Podcasts about Pathophysiology

In this episode of the Nuanced Naturopaths, we explore the often misunderstood condition of lipedema. We discuss its symptoms, how it differs from lymphedema (which it's often confused with) and the importance of hormones, especially estrogen, in its development. We highlight the role of chronic inflammation, the unique characteristics of lipedema fat, and how it resists conventional weight loss methods. Plus, we delve into holistic, naturopathic treatments, including diet, herbal remedies, stress management, and the critical role of circadian rhythm (surprise, surprise!) in managing this condition.~MENTIONED IN THIS EP:⁠https://www.ncbi.nlm.nih.gov/books/NBK573066/https://onlinelibrary.wiley.com/doi/10.1111/jpi.12965https://pmc.ncbi.nlm.nih.gov/articles/PMC8583809/Lymph Love Club on Instagramhttps://lipedemaproject.org/lipedema-support-community/https://www.facebook.com/groups/1194013721968427/https://www.inspire.com/groups/the-lipedema-project/https://www.reddit.com/r/lipedema/~TIMESTAMPS00:00 Introduction01:17 Meet the Hosts: Karinda and Julie02:41 Episode Topic: Lipedema06:33 Understanding Lipedema: Symptoms and Diagnosis12:09 Comparing Lipedema and Lymphedema21:44 Pathophysiology of Lipedema36:01 Understanding LymphoScintigraphy37:26 Conventional Treatment Strategies for Lymphedema and Lipedema40:29 Complementary Medicine Approaches41:39 Anti-Inflammatory Diet and Nutritional Support45:51 Hormonal Influence on Lipedema55:37 Differences Between Lipedema Fat and Regular Fat01:04:04 Naturopathic Treatment Strategies for Lipedema01:08:51 Circadian Rhythm and Insulin Resistance01:16:06 Conclusion and Support Resources~Reach out to the Nuanced Naturopaths⁠ ⁠here⁠⁠! Send us your feedback, questions & episode requests.⁠Check out our Nuanced & Nourished Membership here⁠⁠Connect with us on Instagram⁠~CONNECT WITH JULIE:⁠⁠Email⁠⁠⁠⁠Website⁠⁠⁠⁠Instagram⁠⁠⁠⁠Book in with Julie⁠⁠CONNECT WITH KARINDA:⁠⁠Email⁠⁠⁠⁠Website⁠⁠⁠⁠Instagram⁠⁠⁠⁠Book in with Karinda⁠~DISCLAIMER FOR PUBLIC: The contents of this podcast or any information mentioned is not intended to be a substitute for professional medical advice, diagnosis or treatment. If you're seeking assistance with your health, please contact an accredited healthcare professional. If you'd like personalised support with your health, you can book a session with Julie or Karinda using the links above.DISCLAIMER FOR HEALTH PRACTITIONERS: The content provided is intended for entertainment and educational purposes. The information discussed in this podcast is not a substitute for professional training. While the authors/hosts make every effort to provide the most up-to-date data and evidence on naturopathic information, this content should not necessarily be considered standard of care and may not reflect individual practices within or outside of Australia.~The Nuanced Naturopaths Podcast is a friendly conversation between two friends, us! Karinda and Julie. We're passionate about finding the nuance in natural health. As degree-qualified naturopaths, we like to ask the questions that need to be asked - about all aspects of health, healing and well-being. We delight in questioning firmly held beliefs and finding the nuance in all subjects health-related and beyond. Sometimes it can get a little technical, but hopefully we explain things in a way that's accessible to anyone interested in natural health, whether you're a practitioner or someone who wants to learn more and optimise your wellbeing. It's a chat about poop, periods and everything in between - buckle up for a laugh, a cry and for some things you are yet to consider about your health! Stay nuanced!

In this episode, host Dr. Doug Reh speaks with Dr. Josh Levy. They discuss the recently published Review Article: “Allergic Fungal Rhinosinusitis Diagnosis, Management, Associated Conditions, Pathophysiology, and Future Directions: Summary of a Multidisciplinary Workshop”. The full manuscript is available online in the International Forum of Allergy and Rhinology. Listen and subscribe for free to […]

Chronic sinusitis might be doing more than just clogging your nose–it could be clouding your brain. In this episode of Backtable ENT, Dr. Aria Jafari, an assistant professor at the University of Washington and co-director of the Neuroendocrinology Advanced Sinus and Skull-base Surgery Fellowship, discusses the connection between sinusitis and cognitive dysfunction with hosts Dr. Gopi Shah and Dr. Ashley Agan. --- SYNPOSIS Dr. Jafari shares how his interest in this field developed and details his research on the relationship between chronic rhinosinusitis (CRS) and brain function. The conversation highlights the comprehensive impact of sinus inflammation on overall health, emphasizing the importance of viewing CRS as a whole-body condition. They also discuss patient experiences, the methodologies used to assess cognitive dysfunction, potential treatments, and what's next in the research frontier.---TIMESTAMPS00:00 - Introduction 06:18 - The Impact of CRS on Quality of Life14:02 - Understanding Brain Fog and Cognitive Dysfunction24:29 - Pathophysiology and Theories of Cognitive Dysfunction27:44 - Chronic Inflammation and Cognitive Effects28:59 - Impact of Biologics on Cognitive Function31:28 - Risk Factors for Cognitive Dysfunction35:02 - Olfactory Symptoms 37:13 - Future Research and Treatment Approaches45:31 - Conclusion and Final Thoughts --- RESOURCES Dr. Aria Jafari https://www.uwmedicine.org/bios/aria-jafari

Tinnitus—the phantom ringing, buzzing, or hissing that affects millions. For those patients who suffer with this debilitating condition, it is frustrating to find any relief. For those clinicians trying to treat it, the causes are so multi-faceted, and the treatments seem to be lacking. Today we break down the physiology of hearing, what can go wrong in the auditory system, and the many potential causes of tinnitus, from noise exposure to neurological conditions. We also examine current treatment options, emerging therapies, and what the latest research says about finding relief. Whether you're a sufferer or just curious, this episode tunes into the facts behind the noise. Today on The Lab Report: 5:00 Tinnitus – what is it? 7:00 Physiology of hearing sound 10:30 Basic causes of tinnitus 13:45 Pathophysiology & mechanisms 17:45 Loud noise causing tinnitus 22:35 Presbycusis, ototoxicity, hearing loss 25:05 Root causes and treatment of tinnitus 28:00 Functional approach for clinicians Subscribe, Rate, & Review The Lab Report Thanks for tuning in to this week’s episode of The Lab Report, presented by Genova Diagnostics, with your hosts Michael Chapman and Patti Devers. If you enjoyed this episode, please hit the subscribe button and give us a rating or leave a review. Don’t forget to visit our website, like us on Facebook, follow us on Twitter, Instagram, and LinkedIn. Email Patti and Michael with your most interesting and pressing questions on functional medicine: podcast@gdx.net. And, be sure to share your favorite Lab Report episodes with your friends and colleagues on social media to help others learn more about Genova and all things related to functional medicine and specialty lab testing. To find a qualified healthcare provider to connect you with Genova testing, or to access select products directly yourself, visit Genova Connect. Disclaimer: The content and information shared in The Lab Report is for educational purposes only and should not be taken as medical advice. The views and opinions expressed in The Lab Report represent the opinions and views of Michael Chapman and Patti Devers and their guests. See omnystudio.com/listener for privacy information.

A New Podcast from Obstetrics & Gynecology, featuring members from the Editorial Team and contributing authors, each month as they highlight the latest research and practice updates in the field. This episode features interviews with Dr. Yalda Afshar, author of “Biology and Pathophysiology of Placenta Accreta Spectrum Disorder,” and Dr. Clarel Antoine, author of “Endometrium-Free Closure Technique During Cesarean Delivery for Reducing the Risk of Niche Formation and Placenta Accreta Spectrum Disorders.”

