Antibiotic and antiprotozoal medication
POPULARITY
4 episodes with Metronidazole
2 episodes with Metronidazole
2 episodes with Metronidazole
2 episodes with Metronidazole
2 episodes with Metronidazole
In this episode encore we discuss the management of digestive disorders with pureANIMAL ambassador Dr Caroline Mansfield. Topics discussed include: What made Dr Mansfield want to become a veterinarian and what sparked her interest in gastroenterology. Projects Caroline has been involved in throughout her career. Dr Mansfield's current canine microbiome and chronic enteropathy study. Effects of diet on diet-responsive enteropathies. Dr Caroline talks about her project on ‘Modifying the gut-brain axis to improve outcomes in shelter animals'. Probiotic benefits in decreasing stress in dogs. Common feline digestive disorders Dr Mansfield gets presented with and how she manages them. When are probiotics indicated in feline digestive disorders? When to reach for prebiotics or synbiotics? Dr Caroline specifies the indication for Metronidazole. See omnystudio.com/listener for privacy information.
Challenge preconceived notions in obstetrics and gynecology with our latest episode, where we dismantle myths that have long influenced medical practices, even in the absence of scientific backing. From unraveling the misunderstood reaction between alcohol and metronidazole to examining the overlooked risks of clindamycin cream, we'll look at how these misconceptions take root in medical culture. We continue with a critical analysis of intrapartum GBS prophylaxis, correcting widespread misunderstandings around its purpose and timing during labor and how it affects labor management.We address the rise of dubious hormone tests, like the DUTCH Test, marketed to consumers, painting a cautionary picture of how social media amplifies these unvalidated products. We highlight the importance of consulting healthcare professionals while discussing the potential paradigm shift that self-collected HPV testing could bring to cervical screening, as recommended in the coming cervical cancer screening guiudelines. This new approach might revolutionize screening rates and quality of care, especially for underserved populations, all while realigning healthcare providers' focus on more pressing medical needs.Prepare for an engaging conclusion as we scrutinize the comparative effectiveness of postpartum hemorrhage devices Jada and Bakri, emphasizing the ethical implications of cost versus efficacy. We'll take you on a historical journey through the concept of "quickening" in pregnancy, reflecting on its cultural significance and evolution with modern science. Plus, changes for next season!00:00:02 Metronidazole and Alcohol00:13:03 Intrapartum GBS Prophylaxis Guidelines Clarified00:24:54 Hormone Testing and Cervical Screening 00:31:07HPV Self-Collect Screening Implications00:42:54 Comparative Efficacy of Postpartum Hemorrhage Devices00:51:29 Historical Perspectives on Fetal DevelopmentFollow us on Instagram @thinkingaboutobgyn.
TWiP solves the case of the Manhattan man with pain on urination or ejaculation, and presents a new case for you to solve. Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Links for this episode Join the MicrobeTV Discord server Hero: Charles Louis Alphonse Laveran Letters read on TWiP 247 New Case A middle-aged male is referred to evaluation because of eosinophilia. This man is married, living here in the NY tristate area, and this was picked up on ‘routine blood work' by his primary care doctor. This man had been in the military, serving as a marine, with time spent in Okinawa, Japan. This individual does report sexual activity with paid sex workers while in Okinawa but has been monogamous with his current wife for many years. A number of investigations are done with a test coming back showing serological evidence of a prior parasitic infection and he was treated with an antiparasitic medicine with resolution of the eosinophilia. The eosinophilia returned and he was referred to us. Blood work is now down showing evidence of a viral infection that might explain why the eosinophilia returned after treatment. Pt is HIV negative. This was prior to the COVID-19 pandemic. He is on no medications and in general feels fine. Become a patron of TWiP Send your questions and comments to twip@microbe.tv Music by Ronald Jenkees
Watch every WBH episode on demand: https://covid19criticalcare.com/courses/whole-body-health-with-dr-saleeby/ In this crucial video, Dr. Saleeby sheds light on the severe, potentially life-threatening interaction between Mebendazole and Metronidazole. As more individuals turn to repurposed drugs like Mebendazole for cancer treatment due to systemic healthcare shortcomings, awareness of this drug interaction is vital. The combination can trigger severe dermatological reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis (TEN). It is essential for anyone considering these treatments to work closely with a doctor, whether their oncologist or an adjunctive integrative specialist, and ensure all medications and supplements are disclosed to avoid dangerous interactions. Learn more about 'Whole Body Health' here: https://flccc.net/wholebodyhealth Dr. JP Saleeby | Carolina Holistic Medicine https://carolinaholisticmedicine.com/ Dr. JP Saleeby's Substack | Yusuf's Substack https://jpsaleebymd.substack.com/ The FLCCC Alliance is a healthcare nonprofit on a mission to restore trust, integrity, and the doctor-patient relationship. Get involved by clicking below:• Donate: https://geni.us/Donate-Today • Follow: https://geni.us/Follow-FLCCC • Protocols: https://geni.us/Treatment • Webinar: https://geni.us/FLCCC-Webinar • Shop: https://geni.us/Shop-FLCCC • Medical Disclaimer: https://geni.us/Disclaimer cancerdr jp saleebyflcccmebendazolemetronidazole
Free book is here at https://www.memorizingpharm.com/books Summary 3.17 Antiprotozoals Chapter 3.17 discusses antiprotozoals, medications used to treat protozoan infections such as Giardia. An example is metronidazole, which disrupts protozoal folic acid synthesis. It can be administered orally, topically, or intravenously. Side effects may include seizures, peripheral neuropathies, and dizziness. Patients should avoid alcohol during treatment and be aware that the medication can cause darkened urine. Multiple Choice Questions What is a common antiprotozoal medication? a) Penicillin b) Metronidazole c) Acyclovir d) Fluconazole How does metronidazole work? a) Enhances protein synthesis b) Inhibits folic acid synthesis c) Blocks DNA replication d) Prevents cell wall formation What side effect should patients monitor while taking antiprotozoals? a) Hair loss b) Seizures c) Increased appetite d) Weight gain What should patients avoid while taking antiprotozoals? a) Dairy products b) Alcohol c) Exercise d) Salty foods What symptom might indicate a protozoal infection? a) Dry skin b) Diarrhea c) Hair growth d) Weight gain Answer Key b) Metronidazole b) Inhibits folic acid synthesis b) Seizures b) Alcohol b) Diarrhea
Real Life Pharmacology - Pharmacology Education for Health Care Professionals
On this episode of the Real Life Pharmacology podcast, we cover 5 more medications in the top 200. Metronidazole is an antibiotic for infection. One of the most common complaints from patients involves reporting of a metallic taste in the mouth. Levetiracetam is an anti-seizure medication. Sedation, dizziness, and other adverse effects of the central nervous system are the most common complications. Colchicine is a gout medication. The most memorable side effect associated with this medication is diarrhea. Olanzapine is an antipsychotic. Olanzapine carries a higher risk for metabolic syndrome compared to other antipsychotics. Dutasteride is a 5 alpha-reductase inhibitor that is indicated for the treatment of BPH. If you are looking for all of our study materials and Amazon books, check them out at Meded101.com/store!
Get access to our clinical podcast series with our 30% off IVECCS Special. Get case support from our team at specialists in our Specialist Support Space. Does anyone else feel a bit powerless in those acute diarrhoea consults since we've learned that we shouldn't give metronidazole? Your client has come to you for a solution, and you want to help, but there's nothing you can give them that will really help that much. Or is there? Our bonus episode for day three of our IVECCS 2024 highlights series might give you that magic pill you've been looking for… poop! Dr. James Oldeschulte is well-acquainted with treating acute diarrhoea as an experienced ER vet, and in this conversation, he shares some freshly published data that highlights the efficacy and clarifies the practicalities of using psyllium fibre and faecal transplants in the treatment of acute diarrhoea in veterinary patients. Sign up for our free weekly newsletter to hear about my favourite 3 lessons I learnt in that week from making the podcasts.
Your Natural Dog with Angela Ardolino - Formerly It's A Dog's Life
On this episode of Your Natural Dog with Angela Ardolino, we're joined by Dr. Lynda Loudon, an emergency veterinarian with over two decades of experience and a holistic approach to pet care, coupled with a strong commitment to education. Dr. Loudon joins Angela to address a common question from pet parents, when should you take your dog to the ER, and when can you provide aid at home? They explore common causes of emergency room visits, including issues like diarrhea, gut health, and situations where dogs may ingest toxic substances such as chocolate, grapes, or even your own stash of edibles. Together they also discuss the over-prescription of medications, including antibiotics, steroids, and NSAIDs, and how to ask your veterinarian important questions. Tune in for a comprehensive discussion that's both informative and empowering for responsible pet care!Episode Recap: Preventing and Treating Diarrhea at HomeOver-prescribing dogs with antibiotics like Metronidazole for diarrheaWhy you shouldn't use FortiFloraOveruse of Steroids & NSAIDs in petsWhen pet parents want a quick fix Having the right tools at home, like CBDConventional Vets taught to prescribe firstAsking your veterinarian questionsAngela's journey with her dog LucyVeterinarians aren't taught about everythingThe need for veterinary education on diet & nutritionQuestions for Dr. Lynda Loudon on when to go to the ERWhat if my dog eats grapes? Can I induce vomiting at home?Eating chocolate? Eating butter?What if my dog gets into my marijuana stash?Use code RADIO for 15% off your first order at https://cbddoghealth.com/Use code MYCO10 for 10% off your order of https://mycodog.com/Episode Resources:Dr. Lynda LoudonTelehealth with Dr. Lynda LoudonFollow Dr. Loudon on FacebookJoin Dr. Loudon in the Dog Mom Society where she provides weekly Q & A sessions, monthly live trainings and access to her vault of canine masterclasses!Angela's Essential At-Home Holistic Toolkit What if your dog eats edibles?Have a question about your pet that you want answered on the podcast? Email us at Carter@yournaturaldog.com Angela ArdolinoCBD Dog HealthNote: Like all discount codes, they don't last furever!Follow Your Natural Dog on Facebook and Instagram and if you want to see what Angie (our founder) is up to, follow her on Facebook
Drs. Nicholas Torney (@NPT_PharmD) and Sunish Shah join Dr. Jeannette Bouchard (@jlbouchard001) to discuss our next topic in our Dosing Consult series: BID vs TID dosing for metronidazole. Deep dive into the PK/PD and real-world application of this switch with experts in this dosing strategy. References: Addition of anaerobic coverage in biliary infections: Addition of anaerobic coverage for treatment of biliary tract infections: a propensity score-matched cohort study Eggerthella lenta and Pipercillin-tazobactam: Eggerthella lenta Bloodstream Infections Are Associated With Increased Mortality Following Empiric Piperacillin-Tazobactam (TZP) Monotherapy: A Population-based Cohort Study Q12H Dose Schedule in Surgery Prophylaxis: Twelve-hourly dosage schedule for oral and intravenous metronidazole 2018 Clinical Data on Q12H Dosing in Mixed Infections: Clinical efficacy of 12-h metronidazole dosing regimens in patients with anaerobic or mixed anaerobic infections 2021 Clinical Data on Q12H Dosing: Three is a crowd: Clinical outcomes of a twice daily versus a thrice daily metronidazole dosing strategy from a multicenter study Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/ Check out our podcast host, Pinecast. Start your own podcast for free with no credit card required. If you decide to upgrade, use coupon code r-7e7a98 for 40% off for 4 months, and support Breakpoints.
