Podcasts about new engl j med

In this episode, we will discuss Central Line-Associated Bloodstream Infections (CLABSI). My guest is Dr. Naomi O'Grady, a critical care and infectious disease physician at the National Institutes of Health. She is Chief of the Internal Medicine Service and an attending physician in the Clinical Center's Critical Care Medicine Department (CCMD). Her research focuses on strategies to reduce the incidence of antimicrobial-resistant pathogens in the ICU and catheter-related bloodstream infections. Additional Resources: Prevention of Central Line-Associated Bloodstream Infections. N. O'Grady. New Engl J Med 2023: https://pubmed.ncbi.nlm.nih.gov/37733310/ Sustaining reductions in central line-associated bloodstream infections in Michigan intensive care units: a 10-year analysis. P Pronovost, et al. Am J Med Qual 2016: https://pubmed.ncbi.nlm.nih.gov/25609646/ Bloodstream infection event (central line-associated bloodstream infection and non central-line associated bloodstream infection.) National Healthcare Safety Network: https://www.cdc.gov/nhsn/pdfs/pscmanual/4psc_clabscurrent.pdf Books Mentioned in this Episode: Nancy Drew Book Series. By Carolyn Keene. Nancy Drew Books: https://tinyurl.com/4rjx6st8 The Checklist Manifesto. By Atul Gawande The Checklist Manifesto- Atul Gawande: https://tinyurl.com/5pccn98p

6 Brüste: Große Freude! Evelyn Weigert von „Heinlein & Weigert“ und „Hoppe Hoppe Scheitern“ ist heute bei Sophia und Paula zu Gast. Zu dritt galoppieren die bayerischen Berlinerinnen durch ein herzliches und herrlich witziges Gespräch mit vielen persönlichen Storys zum Thema Streiten – egal ob mit dem Partner, Passanten, Nachbarn, Freunden oder Familie. Paula liebt Evelyns positiven Blick aufs Leben. Evelyn übt gerade ihren inneren Arsch mehr zurückzuhalten und Sophia nahm schon früh die roten Gummistiefel und flüchtete. Beide finden Paula unglaublich sexy. Harmonie!

Semaglutide aka Ozempic is a GLP-1 agonist that's been around for a long time, suddenly Hollywood elites are now promoting it for fat loss. Here's the science you need to know. Sponsored: Support your Workout Sessions and Healthy Hydration with this Creatine Electrolyte Combo by MYOXCIENCE Save 15% with code podcast at checkout Video and Images: https://bit.ly/3wpnpAE Research Mentioned: Wilding, J. P. H. et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. New Engl J Med 384, 989–1002 (2021). Sharma, D., Verma, S., Vaidya, S., Kalia, K. & Tiwari, V. Recent updates on GLP-1 agonists: Current advancements & challenges. Biomed Pharmacother 108, 952–962 (2018). Show Notes: 0:20 Semiglutide is a GLP-1 agonist. 00:30 GLP-1, glucagon like peptide 1, functions under the category of gastrointestinal incretin hormones that helps you process the foods you eat. It improves insulin sensitivity. Decreases glucagon. 01:30 About 80% of the mechanisms of bariatric surgery is by amplifying the release of incretin hormones. 02:00 There was a 14% loss of body weight in study participants. 02:50 Semiglutide exerts stress on pancreatic beta cells, with an increased prevalence of pancreatitis and potentially pancreatic cancer. 04:40 GIP and GLP-1 are released after eating to increase insulin secretion from beta cells and prevent post-meal glucose excursions. 05:50 The diminished activity of GIP and GLP-1 is a feature of type-2 diabetes, beta cell insulin resistance, an obesity. 07:10 Exercise increases the release of gastrointestinal incretin hormones. 07:25 Berberine increases gut hormones and changes your microbiome. 07:40 These incretin hormones control the ecosystem of your gut microbiome and can improve function of immune cells around your gut. 08:10 Bifidobacterium can lead to a healthier GI incretin response. 09:00 GABA and L-glycine. 09:45 Protein and fat. 10:30 Polyphenols    