In this episode of the PFC Podcast, Ian Wedmore, an expert in high altitude medicine, discusses the newly released Clinical Practice Guidelines (CPG) for altitude-related illnesses. The conversation covers the pathophysiology of acute mountain sickness, high altitude pulmonary edema, and high altitude cerebral edema, as well as their diagnosis and treatment protocols. Ian emphasizes the importance of understanding the symptoms, utilizing technology, and implementing prevention strategies to effectively manage altitude illnesses in military and wilderness settings.TakeawaysThe new CPG for altitude medicine is a significant advancement.Acute mountain sickness occurs when the body ascends too quickly without acclimatization.Diagnosis of altitude sickness relies heavily on symptom scoring systems.Vital signs are crucial for diagnosing high altitude pulmonary edema.Dexamethasone is essential for treating high altitude cerebral edema.Pre-exposure prophylaxis can reduce the risk of altitude sickness.Acetazolamide is the primary medication for preventing acute mountain sickness.Understanding the pathophysiology of altitude illnesses is key for treatment.Good hydration and nutrition are critical for acclimatization.Data collection through medic encounter forms will improve altitude care.Chapters00:00 Introduction to High Altitude Medicine02:51 Understanding Acute Mountain Sickness06:13 Diagnosing and Differentiating Altitude Illnesses08:56 Pathophysiology of High Altitude Pulmonary and Cerebral Edema12:04 Treatment Protocols for Altitude Illnesses15:08 Utilizing Technology in Altitude Medicine18:00 Prevention and Prophylaxis Strategies20:45 The Role of Medications in Altitude Care24:13 Future Directions in Altitude Medicine27:01 Conclusion and Key TakeawaysLink to full podcast:⁠https://creators.spotify.com/pod/show/dennis3211/episodes/Prolonged-Field-Care-Podcast-228-DImE-e32aek2⁠Thank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠For more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠⁠

We dive into the recognition and management of blast crisis. Hosts: Sadakat Chowdhury, MD Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Blast_Crisis.mp3 Download Leave a Comment Tags: Hematology, Oncology Show Notes Topic Overview Blast crisis is an oncologic emergency, most commonly seen in chronic myeloid leukemia (CML). Defined by: >20% blasts in peripheral blood or bone marrow. May include extramedullary blast proliferation. Without treatment, median survival is only 3–6 months. Pathophysiology & Associated Conditions Usually occurs in CML, but also in: Myeloproliferative neoplasms (MPNs) Myelodysplastic syndromes (MDS) Transition from chronic to blast phase often reflects disease progression or treatment resistance. Risk Factors 10% of CML patients progress to blast crisis. Risk increased in: Patients refractory to tyrosine kinase inhibitors (e.g., imatinib). Those with Philadelphia chromosome abnormalities. WBC >100,000, which increases risk for leukostasis. Clinical Presentation Symptoms often stem from pancytopenia and leukostasis: Anemia: fatigue, malaise. Functional neutropenia: high WBC count, but increased infection/sepsis risk. Thrombocytopenia: bleeding, bruising. Leukostasis/hyperviscosity effects by system: Neurologic: confusion, visual changes, stroke-like symptoms. Cardiopulmonary: ARDS, myocardial injury. Others: priapism, limb ischemia, bowel infarction.

Chapters 00:00 Introduction to Finger Tendons and Climbing Injuries 03:13 Understanding Finger Anatomy and Function 06:02 Common Finger Injuries in Climbers 08:53 Pathophysiology of Tenosynovitis 12:06 Rehabilitation Strategies for Finger Injuries 15:04 Comparing Tenosynovitis and Pulley Injuries 17:56 Managing Climbing Volume and Injury Prevention 25:38 Understanding Power Loss in Climbing 29:27 Tendon Adaptation Through Lifelong Loading 33:22 Rehabilitation Challenges for Climbers 35:05 The Role of Strength Training in Climbing 37:10 Tendon Adaptation Mechanisms 38:56 Controversies in Climbing Training Methods 41:07 Ultrasound in Diagnosing Climbing Injuries 42:22 Using Strain Gauges for Performance Measurement 43:53 Understanding Pulley Ruptures 45:36 Rehabilitation Techniques for Finger Tendons 47:14 Thumb Tendon Issues in Climbers 49:09 Future Directions in Climbing Research 50:07 Finding Professional Help in Climbing Rehabilitation   Takeaways Tyler Nelson has a doctorate in chiropractic and a master's in tendon research. Rock climbers often experience finger injuries due to overtraining. Finger tendons are unique in their anatomy and function compared to other tendons. Tenosynovitis is a common injury among climbers, often due to too much stress too soon. Rehabilitation for finger injuries should focus on gradual load increase and proper technique. The A2 pulley is crucial for finger movement and is often injured in climbers. Climbers need to be aware of the specific loads their fingers endure during training. Managing climbing volume is essential to prevent injuries in climbers. The tendon sheath plays a vital role in the health of finger tendons. Understanding the mechanics of finger tendons can aid in better training and injury prevention. Power loss is a key metric in understanding climbing performance. Beginners should focus on skill development rather than overloading their fingers. Body weight significantly affects the load on tendons during climbing. Lifelong loading is crucial for tendon adaptations in climbers. Climbers often underload their tendons during rehabilitation, leading to prolonged recovery. Strength training is essential for injury prevention and performance enhancement in climbing. Tendon adaptations require significant muscle load and proper joint positioning. Controversial training methods are gaining popularity, but their efficacy is debated. Ultrasound is the gold standard for diagnosing climbing injuries and assessing tendon health. There is a growing interest in climbing research, leading to better understanding and treatment of climbing-related injuries. Instagram: https://www.instagram.com/c4hp/ Website: https://www.camp4humanperformance.com Notes: https://jackedathlete.com/podcast-142-finger-tendons-with-tyler-nelson/

Hombres y mujeres tenemos biologías distintas: en promedio, los hombres tenemos más testosterona que las mujeres y, aparte, las mujeres experimentáis fluctuaciones hormonales grandes debido al ciclo menstrual. Pero, ¿eso implica necesariamente que tengáis que entrenar/ comer distinto? Vamos a revisar algunos estudios (especialmente los derivados del proyecto FENDURA) para ver dónde sí y dónde no puede tener sentido introducir adaptaciones. Pongo a continuación los links a todas las fuentes consultadas para el episodio: Publicaciones del proyecto FENDURA: https://uit.no/research/fendura#region_705939 Newsletter de Veronique Billat: https://substack.com/@billat Relative Energy Deficiency in Sport (REDs): Endocrine Manifestations, Pathophysiology and Treatments https://pubmed.ncbi.nlm.nih.gov/38488566/ Exogenous Glucose Oxidation During Exercise Is Positively Related to Body Size https://pubmed.ncbi.nlm.nih.gov/39332815/ --- Si te ha gustado, suscríbete, ponle un Like, comenta, comparte. Gracias ! Sígueme en https://www.instagram.com/correrporsenderos/ donde publico píldoras sobre trail running y deporte endurance a diario en Stories . Puedes mandarme un MD por ahí para plantear dudas o sugerencias. Suscríbete a mi canal YouTube para ver estas explicaciones con apoyo visual: https://www.youtube.com/@C0rrerP0rSender0s Puedes ver mis entrenamientos en Strava: https://www.strava.com/athletes/93325076 --- #running #runningtips #maraton #fisiologia #exercisephysiology #red-s

Hiccups- that annoying and at times, painful reflex that sneaks up on you when you least expect it, and sometimes refuses to leave. But what are they really? Is there an evolutionary reason we’ve developed this reflex? When should you be concerned? Can we prevent them? In this episode, we break down the pathophysiology of hiccups (yes, there’s real science behind it) Knowing the science of why they occur, we can separate fact from fiction on how to cure them. From medical insights to strange home remedies, we’re getting to the root of the world’s most inconvenient reflex. Today on The Lab Report: 3:45 Hiccups – the diaphragm and phrenic nerve 6:30 Pathophysiology of the hiccup and evolution of this reflex 9:30 Diet and lifestyle hiccup triggers 11:00 The rhythmic reflex arc 13:40 When should you be concerned? 15:50 Common cures – fact vs. fiction 21:25 Traditional Chinese Medicine and Charles Osborne 23:09 Take-aways for functional medicine practitioners Additional Resources: Genova Connect Subscribe, Rate, & Review The Lab Report Thanks for tuning in to this week’s episode of The Lab Report, presented by Genova Diagnostics, with your hosts Michael Chapman and Patti Devers. If you enjoyed this episode, please hit the subscribe button and give us a rating or leave a review. Don’t forget to visit our website, like us on Facebook, follow us on Twitter, Instagram, and LinkedIn. Email Patti and Michael with your most interesting and pressing questions on functional medicine: podcast@gdx.net. And, be sure to share your favorite Lab Report episodes with your friends and colleagues on social media to help others learn more about Genova and all things related to functional medicine and specialty lab testing. To find a qualified healthcare provider to connect you with Genova testing, or to access select products directly yourself, visit Genova Connect. Disclaimer: The content and information shared in The Lab Report is for educational purposes only and should not be taken as medical advice. The views and opinions expressed in The Lab Report represent the opinions and views of Michael Chapman and Patti Devers and their guests.See omnystudio.com/listener for privacy information.