In this episode, we review the high-yield topic of Metronidazole from the Microbiology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://podcasters.spotify.com/pod/show/medbulletsstep1/message
Check out our free downloads at nascentmc.com: Implementing AMA Style – 8 Things to Get Right in Your Next Project Needs Assessments – 7 Essentials for Getting Funded Working With Your Medical Writer – 8 Ways to Get the Most out of Them See the full write ups for today's episode at nascentmc.com/podcast Here are the highlights: Ryzumvi (Phentolamine Ophthalmic Solution) for Dilated Pupil Reversal The FDA has approved Ryzumvi for treating pharmacologically-induced mydriasis (dilated pupils). Ryzumvi, formerly known as Nyxol, will be available in the US in 2024 and is currently the only commercially available treatment for reversing dilated eyes. Exxua (Gepirone Hydrochloride) for MDD Exxua, an antidepressant, has received FDA approval for the treatment of major depressive disorder in adults. Exxua has faced regulatory challenges in the past. It works through selective agonism of 5HT1a receptors without causing common antidepressant side effects like sexual issues or weight gain. Likmez, Liquid Formulation of Metronidazole The FDA has approved Likmez, the only liquid oral suspension of metronidazole in the US. The liquid formulation provides an alternative for patients who struggle with the tablet version due to taste or swallowing difficulties. DNA Test for Hereditary Cancers The FDA granted marketing authorization for Invitae Common Hereditary Cancers Panel, a diagnostic test identifying genetic risks for certain cancers. This is the first FDA-approved test of its kind, with over 99.0% accuracy in detecting variants in 47 cancer-associated genes. Tofidence (Actemra [toclizumab] Biosimilar) Tofidence, a biosimilar referencing Actemra, has been approved by the FDA for certain rheumatologic indications. A biosimilar, it closely resembles the FDA-approved biologic Actemra in safety, purity, and efficacy. Pombiliti + Opfolda for Pompe Disease The FDA approved Pombiliti + Opfolda, a two-component therapy for adults with Pompe disease. The therapy shows significant improvements in patient mobility and is designed to address enzyme deficiency while maintaining it's efficacy in Pompe disease. Subcutaneous Entyvio (Vedolizumab) for Moderate-to-Severe Ulcerative Colitis The FDA has approved a subcutaneous form of Entyvio for maintenance therapy in adults with ulcerative colitis. Previously approved as an intravenous formulation, this subcutaneous version achieved significant clinical remission in trials for use as maintenance therapy. Experimental Stromal Cell Platform in Mild-To-Moderate ALS The FDA Advisory committee voted against the effectiveness of BrainStorm Cell Therapeutics' NurOwn stromal cell therapy for mild to moderate ALS. BrainStorm Cell Therapeutics plans to initiate a phase 4 study in 2024. Intro and outro music Garden Of Love by Pk jazz Collective
These days, doctors and vets are giving antibiotics and flagyl out like candy. In this short, I highlight the potential risks of the antibiotic Metronidazole, commonly known as Flagyl, and its impact on a dog's gut health and ability to process and digest protein. I emphasize the importance of understanding the effects of such medications on your pet's health and discuss the potential for systemic inflammation and triggering of certain genes linked to inflammatory skin conditions. Listen in for a fresh perspective on your dog's health and wellness. Books Mentioned: The Forever Dog Sponsored By: Earth Buddy Farms CBD Use Code HERBALBUDDY20 for 20% off today! Check Out Rita: Rita's Instagram Facebook Group My Courses My Website and Store
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Veterinary internal medicine specialist, Dr. Adam Rudinsky, author of "Randomized controlled trial demonstrates nutritional management is superior to metronidazole for treatment of acute colitis in dogs in: Journal of the American Veterinary Medical Association Volume 260 Issue S3 (2022) (avma.org)", discusses how for canine noninfectious acute colitis, dietary management with an easily digestible diet with or without psyllium enhancement proved a superior management strategy compared to metronidazole. Hosted by Associate Editor, Dr. Sarah Wright, and Editor-in-Chief, Dr. Lisa Fortier.INTERESTED IN SUBMITTING YOUR MANUSCRIPT TO JAVMA OR AJVR?JAVMA: https://avma.org/JAVMAAuthorsAJVR: https://avma.org/AJVRAuthorsFOLLOW US:JAVMA:Facebook: Journal of the American Veterinary Medical Association - JAVMA | FacebookInstagram: JAVMA (@avma_javma) • Instagram photos and videosTwitter: JAVMA (@AVMAJAVMA) / Twitter AJVR: Facebook: American Journal of Veterinary Research - AJVR | FacebookInstagram: AJVR (@ajvroa) • Instagram photos and videosTwitter: AJVR (@AJVROA) / TwitterJAVMA and AJVR LinkedIn: https://linkedin.com/company/avma-journals#VeterinaryVertexPodcast #JAVMA #AJVRINTERESTED IN SUBMITTING YOUR MANUSCRIPT TO JAVMA ® OR AJVR ® ? JAVMA ® : https://avma.org/JAVMAAuthors AJVR ® : https://avma.org/AJVRAuthorsFOLLOW US:JAVMA ® : Facebook: Journal of the American Veterinary Medical Association - JAVMA | Facebook Instagram: JAVMA (@avma_javma) • Instagram photos and videos Twitter: JAVMA (@AVMAJAVMA) / Twitter AJVR ® : Facebook: American Journal of Veterinary Research - AJVR | Facebook Instagram: AJVR (@ajvroa) • Instagram photos and videos Twitter: AJVR (@AJVROA) / Twitter JAVMA ® and AJVR ® LinkedIn: https://linkedin.com/company/avma-journals
Download the cheat: https://bit.ly/50-meds View the lesson: https://bit.ly/MetronidazoleFlagylNursingConsiderations Generic Name metronidazole Trade Name Flagyl Indication intra-abdominal infections, gynecoligical infections, skin infections, bone and joint infections, CNS infections, septicemia, endocarditis, amebic liver abscess, peptic ulcer disease Action Inhibits DNA and protein synthesis in bacteria, bactericidal Therapeutic Class anti-infectives, antiprotozoals, antiulcer agents Pharmacologic Class none Nursing Considerations • do not take with alcohol-disulfiram reaction • assess for infection before and during treatment • obtain cultures before therapy • monitor neurologic status: parasthesia, weakness, ataxia, or seizures • monitor intake and output, daily weights • may alter liver enzyme tests
Pyrlcasts, brought to you by Pyrls.com! We take a closer look at interesting and relevant clinical topics related to pharmacotherapy. Want to learn more clinical pearls? Boost your clinical confidence? Visit and sign-up for an account at pyrls.com to get over 10 high-quality charts absolutely FREE! Episode References: Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021). Sexually transmitted infections treatment guidelines, 2021. MMWR. Recommendations and Reports: Morbidity and Mortality Weekly Report. Recommendations and Reports, 70(4), 1–187. https://doi.org/10.15585/mmwr.rr7004a1 Katzung BG, ed. Basic and Clinical Pharmacology. 13th ed. New York: McGraw-Hill Education; 2015. Antabuse (disulfuram) tablet package insert. Pomona, NY: Duramed Pharmaceuticals, Inc.; 2010 Feb.
Since the 1960s, metronidazole has carried a label warning stating that alcohol use while taking the medication can lead to significant side-effects. This was termed a “Disulfurim-like reaction”. However, that's 100% not true! Where did this metronadazole myth come from? Why has it survived for over 50 years? In this podcast… We'll set the record straight! Yes, you can have your cake and eat it too… I mean, your beer and drink it too!
Fill up with delicious practice-changing knowledge food from #SGIM22 as The Curbsiders team discusses breast cancer survivorship, sexual dysfunction, How climate change will affect health, Are PT consults necessary in the hospital?, Do we need antibiotics for aspiration events?, bias in note writing, Are plant-based meats a healthy?, complications after breast implantation, how to get breast reduction approved, doxycycline for chlamydia, the metronidazole and alcohol myth, pearls for clinician-educators, telehealth, TEACHIM.org, CGMs help lower a1c, PT for rotator cuff disease, Is it safe to taper antidepressants? and how to treat methamphetamine use disorder! Note: There is no CME for this episode, but claim CME for prior episodes at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Written and Hosted by: Nora Taranto MD, Beth Garbitelli (about to be an MD!), Era Kryzhanovskaya MD, Justin Berk MD, MPH, MBA, Shreya Trivedi MD, Chris Chiu MD, Paul Williams MD, Matthew Watto MD Show Notes and Cover Art: Matthew Watto MD, FACP Showrunner: Matthew Watto MD, FACP Technical Production: Pod Paste Show Segments Intro A few ambulatory teaching models include the One Minute Preceptor, SNAPS (summarize, narrow, analyze, probe, plan, and select), PIPP (precepting in the presence of the patient) [see Community Preceptor Toolbox] Ikigai is a Japanese term indicating a motivational force or reason for living. It is associated with decreased mortality [Tanno, 2009]. Explore your ikigai here (PositivePsychology.com). Listening to podcasts while driving does not affect knowledge retention (Gottleib et al. 2021) Treatment of Hot flashes: Avoid paroxetine, fluoxetine, and sertraline in breast cancers survivors taking tamoxifen. Instead use venlafaxine (or another SNRI), citalopram, or escitalopram. Gabapentin given at bedtime is also an option. (Clinical Update 2019: Tamoxifen and Antidepressants) Distress in patients with cancer can be measured using the NCCN screening tool [NCCN Distress Thermometer] Don't forget to ask for a Cancer Survivorship Plan from oncology [CDC Cancer Survivorship Care Plans] Ask about sexual dysfunction in cancer survivors. How will climate change impact our patient's health? NIH framework; CH2OPD2 environmental screening tool [CH2OPD2 ]; and the 15 steps of climate communication. Use the AM-PAC score cutoff of >18 to avoid a PT consult in hospitalized patients (Martinez 2021). Early antibiotics after an aspiration event do not improve outcomes (Aga 2021). Biased language is more common in notes about Black patients (Beach 2021). Be thoughtful about what you write and role model good behavior. While plant-based meats are more eco-friendly than animal-sourced meats, they are heavily processed foods (van Vliet 2021) and may have high sodium. Silicone breast implant rupture can be insidious. Guidelines recommend screening with MRI after 6 years, then every 2-3 years (FDA 2020, More FDA info) (Note: FDA's most recent guidance also recommends ultrasound as an alternative screening method, so always check with the patient's insurance about which modality will be covered) Document a trial of NSAIDs, physical therapy, attempted weight loss, and supportive bra usage before breast reduction surgery for macromastia. Doxycycline is now first line for chlamydia rather than azithromycin [STI Treatment Guidelines Update], BUT the most effective treatment is the one your patient will take! Metronidazole does not cause a disulfiram-like reaction and is no longer recommended by the guidelines [STI Treatment Guidelines Update] More clinician-educator pearls from Era: Don't be afraid to brand yourself! Network with like-minded individuals (e.g. interest groups). BST mode: bite-sized teaching pearls can help reduce extrinsic load and improve retention [Manning, 2021] A guided discussion based on Scrubs episodes can improve resident wellness [Holtzclaw 2021] Chris recaps some posters (click links to see them on Twitter!): Telehealth disparities and tech equity (poster 1, poster 2); TeachIM.org (poster) Continuous glucose monitors can help lower a1c in patients on basal insulin [Martens 2021] A single session of PT improved shoulder pain. The benefits of steroid injections were limited to 8 weeks in the GRASP trial [Hopewell 2021] There is a high risk of recurrence after tapering antidepressants [Lewis 2021] Methamphetamine use disorder can be treated with IM naltrexone every 3 weeks, plus oral bupropion 450 mg daily [Trivedi 2021]. Limitations include cost and co-use of opioids. Outro Sponsor: Masterworks Get started at masterworks.art/curbsiders. Sponsor: Ten Thousand Get 15% off at tenthousand.cc/curb Sponsor: Green Chef Go to GreenChef.com/curb130 and use code curb130 to get $130 off, plus free shipping! Sponsor: Blueland Get 20% off your first order at blueland.com/curb
Professor Caroline Mansfield is a registered specialist in small animal medicine and she is recognized as an international leader in veterinary internal medicine. She graduated from Murdoch University and worked in mixed animal and small animal practice in Australia and the UK before completing a residency in small animal medicine at University College, Dublin. Caroline developed an interest in gastroenterology during that time and continued her clinical and research passion in academia. From 2001 until 2010 she was employed at Murdoch University as a clinical registrar and then senior lecturer – moving to the University of Melbourne in late 2010 as the Head of Small Animal Medicine and then becoming Professor and Director of Clinical Research. Her research involves projects investigating mechanisms involved in canine inflammatory bowel disease, the pancreas and establishing the impact in the gut microbiome has on health and disease in dogs. Topics discussed include: What made Dr Mansfield want to become a veterinarian and what sparked her interest in gastroenterology. Projects Caroline has been involved in throughout her career. Dr Mansfield's current canine microbiome and chronic enteropathy study. Effects of diet on diet-responsive enteropathies. Dr Caroline talks about her project on ‘Modifying the gut-brain axis to improve outcomes in shelter animals'. Probiotic benefits in decreasing stress in dogs. Common feline digestive disorders Dr Mansfield gets presented with and how she manages them. When are probiotics indicated in feline digestive disorders? When to reach for prebiotics or symbiotics? Dr Caroline specifies the indication for Metronidazole. See omnystudio.com/listener for privacy information.
For this month of March, we bring you an interview with Mr. Michael Craig, director of the CDC's Antibiotic Resistance Coordination and Strategy, where we learn more about the role and work of public health agencies, how the CDC works in its strategy against antibiotic resistance, and the importance of prevention. In our news section, we present to you a recent publication on how the WHO antimicrobial resistance global action plan and the COVID-19 pandemic have impacted the global consumption of antimicrobials, and an article just published by one of our PhD students, investigating the mechanisms of metronidazole resistance in Giardia intestinalis. Hope you enjoy! Check relevant links in the show notes at www.uac.uu.se/the-amr-studio/episode36/. Follow our updates on twitter on www.twitter.com/uac_uu with #theAMRstudio hashtag! Theme music by Henrik Niss: www.tinyurl.com/henriknissspotify.
Doing Battle Against Giardia and Coccidia Dr. Marty Greer, DVM joins host Laura Reeves to discuss how breeders and dog owners in general can do battle against the dreaded "bad potty bugs," giardia and coccidia. These single cell organisms can become endemic, Greer notes. "You can't get rid of it (on your property)," Greer said. "And that's the bad news. There's no really great treatment for either of them. There's nothing you can do that's going to disinfect your way out of it. We can't vaccinate our way out of it. So we need to talk about all of our options. "Many of the organisms that we see in the GI tract, whether it's Giardia or coccidia or parvo, or tonight I got a text message from a lady in Florida about campylobacter, many of those are secondary to something else. "So good gut health in general is your best defense. That's really the primary backbone of what you can do. So that means a diet that's appropriate, that doesn't cause your dog to have diarrhea or loose stools. A probiotic that's appropriate to keep the right bacteria there. Making sure you vaccinate for all the things you can vaccinate against, such as parvo. And making sure that you get regular fecal analysis done. "One of the best defenses you have right now are the monthly heartworm preventives that you give orally... will give you better gut health because it controls intestinal parasites such as roundworms, hookworms and whip worms. So the fewer other things your dog's body has to deal with, the healthier the gut, the better the dog's overall health is going to be. "The most commonly affected dogs that get sick are gonna be the younger ones or the dogs that are immunocompromised. So in general, if your dog has a little loose stool but they're feeling OK, they're eating OK, they're not vomiting, everything is OK other than their stools are intermittently or consistently loose, you take a stool sample in to your vet and ask if they can send it to a reference lab if they can't do Giardia testing. "Treatment for coccidia is Albon. Number one, you have to weigh (your dog) so your dose is accurate. Number two, if you're using the liquid, you have to shake it up really well because it does settle out. "Treatment of Giardia, there is no labeled drug for use in the United States, but there are a couple that are commonly used and very effective. Metronidazole, fenbendazole (Do not use metronidazole on puppies that are very young or pregnant bitches) Panacur, Safeguard, those are fine."