Werden wir überfluchtet mit Wissen zum Coronavirus oder doch nur mit Informationen, Daten und Spekulationen? Immer mehr erfahren wir über die klinischen Aspekte von COVID-19. Ein Thema nach wie vor ist das Renin-Angiotensin-Aldosteron-System, das RAAS. Und immer mehr rücken Thromboembolien in den Fokus. Die Frage ist nur: Was ist gesichert, was ernst zu nehmen, was vielleicht weniger? Und welche therapeutischen, vielleicht sogar prophylaktischen Konsequenzen sollten Ärzte ziehen? Zu diesen Fragen machen wir in der heutigen Episode vom "CoronaUpdate" ein Evidenz-Update. Und wir reden darüber, was der Klimawandel mit COVID-19 zu tun hat. Quellen: 1. Victor G. Puelles et al. Multiorgan and Renal Tropism of SARS-CoV-2. New Engl J Med. May 13, 2020. doi: https://doi.org/10.1056/NEJMc2011400 2. Weber F., Anlauf M. (2019) Hemmstoffe des Renin-Angiotensin-Systems. In: Schwabe U., Paffrath D., Ludwig WD., Klauber J. (eds) Arzneiverordnungs-Report 2019. Springer, Berlin, Heidelberg. doi: https://doi.org/10.1007/978-3-662-59046-1_9 3. Katherine Mackey et al. Risks and Impact of Angiotensin-Converting Enzyme Inhibitors or Angiotensin-Receptor Blockers on SARS-CoV-2 Infection in Adults. A Living Systematic Review. Ann Int Med 15 May 2020. doi: https://www.acpjournals.org/doi/10.7326/M20-1515 4. Dominic Wichmann et al. Autopsy Findings and Venous Thromboembolism in Patients With COVID-19. A Prospective Cohort Study. Ann Int Med May 6th 2020. Doi: https://doi.org/10.7326/M20-2003 5. Sigurd F. Lax et al. Pulmonary Arterial Thrombosis in COVID-19 With Fatal Outcome: Results From a Prospective, Single-Center, Clinicopathologic Case Series. Ann Int Med May 14th 2020. Doi: https://doi.org/10.7326/M20-2566 6. Christina Creel-Bulos, et al. Acute Cor Pulmonale in Critically Ill Patients with Covid-19. New Engl J Med May 6th 2020. Doi: https://doi.org/10.1056/NEJMc2010459 7. Julien Poissy, et al. Pulmonary Embolism in COVID-19 Patients: Awareness of an Increased Prevalence. Circulation 24 Apr 2020. doi: https://doi.org/10.1161/CIRCULATIONAHA.120.047430 8. Ishan Paranjpe, et al. Association of Treatment Dose Anticoagulation with In-Hospital Survival Among Hospitalized Patients with COVID-19. JACC 2020. https://doi.org/10.1016/j.jacc.2020.05.001 9. Le Quéré, C., et al. Temporary reduction in daily global CO2 emissions during the COVID-19 forced confinement. Nat. Clim. Chang. (2020). https://doi.org/10.1038/s41558-020-0797-x

The world of emergency neuroimaging is evolving and increasingly influencing time-sensitive treatment decisions. A basic understanding of the imaging studies and sequences you may be asked to obtain in the ED may help you better manage your patients. In this post, Dr. Matthew Siket reviews the four major neuroimaging modalities (CT, CTA, Perfusion, and MRI). For the full show notes on our DownEast EM blog https://www.downeastem.org/downeastem/2018/6/29/neuroimaging   References: Smith AG and Hill CR. Imaging assessment of acute ischaemic stroke: a review of radiological methods. Br J Radiol. 2018;91:1083.[Pubmed] Albers GW et al. New Engl J Med 2018;378:708-18.[Pdf] Thomalla G et al. New Engl J Med 2018; 379(7):611-22.[Pdf] Author Matt Siket, MD and Jeff Holmes, MD Peer Reviewed by Andrew Perron, MD