Welcome back to The Resus Room! This time, we're diving into the fascinating and often overlooked world of electrical injuries. From household mishaps and workplace accidents to tasers and even lightning strikes, electrical injuries can range from minor shocks to life-threatening cardiac arrests. As always, we'll be taking you through the full spectrum of care, from first contact at the roadside to critical management in resus. And let's be honest, there's a real lack of clear guidance out there when it comes to managing these cases. So, we've done the legwork, scoured the literature, and we're here to make sense of it all. In this episode, we'll cover: Pathophysiology; how electricity interacts with the body and why not all shocks are created equal. Classification; what makes a low-voltage injury different from a high-voltage one, and why that matters. Prehospital & ED Management; who needs an ECG, who needs admission, and what to do with those tricky "seemingly fine" patients. Special cases; tasers, lightning strikes, and the unique challenges they pose. One of the big questions we'll be tackling: Does everyone who gets an electric shock need to go to hospital? We've all seen them, the patient that has a shock at work, but they feel fine. So, do they need a work-up, or can they safely go home? So, grab a coffee (or maybe a non-conductive beverage of choice), and let's get stuck in to Electrical Injuries! Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James

In this episode of the PFC Podcast, host Dennis speaks with Eric Bauer from FlightBridge ED about the critical topic of anaphylaxis. They explore the importance of understanding anaphylaxis through real-life scenarios, the initial assessment and response required in emergency situations, and the underlying pathophysiology of allergic reactions. The conversation emphasizes the urgency of treatment protocols, particularly the use of epinephrine, and discusses advanced management strategies for patients experiencing anaphylaxis. This episode serves as an essential guide for emergency medical professionals and anyone interested in critical care. This conversation delves into advanced airway management, IV access, and medication protocols in the context of anaphylaxis treatment. The speakers discuss the importance of proactive decision-making, fluid resuscitation strategies, and the need for careful monitoring and adjustment of treatment. They also touch on Kuhn's syndrome, a condition that can complicate anaphylaxis cases, and emphasize the importance of seeking help when needed in critical care situations.TakeawaysAnaphylaxis is a lower frequency type of call in EMS.Initial assessment should focus on the patient's airway and breathing.Respiratory involvement indicates a more severe allergic reaction.Benadryl is not the first-line treatment for anaphylaxis.Epinephrine should be administered promptly in anaphylactic cases.Timing of treatment is crucial; reactions can escalate quickly.Advanced airway management may be necessary in severe cases.Patient positioning and PEEP can aid in respiratory distress.Understanding the pathophysiology of anaphylaxis is essential for effective treatment.Continuous reassessment is key in managing anaphylactic patients. Advanced airway management is crucial in critical situations.Proactive decision-making is essential in emergency care.Fluid resuscitation strategies must be tailored to the patient's condition.Medication protocols should include timely administration of epinephrine and steroids.Monitoring patient response is vital for adjusting treatment plans.Kuhn's syndrome can mimic myocardial infarction in young patients.It's important to be aware of the potential for rebound responses in anaphylaxis.Healthcare providers should be comfortable adjusting medications as needed.Telemedicine can provide valuable support in critical care situations.Continuous education and self-awareness are key in emergency medicine.Chapters00:00 Introduction to Anaphylaxis and Its Importance02:56 Understanding Anaphylaxis Through a Scenario05:50 Initial Assessment and Response to Anaphylaxis09:07 The Pathophysiology of Anaphylaxis11:51 Timing and Severity of Anaphylactic Reactions15:00 Treatment Protocols for Anaphylaxis18:11 Advanced Management Strategies in Anaphylaxis23:20 Advanced Airway Management in Critical Situations26:04 IV Access and Pressor Administration28:58 Fluid Resuscitation Strategies32:02 Medication Protocols in Anaphylaxis36:03 Monitoring and Adjusting Treatment41:27 Understanding Kuhn's Syndrome45:48 Final Thoughts on Anaphylaxis ManagementThank you to Delta Development Team for in part, sponsoring this podcast.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at PeerView.com/AFJ865. CME credit will be available until March 9, 2026.Visualizing the Role of Neuroinflammation in the Pathophysiology and Management of Alzheimer's Disease In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Novo Nordisk Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at PeerView.com/AFJ865. CME credit will be available until March 9, 2026.Visualizing the Role of Neuroinflammation in the Pathophysiology and Management of Alzheimer's Disease In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Novo Nordisk Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at PeerView.com/AFJ865. CME credit will be available until March 9, 2026.Visualizing the Role of Neuroinflammation in the Pathophysiology and Management of Alzheimer's Disease In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Novo Nordisk Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at PeerView.com/AFJ865. CME credit will be available until March 9, 2026.Visualizing the Role of Neuroinflammation in the Pathophysiology and Management of Alzheimer's Disease In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Novo Nordisk Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at PeerView.com/AFJ865. CME credit will be available until March 9, 2026.Visualizing the Role of Neuroinflammation in the Pathophysiology and Management of Alzheimer's Disease In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Novo Nordisk Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at PeerView.com/AFJ865. CME credit will be available until March 9, 2026.Visualizing the Role of Neuroinflammation in the Pathophysiology and Management of Alzheimer's Disease In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Novo Nordisk Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at PeerView.com/AFJ865. CME credit will be available until March 9, 2026.Visualizing the Role of Neuroinflammation in the Pathophysiology and Management of Alzheimer's Disease In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Novo Nordisk Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at PeerView.com/AFJ865. CME credit will be available until March 9, 2026.Visualizing the Role of Neuroinflammation in the Pathophysiology and Management of Alzheimer's Disease In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Novo Nordisk Inc.Disclosure information is available at the beginning of the video presentation.

This ASPEN podcast series is based on the Nutrition in Clinical Practice Supplement titled ‘Fat Malabsorption in Disease States' published in April 2024. This episode features Dr. Endashaw Omer, MD, MPH, focusing on physiology, pathophysiology, and diagnosis of fat malabsorption. This podcast series provides an in-depth look at the latest understanding of fat malabsorption in various disease states and was developed to educate clinicians on the current evidence in the management of this condition. This podcast is supported by Alcresta. Business Corporate by Alex Menco | alexmenco.net Music promoted by www.free-stock-music.com Creative Commons Attribution 3.0 Unported License creativecommons.org/licenses/by/3.0/deed.en_US March 2025

In this podcast, expert clinicians will discuss the pathophysiology of gMG and the significance of disease subtype on clinical decision-making. To claim CE credit after listening to this episode, go to this link and check the "Already listened on another platform?" box: https://healio.com/cme/mededtalks/neurology/20250220/2-unraveling-the-pathophysiology-of-gmg-and-its-impact-on-treatment-selection

Discuss the pathophysiology of trigger points, describe the role trigger points have in musculoskeletal injury, discuss the treatment options for trigger pointsTimestamps(1:44) What are trigger points?(2:43) How are trigger points formed?(6:56) Trigger points and musculoskeletal injury(11:04) Treatment options for trigger points--ARTICLE CITATIONS used for this episode: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://atcornerds.wixsite.com/home/blog⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠AT CORNER FACEBOOK GROUP: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/groups/atcornerpodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram, Website, YouTube, and other links: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠atcornerds.wixsite.com/home/links⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠EMAIL US: atcornerds@gmail.comSAVE on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbridge⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠: Use code ATCORNER to get $101 off your subscriptionMusic: Jahzzar (betterwithmusic.com) CC BY-SA—TO GET CEUs, enroll in this course: https://clinicallypressed.org/courses/Take the quiz and course evaluation and your certificate will be generated for you! We have no financial disclosures or conflict of interests.---Sandy & Randy