This episode features Dr. April Dyer from DASON. The article reviewed in this episode is available here: https://doi.org/10.1093/cid/ciaa395. For more information about DASON, please visit: https://dason.medicine.duke.edu.
HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast
In this episode, we debunk four medication myths that have persisted for decades: metronidazole and alcohol; statins and hepatotoxicity; cidal vs. static antibiotics; and "sulfa" allergies. Key concepts Metronidazole does not interact with alcohol (ethanol) and does not cause a disulfiram-like reaction. Statins can cause transient increases in liver function tests; however, these increases are not associated with hepatotoxicity. Routine LFT monitoring is not recommended unless clinically indicated signs or symptoms of liver injury exist. The distinction of bactericidal versus bacteriostatic antibiotics is irrelevant. No evidence exists showing that having a bactericidal drug has superior efficacy to a bacteriostatic drug. A “sulfa” allergy nearly always means an allergy to Bactrim (sulfamethoxazole-trimethoprim). There are many non-antibiotic sulfonamide-containing medications that do not need to be avoided in patients with a sulfa allergy; however, patients with an allergy to any medication have an increased risk of an allergic reaction to other medication classes.
It's the JournalFeed Podcast for the week of July 19-23, 2021. We cover treatment of blunt cerebrovascular injury, CNS and PNS side effects of metronidazole, chest POCUS or CXR for PTX, performance of the Canadian syncope rule in a different demographic, and more HEART score woes.
In this episode, we review a potentially practice-changing study. Should we treat PID with three antibiotics? Click HERE to leave a review of the podcast!References:All references for Episode 54 are found on my Read by QxMD collection
It’s the JournalFeed Podcast for the week of May 10-14, 2021. We cover a new PID treatment add-on, LP after CT for SAH, repeat epinephrine dosing for anaphylaxis, ketofol for children, and POCUS for peritonsillar abscess.
Wizzwatch Stock Market Podcast Vol. 112Stock 2 Watch 03.15.2021 $ZOM$ZOM - Zomedica Corp.. INFOBlogger - wizzwatch.blogspot.comFacebook - wizzwatch stock trading groupTwitter - wizzwatchPinterest - wizzwatchLinkedin - marlinrolleDiscord - wizzwatchInstagram - wizzwatchABOUT WIZZWATCHWizzWatch is the place for active traders as well as individual investors to find the very best stocks on Wall St. We provide commentary, picks of the week, as well as stocks on the move. "We find the very best stocks to fit your investment objectives". We cover thousands of publicly traded companies that trade on the NASDAQ,OTCBB, Pink Sheets and the NYSE. We have the answers for your stock market day to day questions. If you have a question about a publicly traded company, and would like to find out more, feel free to ask or send an email to wizzwatch@gmail.com.BECOME A STUDENT If you are interested in finding out more information or learning how to trade stocks please feel free to send me a message via email at wizzwatch@gmail.com. DISCLAIMERLegal Disclaimer: This channel is solely for informational purposes. Past performance is no guarantee of future returns. Stock trading involves risk, the stocks listed are not buy recommendations please do your own due diligence or get help from a proffesional before trading.HASHTAGS#zom #zomedicacorp #pets #dogs #cats #metronidazole #animals #diahrrea #methaimazole #hyperthyroidism #fluoxitine #michigan #usa #biotechnology #pharmaceuticals #medicine #transplants #therapeutics #solutions #treatments #data #healthcare #worldwide #nasdaq #technology #stocks #stockmarket #investing #investors #thefuture #technicalanalysis #michigan #marlinrolle
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Tired of the kibble, home cooked, raw debate? Would you just like to know if what you are feeding your dog is supporting health? Follow your gut...and listen to this episode!You have heard the buzzwords--microbiome, gut health, microflora, probiotics, immune health. After this episode, you will easily understand what they are and how caring for them first will create a foundation for good health.Did you know 80% of immune health comes from the health of the gut? Is what you are doing for your pet creating health or feeding imbalance?Have you used antibiotics, pain medicines, or deworming medicines with your dog? Are probiotics helping or harming your dogs health?Does your dog have IBD or any chronic GI Issue? How can a fecal transplant improve health?Get the answers to those questions and more! The information in this episode will benefit dogs, cats and humans. Please listen and share with friends and family.For more information on AnimalBiome click here Watch the YouTube version of the podcast and see the reports we discussed or just look for more videos and information from this episode by going here or www.doghappi.com
GERD vs Acid Reflux PPI's --> C. Diff Metronidazole and Vanco! A topic that confuses many, but listen to how Dr. Zeeshan breaks this bad boy down! Many people get overwhelmed with all the information that's out there, we keep it simple! Join us weekly for FREE Zoom Sessions and be one of the many REPEAT test takers that passed the exam by spending NO MONEY with NCLEX High Yield! NCLEX High Yield is a Prep Course and Tutoring Company started by Dr. Zeeshan in order to help people pass the NCLEX, whether it's the first time , or like the majority of our students, it's NOT their first time. We keep things simple, show you trends and tips that no one has discovered, and help you on all levels of the exam! Follow us on Instagram: @NCLEXHighYield or check out our website www.NCLEXHighYield.com Make sure you join us for our FREE Weekly Zoom Sessions! Every Wednesday 3PM PST / 6PM EST. The link is in out Instagram Bio, or email contact@nclexhighyield.com to be added to our list. --- Support this podcast: https://anchor.fm/nclexhighyield/support
This podcast presents, Dr. Elliot Francke, an infectious disease specialist with Midwest Infectious Disease Consultants, who provides an update on clostridioides difficile (C.Diff). Enjoy the podcast! Objectives: Upon completion of this podcast, participants should be able to: Identify factors of clostridioides difficile (C.diff). Describe the management of clostridioides difficile (C.diff) in a hospital setting. Explain the clinician's role in clostridioides difficile (C.diff) prevention. Differentiate the status of clostridioides difficile (C.diff) at Ridgeview. CME credit is only offered to Ridgeview Providers & Allied Health Staff for this podcast activity. Complete and submit the online evaluation form, after viewing the activity. Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within approximately 2 weeks. You may contact the accredited provider with questions regarding this program at rmccredentialing@ridgeviewmedical.org. Click on the following link for your CME credit: CME Evaluation: "Haunted Bowels: A Clostridioides Difficile (C.Diff) Update" (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.) DISCLOSURE ANNOUNCEMENT The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview Medical Center & Clinics. Any re-reproduction of any of the materials presented would be infringement of copyright laws. It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented. Ridgeview's CME planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event. SHOW NOTES: CHAPTER 1: ORIGIN STORY:In 1983, a pseudomembranous colitis was identified. In 1935, the organism was isolated. In 1978, Clostridium Difficile was identified as an organism that produces toxins causing diarrhea. In the last year, the genius has been renamed and the organism is now known as Clostridioides Difficile. The organism produces two toxins A and B. A is an immunogenic toxin that causes an influx of immune cells and some cell necrosis. Toxin S can be eliminated with a monoclonal antibody but does not stop the disease. Toxin B is of greater concern and causes cell death and pseudomembrane buildup in the large bowel lining. Bezlotoxumab is discussed again later, but is a commercial antibody that does not eliminate the disease but decreases the severity of it. PREVALENCE: Prevalence in the adult population is around 3-5%. For those over 60, prevalence is 50%. There are a large percentage of individuals who are colonized but not producing the toxin, otherwise known as non-toxigenic C. DIff. C. Diff organisms are difficult to combat for several reasons. The organism is a gram positive rod, that does not have the attachment points for some standard antibiotics. It also has that ability to efflux antibiotics out of the cell. When attacked, it can produce spores that are impenetrable by both the immune system and many antibiotics, and can live for long periods of time on surfaces waiting for the right opportunity. Creepy microbes. Growth in the bowel can be inhibited by 14-16 natural flora identified in two Canadian studies. RISK FACTORS: Those at greater risk for C. Diff infections are over the age 65, in long-term hospitals or institutions, immunosuppressed, or chronic PPIs, or have had recent use of certain systemic antibiotics. The correlation to antibiotics was discovered in 1978, and originally linked to clindamycin. Currently use of 3rd or 4th generation cephalosporins and quinolones are risk factors; though that does not mean another antibiotic may also be the cause of infection. CHAPTER 2: PROBIOTICS:Post-antibiotic treatment, the normal flora of the bowel reconstitute in 204 weeks. This occurs through food and bacteria introduced orally and also via the appendix which serves as a reservoir for bacterial flora. Probiotics are not necessary for every patient, but have proven benefits. Here are some numbers regarding probiotic success in reducing the disease; Lactobacillus, 60-65%, Bifidobacterium 80% and Kefir 65% reduction in C. Diff relapses. Dr. Francke recommends Keefer to his patients because it contains 11 of the 14-16 organisms identified to be beneficial in the aforementioned Canadian studies. Dr. Francke noted a decrease in relapse rates from 50-60% to 5-10%, through notes that this is an anecdotal observation. TESTING: Positive risk factors, combined with patient complaints of severe watery diarrhea, with or without blood, fever and an elevated white count, raises high suspicion for C. Diff. When suspected a PCR test should be ordered, rather than a stool culture or multiplex test. These would be used when another disease process is suspected. The C. Diff PCR looks for the DNA coding for the production of the toxins, both A and B, but again B is more concerning. Two instances where PCR testing would not be required is the patient has already tested positive for C. Diff. or the patient has less than 3 stools a day - meaning they are not experiencing significant pathology of the disease. Not every case of diarrhea is C. Diff, and differential diagnosis would include obtaining imaging - such as CT or X-ray. Colonic distention with edema on the wall of the colon could be seen in a case of C. Diff. If a patient were symptomatic, but the C. Diff PCR was negative, it is not recommended to treat them for C. Diff, as the toxin test has a 98% predictive value. CHAPTER 3: TREATMENT: First line treatment for an initial infection is 125mg of oral vancomycin, 4 times a day for a 10-14 day course. After the first relapse, repeat oral vancomycin, but with longer taper over several weeks. A probiotic can be added at this stage. If a second relapse occurs, consider adding rifaximin or fidaxomicin, and for the severely ill, Bezlotoxumab can be given, which helps decrease the relapse rates. Metronidazole is no longer used as first line treatment due to a high relapse rate. EFFECTIVENESS: Oral vancomycin is 72-75% effective for treatment of an initial infection. After the first relapse, vancomycin treatment is again 72-75% effective. After the 2nd relapse, effectiveness is 50-65%. Use of fidaxomicin at any stage is 80-85% effective. Adding rifaximin to oral vancomycin increases effectiveness by 10-15%. FMT: Fecal Microbiota Transplant Fecal microbiota transplant is a treatment option for C. Diff. Fecal matter is collected from donors carefully screened for infectious disease. Administration to the patient is achieved in one of three ways: One time administration via nasogastric tube or enema or administered via 6-8 oral capsules over several days. Research has shown pre-treatment with Bezlotoxumab increases the effectiveness of FMT by 65-85%. Literature has also shown that a vancomycin taper can increase the success rate of FMT. PREVENTION: Community colonization of C. Diff has increased by 3-5%, but nosocomial infections have decreased. Prevention includes: handwashing with soap, isolation of infected patients, terminals cleans after discharge, and use of UVC light machines. Antibiotic stewardship is also important and it takes a combined effort to ensure the most efficient and appropriate antimicrobial agents are being used. For those being treated as outpatients it is most likely that other family members and even pets are already colonized. To prevent reinfection or spread, outpatient education includes, washing linens, wiping down commonly used surfaces with bleach, and hand washing. Thanks for listening.
Avi, Tony, and Hannah are back at it, investigating why metronidazole treats both bacterial and parasitic infections, why it's only effective against anaerobic organisms, and how this relates to the supposed disulfiram-like reaction. The episode opens with an important message from Dr. Mark Shapiro (host of the Explore The Space podcast) about VoteHealth 2020. Here are some links for obtaining CE/MOC credits just for listening to this episode and to read the show notes on our website. You can also check out Avi's original tweetorial on metronidazole and all of The Curious Clinician Podcast's other episodes.