  Mark S. Gold, MD, joins Lorenzo Norris, MD, host of the MDedge Psychcast and editor in chief of MDedge Psychiatry, to discuss the intersection between the rise in suicide and the opioid crisis in the United States. Dr. Gold is adjunct professor of psychiatry at Washington University in St. Louis. He also serves on the editorial advisory board of MDedge Psychiatry. Previously, Dr. Gold served as distinguished professor and chairman of the psychiatry department at the University of Florida, Gainesville. * * *  Help us make this podcast better! Please take this short listener survey: https://www.surveymonkey.com/r/podcastsurveyOct2019 * * * Timestamps: This week in Psychiatry (01:11) Interview with Dr. Gold (03:40) This week in Psychiatry Demeaning patient behavior takes an emotional toll on physicians by Steve Cimino Suicide and the opioid crisis In 2017, more than 70,000 people died from overdose, and 47,600 of those deaths involved prescription or illicit opioids. Most coroners list the deaths as “accidental” unless there is a suicide note or the deceased spoke about an intent to die. Chronic opioid self-administration changes the brain. The person becomes less high and more depressed over time. The prevalence of depression is at least 50% in those with opioid use disorder. Some experts estimate that up to 30% of opioid overdoses are intentional and count as suicide. A person with opioid use disorder has 13 times the risk of attempting and completing suicide, compared with the general population. Until recently, psychiatric evaluations and suicide assessments were not routine in the chain of events from opioid use to overdose to transition to medication-assisted treatment (MAT). People whose overdoses are reversed by naloxone are prime candidates to ask whether an overdose was accidental. In an emergency department in Flint, Mich., 30% of overdose patients rescued with naloxone described their overdose as a suicide attempt. Although some people revived with naloxone are angry, it is important to consider irritability and anhedonia that come from giving an opioid antagonist during a high. Future of treatments in the opioid crisis Much is still unknown. For example, there are no MAT options for either stimulant or cannabis use disorders, which are implicated in the morbidity and mortality of the overdose crisis. More research is needed to determine how long patients should be on MAT and when their brains “reset” after addiction. Also, in the pipeline is advanced imaging showing how drug use changes a person’s neurocircuitry and genetics. The OPRM1 gene, for example, is a polymorphism whose presence predicts whether a person is more likely to become addicted after their first use of opiates and determines treatment resistance to recovery. In the next year, efforts aimed at preventing overdoses and investigating the risk and rates of suicide are likely to continue. If every patient with a high-dose opioid prescription were offered naloxone, nearly 9 million more naloxone prescriptions could have been dispensed in 2018. So, we might see state-level policies that seek to increase naloxone prescriptions to patients based on morphine equivalents. Looking beyond overdoses and relapse prevention, the National Institute on Drug Abuse (NIDA) has identified novel targets focused on regenerating the reward system in order to return the brains of people with addictions to premorbid function after years of abuse.   References Volkow N and Gordon J. Suicide deaths are a major component of the opioid crisis. NIDA. 2019 Sep 19. Oquendo MA and Volkow ND. Suicide: A silent contributor to opioid-overdose deaths. New Engl J Med. 2018;378:1567-9. 5-point strategy to combat the opioid crisis. U.S. Department of Health & Human Services. Still not enough naloxone where it’s most needed. Centers for Disease Control and Prevention. 2019 Aug 6.   For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgePsych  

https://accadandkoka.com/wp-content/uploads/2019/03/McHugh-image-e1553385871910.jpg ()Paul McHugh, MD Despite its many scientific and therapeutic advances, the field of psychiatry remains lacking in coherence or cohesiveness as compared to other areas of medicine.  Part of the issue undoubtedly has to do with the intractable mind-body problem, but part of it may also be due to the effort of standardization of diagnosis set in motion by the Diagnostic and Statistical Manual.  Is there a way to move forward? Our guest is optimistic.  Paul McHugh, MD, is one of the most important figures in academic psychiatry of the last 30 years.  He is University Distinguished Professor of Psychiatry at Johns Hopkins University School of Medicine where he was department chairman from 1975 until 2001.  He is the author or co-author of several academic books and texts of psychiatry. GUEST: Paul McHugh, MD. https://www.hopkinsmedicine.org/profiles/results/directory/profile/0003340/paul-mchugh (Professional web page) LINKS: Paul R. McHugh and Philip R. Slavney, D. https://www.nejm.org/doi/full/10.1056/NEJMp1202555?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed (Mental Illness: Comprehensive Evaluation or Checklist?) (New Engl J Med, 2012) Paul McHugh and Philip Slavney.  https://www.amazon.com/Perspectives-Psychiatry-Paul-R-McHugh/dp/0801860466 (The Perspectives of Psychiatry )(Wolters Kluwer, 2nd ed. 1998) Support this podcast