For his 40th birthday, a man is treating himself to his very first massage. His health history includes a few noteworthy details, one of which is a condition neither his massage therapist nor I had ever encountered before: hereditary spherocytosis. Are there any potential concerns? Possibly. Resources:  Hereditary Spherocytosis - Symptoms, Causes, Treatment | NORD (no date). Available at: https://rarediseases.org/rare-diseases/anemia-hereditary-spherocytic-hemolytic/ (Accessed: 19 February 2025). Hereditary spherocytosis: MedlinePlus Genetics (no date). Available at: https://medlineplus.gov/genetics/condition/hereditary-spherocytosis/ (Accessed: 19 February 2025). ‘Hereditary Spherocytosis: Practice Essentials, Pathophysiology, Etiology' (2023). Available at: https://emedicine.medscape.com/article/206107-overview?_gl=1*1ulm2jw*_gcl_au*NDQwNzg1MDc3LjE3MzkzMDYxNDM. (Accessed: 19 February 2025). Hereditary Spherocytosis: What It Is, Symptoms, Causes & Treatment (no date) Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/23058-hereditary-spherocytosis (Accessed: 19 February 2025). Mehta, P. (no date) What Is Hereditary Spherocytosis?, WebMD. Available at: https://www.webmd.com/children/what-is-hereditary-spherocytosis (Accessed: 19 February 2025).   Host Bio:                    Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP's partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner's books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com.                    About our Sponsors:   Anatomy Trains: www.anatomytrains.com    American Massage Conference:  https://www.massagetherapymedia.com/conferences   Anatomy Trains is a global leader in online anatomy education and also provides in-classroom certification programs for structural integration in the US, Canada, Australia, Europe, Japan, and China, as well as fresh-tissue cadaver dissection labs and weekend courses. The work of Anatomy Trains originated with founder Tom Myers, who mapped the human body into 13 myofascial meridians in his original book, currently in its fourth edition and translated into 12 languages. The principles of Anatomy Trains are used by osteopaths, physical therapists, bodyworkers, massage therapists, personal trainers, yoga, Pilates, Gyrotonics, and other body-minded manual therapists and movement professionals. Anatomy Trains inspires these practitioners to work with holistic anatomy in treating system-wide patterns to provide improved client outcomes in terms of structure and function.                      Website: anatomytrains.com                        Email: info@anatomytrains.com             Facebook: facebook.com/AnatomyTrains                       Instagram: www.instagram.com/anatomytrainsofficial   YouTube: https://www.youtube.com/channel/UC2g6TOEFrX4b-CigknssKHA     American Massage Conference   Get ready to immerse yourself in the excitement as the American Massage Conference (AMC) arrives to Disney Springs near Orlando, Florida (May 16th-18th, 2025)! With a legacy of 17 successful years in Ontario, Canada, this premier event, proudly hosted by ONE Concept Conferences and expertly produced by Massage Therapy Media (MTM), boasts a lineup of presenters from across the nation and around the globe. The American Massage Conference began in Atlanta in 2011 and has been hosted through the years in San Diego, Chicago, and Virginia Beach. The conference provides educational opportunities with engaging one-, two-, three- and four-hour class formats, networking opportunities, masterminds, MTM Talks, demonstrations, and an extensive exhibitor tradeshow.   Mark your calendars for an unforgettable experience filled with education, networking, and the celebration of massage therapy excellence! ABMP members receive a special discount to attend this in-person conference—log in to your ABMP account to access the discount code and register today. Website: https://www.massagetherapymedia.com/conferences  

We often think about exercising to stay fit as we age–but what about keeping our voices in shape? In this episode of BackTable ENT, Dr. Neel Bhatt, a laryngologist from the University of Washington in Seattle, discusses the intricacies of the aging voice with hosts Dr. Gopi Shah and Dr. Ashley Agan. --- SYNPOSIS Dr. Bhatt sheds light on the pathophysiology behind vocal fold atrophy, the role of glottic image capture, and the innovative use of the GlottIC (Glottal Image Capture) in measuring vocal fold bowing. They explore the impact of aging on the voice and swallowing, the relationship between vocal fold activity and overall health, and the benefits of voice therapy and procedural interventions in treating age-related voice changes. Overall, this episode summarizes valuable insights into maintaining vocal health as we age. --- TIMESTAMPS 00:00 - Introduction 01:33 - Understanding the Aging Voice and Clinical Presentations 10:41 - Impact of Aging Voice on Quality of Life 15:31 - Pathophysiology of Aging Voice 24:45 - Clinical Examination and Diagnosis 32:09 - Challenges in Scope Exams 39:33 - Swallow Studies: Fees vs. Video Fluoroscopy 41:16 - Management of Age-Related Voice Changes 58:27 - Maintaining Vocal Health with Age 01:01:01 - Conclusion and Contact Information --- RESOURCES Dr. Neel Bhatt https://otolaryngology.uw.edu/our-people/faculty/neel-k-bhatt-md BackTable+ for ENT https://plus.backtable.com/pages/ent Check out BackTable+ for ENT, our sponsor and new e-learning platform! https://plus.backtable.com/pages/ent

In this episode of the PFC Podcast, Dennis, Paul, and Ian discuss the critical topic of cold weather injuries, focusing on frostbite and trench foot. Ian shares his extensive experience in wilderness medicine and military contexts, providing historical insights into the impact of these injuries in warfare. The conversation covers prevention strategies, treatment protocols, and the importance of buddy checks in cold environments. Ian explains the pathophysiology of frostbite, the classification of injuries, and the role of thrombolytics in treatment. The episode concludes with a discussion on trench foot, emphasizing the need for proper foot care and hydration to prevent these injuries. Takeaways Frostbite and trench foot have significant historical military implications. Prevention is key in avoiding cold weather injuries. Buddy checks can help identify early signs of frostbite. Rapid rewarming in warm water is the best treatment for frostbite. Thrombolytics can help reduce tissue loss if administered early. Trench foot requires slow, dry rewarming and careful monitoring. Frostbite classification helps determine treatment and prognosis. Hydration and keeping feet dry are crucial for preventing trench foot. Avoid using active heat sources for rewarming frostbite. Rubbing frostbite with snow is a dangerous myth. Chapters 00:00 Introduction to Cold Weather Injuries 01:49 Historical Context of Cold Weather Injuries 03:14 Understanding Frostbite and Non-Freezing Cold Injuries 05:51 Prevention Strategies for Cold Weather Injuries 09:06 Buddy Checks and Hydration 10:58 Pathophysiology of Frostbite 14:01 Treatment Protocols for Frostbite 20:03 Evacuation Considerations for Frostbite 24:42 Assessment and Classification of Frostbite 30:25 Thrombolytics and Their Role in Treatment 36:11 Trench Foot: Understanding and Treatment 45:39 Conclusion and Key Takeaways Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

Degenerative disc disease, a major cause of low back pain, is the most common musculoskeletal issue worldwide, affecting an estimated 15-30% of the population. In this episode of BackTable MSK, interventional radiologists Dr. Olivier Clerk-Lamalice and Dr. Jacob Fleming cover symptomatic degenerative disc disease, focusing on its diagnosis and treatment with anesthetic injections. This is the first episode in a two-part series on discogenic back pain. --- Get $100 off of your GRIBOI Conference registration using this link: www.eventbrite.com/e/1027273521757/?discount=BackDoorGRIBOIPromoCode Visit the GRIBOI website for special hotel rates, available until March 11, 2025: https://www.griboi.org/annualconference --- This podcast is supported by: Medtronic Interventional https://www.medtronic.com/interventional --- SYNPOSIS Dr. Clerk-Lamalice begins by explaining the pathophysiology of disc degeneration, which can lead to painful annular tears and loss of disc height. The doctors also reflect on the history of discography, from provocative discograms to the more recent anesthetic and CT discograms. They review the modified Dallas Discogram Classification for annular tears, the vacuum disc phenomenon, and the importance of dynamic imaging to assess treatment candidacy. Dr. Clerk-Lamalice emphasizes the need to correlate imaging with physical examination to better identify the symptomatic disc level. The episode also discusses the challenges of managing multi-level disc degeneration and underscores the importance of early-stage intervention. --- TIMESTAMPS 00:00 - Introduction 02:44 - Pathophysiology of Disc Degeneration 06:49 - Evolution of Discography 12:55 - Classification of Annular Tears 09:01 - Diagnostic Tools and Techniques 14:00 - CT Discogram and Annular Tear Classification 17:12 - Dynamic Aspects and Instability 22:20 - Identifying Symptomatic Disc Level 28:25 - Treatment Approaches and Patient Selection --- RESOURCES BackTable MSK Ep. 13- Basivertebral Nerve Ablation with Dr. Olivier Clerk-Lamalice: https://www.backtable.com/shows/msk/podcasts/13/basivertebral-nerve-ablation Modified Dallas Discogram Classification System: https://pubmed.ncbi.nlm.nih.gov/2954226/

In this episode, learn from leading experts about managing preeclampsia with and without severe features. The panel will define the pathophysiology and potential for multi-organ system impact with preeclampsia; discussion to include postpartum care recommendations. 

