldhuisen  39 studies, all prospective or retrospective cohort studies, showed Bariatric surgery is associated with a reduced hazard ratio (HR) of CV morality (0.59), all-cause mortality (0.55), incident HF (0.50), myocardial infarction (0.58) and stroke (0.64) Authors state “”The present systematic review and meta-analysis suggests that bariatric surgery is associated with reduced all-cause and CV mortality, and lowered incidence of several CV diseases in patients with obesity. Bariatric surgery should therefore be considered in these patients.””” Here is the problem and I have said it before—“no randomized control trials examining the effect of bariatric surgery on CV outcomes,”Among frail patients with AF, OAC treatment was associated with a positive net clinical outcome. Direct OACs provided lower incidences of stroke, bleeding, and mortality, compared with warfarin. Just talked recently about continue doac in hospice and everyone agrees that is bad but ultimately there are very few conditions in which you should not resume anticoag—even in those with GI bleed, falls, or subachrnoid hemerage—the data suggest the pts are better off back on anticoag. Well this study looked at the frail. In this retrospective cohort study analyzed 83 635 patients  with mean age 78.5 those individuals who were on ORAL anticoag(doac or warfarin) had overall lower risks of ischemic stroke (HR, 0.91) and cardiovascular death (HR, 0.52), with no significant difference in major bleeding (HR, 1.02),   Bottom line- restart the OAC – even in the frail to prevent the outcomes we really care about like stroke and death    Dave CV et al. Risks for anaphylaxis with intravenous iron formulations: A retrospective cohort study. Ann Intern Med 2022 Mar 29; [e-pub]. (https://doi.org/10.7326/M21-4009. opens in new tab) Anaphylaxis occurs rarely with intravenous (IV) iron does happen but how often does it happen??  It is a mystery—till now Using a retrospective cohort design, investigators assessed 167,000 U.S. Medicare patients who received IV iron products between 2013 and 2018. Patients who had received IV iron within the previous year and those with end-stage renal disease, HIV infection, history of anaphylactic reaction, or recent transfusions were excluded. This is the perfect study for observational data. We know it happens so we look at a large data set and try to see how often it happens. In this population of older adults, the rate of anaphylaxis for iron dextran was ≈0.1%, but it was closer to 0.01% for iron sucrose, ferric gluconate, and ferric carboxymaltose (can give once== carboxy and dextran). As indications have broadened for use of IV iron in managing various clinical conditions (e.g., heart failure, chronic kidney disease) when iron deficiency is present, clinicians might use these data to inform selection of a preparation.  A lot depends on cost and availability but these are good numbers to have in your head for the anaphylaxis event rate... Sure it might take 5 years or even 10 years but some of the outcomes like MI and HF will easily hit in the first 5-10 years!! This RCT could be done tomorrow! Instead we continue to do this observational studies and say look how great this procedure is!! Well maybe it is ‘healthy' patient bias—you have two pts with BMI of 40 but one seems motivated is working out eating better- trying to take all the right steps and the other hasn't left the couch in 6 years. The one that is active then gets referred for bariatric surgery and when we match them up we say LOOK AT THIS THE BARIATRIC SURGERY person did so much better. WEEELLLLLL that pt was likely going to do better anyways!!! AT this point everyone know that bariatric surgery seems to have great CV outcomes in retrospective and prospective observational trials we have done enough of them.. THIS analysis had 39 STUDIES—39!!!! We don't need 30 more we need and RCT!!!     Katz PO et al. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol 2022 Jan; 117:27. (https://doi.org/10.14309/ajg.0000000000001538. opens in new tab) Much of this guideline is worthwhile for nongastroenterologists.  An empirical 8-week trial of a proton-pump inhibitor (PPI), given once daily, is recommended for a patient who has classic heartburn and regurgitation but no alarm symptoms.  PPIs should be taken 30 to 60 minutes before a meal, because they bind to proton pumps that have been stimulated by meals. Bedtime dosing is discouraged because this is less effective than a predinner dose in acid control GERD is thought to contribute to various extraesophageal symptoms, including chronic cough, hoarseness, and laryngitis; however, a causal relation often is unclear in any given patient. For patients with extraesophageal symptoms — but no heartburn or regurgitation — the authors argue against empirical PPI therapy  After 8 weeks you STOP the PPI--PPI nonresponders, and PPI responders whose symptoms return after an 8-week PPI course, should be evaluated with Endoscopy about 2 to 4 weeks off PPIs.  If endoscopy is normal, ambulatory pH monitoring (off treatment) is the next step. authors encourage intermittent or “on-demand” (rather than indefinite) PPI therapy in patients with no history of high-grade esophagitis or Barrett esophagus. IF requires ongoing PPI therapy for symptom control should use the lowest effective dose.I do like these guidelines cause they seem to be great at making sure PPI are stopped (ideally). I do hate these guidelines cause getting a scope after 8 weeks of a PPI with reoccurring symptoms seems like a lot of scopes will be done. Especially because some people get rebound gerd when going off of a PPI. As the authors state “One area of controversy relates to abrupt PPI discontinuation and potential rebound acid hypersecretion, resulting in increased reflux symptoms. Although rebound acid hypersecretion has been demonstrated to occur in healthy controls, strong evidence for an increase in symptoms after abrupt PPI withdrawal is lacking.”  -- none of this is super strong evidence!!! This seems like a lot of scopes.The fear of progression to adenocarcinoma with Barrett's Esophagus would make for an easy decision for prolonged PPI use, however, a systematic review and meta-analysis published in PLoS One - Hu Q, Sun TT, Hong J, et al. Proton Pump Inhibitors Do Not Reduce the Risk of Esophageal Adenocarcinoma in Patients with Barrett's Esophagus: A Systematic Review and Meta-Analysis. PLoS One 2017;12(1):e0169691. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0169691 found no protective effect.1And even though long term use of PPI is associated with many bad outcomes even the authors state -  “””“PPIs are the most effective medical treatment for GERD. Some medical studies have identified an association between the long-term use of PPIs and the development of numerous adverse conditions including intestinal infections, pneumonia, stomach cancer, osteoporosis-related bone fractures, chronic kidney disease, deficiencies of certain vitamins and minerals, heart attacks, strokes, dementia, and early death. “” the authors go on to say “””Those studies have flaws, are not considered definitive, and do not establish a cause-and-effect relationship between PPIs and the adverse conditions. High-quality studies have found that PPIs do not significantly increase the risk of any of these conditions except intestinal infections. .”””  THIS IS ALSO GARBAGE!!! The reason the high quality studies don't show this is because most studies are only 8-12 weeks long PPI you need long term trials which most people are on and you have to power your study so large to find a super rare outcome that observational data is the best we are ever going to have for this particular finding. I know the authors knew this but it didn't fit their agenda…Which is my last point—although we will never know—all but one of the authors has or is taking big pharma money. Take home if you are following the guideslines-- start PPI only for Gerd like symptoms. Make sure taking the PPI correctly. Stop after 8 weeks. If it reoccurs then 2-4 weeks later off the PPI they need a scope and if the scope is normal then they need PH monitoring. Then the rec is for PRN PPI.  

Gibbons RC et al. Ultrasound-versus landmark-guided medium-sized joint arthrocentesis: A randomized clinical trial. Acad Emerg Med 2022 Feb; 29:159. (https://doi.org/10.1111/acem.14396. opens in new tab)Use a ultrasound for arthrocentesis when possible Circ Arrhythm Electrophysiol 2022 Mar; 15:e010646. (https://doi.org/10.1161/CIRCEP.121.010646)Apple AirPods Pro and their wireless charging case, the Microsoft Surface Pen, and the Apple Pencil second generation — also have strong enough magnetic fields to affect current-generation CIEDs.https://pubmed.ncbi.nlm.nih.gov/34862940/first of all empiric therapy with clarithromycin is no longer effective for treating Helicobacter. You have two choices. The choices are thus: 14-day bismuth quadruple therapy or rifabutin triple therapy,Andreadis K, Chan E, Park M, et al. Imprecision and preferences in interpretation of verbal probabilities in health: a systematic review. J Gen Intern Med 2021;36(12):3820-3829. . The interpretation of "common" which means- accepted definition of 1% to 10%.But people thought it meant 59% (on average) --------59% is basically all the time that is great odds and would bankrupt vegas TAKE HOME!!In studies asking for preference, a majority of patients prefer numbers rather than word-based estimates of risk. Risks and Benefits of Early Rhythm Control in Patients With Acute Strokes and Atrial Fibrillation: A Multicenter, Prospective, Randomized Study (the RAFAS Trial) | Journal of the American Heart Association (ahajournals.org) The main findings were that early rhythm control led to a lower risk of stroke at 12 months (3 [1.7%] vs 6 [6.3%]; HR, 0.251; P = .034). There was no difference in risk of recurrent stroke at 3 months. 

In today's episode we talk with Brian McLaughlin about Medical Update for Instructors The Concealed Carry Podcast network is brought to you by XS Sights manufacturer here in the USA. Today's episode is also brought to you by the following: Firearm Trainers Association (FTA) FTAProtect.com – In today's world you need the backing from a… The post S3E04 Instructor Medical Update first appeared on The Firearm Trainer Podcast.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00572-9/fulltextOld calculators use old studies and can over exaggerate the calculated effecthttps://pubmed.ncbi.nlm.nih.gov/33970197/We know when to start medication but it is so hard to prospectively know when to stop medication like anticoagulationhttps://pubmed.ncbi.nlm.nih.gov/34074830/2 Kiwi a day will increase your bowel movementshttps://pubmed.ncbi.nlm.nih.gov/34100866/We want to believe routine checkups work but realistically they don't work for patient oriented outcomes--but they make people 'feel good'-- what we do isn't always the doing, it's just being therehttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01063-1/fulltextDAPT following a stent-- but then just maybe we should stay with plavix and not aspirin