El programa de esta semana lo dedicamos a discutir el tema de la recaída de malaria por infecciones con Plamodium vivax, aprovechando tres articulo recientes que tienen que ver con el tema.    Referencias: Robert j Commons y colaboradores. The effect of chloroquine dose and primaquine on Plasmodium vivaxrecurrence: a WorldWide Antimalarial Resistance Network systematic review and individual patient pooled meta-analysis.  Lancet Infect Dis, Sept 01, 2018. M.V.G Lacerda y colaboradores. Single-Dose Tafenoquine to Prevent Relapse of Plasmodium vivax Malaria. New Engl J Med  Jan 17, 2019. Alejandro Llanos-Cuentas y colaboradores. Tafenoquine versus Primaquine to Prevent Relapse of Plasmodium vivax Malaria. New Engl J Med  Jan 17, 2019.   La Frase de la Semana:  Esta vez la tomamos de  William Faulkner. Nacido el 25 de septiembre de 1897 en Oxford Mississippi y fallecido el 6 de julio de 1962. Faulkner es uno de los más celebrados escritores estadounidenses. Fue el ganador del Premio Nobel de Literatura en 1949. Faulkner escribió novelas, cuentos, guiones, poesía, ensayos y una obra de teatro. La frase dice:   “La sabiduría suprema es tener sueños bastante grandes para no perderlos de vista mientras se persiguen”        

En el programa de esta semana comentamos varios artículos de reciente publicación referentes a la epidemiologia, tratamiento y prevención de la infección por Clostridiodes difficile.     Referencias:  LY Kong y colaboradores. Clostridium difficile: Investigating Transmission Patterns between Infected and Colonized Patients using whole Genome Sequencing. Clin Infect Dis. May 2018 Benot Guery y colaboradores. Extended-pulsed daxomicin versus vancomycin for Clostridium di cile infection in patients 60 years and older (EXTEND): a randomised, controlled, open-label, phase 3b/4 trial . Lancet Infect Dis. March 2018. Thomas Birch y colaboradores. Efficacy of bezlotoxumab based on timing of administration relative to start of antibacterial therapy for Clostridium difficile infection. J Antimicrob Chemother. May 2018.  WE Trivk y colaboradores. Effectiveness of Probiotic for Primary Prevention of Clostridium difficile Infection: A Single-Center Before-and-After Quality Improvement Intervention at a Tertiary-Care Medical Center. Hosp Epidemiol Infect Control. May 2018. Bradley C. Johnson y colaboradores. Microbial Preparations (Probiotics) for the Prevention of Clostridium difficile Infection in Adults and Children: An Individual Patient Data Meta-analysis of 6,851 Participants. Hosp Epidemiol Infect Control. May 2018   FE Juul y colaboradores. Fecal Microbiota Transplantation for Primary Clostridium difficile Infection. New Engl J Med. June 2, 2018.   La Frase de la Semana:   La tomamos de JF Kennedy. John Fitzgerald "Jack" Kennedy (29 de mayo de 1917 - 22 de noviembre de 1963), comúnmente conocido por sus iniciales JFK, fue un político estadounidense que sirvió como el 35º presidente de los Estados Unidos desde enero de 1961 hasta su asesinato el 22 de noviembre de 1963 en Dallas, Texas.  La frase dice:   “Perdona a tus enemigos, pero nunca olvides sus nombres”    

Long-term anti-thrombotic treatment of embolic stroke sounds like a tricky field to navigate. Aspirin is the drug of choice in the acute setting for most patients, but when cardioembolic stroke is suspected, aspirin is inferior to anticoagulation for preventing recurrent stroke. In the age of novel oral anticoagulants, why choose warfarin and risk drug interactions, dietary restrictions and bleeding risk? In this episode, we discuss the pros and cons of each of the major NOACs for secondary stroke prevention. Enjoy! BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health identifying information. REFERENCES 1. Connolly SJ, et al. Dabigatran versus warfarin in patients with atrial fibrillation. New Engl J Med 2009; 361:1139-1151. 2. Granger CB, et al. Apixaban versus warfarin in patients with atrial fibrillation. New Engl J Med 2011; 365:981-992. 3. Patel MR, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. New Engl J Med 2011; 365:883-891. 4. Giugliano RP, et al. Edoxaban versus warfarin in patients with atrial fibrillation. New Engl J Med 2013; 369:2093-2104.

An interview with C. Miller Fisher, MD author of An unusual variant of acute idiopathic polyneuritis (syndrome of opthalmoplegia, ataxia and areflexia). New Engl J Med 1956;255:57-65 Interviewed by Ted Burns, MD and Robert Pascuzzi, MD. The participants in this Podcast had nothing to disclose.

An interview with C. Miller Fisher, MD author of An unusual variant of acute idiopathic polyneuritis (syndrome of opthalmoplegia, ataxia and areflexia). New Engl J Med 1956;255:57-65 Interviewed by Ted Burns, MD and Robert Pascuzzi, MD. The participants in this Podcast had nothing to disclose.