Eileen Egan, DNP, FNP-C, BC-ADM, CDCES, FADCES joins The Huddle to share her expertise about the interplay between weight and glycemic management in people with Type 2 diabetes, the importance of meeting glycemic and weight goals early after a Type 2 diabetes diagnosis, as well as best practices for helping people stay motivated and engaged. This episode was made possible with support from Lilly, A Medicine Company. Learn more about this topic in this accompanying patient/client handout (support for the development of this handout was provided by Lilly, A Medicine Company): adces_tipsheet_early_control2.pdf References:American Diabetes Association. Obesity and weight management for the prevention and treatment of type 2 diabetes: standards of care in diabetes- 2024. Diabetes Care, 47(1): S145-S157.Center for Disease Control and Prevention. Adult overweight and obesity. https://www.cdc.gov/obesity/basics/adult-defining.htmlDCCT/EDIC study research group. Intensive Diabetes Treatment and Cardiovascular Outcomes in Type 1 Diabetes: The DCCT/EDIC Study 30-Year Follow-up. Diabetes Care. 2016;39(5):686-693. Gregg E, Jakicic J, Blackburn G, et al. Association of the magnitude of weight loss and changes in physical fitness with long-term cardiovascular disease outcomes in overweight or obese people with type 2 diabetes: a post hoc analysis of the Look AHEAD randomized clinical trial. Lancet Diabetes Endocrinol. 2016; 4(11): 913-921.Gutiérrez-Cuevas J, Santos A, Armendariz-Borunda J. Pathophysiological Molecular Mechanisms of Obesity: A Link between MAFLD and NASH with Cardiovascular Diseases. Int J Mol Sci. 2021. 27;22(21):11629.Howard BV, Ruotolo G, Robbins DC. Obesity and dyslipidemia. Endocrinol Metab Clin North Am. 2003;32(4):855-867. Jin X, et al. Pathophysiology of obesity and its associated diseases. Acta Pharm Sin B. 2023;13(6):2403-2424.  Laiteerapong N, Ham SA, Gao Y, et al. The legacy effect in type 2 diabetes: impact of early glycemic control on future complications (The Diabetes & Aging Study). Diabetes Care. 2019;42(3):416-426.Lean MEJ, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial.Lancet Diabetes Endocrinol. 2019;7(5):344-355.Lingvay I, Sumithran P, Cohen RV, le Roux CW. Obesity management as a primary treatment goal for type 2 diabetes: time to reframe the conversation. Lancet. 2022 Jan 22;399(10322):394-405. doi: 10.1016/S0140-6736(21)01919-X. Epub 2021 Sep 30. Erratum in: Lancet. 2022 Jan 22;399(10322):358. PMID: 34600604Rachel G. Miller, Trevor J. Orchard; Understanding Metabolic Memory: A Tale of Two Studies. Diabetes 1 March 2020; 69 (3): 291–299. https://doi.org/10.2337/db19-0514Ross, R., Neeland, I.J., Yamashita, S. et al. Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. Nat Rev Endocrinol16, 177–189 (2020). https://doi.org/10.1038/s41574-019-0310-7Thom G, McIntosh A, Messow CM, et al. Weight loss-induced increase in fasting ghrelin concentration is a predictor of weight regain: Evidence from the Diabetes Remission Clinical Trial (DiRECT). Diabetes Obes Metab. 2021;(23):711-719.Tsai AG, Bessesen DH. Obesity. Ann Intern Med. 2019;170(5):ITC33-ITC48.Wing RR, Bolin P, Brancati FL, et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013;369(2):145-154.World Health Organization. Obesity. https://www.who.int/health-topics/obesity#tab=tab_1 Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.Learn more about ADCES and the many benefits of membership at adces.org/join.

In this week's episode we'll learn about the role of iron in myelodysplastic syndromes, or MDS. After that: long-term treatment outcomes in immune thrombocytopenia from the STOPAGO study.  Finally, new insights into APL treatment outcomes and prognostic factors from the large-scale Harmony APL project which used ATRA-Arsenic combination therapy.Featured Articles:Genetic iron overload aggravates, and pharmacological iron restriction improves, MDS pathophysiology in a preclinical studyLong-term follow-up of the STOPAGO studyAcute promyelocytic leukemia: long-term outcomes from the HARMONY project

We discuss the recognition and treatment of necrotizing fasciitis. Hosts: Aurnee Rahman, MD Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Necrotizing_Fasciitis.mp3 Download Leave a Comment Tags: Critical Care, General Surgery Show Notes Table of Contents 0:00 – Introduction 0:41 – Overview 1:10 – Types of Necrotizing Fasciitis 2:21 – Pathophysiology & Risk Factors 3:16 – Clinical Presentation 4:06 – Diagnosis 5:37 – Treatment 7:09 – Prognosis and Recovery 7:37 – Take Home points Introduction Necrotizing soft tissue infections can be easily missed in routine cases of soft tissue infection. High mortality and morbidity underscore the need for vigilance. Definition A rapidly progressive, life-threatening infection of the deep soft tissues. Involves fascia and subcutaneous fat, causing fulminant tissue destruction. High mortality often due to delayed recognition and treatment. Types of Necrotizing Fasciitis Type I (Polymicrobial) Involves aerobic and anaerobic organisms (e.g., Bacteroides, Clostridium, Peptostreptococcus). Common in immunocompromised patients or those with comorbid...

A nearby house fire has brought several patients to your hospital via ambulance, where you are the sole provider on duty. These patients require urgent triage and stabilization before transfer to the regional burn center. You are very concerned about inhalation injury and are tasked with making complex clinical decisions in a high-pressure situation. What are the next steps? Join Drs. Kevin Foster, Tina Palmeri, Ryan Rihani, Tommy Tran, and Kiran Dyamenahalli as they explore the intricacies of managing smoke inhalation injury and more! Hosts: Tommy Tran, Tristar Skyline Medical Center Kiran Dyamenahalli, MGH Sumner Redstone Burn Center Kevin Foster, Arizona Burn Center Tina Palmeri, UC Davis Firefighters Burn Institute Regional Burn Center Ryan Rihani, UT Health Dunn Burn Center Tam Pham, Harborview Medical Center (Editor) Learning Objectives: Understand the etiology and common scenarios associated with inhalation injury  Understand the effect of inhalation injury on morbidity and mortality Describe indications for invasive airway management (intubation, bronchoscopy, and mechanical ventilation). Describe complications of inhalation injury and their management. References: Fournier, M., Turgeon, A. F., Doucette, S., Morrisette, M., Archambault, P., & Bouchard, N. (2016). Nebulized heparin for inhalation injury in burn patients: A systematic review and meta-analysis. Critical Care, 20(1), 1-10. https://doi.org/10.1186/s13054-016-1285-8 Norris, C., LaLonde, C., Slater, H., & Purser, D. (2005). Survival from inhalation injury. Burns, 31(7), 803-815. https://doi.org/10.1016/j.burns.2005.04.003 Li, W., Tang, X., Chen, Y., & Zhao, Z. (2021). Update on smoke inhalation injury: Pathogenesis, diagnosis, and treatment. Journal of Thoracic Disease, 13(4), 1797-1808. https://doi.org/10.21037/jtd-20-3328 Hahn, S. M., Kim, Y. H., Kim, K. H., & Lee, S. U. (2020). Advances in the diagnosis and treatment of smoke inhalation injury in burn patients. Acute and Critical Care, 35(1), 1-10. https://doi.org/10.4266/acc.2020.00175 Bittner, E. A., Shank, E., Woodson, L., & Martyn, J. A. (2015). Acute and long-term outcomes of burn injuries: A focus on inhalation injury. Clinics in Chest Medicine, 36(4), 549-560. https://doi.org/10.1016/j.ccm.2015.08.007 Romanowski, K. S., & Palmieri, T. L. (2019). Inhalation injury in burns: Pathophysiology, diagnosis, and treatment. Journal of Burn Care & Research, 40(5), 517-523. https://doi.org/10.1093/jbcr/irz123 Dyamenahalli, K., Garg, G., Shupp, J. W., Kuprys, P. V., Choudhry, M. A., & Kovacs, E. J. (2019). Inhalation injury: Unmet clinical needs and future research. Journal of Burn Care & Research, 40(5), 570-584. https://doi.org/10.1093/jbcr/irz055 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