On this new part series called 'know your drug', we start by looking at metronidazole. We look at what metronidazole is, the side effects, how it works and additional pharmaceutical advice.
a continuación intentaremos dar una revisión sistemática por los temas mayormente preguntados en los exámenes de residencias médicas en Colombia y que frecuentemente son motivo de consulta en atención primaria. Todas las decisiones médicas y recomendaciones aquí expresadas deben de ser comparadas con la información académica oficial y jamás deben de ser tomados como un absoluto, los actos médicos derivados de estos audios son responsabilidad de aquellos que ejercen. Se han notificado reacciones similares al disulfiram en pacientes que bebían etanol mientras se les administraba metronidazol sistémico o vaginal. Una reacción típica de disulfiram causa rubor, taquicardia, palpitaciones, náuseas y vómitos. El alcohol debe evitarse durante el tratamiento y hasta cuarenta y ocho horas hasta catorce días después de la finalización del tratamiento, dependiendo de la fuente; la información del producto del fabricante recomienda evitar la ingestión de alcohol durante la terapia con metronidazol y durante al menos 48 horas después. Los medicamentos que contienen etanol, como elixires y tipranavir, cápsulas, anidulafungina intravenosa (IV), trimetoprim-sulfametoxazol IV y muchos jarabes para la tos / el resfriado también pueden provocar una reacción similar al disulfiram cuando se ingieren con metronidazol. Referencia Weir CB, Le JK. Metronidazole. [Updated 2020 Jun 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539728 Este podcast se distribuye bajo los términos de Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), que permite su uso, duplicación, adaptación, distribución y reproducción en cualquier medio o formato, siempre que otorgue el crédito apropiado al autor o autores originales y la fuente, se proporciona un enlace a la licencia Creative Commons, y se indican los cambios realizados.
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Acute Gastroenteritis- Author: Dr. Brian Geyer Introduction: Do both vomiting and diarrhea have to be present? No 1996 AAP guidelines, 2016 ACG guidelines, and 2017 IDSA guidelines all note diarrhea illness but may be vomiting predominant. Studies use more vague definitions like: > 1 episode of vomiting and/or > 3 episodes of diarrhea in 24 hours without known chronic cause like inflammatory bowel disease. Diarrhea is at least 3 unformed stools per day. Acute episode 29 days Patients in the ED may present with only some of these symptoms depending their time in course of illness. Literature Review: There is abundant literature on pediatric AGE but sparse research on AGE in adults. Therefore, many recommendations are extrapolated from the pediatric literature. Causes: 70% of US cases are estimated to be caused by viruses, norovirus being most common. o 26% norovirus o 18% rotavirus Among bacterial causes: o 5.3% Salmonella, most common o 5.3% Clostridium o 3% Campylobacter o 3% parasitic infections Large portion, 51%, have no cause identified. (In ED patients) Interestingly, 79% of cases never have a cause identified (not ED specific) In ED patients, only 25% ever have a cause identified, this increases to 49% when a stool sample is obtained. (not ED specific) Food poisoning is responsible for 5% of AGE but results in 30% of deaths. Most commonly: Salmonella, Clostridium perfringens, and Campylobacter Majority of foodborne illness is still viral, mostly norovirus E Coli is normal in the gut, but two most common causes are: Shiga toxin Ecoli (STEC) AKA enterohemorrhagic Ecoli (EHEC) - causes Hemolytic Uremic Syndrome in 5-10% Entertoxigenic Ecoli (ETEC) - causes traveler's diarrhea Both cause self-limited illness. Alternate Diagnoses: Appendicitis: In the peds literature, misdiagnosis of appendicitis as AGE leads to 47% absolute increased risk of perforation. Suggestive findings include: Migration of pain to RLQ RLQ tenderness on exam (initial or repeat) Absence of diarrhea Pain not improved with episodes of diarrhea Negative factors include multiple ill family members, recent international travel, presence of diarrhea (as defined above). Ciguatera Fish Poisoning Toxin produced by algae consumed by reef fish like grouper, red snapper, sea bass and Spanish mackerel. Symptoms begin 6-24 hours post ingestion. Fish tastes normal. Patients may develop neurological symptoms like paresthesias, generalized pruritis, and reversal of hot/cold sensation. Symptoms resolve spontaneously, and treatment with mannitol is controversial. Scombroid Poisoning Ingesting fish in the Scombroidae family - mackerel, bonito, albacore, and skipjack - that have been stored improperly Bacteria produce histidine decarboxylase which converts histidine to histamine Causes abdominal cramps and diarrhea, and may cause metallic bitter or peppery taste in mouth, and facial flushing within 20-30 min of ingestion Can be confused with allergic reaction Symptoms resolve in 6-8 hours Notification of health dept may prevent others from being infected. Page 5 Table 1- Distinguishing Factors in the Differential Diagnosis of AGE History: Table 2, page 6 has key questions to ask. Onset, timing, number of stools, presence of blood, fever, quality of abdominal pain and location, recent antibiotics, etc. Extremes of age, immunosuppression, and pregnancy should be identified. Mortality is highest in the patients >65 yo. Physical Exam: We talked about RLQ abd pain, but what about bloody stool? An observational study of 889 adults and 151 pediatric with AGE showed that a negative fecal occult test showed accurately excluded invasive bacterial etiology with a NPV 87% in adults and 96% in children. But PPV was only 24%. Laboratory Testing and Imaging: Dehydration is the biggest contributor to mortality, especially in the very young and elderly. Lab evaluation for dehydration is recommended in these populations. No consistent association between lab abnormalities and bacterial etiology. WBC and differential does not differentiate bacterial vs viral, but may help in identifying severity of illness. Hemoglobin and platelets are helpful if HUS is suspected. Stool Cultures: 2017 IDSA guidelines recommends them in patients with fever, bloody or mucoid stools, severe abdominal cramping or tenderness, or signs of sepsis, noting these patients are at higher risk of bacterial infection. Specifically, Salmonella, shigella, Campylobacter, and Yersinia 2016 ACG guidelines recommend them for patients with watery diarrhea and moderate to severe illness with fever for at least 72 hours. Consider them for immunocompromised patients and those with recent abx use or hospitalization. C Difficile testing is recommended for all patients with AGE who are age >2 with a history of recent abx use or recent hospitalization Blood cultures are recommended for patients
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Real Life Pharmacology - Pharmacology Education for Health Care Professionals
Metronidazole (Flagyl) is an antibiotic that is used for various infections. Metronidazole can certainly cause GI upset like most antibiotics, but uniquely may also cause a metallic taste. Metronidazole is also rarely associated with CNS changes and can induce the potential for peripheral neuropathy. Patients should avoid alcohol with the use of metronidazole and this is on account for the possibility of a disulfiram reaction. I discuss some of the symptoms of this reaction in the podcast. Metronidazole can substantially raise the concentrations of warfarin. INR monitor and a reduction in dose of warfarin may be necessary.
EP199 - Dreamforce and Retail Earnings Episode 199 covers the 2019 Dreamforce Conference as well as this weeks news including Walmart and Target earnings reports.. Dreamforce Salesforce held their annual Dreamforce Conference in San Francisco this week. They launched a major new functionality "Customer 360 Truth" a universal customer data platform. Singles Day - 11.11 Day - $38.38 billion US (up 26% YoY) Amazon News Nike leaves Amazon Amazon Grocery Concept in LA won't have Amazon-Go Amazon is internally testing Amazon-Go in grocery sized space in Seattle Earnings Reports Walmart - US up 6.6%, E-commerce up 41% (mostly grocery) Target - Retail up 4.5%, E-Commerce up 31% (mostly store pickup/fulfillment) Other News PayPal acquired Honey for $4b. 20X their $200M Revenue Kylie Jenner sold 51% of her business to Coty for $600m Don't forget to like our facebook page, and if you enjoyed this episode please write us a review on itunes. http://jasonandscot.com Join your hosts Jason "Retailgeek" Goldberg, Chief Commerce Strategy Officer at Publicis, and Scot Wingo, CEO of GetSpiffy and Co-Founder of ChannelAdvisor as they discuss the latest news and trends in the world of e-commerce and digital shopper marketing. Episode 199 of the Jason & Scot show was recorded on Thursday November 21st, 2019. Automated Transcription of the show Transcript Jason: [0:24] Welcome to the Jason and Scott show this is episode 199 being recorded on Wednesday November 20th 2019 I'm your host Jason retailgeek Goldberg and as usual I'm here with your compost Scott Wingo. Scot: [0:39] Hey Jason and welcome back Jason Scott show listeners, well that's pretty exciting times here it's November 20th we are about seven days away from Thanksgiving T minus 7 Days folks to Holiday kicks in some would argue it done right after Halloween but I like to think of it really kind of kicking off at Thanksgiving, Jason was kick-off I saw on Twitter Some Noise around the world's largest Starbucks where you the first person in there. Jason: [1:08] Sadly I was not a side note on Thanksgiving I've been training all week by eating pumpkin pies. Scot: [1:14] Nice already. Jason: [1:14] Getting ready. I think it's a rookie mistake to just go in the Thanksgiving cold without a good one. Scot: [1:21] If you been pumpkin spice latte into it as well. Jason: [1:25] I don't I stick with my classic ice cream key around I'm weird. I did try to get my classic iced drink at the world's largest Starbucks which opened on Friday. So a little less than a week ago in Chicago, and I struck out so I was out of town Friday I went there Saturday morning at 8 when the store scheduled to open and there was already an hour line waiting to get in. And I had families in toddler with me so I we had to abort in. Do a plan B so I'll have to go back and visit another time that kind of an impressive draw that it's drawing that kind of crab for a retail store open. Scot: [2:06] You think the world's largest could hold more people. Jason: [2:09] That was my promise I actually thought they would be popular but it would still be easy to get in because. It was on Michigan Avenue which is like the premier shopping location on in Chicago and this was formerly The Crate & Barrel flagship store, so it was a four-storey 40,000 square foot furniture store that they've converted into a Coffee Roastery. So my assumption was it could hold an awful lot of people but apparently they're still you were still sort of them dating how many people they let in. Scot: [2:40] Is this one of those doesn't really have much mobile order it's going to be a food concentration there's no venti takeaway cups all that kind of strangeness. Jason: [2:51] Semite so that the concept of this is called The Reserve Roastery I want to say it's the like this one. If I have this right the first one was in Seattle there's another one in New York this is the third one in the US there's one in Shanghai there's one in Italy on which is controversial, enter this is like the premiere Starbucks concept it was a pet project of the founder of Howard Schultz the founder of Starbucks. It does have all the regular stuff you could place a mobile order there you can get all your traditional drinks. But it has a lot more stuff so they roast beans there and if you go to any Starbucks anywhere in the world and you buy a reserve being the beans that come in the the black and gold Packaging. [3:37] I got roasted in one of these roasteries so they're so it is a commercial Roastery but then they have kind of a you know it's a it's a beautiful. Kind of handmade Roastery with all glass windows so you can watch them working and they have kind of a Willy Wonka set up where they have these, translucent vacuum tubes that lead from the Roasterie to all the coffee bars in the in the building and said the beans like, fly through the tubes over your head so you can watch the beans getting delivered for making coffee. Any of your classic drinks with a much wider variety of beans that make a bunch of other drinks that aren't typical they make a bunch of drinks mixed with alcohol that have ice cream that was stand-alone restaurant everything merchandising section, this is all based on the other roasteries I visited and I'm assuming that what we're going to see in the Rock somewhat localized so when I'm assuming we're going to see you soon. Cool architecture in some variation of all that in this the Chicago store will have to report on it after I physically get in one. Scot: [4:46] Awesome well I'm here at home in North Carolina and you are out in California at drink for so tell us what's going on at dreamforce. Jason: [4:57] Dreamforce has the annual trade show for salesforce.com sales force is based in San Francisco so this is kind of on their home turf and that I saw someone refer to this is a quite Big Show it's it's every hotel room in the city of. San Francisco sold out I think I saw that I was like 40,000 people are here attending it so they they call it Burning Man for people with jobs. Which I thought was pretty funny because there is a lot of like chocolate brand building entertainment experiences in addition to the sort of. Salesforce product experience is so that like really extravagant. White outdoor Forest that they built in they give away free expressos the forest has like. Like a redwood tree that you can drive through and you know all this kind of cool stuff and have a lot of celebrity speakers, show Emilia Clarke from Game of Thrones this year Megan Rapinoe dying from USA World Cup team this year, a Beckham the musical act is like Fleetwood Mac and then the the big headliner Tina I mean Tim Cook is speaking but the big headliner is Barack Obama speaking tomorrow so they get a lot of. Interesting to listen to people that are you know probably not talking about the marketing cloud. Scot: [6:23] Yeah and then so then they that they talked a lot about a lot of social kind of stuff obviously so that the CEO of Salesforce is really into that and then I usually wear like crazy shoes. Jason: [6:37] Yeah he likes a mark Billy off is a very Progressive CEO and he be like there's a lot of really good causes and so we highlight some of those, on the stage right he's built through hospitals in San Francisco and sponsored some public schools and things that are kind of cool but they do they have like they have content about helping people to, be more Mindful and they they have a whole exhibit full of actual monks that are helping people to meditate you know they have a lot of bad like Arianna Huffington talking about like. Trust and transparency and yeah I just I mean yeah she wouldn't go into the sweet thing but. Yesterday they have a lot of people talking about like their pet interest which are you know potentially interesting helpful lifestyle Tibbetts. But then they also do generally make some big product announcements at Salesforce and and so like. I'm not sure this is going to go down as the biggest year but there's some I guess I'm reasonably sized interesting new announcements. Scot: [7:46] How much of the show is there like a track for e-commerce and an of the you know they're there I guess they called the Commerce club now is that a thing or is it. Jason: [7:59] There is there so there's a there's a Commerce track Commerce is like integrated into the the Keynotes along with the other clouds but I will say. They're shifting a little bit more from products to rolls so, when they were product-based like the Commerce cloud is about e-commerce in the marketing cloud is about sending emails, and you know that they're kind of Shifting the content to be more roll bass content so it's a retailer or a b2c company and that that roll. Yeah would obviously you need Commerce and marketing cloud and CRM and customer success rights are there. I would say like they haven't completely transition there still are definitely some products and Trick Tracks and there's there's a stand-alone Commerce keynote for example as well as some. Dedicated Commerce content in the the main stage keynote but I do think I feel like it is Shifting more it won't surprise me if a couple years from now there's a retail track. Not accomplished you know that's a pretty reasonable thing to do. Scot: [9:07] What are the highlights of utena the show. Jason: [9:09] Yep so the a big one so one thing that like. Obviously is well known to you but you know very first Cloud companies so in fact when they launched the company they launched it at Oracle world and they they did like fake picketing outside of Oracle works at World saying like. Like free software you know and put it in the cloud and it was you know this whole like counterculture thing, and anyways I still feel like they are a really good example of the cloud like they, it took a lot of feedback on features from their customers and their customers can vote on the features they most want in every quarter they do a new release and you go to the home from work on Friday and you come back to work on Monday and suddenly you have all these new features, that where that features most requested by their customers and so that doesn't sound like rocket science but a lot of other Cloud companies I still think like. You're not getting the full advantage that you should from the cloud and so at the show what they tend to do is release some major new feature. It's free and instantly available to all the that users on the cloud so I can couple years ago they launched Einstein which was their AI module and it was, you know a free new thing for all their customers so this year they watch them a major new platform that's free to August and customers of customer 360 true. [10:32] I think they're starting to struggle with their naming conventions a little bit here. But that this is is interesting like I feel like this is very on-trend so it's a couple of, can a customer data features rolled into a meta offering so the Met offerings called customer 360 truth and I think truth stands for kind of, the single source of Truth for all customer data and the the modules inside of it is they have kind of a data manager that lets you map all your data from your various Salesforce and non Salesforce systems, into a single Universal. [11:10] Data platform so it's based on customer and it has a unique ID for each customer so like normally we would call that a CDP or a customer data platform, so it seems like Salesforce has launched one and they made it free to all their existing customers, and said that the actual example that use on stage was a retail example they had Louis Vuitton they commented you know. Despite the fact that Louis Vuitton uses marketing cloud in the Commerce Cloud that the you know the keynote speaker bought some cool Louis Vuitton shoes. Last week and he got an email you know marketing on this week because the in-store POS doesn't know you know that the the email system doesn't know that the insert POS old shoes. I'm inside with this new 360 data manager you can't. Relatively easily Plum all that data together and then the marketing Cloud knows to you know Market stuff to people that already bought their shoes instead of, to try to sell you the shoes you already bought so, the CDP space is pretty popular right now makes total sense that sells words would be in it kind of big news that they are not trying to sell it but they are giving it away and because they a lot of companies already have a lot of their data in Salesforce. [12:30] That's a pretty big competitive advantage of its kind of one click and you load all that data and all the data mapping and stuff is already done for you so that's pretty slick. New problem we're all struggling with is data governance and privacy, you know there's a European data standard and the California did a standard goes Live January 1st and so suddenly we all need new metadata about, who has permission what rights to us or what data and how we collected and all that sort of stuff so part of this 360 trap trust is a privacy and data governance module which is a product a lot of people are having to buy right now to get compliant so that's interesting, and then they have a customer in audience is module I may have the name wrong, this to me sounds sort of like what we would in the advertising space traditionally call a DMP or data management platform and so this is kind of, ability that take all the state of that you now a aggregated, and like create audiences and segments for specific campaigns and specific uses so it's the ability to do really sophisticated slicing and dicing of all this customer data you have, and the work with it. Known data IE people that you actually know and also unknown data IE you know an honest users that I've text you but haven't identified themselves, so that's kind of a pretty comprehensive interesting product that they want that's basically available immediately we stand. [13:59] In their sandbox so I'm sure some customers are excited about that. Scot: [14:03] Is the CDP thing on acquisition or something they build organically. Jason: [14:06] To the best of my knowledge they built that because I am not familiar of this specific acquisition there are like, a lot of the plumbing like so a big part of this is is data mapping and transformation and they they bought a very big company in that space mulesoft. Last year so it wouldn't surprise me if they revered some of that capability in here but you know they also had new announcements around how you'll stop is developing as a standalone tool so. So don't know I'm not specifically aware that they bought a CDP. Scot: [14:37] Do this is disrupted in the CDP world because if you already have a salesperson you get this for free then you're going to. Jason: [14:44] I think if you're a. Scot: [14:45] Buy another city. Jason: [14:46] Has has like you know very much data in the Salesforce Cloud it's it's definitely going to be a much tougher sell for anyone else and you know I would say a lot of people that have had a lot of trouble getting. The anticipated return or value out of it right like they you know the IT department to love to move around all this data and buy all these new tools that they often don't have buying from the business users in the office. Don't don't change their marketing activities based on having these new tools and so you don't get a very good Roi and. Because Salesforce has a lot of the marketing tools. Yeah I think they have a better chance to be successful and I think it's going to mostly go head-to-head with Adobe that you know also has a very robust marketing stack and has their own CDP, but yeah I'm sure the rest of the CDP vendors would rather a Salesforce have not gotten into this place. Scot: [15:41] And then if I remember from our deep dive on personalization that's kind of the heart of personalization alive times has this CDP thing. Jason: [15:49] Exactly in Encino sales force has a lot of person with Asian features they have a pretty robust a eye capability the day they have Brandon Einstein and so, kind of one of the cool things about the cloud is like you do do this mate data mapping you plug better data into it and all the recommendation tools you have and they iTunes you have. Just start working better without really having to do any new implementations or anything else which is to me pretty cool kind of like when you get up in the morning and your test was faster. [16:21] And then add some more. [16:23] Some other product announcements I mention Einstein a couple of times that big Einstein announcement is that they there beta testing Einstein voice so this is a natural language processing engine for all the sales for school, and so that they use case they damn it is you know you're in. In a sales meeting with a customer and you walked out of the meeting and now you kind of dictate your notes into the Salesforce app you just using natural language and you know Salesforce logs at contact in the CRA, you don't create the forecast if that's appropriate their you know all those kinds of things they did a couple other use cases that are kind of cool where. It can listen to the sales calls on the phone and listen to customer service calls on the phone and, either do kind of post call analysis and recommend different things to the salesperson than what they actually did you know based on its artificial intelligence, when the case of the customer service module it can be calling up like knowledge articles in and and helpful resolution to a problem just while it's listening to the, the customer service person talk to the customer so voice. That seemed a little less like live in a little more kind of this is the early version. [17:45] And then they now have some partnership well I guess those first ones not a partnership Salesforce about Tableau last year which is a big. [17:55] Data visualization data analytics tool. Today announced that the full integration of Tableau and Salesforce so now your Salesforce customer you get the whole Tableau capability set to use against your data for free so that's kind of cool. Is Salesforce a much better fate of visualization and analytics capability and then they announce Partnerships with three other companies so they announce the apartment or they, renew to partnership with apple the announces partnership a few years ago and this mostly takes the form of they launched on the sales force apps to run on iOS and so they have a. Pretty robust. Interface for all their tools that runs on iOS and and that's where they demoed Einstein voice is Kentucky into that app and stuff that was kind of cool. They announced a partnership with Amazon and I would call this one the least interesting they. [18:52] Have made a version of their customer service module stand alone and they're selling it as a as an app on AWS sojourn AWS customer you can turn on this. Customer success portal from Salesforce they announced that some of that Einstein voice stuff that we just talked about is available in beta on the Alexa devices. I'm so you potentially could dictate yourselves notes into an Alexa instead of in your phone. And they announce some training material that sells horse has a big warning portal and they announce the AWS training is is now available on the Michelle Sports training for so a pedestrian stuff there I would say, and then the last announcement which was a little surprising to me was a partnership with Microsoft. And the the biggest component of this is that they're moving the whole marketing Cloud to Microsoft Azure so this is to my knowledge the first time Salesforce is kind of formally picked. A public Cloud to host their Solutions on I think you're the for like most of the apps that run on Salesforce his own cloud so interesting and I'm sure a big win for Microsoft. Scot: [20:03] The so I guess that won't really be back customers just got like the back ends where it says. Jason: [20:10] Yeah I know it's Maura inside baseball thing like I'm sure you know if your Google Cloud platform you're upset and I you know I almost feel like the AWS announcements might have been to kind of soften the blow that they didn't pick it up. Scot: [20:24] Brickell the other big event that has happened since our last podcast that were recovered news is singles day did you track a I had to be at a fleet conference so I was not able to track lost a very close see did you see how that one. Jason: [20:38] I did I kept an eye on it it's it's almost gone so mature that it like personally I'll say it's like slightly less exciting for me. Then it was four years ago when we started this podcast for example but not shockingly they had another big year so, total sales for the day we're 38.38 billion dollars in US so that's a. Huge number that's more than six times bigger than the biggest e-commerce stay in North America. The scales just amazing and they're all these ridiculous stats about how many orders they take in the first minute in the first hour and all that stuff by partly because. Bape resell all the sales for so much that customers have chewed up a lot of purchases and they log on the first or second of the sale and click by, to my knowledge alibaba's never had any major infrastructure problems with this day which is like super impressive to me, is this feels like one of the biggest stress test of it and a delivery infrastructure in the world then it seems like they nail it every year. The one thing I would say so that that 30 billion dollars represents 26% year-over-year growth which is where the first time ever a deceleration in the rate of growth. [21:56] So you know the day might be kind of maturing a little bit the thing I go in a single day looking for most is if there's any evidence that there. [22:06] Expanding their International reach so single day like definitely. A place to a broader audience than just China but it tends to live primarily in Asia and there's some you know Western retailers that try to piggyback on it but but Alibaba themselves you know their main pushes get Western brands, on the platform selling to Asia for singles day not get Western consumer shopping on Singles day. And I would say like I saw less evidence this year than I had in the past that they were even sort of leaning in that direction, but it's definitely true that you know Western Brands tend to be amongst the biggest Sellers and fastest runners, on Singles day like it was a mix this year so they were like 15 brands that did over a billion one, in sales and that was like Chinese companies like way way, a Japanese company like Fast retailing that owns Uniqlo and then you know it's apple and Nike so, kind of a good mix food supplements are actually the biggest category so you know it's a lot of people buying like like gourmet food and nutritional supplements. Mostly imported products and then Cosmetics makeup Beauty are the second biggest category in her quite huge. [23:30] And then you know stuff like and Mike are like diapers do well to so so good day all around. [23:39] It felt like generally continuations of trends that we seen in the past rather than something while be different this year. Scot: [23:45] Used to be on Amazon would be up on that list as well have I wonder if they had a good singles day and I didn't see anything about. Jason: [23:52] I didn't see them referenced and you know singles Day falls on Veterans Day in the US and obviously you know it's a. Short. Of time before Thanksgiving and this year because. You know there are fewer days between Thanksgiving and Christmas like a lot of people started their Thanksgiving promotions earlier so you know it all together. Scot: [24:18] Yeah Google when did Jason Scott show without some Amazon news. Jason: [24:22] Amazon news new your margin is there opportunity. Scot: [24:36] Big amazon news that we want a report on is discovernursing so on the 13th of November not called this kind of the holiday punch in the news Nike pretty publicly announced that they are going to suspend that pilot program where they were selling Direct on Amazon there's a lot of this started this in 2017 there's a lot of speculation that so John Donahoe who was CEO of eBay and then went to, assassin company for a while and then it now has become CEO of Nike he had something to do with this obviously not a huge Amazon fan so that was pretty interesting Jason what it what did you make of that one. Jason: [25:20] Well there's a lot of speculation I Channelview the speculation that like when Nike started this pilot in there in 2017 I think it was, did it wasn't necessarily an effort to sell a ton of product on Amazon and Nike sort of felt like they had to be on Amazon for their customers the speculation was, did they wanted more leverage over Amazon to help and get Amazon to cooperate with sort of anti counterfeit anti gray marketing. And so you know a lot of us think that they they put a limited assortment of Nike products and certainly not the like poppy are new releases on Amazon in order to have a more formal business relationship with Amazon to achieve some of these softer goals and you don't now the inference is that didn't work very well or Donahue felt like it wasn't worth it or or you know whatever the case is but it, doesn't it never seemed like it was a full court press to create an amazing Amazon Nike brand experience on Amazon. I still like I think it's interesting I think it definitely gives cover to a lot of other brands that are on the fence about whether they should be on Amazon or not like I definitely think when Amazon Nike moved on there. It made it harder for other brands to say like we don't think that's right for our brands, and now like I think it did they're not on there I think it makes it easier for other brands that make that say move what it what do you think about that. Scot: [26:48] Yeah Yeah lyrics and see what how other brands react part of I think what Nike was thinking when they did this was they could control part of this was simultaneously Amazon put the clamps on people selling Nike products and if so I haven't heard anything but I'll be interesting to see if those, yo come off as well and then so will happen is this product will still be on on Amazon but just did the third-party Marketplace and argue, Amazon Prime makes more money that way anyway so I think Amazon will be okay I wouldn't I wouldn't cry for an hour don't stay up all night worrying about Amazon Chase. Jason: [27:28] I was not