In today's episode, we explore a tragic but educational case involving a 15-year-old girl who suffered severe inhalation injury following a house fire. While heroically rescuing her brother and his friend, she endured prolonged cardiac arrest and severe multi-organ dysfunction. We'll focus on the pathophysiology, investigation, and management of inhalation injuries, including the critical role of recognizing carbon monoxide and cyanide poisoning in these complex cases.Key Learning Points:Exposure to house fire and prolonged cardiac arrestSigns of inhalation injury and airway compromisePathophysiology of inhalation injuries and their impact on multiple organ systemsManagement strategies for inhalation injury, including airway protection and ventilationDifferentiating carbon monoxide and cyanide poisoning in pediatric fire victimsCase PresentationA 15-year-old previously healthy girl is brought to the Pediatric Intensive Care Unit (PICU) after experiencing cardiac arrest during a house fire. She was found unconscious by firefighters after a heroic rescue attempt where she saved her brother and his friend. Upon arrival at the hospital, she was unresponsive, intubated, and in severe cardiovascular distress with signs of multi-organ dysfunction.Key findings include:Soot deposits and superficial burns on extremitiesProlonged resuscitation (45 minutes of field CPR and 47 minutes of in-hospital CPR)Cardiovascular compromise with PVCs, cool extremities, and delayed capillary refillMetabolic acidosis, AKI, coagulopathy, transaminitisSevere hypoxic-ischemic encephalopathy on EEGThese findings raise immediate concern for inhalation injury, which is the primary focus of today's discussion.Pathophysiology of Inhalation InjuryWhen a patient is exposed to smoke and hot gases during a fire, inhalation injury results in significant damage to the respiratory system. Inhalation injury has three main components:Upper airway involvement – Thermal injury can cause swelling and obstruction.Chemical pneumonitis – Noxious chemicals like carbon monoxide and cyanide trigger inflammation in the lungs.

Episode 181: Cannabinoid Hyperemesis SyndromeFuture Dr. Johnson explains the pathophysiology, assessment, and management of Cannabinoid Hyperemesis syndrome. Dr. Arreaza adds some insights on the topic.  Written by Tyler Johnson, MSIV, Western University of Health Sciences, College of Osteopathic Medicine of the Pacific-Northwest. Editing and comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Definition Cannabinoid hyperemesis syndrome (CHS) is a syndrome of cyclic abdominal pain, vomiting, or nausea in older adolescents and adults who have chronic ϲаnոаbis use.The term “marijuana” is considered racist by some people. In the 1930s, American politicians popularized the term “marijuana” in the U.S. to portray the drug as a “Mexican vice” and to have a justification to persecute Mexican immigrants. Epidemiology The overall prevalence of cannabinoid hyperemesis syndrome is unknown due to a lack of definitive criteria or diagnostic tests. It occurs in a population that may not disclose substance use. One study conducted in 2015 in a United States urban emergency department not named, found one-third of patients with near-daily cannabis use met criteria for having had CНЅ in the prior six months.Why are rates of CHS increasing?Between 2005-2014 hospitalizations cyclic vomiting syndromes increased by 60 %. concurrent cannabis use in hospitalized patients increasing from 2 to 21 percent. 7 years after the commercialization of cannabis in Canada, the Canadian health services found a 13-fold increase in cyclic vomiting syndromesPotential correlations for the increase in CHS are increased legalization and commercialization of cannabis, higher tetrahydrocannabinol concentrations in cannabis products, and increased recognition of the syndrome.Legal status of Cannabis in the USCannabis is legal in 24 states: Alaska, Arizona, California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Jersey, New Mexico, New York, Ohio, Oregon, Rhode Island, Vermont, Virginia, and Washington. It is also legal in Washington, D.C. Cannabis is approved for medical use in 38 states.Federal level: Cannabis is a Schedule I drug, under the Controlled Substance Act (added in 1970) in the group of Hallucinogenic or psychedelic substances. Tetra-hydro-cannabinol (THC, a “mind-altering substance in cannabis”) is on the same list. However, cannabidiol (CBD, derived from hemp or non-hemp plants) was removed from the Controlled Substances Act in 2018. CBD is FDA-approved (under the name of Epidiolex®) to treat rare seizure disorders. CBD is still on the list of controlled substances in some states. I see THC as a problem.THC increased concentration As recreational Cannabis becomes more normalized, innovators look to find new ways to differentiate their product and increasing THC has become a common way to perform this similar to alcohol content in the beer, wine, and liquor industry. An article by Yale School of Medicine titled “Marijuana: Rising THC Concentrations in Cannabis Can Pose Health Risks” states, “In 1995, the average THC content in cannabis seized by the Drug Enforcement Administration was about 4%. By 2017, it had risen to 17% and continues to increase. Beyond the plant, a staggering array of other cannabis products with an even higher THC content like dabs, oils, and edibles are readily available—some as high as 90%.”Recently, cannabis-infused water started to be sold in some grocery stores.Pathophysiology of CHSIt is not entirely understood. Some suggest multifactorial involving cannabinoid metabolism, exposure dose and tolerance modifying receptor regulation, complex pharmacodynamics at Cannabinoid receptors, and even changes in genetics and cannabinoid variation in plants. CB1 receptors are involved in gastric secretion, sensation, motility, inflammation, and lipogenesis. The activation of CB1 and CB2 receptors has been suggested as the possible cause of CHS.Risk FactorsCHS can occur after acute or acute on chronic use but many report daily 3-5x cannabis use cannabis use over one year and many over at least two years. Median age 24 years. Interesting factsMedical visits for inhaled cannabis are more likely associated with CHS while edibles are more likely for acute psychiatric reactions.Also, CHS is a paradoxical effect since cannabis and cannabinoid receptor agonists are known antiemetics (as seen in nabilone and dronabinol (synthetic analogs of THC)) and prescribed by some physicians to combat chemotherapy effects.Clinical Features of CHSCyclical pattern with abdominal pain, severe nausea, and vomiting up to 30 episodes daily. Pain is intense and even referred to as “scromiting” due to its intense nature, causing patients to scream and vomit concurrently.Typically, it presents with 2 or more episodes over a 6-month period with no symptoms in between. It starts within 24 hours of last cannabis use (differentiating from cannabis withdrawal) and occurs at day or night. There is a gradual symptom resolution of nausea and vomiting after several days of cannabis cessation. Some patients had symptoms 2 days to 2 weeks after cessation. Diagnosis of CHSClinical diagnosisRule out neurological symptoms such as migraine headaches, acute abdomen, motion sickness, and medications, such as recent antibiotics and chemotherapy.Often the diagnosis is discovered with a thorough history reporting a decrease in symptoms with hot showers/baths.Management of CHS AcuteRehydrate with Fluids Dopamine Antagonists– Droperidol (0.625 or 1.25mg) /Haloperidol (0.05 to 0.1mg/kg with max dose of 5mg initially) favored over typical antiemetics like Zofran or Reglan.If needed, combine with an antiemetic like metoclopramide IM or ondansetron IV and consider patients' dehydration status likely requiring US-guided IV.Topical capsaicin cream 0.025 – 0.1% on the abdomen. Long term97% resolution of symptoms completely in a systematic review of patients who stopped cannabis use.Reinforce it may take several weeks of abstinence for symptoms to resolve and symptoms can worsen if cannabis is resumed. It is unknown if a reduction in use can prevent recurrence.Approaches in the clinicEducate patients on the etiology of their symptoms with complete cessation of cannabis use.Consider referral to counseling for cannabis use disorder and abstinence support for treatment-seeking cannabis users. Approach topics such as changing one's environment, seeking social support, and using self-help techniques to non-treatment-seeking individuals.Consider referring patients with polysubstance use and significant comorbidities to a supervised withdrawal management setting. Conclusion: Cannabis use is increasing with legalization and commercialization across the United States. With increased use, Cannabinoid hyperemesis syndrome incidence increases. Often it can be diagnosed with a thorough history including chronic cannabis consumption and symptomatic relief by showers. Physicians will need to develop counseling approaches to better understand CHS patients and how to approach an often-difficult topic.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Angulo MI. Cannabinoid Hyperemesis Syndrome. JAMA. 2024;332(17):1496. doi:10.1001/jama.2024.9716. Link: https://jamanetwork.com/journals/jama/fullarticle/2824833#:~:text=Cannabinoid%20hyperemesis%20syndrome%20(CHS,last%20less%20than%201%20week.Backman, Isabella, Marijuana: Rising THC Concentrations in Cannabis Can Pose Health Risks, Yale School of Medicine, August 30, 2023. https://medicine.yale.edu/news-article/not-your-grandmothers-marijuana-rising-thc-concentrations-in-cannabis-can-pose-devastating-health-risks/Buchanan, Jennie A and George Sam Wang, Cannabinoid Hyperemesis Syndrome, Up To Date, updated July 17, 2024. https://www.uptodate.com/contents/cannabinoid-hyperemesis-syndromeTheme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