going to but you actually reminded me of another day point I actually heard some rumors that in the run-up to this that Nike may have been. Actively soliciting some of their authorized dealers to be comforted party sellers so like Nike may have even decided to help make sure that the. The product stayed on the platform when they pulled off the one piece sales. And I would just add one another thing that's a little more about Nike than Amazon but the to me. Nike being on Amazon was kind of counterintuitive because the same time they announced this pilot they announce this big initiative to cut way back on the number of wholesalers that they had, in the premise was we only want to work with retailers that have a really differentiated customer experience otherwise we would just rather sell the rest. [28:19] And so they literally had like 30,000 businesses that were selling Nike shoes and allegedly they tried to cut that down to 40 in these forty all had to kind of commit to have an enhanced Nike experience so think of like, Nordstrom with a Nike shop and shop for things like that, so to be kind of a commodity on Amazon at the same time you making that other shift kind of fell in kangaroo it is and they really had a lot of success with that initiative so, in 2013 so while ago 19% of their sales were direct-to-consumer today 30% of their cells are directions to consumer in it it's a that's a big number and Nikes case so that's pretty successful. [29:02] They're like 35% of their their their online sales are growing at 35% same-store sales growth like 6% so like most of the growth is coming from, their online direct to Consumer which is super interesting and I talked a lot about Nike being really good at digital in-store and doing a lot of really smart things, in their house of Innovations and their Nike towns and the one bit of news I didn't get to cover when it happened but that I think is super interesting is, Nike has this really good app that lets you kind of specify shoes you want to try on and in a Nike store of the shoes get delivered to a locker and you can try them on and buy them without ever having to talk to a Nike salesperson there now. Piloting that capability in Foot Locker stores so you walk into a Foot Locker in the upper east side of Manhattan and you can. Use the Nike Plus app to try to win merchandise and Foot Locker store you can order merchandise and it gets delivered to a Nike Locker inside the Foot Locker store it's a, it's super smart and interesting for Nike it was shocking to me for Foot Locker because it essentially means that Footlocker is encouraging. Customers to use the Nike app in Footlocker and you know like that doesn't help their Adidas sales very much so it was it that was it. An interesting thing that I've never seen before where a brand had a successfully done a takeover of the in-store digital experience of a retailer. Scot: [30:32] Yeah yeah must be complicated to manage all these different brand experiences at some point. Jason: [30:36] And then one other like so I started with an irony of and I'll finish with an irony this announcement that they're pulling off of Amazon happened two days after single day and of course Nike is one of the biggest presences and is all in on, I'm single day so that you know they one of those 40 retailers definitely is Ali Baba. Scot: [30:56] One of the R9 listeners were one of the kind of previous holiday punches in the nose that Amazon received was from Toys R Us so we'll see how this goes for Nike. Never a good idea to kind of flip your nose in Amazon so maybe we'll see some amazonbasics shoes with swoosh like things on them. Jason: [31:18] Yep. Be interesting. Scot: [31:19] Another quick Amazon one they did announce that they are going to start a week of Black Friday deals on the 22nd so they're they're going to have a week of Black Friday deals so it'll be interesting to see the kind of settled on on this deal format with a good kind of a combo of it got the gold box it got some Lightning Deals at the other day and then they wrote a bunch of that stuff in the past experiment was video and whatnot. I'll be watching on the 22nd just going to get a flavor for is there some new kind of platform at the deals as a kickoff Black Friday deals. Jason: [31:57] Yeah yeah I'm watching it in a we talked a little bit about this but the you know they also publish their physical toy catalog and one of the things they did a really good job this year and the toy catalog is. Digital integration in the paper catalog in it and sort of quick to buy capability and so. I thought that was really smart and then I noticed that the Walmart toy catalog holiday catalog just came out and is the first time Walmart has implemented that capability as well so that seems like the new the new standard and catalogs as you finally have to. You don't make your catalog digital friendly. Scot: [32:33] The any other Amazon news before we go on to Walmart earnings. Jason: [32:40] Just too quick to bits on grocery so we've talked about the fact that Walmart or Amazon has some real estate in Los Angeles and that and that they intend to open in grocery stores in Los Angeles. They they responded to some press inquiries last week, and in one of the one of the questions was are these stores going to be Jay Watts stores just walk out store so will they will they use Amazon go in this La Market in these much bigger grocery stores and Amazon said no so, that was kind of a definitive answer that you have these grocery stores aren't going to be bigger go stores and of course all the speculation is that they're going to be. Lower price of grocery stores like Target in a broader audience. [33:26] So we're all going to be eager to see when in January these doors open and I'll sure make a truck out to LA. Take it out of the winter and do some shopping in the new Amazon grocery concept but then there was an article that came out this week that although they're not using, Amazon go in this La Market concept that they're opening, Amazon did admit that they have a dark store at private store that they don't you know what let test customers and employees into in Seattle this a 20,000 square foot grocery store, that is using the Amazon Go technology so they apparently are pressure testing and stress testing, the the Amazon Go technology for a bigger form factor store which is interesting and in that same article they also acknowledge that they're actively talking to several retailers, about attentively licensing the technology and one of the ideas was apparently Amazon has productized kind of a small kiosk version of The Go technology. That you might use it like an airport or a hotel lobby and that a sibo which is a sort of a gourmet food and convenience store concept it's in a lot of airports. Was apparently named as a potential licensee for that so give me interesting stuff to watch. Scot: [34:50] Record then we have a couple earnings to report on super stuff is Walmart. Jason: [34:56] And not shocking but they they had a good earnings call so Revenue was up 3.3% same-store sales in the US were up 6.6% so the US is doing better than International for them econ was up 41% so that's right in the range that they've been. [35:16] Announcing a recorder they've been kind of bouncing around between 39 and 45 per cent they promised that for the year that be up 40% so 41%, feels good and Doug mcmillon acknowledged that the bulk of that gross in e-commerce is Grocery and specifically grocery pick-up and and he did kind of, talk about the the elephant in the room on that that that growth is not particularly profitable and you know one of the goals for Walmart is that they need to do a much better job of. Selling more stuff to those those grocery customers to make the sales more profitable and so what's interesting about that is the aov, on grocery pick-up is already higher like twice as high as the it'll be in the store but what isn't happening in grocery is you're not adding any general merchandise to that order, and though that's you know one of the big challenges that that Doug mcmillon talked about is they got to turn online grocery customers into overall Walmart customers. And you know we were at the moment there's a separate app that you use to buy groceries then there is to buy general merchandise and so you know. [36:29] They call that the gold and blue app and don't be surprised if you see, the feature set of those two apps kind of merge in order to affect the School of the Dead was talking about but it is interesting to me either. 1400 their stores now do grocery delivery $3,000 stores now do grocery pickup, again they have about 4,000 stores in the US so they can expand for another quarter and a thousand more stores and keep having this kind of growth, you know is very likely that growth is going to slow down once they get to 4000 stores that are all doing grocery pick-up and delivery and then it's going to be really critical that they, change the customer Behavior or their other cops are going to be really challenging and then kind of related to the earnings announcement they did introduce their new CEO for the us so that used to be a CEO named Greg foran he left to become the president of New Zealand airlines he's a native New Zealander so, best way to drag and they promoted John firmer who was the former CEO of Sam's Club to be the president of the u.s. So he's a longtime Walmart guy but he's a really young guy so. [37:42] Congrats and it's going to be interesting to see how he does it Walmart and then they back filled his job with Katherine Maclay who used to run Neighborhood Market so that's. The stand-alone Walmart grocery concept and so she steps up to become the CEO of Sam's Club so some some internal matriculation happening it at, at Walmart. Scot: [38:05] Sunmark Lori reports right to McMillan right so would does he is eCommerce, cross-section so the u.s. guide actually just run stores in the Commerce a separate how does that. Jason: [38:19] Yeah yeah so there's two presidents of the US there's there's the president of stores which it was dragging now John and there's the president of digital which is Mark they both report to the CEO. At Walmart which is Doug mcmillon and the like there's a chief customer officer, that's kind of above marketing and she reports to both of them so she coming to you don't have to report that to the digital and the stores. And you know I think some of the old articles from last year about Walmart we're about like some sort of friction between the store guy in the digital guy in the fact that you know. A lot of the digital growth was actually being delivered by the stores with this online grocery pick-up and that you know Mark was kind of getting credit for it but it was probably, the store guide doing most of the work so it'll be interesting. John's a little younger than Greg you know I think it's a fair assumption that he's a little more. Digitally native then dragged was and so it'll be interesting to see if he has a different relationship with Mark and Greg. Scot: [39:25] Selena on the heels of that we had Target earnings and this is what in the world of all straight we effectively call a beat and raised so this is really well-received by Wall Street, so the beat part expectations was EPS of a dollar 19 came in well north of that at a dollar 36 and then they bumped up the guidance at Wall Street was expecting 592 620 on the revenue side and they came in at 6:45 to 6:45 so they kind of move the range of guidance up above all she was acting self shares were up pretty sharply I saw, thanks to this so that was good and then there was a e-commerce was up 31%. Gets me back to this question we should we talk about Pride like every 10 shows or so if everyone's e-commerce is growing north of 30%, these are big companies so Amazon's at like 25 Walmart we have at 41 Target here at 31 how on Earth, even like Shopify is growing forget their number but it's it's like 30% I think last time I saw GMB wise. [40:40] Then we have e-commerce growing at 15% I I. I don't know how that works something something has to be like a negative growth even eBay is like just flat so it's not going to really be a negative trim there so I can look inclusion e-commerce is either going faster than we think it is or, or there's some peace some dark matter in there that we don't have any visibility on that I'd like to me but I digress did you see anything interesting in the Target earnings date they the talk a lot about ship-from-store some sure you if you were interested in that. Jason: [41:13] Yep yeah that was super interesting that we talked about it before but my answer to your conundrum below is that e-commerce is growing faster than we think, and the problem is like all of these these, companies that come out and say e-commerce is growing at 15% of index there their forecast of the US Department of Commerce data in the US Department of Commerce data is flawed for, Ecommerce particularly for omni-channel e-commerce and so when Walmart says they grow 41% and that's mostly people going to pick up groceries at the curb the US Department of Commerce counts that is best for sale so that's part of your bra. But in any case yeah the target announcement was super interesting to me for some of the granular data they shared about their curbside pickup so first of all they said hey we grew 31%, 80% of that gross was pickup in-store orders. So so that the that you know they bought this company ship they they really enhance their curbside pickup capabilities they do deliveries from store and they do they actually built with all male rooms in the back of all their stores and they do ship from store and so. [42:27] That store inventory is being used for 80% of their digital growth which is huge and then most interesting is that they said that when a customer comes to the store to pick up an order so we don't have to ship it to the customer. That takes 80% out of our cost or 90% rather out of our costs 08, curbside pickup order Casas 10% of what a ship to home order cost us and when we get a ship the homeowner and we can ship it from a store. That cost that's 40% cheaper than ship from a fulfillment center and so, the you know a debate has always been like Ashley stores aren't going to be as efficient at picking and shipping as a fulfillment center so you know the unit economics could arguably be worse the pic and chip, and then the counter argument is but your shipping in a way shorter distance because the inventory is already a lot closer to the customer and so the shipping cost should be well or and you know people debated about whether that netted a positive or negative for the retailer and what Target is saying as. Man we can ship something from the store that I get there faster to the customer and it says it's a bunch of money and we can get the customer to come to us and pick it up it saves us, a boatload of money and that's what most of our customers are doing so. [43:46] To me that's super encouraging for Target and it's fascinating and it really high like me. The difference between the Walmart and Target strategy. [43:59] So one problem with all the ship from store and pick up in store stuff is you can only sell the inventory you have in the store right, is a target's got 65,000 skews in the store and soda Target digital strategy is to sell those 65,000 skus, either Walmart you had like 200,000 skews in the store but you're trying to compete with Amazon for the total wallet share and you're trying to sell tens of millions or hundreds of millions of skews and throat you know Walmart is totally leaned into building more fulfillment centers in developing a Marketplace, and that that kind of thing to sort of get there their catalog up to be you know competitive with Amazon and they're making progress and doing that, but it really makes the unit economics challenging for Walmart whereas Target is selling a much more constrained, catalog but they're actually able to do that profitably you know it's kind of not sure once Reggie's right or wrong but it feels like, Walmart is trying to hit a homerun and compete with Amazon and Target is trying to head a sort of a single or a double and you know being more successful at doing. Scot: [45:09] The one thing that doesn't add up for me so the store has 65,000 items Target's website has I would imagine orders of magnitude more than that right. Jason: [45:21] Maybe a order of magnitude more they have more but it's not their target does not have millions of products. Scot: [45:27] That's what's to say it's a hundred. Jason: [45:30] Yeah could be two hundred thousand. Scot: [45:32] Yeah but what's a 200000 the chances are. Yeah that the thing you order online is not going to be in the store so do they know are they pushing people to order things in the store and some way like the top of search results. How are they or just happens to be the head of the distribution curve and that's kind of the 80/20 rule. Jason: [45:54] So I do I think it's partly