In this episode, we focus on the link between periodontal disease and the systemic effects on the human body. There's more to oral hygiene than just saving our teeth, so let's dive into this fascinating episode with Dr Reena Wadia to learn more about the importance of perio and how it is associated with the rest of our health. https://youtu.be/fldpB_8h2Dc Watch GF024 on Youtube Key Takeaways: There is a strong link between gum health and systemic health. Diabetes and cardiovascular disease are key conditions linked to gum health. Understanding correlation vs. causation is crucial in dental practice. Effective communication with patients can improve treatment outcomes. Treating pregnant patients for periodontal health is safe and beneficial. Proper diagnosis is essential for effective dental treatment. Patients are often unaware of the links between gum health and overall wellness. Motivating patients with health benefits can enhance compliance. Evidence-based dentistry is vital for accurate patient information. Add the word diagnosis to templates for clarity. Team collaboration (dental and medical practices) enhances patient care effectiveness. Screening for conditions like diabetes can save lives. Holistic care in dentistry is becoming increasingly important. A periodontal protocol is crucial for consistent care. Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode:  3:50 Introduction to Dr Reena Wadia 7:14 Systemic Link 12:24 Under Investigation 13:54 Using this with our Patients 17:04 Birthweight-related Studies and Pregnancy 20:14 Make a Periodontal Diagnosis 23:34 Medicine and Dentistry Collaboration 26:29 Understanding the Patient 29:14 HbA1c Machine 32:19 The Perio Handbook This episode is eligible for 0.5 CE credits via the quiz on Protrusive Guidance.  This episode meets GDC Outcome A, B and D. AGD Code: 490 PERIODONTICS (Pathophysiology of periodontal disease)  Aim: To enhance dentists' understanding of the link between periodontal health and systemic diseases, enabling them to integrate evidence-based periodontal care into their clinical practice. Learning Outcomes: Knowledge and Application: Dentists will gain a thorough understanding of the bi-directional relationship between periodontal disease and systemic conditions such as diabetes and cardiovascular disease, and learn how to apply this knowledge in clinical practice to improve patient outcomes. Patient Education: Dentists will acquire practical strategies for effectively educating patients about the systemic implications of periodontal health, using analogies, visual aids, and evidence-based communication methods. Holistic Treatment Planning: Dentists will learn how to incorporate systemic health considerations, such as screening for diabetes or collaborating with medical professionals, into their periodontal treatment plans to deliver comprehensive care. Enhance your knowledge with Dr. Reena Wadia's Perio School and establish a habit of implementing Perio protocols in your practice. Don't forget to grab a copy of the Perio Handbook by Dr. Reena for valuable insights! If you enjoyed this episode, check out: Communication Masterclass for Periodontal Disease [B2B] – PDP086 Click below for full episode transcript: Teaser: When you hear stories like that, it's like, could that have been undiagnosed diabetes, heart attack, et cetera, et cetera. So I feel so privileged being able to have that ability to do that test on our patients. And yeah, it's not the nicest thing to say to someone, you might have diabetes, but actually like that could save someone's life. Teaser:The guidelines now are, for example, for diabetics, once they've been diagnosed with diabetes, they're supposed to see their dentist, but they need to push it more, because they definitely push the eye appointments,

The brain's ability to recover after trauma is astonishing—and often overlooked in conventional care. In this episode of New Frontiers in Functional Medicine, I sit down with Dr. David Musnick, a long-time friend and brilliant clinician, to explore how we can unlock the brain's full potential for healing. Dr. Musnick challenges the standard of care for traumatic brain injuries and post-concussion syndrome, introducing a functional medicine approach that integrates advanced tools like Frequency-Specific Microcurrent, targeted nutritional strategies, and personalized interventions. His insights into the stages of recovery, the importance of addressing neuroinflammation, and the role of the gut-brain connection were a true "aha" for me. We also dive into groundbreaking methods for reversing secondary brain damage, a concept that could change everything for patients and practitioners alike. This conversation is packed with actionable takeaways and hope for those navigating brain injuries, cognitive impairment, or persistent post-concussion symptoms. You don't want to miss it.~DrKF Check out the show notes at https://www.drkarafitzgerald.com/fxmed-podcast for the full list of links and resources. GUEST DETAILS David Musnick MD FMI Center for Optimal Health http://www.fmioptimal.com http://www.peakmedicine.com Clinic: (208)609-9130 David Musnick MD is a Sports Medicine and Functional Medicine MD who practices in Eagle Idaho and Bellevue WA. In 2016 he developed the first program to heal the brain after Concussion based on the Pathophysiology mechanisms that go on after a Concussion and TBI. He has healed hundreds of patients and is published on his approach in the book Integrative Neurology. In his practice he defines the brain areas that have been injured and develops a detailed approach to healing these areas. His approach integrates food choices, supplements, sleep, exercise, EMF protection, HBOT and Frequency Specific Microcurrent. He has expanded his approach to also treat Cognitive Impairment and other Neurological disorders such as MS and Parkinson's. He sees patients in both Idaho and Washington but can see patients from other states on Telemedicine via a Peer to Peer consultation. THANK YOU TO OUR SPONSORS DIAMOND Precision Analytical: https://tinyurl.com/4anbz7b3 Biotics Research: https://www.bioticsresearch.com/ Integrative Therapeutics: https://tinyurl.com/4emwj48z GOLD OneSkin: https://tinyurl.com/ycxtw4zt TimeLine Nutrition:: https://tinyurl.com/bdzx2xms MIDROLL OneSkin: https://tinyurl.com/ycxtw4zt DUTCH https://dutchtest.com/ CONNECT WITH DrKF Want more? Join our newsletter here: https://www.drkarafitzgerald.com/newsletter/ Or take our pop quiz and test your BioAge! https://www.drkarafitzgerald.com/bioagequiz YouTube: https://tinyurl.com/hjpc8daz Instagram: https://www.instagram.com/drkarafitzgerald/ Facebook: https://www.facebook.com/DrKaraFitzgerald/ DrKF Clinic: Patient consults with DrKF physicians including Younger You Concierge: https://tinyurl.com/yx4fjhkb Younger You Group Program: https://tinyurl.com/4hvusavw Younger You book: https://tinyurl.com/mr4d9tym Better Broths and Healing Tonics book: https://tinyurl.com/3644mrfw