that that 80/20 rule but I do think target is more actively merchandising the in-store assortment in are you know, then there are some other retailers and you know it is I think it's two because they have a. Metronidazole a lot of items but and I don't know this for a fact but I would bet you anything did the percentage of customers on target, Define products through the guided navigation is much higher, then the percentage of people that find products through the guided navigation on Amazon or Walmart like the Walmart and Amazon assortments are so big The Galley navigation is use very little and almost everybody has to find things through search but Target is so much more known for curation, a lot more with target cells are their own Brands brands that are exclusively available through Target. And like I do think they have like a more chill rated taxonomy that's more friendly to shopping and so, you know part part of this is a self-fulfilling prophecy is that you know more people are clicking through the menus they're saying the first page of that menu result they're buying stuff that's all stuff that's in the store. I think that's literally the target strategy and it's kind of opposite of the Amazon Walmart strategy. Scot: [47:14] And then a couple Acquisitions to talk about the first one that I think shocked both of us PayPal acquired honey-honey is a well, browser extension so it sits there you install it into your Chrome or your Safari or your Internet Explorer, messenger name that always forget and you know what kind of watch is your shopping behavior and if it sees you throw something in your cart somewhere it will go and try to find a lower price so essentially just like. [47:43] Scot Anderson there's tons of these out there none of them have got no attraction but for some reason honey is done a really good job with marketing and and seems to have a pretty good user base the thing that shocking about this one is a couple things first of all the price tag of four billion dollars this is asbestos, we've seen reported this 200 billion dollar Revenue company just got a 20 x multiple so that's just me there was some kind of a bidding war hear the other thing I wonder how PayPal navigated is I would imagine so if you think of Amazon having 50% of e-commerce it's probably 50% of the honey I'm activity or more is on Amazon. [48:28] My understanding is there some kind of an affiliate relationship they're so so Amazon hasn't black honey but now that it has a new owner I'm Amazon you know do I really want it your PayPal owning this there's going to be some, preference PayPal payments Amazon doesn't take PayPal, yell at my say something happens and they are in Amazon turns off honey which which is very viable yeah you can look at the IP in and just shut the crawlers down that they have you know that thing has huge exposure from getting an award Amazon so I hope PayPal is thoughts through that and, got some somewhere around that challenged his communication to see what happens to that one. Jason: [49:13] Yeah and I can try to shut them down they can make it way harder for honey but like there are companies that successfully still. Do stuff with Amazon even though Amazon doesn't want them to I'm not saying that's the position you want to be in but I'm not sure it would completely exclude on that would just make it much harder if Amazon. Active it at preventing it, but I think they might have a broader version of that problem you know Visa V PayPal in that like I I don't know that much about honey but I imagine that the retailers have a love-hate relationship with him if, you're not a honey partner and people are shopping on your site and honey is trying to divert those customers to a site that is a honey partner, you don't like honey very much right so if your target you're not paying honey and when you you know try to buy stuff on On Target it's saying like hey there's this other retailer that has a lower price, or you know honey you says like hey they have a promo code over here these kinds of things. You have the potential to to alienate a bunch of retailers and those are the same retailers that PayPal is trying to get to a doctor platform, so it is possible that they're going to have some customer conflict here don't don't know enough to know that for sure yet but but it's going to be interesting to see how it all plays out and improve your point. I sure hope PayPal thought through that when they paid for billion dollars for me. Scot: [50:43] Yeah we should probably rename this segment Scott and Jason are super jealous or why didn't we think of that so it so number one congrats. Short forgetting this exit and then the other one that was kind of mind-blowing was Kylie Jenner she started a makeup company and you know obviously she's she in her hole Kardashian Clan there are a really big influencers this has blown up 2 / 200 million in Revenue very quickly and she sold half the business to the large conglomerate in the beauty category called Cody for 600 million which is effectively gives that a 1.2 billion dollar valuation in the real mind-blower is the company has six employees. Jason: [51:29] Yeah that Revenue per employee works out to be pretty good huh. Scot: [51:32] Yeah I have a feeling Kylie may take a disproportionate amount of that but we don't. Jason: [51:40] Yeah I know it's that super anything in that I mean it's a nuanced but I think Cody actually bought 51% so that's that a controlling interest. Which is somewhat interesting like I wonder if that will in any way put off Kylie Jenner fans but I mean mad props to her like I think she's actually totally changed the way influencers think about monetizing, their popularity comes before this they all would take money to, sell other people's stuff and this model has been so successful that you now see a lot of other popular influencer saying hey. I'm not going to promote someone else's product. No launch my own products and so there there's a lot of lot of folks trying to follow in her footsteps but this is a. You know what that huge home run and congrats Shopify by the way cuz that's this probably the biggest biggest retailer on the shop. Scot: [52:33] Yep and it's also important to point out that this is also a DMV be kind kind of a strategy here so imagine fairly large percentage of her sales are from her website and then she does I think she does sell thru I always get it could use which one but she's in either Sephora or Ulta. Jason: [52:55] Yep and I think she started out online only and then only in the last year has she added the the wholesale distribution but so yeah for sure. Scot: [53:06] So Jason and I have a big announcement we are starting the Jason and Scott beauty company and we're going to come out with a palette for Holiday 2020 so stay to. Jason: [53:16] Yep yeah we're not to upgrade the servers for the mass influx of traffic we get for that but looking forward to it and it will include a browser plug-in which will help you buy a product instead of anyone else's product on the web so we're kind of think of it is, honey + Kylie Jenner. Scot: [53:35] Yep we'll just call it Scott and Jason honey or something like that we're still working on the brand. Jason: [53:40] Exactly send your suggestions to Scott, and sadly that's going to be we're going to have to leave it cuz we have used up all our a lot of time as always if you have any questions or comments you have to hit us up on Twitter or Facebook page and I please please please this is a great time for holidays to give us that special gift and go to iTunes and give us that five star review the the reviews key keep coming but we we want and need more and we really appreciate it. Scot: [54:10] Thanks everyone we're probably stay tuned for episode 200 you're going to love it. Jason: [54:18] Yeah absolutely that's going to be fun next week and until then Happy commercing.
In this episode I cover antibiotics.If you want to follow along with written notes on bacteria go to zerotofinals.com/antibiotics/ or find the infectious diseases section in the Zero to Finals medicine book.This episode covers the mechanism of action, local resistance, guidelines, penicillin allergy and coverage of antibiotic. The audio in the episode was expertly edited by Harry Watchman.
En el episodio de esta semana hablamos de metronidazole. Hacemos una revision breve del mismo y discutimos la información disponible en términos de frecuencia de la dosificación. Razones para cambiar. Referencias: Ashley F. Soule, Sarah B. Green and Lisa M. Blanchette . Clinical efficacy of 12-h metronidazole dosing regimens in patients with anaerobic or mixed anaerobic infections. Ther Adv Infectious Dis 2018, Vol. 5(3) 57–62. Wang y colaboradores. Metronidazole Single versus Multiple Daily Dosing in Serious Intraabdominal/Pelvic and Diabetic Foot Infections. J. Chemother. 2007. La Frase de la Semana: La tomamos esta semana de Alfonsina Storni Nació en Capriasca, Suiza, 1892. Falleció en Mar del Plata, Argentina, 1938) Poetisa argentina de origen suizo. Alfonsina Storni pasó a ocupar un lugar destacado en el panorama literario hispanoamericano por la fuerza con que aparece en sus versos la afirmación de una mirada femenina sobre el mundo. La frase dice: "Quizá nos encontremos frente a frente algún día, Quizá nuestros disfraces nos logremos quitar. Y ahora me pregunto…cunado ocurra, si ocurre, ¿sabré yo de suspiros, sabrás tu suspirar?"
Specific initial treatment regimens are discussed. Topics include fulminant disease, Vancomycin, Fidaxomicin, Metronidazole, and recurrence rates/regimens.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode366. In this episode I ll: 1. Discuss an article about using metronidazole in mild Clostridium difficile infection. 2. Answer the drug information question “What is captisol-based amiodarone?” 3. Share a tip for responding to inpatient medical emergencies. The post 366: Metronidazole in mild Clostridium difficile infection, captisol-based amiodarone, and a tip for responding to inpatient medical emergencies appeared first on Pharmacy Joe.
A new study led by a Tulane University researcher and recently published in the journal, Lancet Infectious Diseases, could change the way doctors treat the common, sexually transmitted parasite, Trichomonas vaginalis. Joining me today to talk about trichomoniasis and the new study is the lead author, infectious disease epidemiologist at the Tulane University School of Public Health and Tropical Medicine , Dr. Patricia Kissinger.
A new study led by a Tulane University researcher and recently published in the journal, Lancet Infectious Diseases, could change the way doctors treat the common, sexually transmitted parasite, Trichomonas vaginalis. Joining me today to talk about trichomoniasis and the new study is the lead author, infectious disease epidemiologist at the Tulane University School of Public Health and […] The post Trichomonas vaginalis treatment: New research shows multi-dose metronidazole is better in women appeared first on Outbreak News Today.
Happy National Preparedness Month! Joe and Amy Alton often talk about the risk of infectious diseases and some of the antibiotics that I’ve been able to find in veterinary form that you can access without a prescription. Of course, in normal times, you should seek out a qualified medical professional first. One of the antibiotics we think is most useful in survival settings is something called metronidazole, brand name Flagyl). Metronidazole (aquatic equivalent: Fish-Zole) 250mg is an antibiotic in the Nitroimidazole family that is used primarily to treat infections caused by anaerobic bacteria and protozoa. Find out more! The diligent medic will be successful in accumulating various medicines that will help keep his family healthy. What happens, however, when all these stockpiled drugs pass their expiration date”? The short answer is: In most cases, not very much. Shocked? Find out why Joe Alton MD says so in this episode. Plus, a short talk about endemic, epidemic, and pandemic diseases. What makes something endemic and something else an epdemic or pandemic. Plus, Nurse Amy talks about a new compact kit she's designed! Wishing you the best of health in good times or bad, Joe and Amy Alton Find us on Facebook at Doom and Bloom(tm), Twitter @preppershow, and YouTube at drbones nurseamychannel! And don't forget to check out Nurse Amy's entire line of medical kits @store.doomandbloom.net!
Happy National Preparedness Month! Joe and Amy Alton often talk about the risk of infectious diseases and some of the antibiotics that I’ve been able to find in veterinary form that you can access without a prescription. Of course, in normal times, you should seek out a qualified medical professional first. One of the antibiotics we think is most useful in survival settings is something called metronidazole, brand name Flagyl). Metronidazole (aquatic equivalent: Fish-Zole) 250mg is an antibiotic in the Nitroimidazole family that is used primarily to treat infections caused by anaerobic bacteria and protozoa. Find out more! The diligent medic will be successful in accumulating various medicines that will help keep his family healthy. What happens, however, when all these stockpiled drugs pass their expiration date”? The short answer is: In most cases, not very much. Shocked? Find out why Joe Alton MD says so in this episode. Plus, a short talk about endemic, epidemic, and pandemic diseases. What makes something endemic and something else an epdemic or pandemic. Plus, Nurse Amy talks about a new compact kit she's designed! Wishing you the best of health in good times or bad, Joe and Amy Alton Find us on Facebook at Doom and Bloom(tm), Twitter @preppershow, and YouTube at drbones nurseamychannel! And don't forget to check out Nurse Amy's entire line of medical kits @store.doomandbloom.net!
A few weeks ago, a post on Clay Smith’s Journal Feedabout the new IDSA C diff guidelines caught my attention (specifically, that metronidazole is no longer recommended as first line therapy). Whuut? I tweeted this and @medquestioningtweeted back, "Need to dig to see why they dropped metro in the bucket." Yes, @medquestioning, my thoughts exactly. Mentioned in this episode ERcast 2.0launches May 1, 2018 To sign up for the new site and 1 year of free CME, click here Essentials of Emergency Medicineis just around the corner. If you can't make it to Vegas, the digital live stream is pretty sweet. New IDSA C Diff Guideline Treatment Recommendations Initial Episode, Non Severe (WBC ≤ 15k, creatinine < 1.5) First Line Vancomycin 125 mg PO QID for 10 days Fidaxomicin 200mg PO BID for 10 days Second line Metronidazole 500mg TID PO for 10 days Initial Episode, Severe (WBC >15k, creatinine >1.5) Vancomycin 125 mg PO QID for 10 days Fidaxomicin 200mg PO BID for 10 days Initial Episode, Fulminant (Hypotension or shock, ileus, megacolon) Vancomycin 500 mg 4 times per day by mouth or by nasogastric tube. If ileus, consider adding rectal instillation of vancomycin. Intravenously administered metronidazole (500 mg every 8 hours) should be administered together with oral or rectal vancomycin, particularly if ileus is present First Recurrence • Vancomycin 125 mg given 4 times daily for 10 days if metronidazole was used for the initial episode, OR • Use a prolonged tapered and pulsed vancomycin regimen if a standard regimen was used for the initial episode (eg, 125 mg 4 times per day for 10–14 days, 2 times per day for a week, once per day for a week, and then every 2 or 3 days for 2–8 weeks), OR • Fidaxomicin 200 mg given twice daily for 10 days if Vancomycin was used for the initial episode Photo Credit Photo by Gabor Monori on Unsplash The Guidelines McDonald, L. Clifford, et al. "Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)." Clinical Infectious Diseases66.7 (2018): e1-e48. PMID:29462280 Original Studies Teasley, DavidG, et al. "Prospective randomised trial of metronidazole versus vancomycin for Clostridium-difficile-associated diarrhoea and colitis." The Lancet322.8358 (1983): 1043-1046. PMID:6138597 Wenisch, C., et al. "Comparison of vancomycin, teicoplanin, metronidazole, and fusidic acid for the treatment of Clostridium difficile—associated diarrhea." Clinical infectious diseases22.5 (1996): 813-818. PMID:8722937 New Evidence Favoring Vancomycin Zar, Fred A., et al. "A comparison of vancomycin and metronidazole for the treatment of Clostridium difficile–associated diarrhea, stratified by disease severity." Clinical Infectious Diseases45.3 (2007): 302-307. PMID:17599306 Johnson, Stuart, et al. "Vancomycin, metronidazole, or tolevamer for Clostridium difficile infection: results from two multinational, randomized, controlled trials." Clinical Infectious Diseases 59.3 (2014): 345-354. PMID: 24799326 CDC C. Diff Statistics New York Times article on the association of the rise of new sweeteners and the rise of C. diff. The Germs That Love Diet Soda
The post Metronidazole (Flagy) Nursing Pharmacology Considerations appeared first on NURSING.com.
Joe and Amy Alton, aka Dr. Bones and Nurse Amy, come down with the flu after their successful appearance at the SHOT show in Nevada, just one of 47 states reporting widespread outbreaks of influenza. Find out how hard it is to escape becoming a victim, even if you walk around with hand sanitizer in your pocket all day! Nurse Amy gives her advice for speeding recovery and Dr. Bones talks about the anti-viral drug Tamiflu and how it works to shorten the duration of illness. Also, Dr. Alton was the first physician to write about the use of fish and bird antibiotics as a survival tool, but this stuff isn't candy, and has to be used wisely if at all. Having a supply, however, may avoid the preventable deaths from infected cuts and other minor ailments that could become big trouble in hard times. Some general advice regarding appropriate usage is given, and a useful antibiotic called metronidazole (Flagyl, Fish-Zole) is spotlighted. All this and more in the latest Survival Medicine Hour with Joe Alton MD and Amy Alton ARNP! Follow us on Twitter @preppershow, FB at Doom and Bloom(tm), and YouTube at DrBones NurseAmy Channel!
Joe and Amy Alton, aka Dr. Bones and Nurse Amy, come down with the flu after their successful appearance at the SHOT show in Nevada, just one of 47 states reporting widespread outbreaks of influenza. Find out how hard it is to escape becoming a victim, even if you walk around with hand sanitizer in your pocket all day! Nurse Amy gives her advice for speeding recovery and Dr. Bones talks about the anti-viral drug Tamiflu and how it works to shorten the duration of illness. Also, Dr. Alton was the first physician to write about the use of fish and bird antibiotics as a survival tool, but this stuff isn't candy, and has to be used wisely if at all. Having a supply, however, may avoid the preventable deaths from infected cuts and other minor ailments that could become big trouble in hard times. Some general advice regarding appropriate usage is given, and a useful antibiotic called metronidazole (Flagyl, Fish-Zole) is spotlighted. All this and more in the latest Survival Medicine Hour with Joe Alton MD and Amy Alton ARNP! Follow us on Twitter @preppershow, FB at Doom and Bloom(tm), and YouTube at DrBones NurseAmy Channel!
In this episode Dr. Sara Kim discusses the history, diagnosis, consequences, and treatment of bacterial vaginosis. feedback@obgyn.fm ACOG. Vaginisits Practice Bulletin. (2015). Chawla, R. B., Preena; Chadha, Sanjim; Grover, Sujatha; Garg, Suneela. Comparison of Hay's Criteria with Nugent's Scoring System for Diagnosis of Bacterial Vaginosis. Biomed Research International 2013 (2013). Eschenbach, D. A. History and review of bacterial vaginosis. American Journal of Obstetrics and Gynecology 169, 441-445 (1993). Fettweis, J. B., J Paul; Serrano, Myrna; Sheth, Nihar; Girerd, Philippe; Edwards, David; Strauss, Jerome; Jefferson, Kimberly; Buck, Gregory, Vaginal Microbiome Consortium. Differences in vaginal microbiome in African American women versus women of European ancestry. Microbiology 160, 2272-2282 (2014). Greenwood, J. P., MJ. Transfer of Haemophilus vaginalis Gardner and Dukes to a New Genus, Gardnerella: G. vaginalis (Gardner and Dukes). International Journal of Systematic Bacteriology 30, 170-178 (1980). Hillier, S. N., Robert; Eschenbach, David; Krohn, Marijane; Gibbs, Ronald; Martin, David; Cotach, Mary Frances; Edelman, Robert; Pastorek, Joseph; Rao, Vijaya; McNellis, Donald; Regan, Joan; Carey, Christopher; Klebanoff, Mary A. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. New England Journal of Medicine 333, 1737-1742 (1995). Koumans, E. S., Maya; Bruce, Carol; McQuillan, Geraldine; Kendrick, Juliette; Sutton; MAdeline; Markowitz, Lauri. The Prevalence of Bacterial Vaginosis in the United States, 2001-2004; Associations with Symptosm, Sexual Behaviors, and Reproductive Health. Sexually Transmitted Diseaese 34, 864-869 (2007). Lachiewicz, M. M., Laura; Jaiyeoba, Oluwatosin. Pelvic Surgical Site Infection in Gynecologic Surgery. Infectious Diseases in Obstetrics and Gynecology 2015 (2014). Larsson, P.-G. a. C., Bodil. Does pre- and postoperative metronidazole treatment lower vaginal cuff infection rate after abdominal hysterectomy among women with bacterial vaginosis? Infect Dis Obstet Gynecol 10, 133-140 (2002). Lin, L. S., J; Kimber, N; Shott, S; Tangora, J; Aroutcheva, A; Mazees, MB; Wells, A; Cohen, A; Faro, S. The Role of Bacterial Vaginosis in Infection After Major Gynecologic Surgery. Infectious Diseases in Obstetrics and Gynecology 7 (1999). Ling, Z. L., Xia; Chen, Weiguan; Luo, Yueqiu; Yuan, Li; Xia, Yaxian; Nelson, KAren; Shalei, Huang; Zhang, Shaoen; Wang, Yuezhu; Yuan, Jieli; Li, Lanjuan; Xiang, Charlie. The Restoration of the Vaginal Microbiota After Treatment for Bacterial Vaginosis with Metronidazole or Probiotics. Microbial Ecology 65, 773-780 (2013). Menard, J.-P. Antibaterical treatment of bacterial vaginosis: current and emerging therapies. International Journal of Women's Health 3, 295-305 (2011). Muthuamy, S. E., Selvi. Comparison of Amsel's Criteria, Nugent Score and Culture for the Diagnosis of Bacterial Vaginosis. National Journal of Laboratory Medicine 5, 37-40 (2016). Onderdonk, A. D., Mary L; Fichorova, Raina N. The Human Microbiome during Bacterial Vaginosis. Clinical Microbiology Reviews 29, 223-238 (2016). Tebes, C. L., Catherine; Sinnott, John. The effect of treating bacterial vaginosis on preterm labor. Infect Dis Obstet Gynecol 11, 123-129 (2003). Xiao, B. N., Xiaoxi; Wang, Ben; Du, Pengcheng; Na, Risu; Chen, Chen; Liao, Qinping. Predictive value of the composition of the vaginal microbiota in bacterial vaginosis, a dynamic study to identify recurrence-related flora. Scientific Reports Nature 6, doi:10.1038/srep26674 (2015).
This podcast is the second part of a series. In the first part, Dr. Shaw and I talked about how to measure metabolism using organic acids. My initial test showed two major problems: yeast and clostridia overgrowth. It’s been about six months since I took probiotics and Raintree Formulas Amazon antifungals for two months and the retest shows some but not complete improvement. The primary focus of this interview is the new Great Plains test for organic (nonmetal) environmental toxicity, something that I think may be a problem for the people that work with us. I won’t know for sure until we collect some more data, as always I like to test myself before recommending others do the same, and my result turned out to be “one of the cleanest Dr. Shaw has ever seen.” The possible exception is a mild elevation of 2-Hydroxyisobutyric and other metabolites that indicate exposure to petrochemicals I suspect from riding my bike on the road. Download my full result About my guest William Shaw, Ph.D., is board certified in the fields of clinical chemistry and toxicology by the American Board of Clinical Chemistry. Before he founded The Great Plains Laboratory, Inc., he worked for the Centers for Disease Control and Prevention (CDC). Order an organic acids test with nonmetal chemicals profile Use the discount code TOX for $150 off. Here’s the outline of this interview with Dr William Shaw, Ph.D. 0:00:18 Previous interview. 0:03:25 HPHPA (3-(3-hydroxyphenyl)-3-hydroxypropionic acid). 0:03:55 D-Lactate free probiotic. 0:04:37 Vancomycin or Metronidazole. 0:05:03 Results, markers 33 and 34. 0:07:00 Arabinose. 0:07:24 Amazon A-F. 0:10:34 The Role of Oxalates in Autism and Chronic Disorders. 0:13:19 How to Protect Your Family from Environmental Toxicity with Dr. Julie Walsh on the Paleo Baby podcast. 0:13:37 AHS16 - Tim Gerstmar - Obesogens and Endocrine Disruptors. 0:16:44 Succinic dehydrogenase. 0:18:20 Tiglylglycine. 0:19:04 Kearns-Sayre syndrome. 0:20:40 2-Hydroxyisobutyric Acid, MTBE and ETBE. 0:43:12 Sauna + niacin flush. 0:50:18 discount code TOX. 0:57:54 GPL webinar archive. 0:58:08 GPL University upcoming events.
What antibiotics should you have in your medical storage in case of disaster? In their continuing series, Joe Alton, MD and Amy Alton, ARNP, aka Dr. Bones and Nurse Amy, talk about Metronidazole (Flagyl, Fish-Zole) and its potential for use in survival settings. Dr. Bones talks about Hurricane Patricia, the latest floods in Texas, and more, plus a visit to Carolina Readiness Supply, an actual brick-and-mortar Prepper Store in Waynesville, NC, and interview owner Jan Sterrett. Plus, Nurse Amy talks about freeze-dried foods and a couple of short interviews with famed prepper author Jim Cobb and Aroundthecabin.com founder Rich Beresford, the first videocast channel for preppers.
What antibiotics should you have in your medical storage in case of disaster? In their continuing series, Joe Alton, MD and Amy Alton, ARNP, aka Dr. Bones and Nurse Amy, talk about Metronidazole (Flagyl, Fish-Zole) and its potential for use in survival settings. Dr. Bones talks about Hurricane Patricia, the latest floods in Texas, and more, plus a visit to Carolina Readiness Supply, an actual brick-and-mortar Prepper Store in Waynesville, NC, and interview owner Jan Sterrett. Plus, Nurse Amy talks about freeze-dried foods and a couple of short interviews with famed prepper author Jim Cobb and Aroundthecabin.com founder Rich Beresford, the first videocast channel for preppers.
In this episode of the Survival Medicine Hour Podcast, Joe and Amy Alton, aka Dr.Bones and Nurse Amy, discuss principles of herbal healing, how penicillin was invented (by accident), the antibiotic Metronidazole (Flagyl, Fish-Zole), and the perils of antibiotic overuse.
In this episode of the Survival Medicine Hour Podcast, Joe and Amy Alton, aka Dr.Bones and Nurse Amy, discuss principles of herbal healing, how penicillin was invented (by accident), the antibiotic Metronidazole (Flagyl, Fish-Zole), and the perils of antibiotic overuse.
Featured Cases: Nutritional Challenges and Complications in Patients with CF
In this randomized, multicenter trial, we evaluated the effectiveness and side effect profile of a modified omeprazole-based triple therapy to cure Helicobacter pylori infection. The control group consisted of patients treated with standard dual therapy comprising omeprazole and amoxicillin. One hundred and fifty-seven H. pylori infected patients with duodenal ulcers were randomly assigned to receive either a combination of omeprazole 10 mg, clarithromycin 250 mg and metronidazole 400 mg (OCM) given three times daily for 10 days (n = 81),or a combination of omeprazole 20 mg and amoxicillin 1 g (OA) given twice daily for 14 days (n = 76). Prior to treatment and after 2 and 6 weeks, gastric biopsies from the antrum and corpus were obtained for histology and H. pylori culture. H. pylori infection was cured in 97.4% after OCM and in 65.8% after OA in the per-protocol analysis (p < 0.001) (intention-to-treat analysis: 93.4% and 63.2%, respectively). H. pylori was successfully cultured in 122 patients (77%). The overall rate of metronidazole resistance was 19.7% (24/122), no primary resistance to clarithromycin or amoxicillin was found. In the OCM group, all patients infected with metronidazole-sensitive H. pylori strains (n = 51) and those infected with strains of unknown susceptibility to metronidazole (n = 14)were cured (100%), while 77% (10/13) of those harboring metronidazole-resistant. strains were cured of the infection (p = 0.36). Side effects leading to premature termination of treatment occurred in 2.5% of the patients in the OCM group and in 1.4 % of the OA group. We conclude that combined treatment with omeprazole, clarithromycin and a higher dose of metronidazole is highly effective in curing H, pylori infection, Helicobacter pylori omeprazole and that this regimen remains very effective in the presence of metronidazole resistant strains.
eCystic Fibrosis Review:Featured Cases: Nutritional Challenges and Complications in Patients with CF
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