Did you know that Multi-Organ Dysfunction Syndrome (MODS) can result from both infectious and non-infectious causes? In our latest episode, we delve deep into the pathophysiology of MODS, exploring how different organs interact and fail in sequence. We discuss key concepts like organ functional reserve and the kinetics of organ injury, which aren't as straightforward as they seem. Tune in to learn about the non-linear progression of organ damage and how it impacts management strategies in pediatric critical care.We break down the case into key elements:Patient Background: A 15-year-old girl with chronic TPN dependence and a PICC line presented with septic shock and respiratory failure.Initial Presentation: Blood cultures confirmed Gram-negative rod bacteremia. She developed multi-system complications, including acute kidney injury (AKI), thrombocytopenia, and cardiac dysfunction.Management: Broad-spectrum antibiotics, mechanical ventilation, vasoactive agents, and supportive care for MODS.Key Case Highlights:Clinical case of a 15-year-old girl with sepsis from a gram-negative rodDependence on total parenteral nutrition (TPN) and prolonged PICC line useDiscussion of septic shock, acute respiratory failure, and acute kidney injuryOverview of multiple organ dysfunction syndrome (MODS) and its definitionsPathophysiology of MODS, including organ functional reserve and kinetics of organ injuryMolecular mechanisms involved in MODS, such as mitochondrial dysfunction and immune responsesSpecific phenotypes of sepsis-induced MODS, including TAMOF and IPMOFManagement strategies for MODS, emphasizing multidisciplinary approachesRole and complications of therapeutic plasma exchange (TPE) in treating MODSImportance of recognizing signs of MODS and timely intervention in pediatric patientsSegment 1: MODS Definitions and PhenotypesKey Definition: MODS is the progressive failure of two or more organ systems due to systemic insults (infectious or non-infectious).Phenotypes:TAMOF (Thrombocytopenia-Associated Multi-Organ Failure): Characterized by thrombocytopenia, hemolysis, and decreased ADAMTS13 activity.Immunoparalysis: Persistent immunosuppression and risk of secondary infections.Sequential Liver Failure: Often associated with viral triggers.Segment 2: Pathophysiology of MODSMolecular Insights:Mitochondrial dysfunction and damage-associated molecular patterns (DAMPs)Innate and adaptive immune dysregulationMicrocirculatory dysfunction and ischemia-reperfusion injuryOrgan Interactions: MODS evolves through complex multi-organ interdependenciesSegment 3: Diagnosis and Evidence-Based ManagementKey Diagnostic Pearls:MODS is not solely infection-driven; it requires a shared mechanism and predictable outcomes.Use biomarkers like ADAMTS13 and TNF-α response for phenotypic classification.Management Highlights:Supportive Care: Multisystem approach including lung-protective ventilation, renal replacement therapy, and hemodynamic support.Therapeutic Plasma Exchange (TPE): Especially effective in TAMOF by restoring ADAMTS13 and removing inflammatory mediators.Segment 4: Practical Tips for IntensivistsEarly recognition of MODS phenotypes for targeted therapyImportance of multidisciplinary teamwork in critical care settingsMonitoring for complications like TMA and immunoparalysis during prolonged ICU staysFollow Us:Twitter: @PICUDocOnCallEmail:

On this week's episode, Cyrus & Nick tackle one of their biggest challenges yet: Acute Respiratory Distress Syndrome, more commonly known as ARDS.***WARNING*** this is no shorty! We cover all things ARDS from pathophysiology, diagnosis, treatments and things NOT to do. Dare we say, this is the definitive FOAM-ARDS experience for anyone and everyone who cares for people suffering from ARDS. Give it a listen and as always, send us your feedback!! Hosted on Acast. See acast.com/privacy for more information.

Dr. Rick Helmich tells us about the role of functional MRI in understanding the circuits of tremor. The conversation starts with a description of his most famous theory on the pathophysiology of Parkinsonism tremor ('dimmer-switch' hypothesis) and moves towards other forms of tremors, such as dystonic, Holmes and essential and even physiological tremor.

Endometriosis is a very difficult disease to diagnose and manage, but effective imaging can make all of the difference. In this episode of the BackTable OBGYN podcast, Mayo Clinic radiologist Dr. Wendaline VanBuren and gynecologist Dr. Tatnai Burnett discuss the complexities of diagnosing, imaging, and surgically treating endometriosis. --- SYNPOSIS The doctors delve into the importance of advanced imaging techniques such as MRI and dedicated protocols, the critical need for a multidisciplinary approach with radiologists and GYN surgeons, and the future potential of imaging in improving endometriosis diagnosis, treatment, and surgical planning. The discussion also covers the upcoming International Endometriosis Imaging Congress aimed at advancing standardized care and collaboration in the field. --- TIMESTAMPS 00:00 - Introduction 05:15 - Dr. VanBuren's Journey to Endometriosis Imaging 08:24 - Dr. Burnett's Surgical Training and Insights 11:57 - Challenges in Diagnosing and Understanding the Pathophysiology of Endometriosis 13:24 - The Role of Imaging in Surgical Planning 25:51 - Imaging Follow-Up, Monitoring for Malignant Transformation 32:03 - Protocol for MRI Imaging of Endometriosis 34:47 - The Role of Radiologists in Endometriosis 36:12 - The Complexity of Bowel Endometriosis 48:02 - The Future of Endometriosis Imaging --- RESOURCES International Endometriosis Imaging Congress-March 8-9, 2025 https://eice.ltd/international-endometriosis-imaging-congress/

Episode 179: Impact of intermittent fasting Impact on T2DMFuture Dr. Carlisle explains the physiology of fasting and how it can help revert type 2 diabetes. Dr. Arreaza adds details on how to do intermittent fasting. Written by Cameron Carlisle, MSIV, Ross University School of Medicine. Comments and edits by Hector Arreaza, MD, FAAFP.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.What is type 2 Diabetes Mellitus (T2DM)?-Type 2 Diabetes Mellitus (T2DM) is a metabolic disorder characterized by insulin resistance and impaired glucose regulation. -This impaired regulation can lead to hyperglycemia, contributing to complications in a myriad of organs: heart, kidneys, eyes, nerves, etc. (target organs). According to the CDC, more than 38 million Americans have T2DM (about 1/10 people). -Multiple mechanisms are believed to contribute to insulin resistance in obese patients with T2DM, such as increased lipid deposition throughout the body and systemic inflammation.What is Intermittent Fasting (IF)? Intermittent fasting (IF) has recently gained popularity as a dietary approach for health benefits, but it has been around for thousands of years. IF is an eating pattern that alternates between eating and fasting (no calories consumed) over a specific period of time. When you are fasting, you are allowed and encouraged to keep drinking water and non-caloric drinks, like coffee, tea, and even homemade bone broth.-According to the International Food Information Council Foundation (IFIC), 10% of Americans engage in IF daily. -According to Mark Mattson, a neuroscientist and IF expert for over 25 years, a mechanism called “metabolic switching” is seen with IF. This is when your body runs out of glucose and starts burning fat (i.e., fatty oxidation). These metabolic changes can help protect your organs and reduce the risk of chronic conditions, like T2DM. Common IF methods: Time-restricted eating: Most common method, involves eating within a specific time frame (e.g., the 16:8, 18:6, 12:12 method is also common.  [16:8 means you have 16 hours of fasting and 8 hours of eating.]Alternate-day fasting: Alternating between fasting days and normal eating days.  [Find more info in The Complete Guide to Fasting, by Jason Fung, who is a nephrologist, he explains that alternate-day is basically eating every other day, which would give 36 hours of fasting, but if you are a beginner you can try a 24 hours fasting, in short, not eating breakfast any day of the week and having lunch 4 days a week, and dinner every night.]5:2 diet (aka periodic fasting): Maintaining a normal diet for 5 days, with 2 days (usually non-consecutive) of caloric restriction (25% of normal caloric intake; e.g., 500 calorie meal). IF is strongly believed to improve metabolic health in individuals with T2DM by reducing insulin resistance via increasing insulin sensitivity, promoting weight loss (patients with obesity and DM… AKA patients with diabesity), and enhancing lipolysis via fat oxidation.While fasting, the body goes through several phases that affect how energy is metabolized. Between 0 and 4 hours after eating, the body enters a feeding state, using glucose as its main energy source. After fasting for 12-16 hours, the body enters ketosis and starts to use fat for energy. Within 24-36 hours, autophagy begins, a process that recycles damaged cells and allows for cellular repair. This process can have great benefits for people with T2DM, such as improved insulin sensitivity and glucose regulation. Pathophysiology of Implementing IF in T2DM. -IF is thought to increase insulin sensitivity by decreasing fatty tissue in the body (i.e., visceral adipose tissue), which is correlated to insulin resistance. Insulin resistance is defined as higher than normal circulating insulin levels needed for a glucose lower response, which is thought to be the culprit for the generation of T2DM. It means you need high levels of insulin to keep glucose normal. -Obesity is an important risk factor for T2DM. Visceral adipose tissue functions as an organ via the secretion of adipokines (cytokines or cellular messengers produced by adipose tissue): leptin and adiponectin. Leptin: proinflammatory, leading to chronic inflammation. Patients with higher BMI levels and increased insulin resistance were found to have increased leptin levels.[Leptin is a good hormone at normal levels, but there is leptin resistance] Adiponectin: anti-inflammatory and antidiabetic effects. Higher adiponectin levels result in decreased hepatic gluconeogenesis, enhanced glucose absorption, and enhanced skeletal muscle and hepatic fatty acid oxidation. Levels drop as visceral fat increases. -Dr. López-Jaramillo, a Colombian endocrinologist and researcher, and colleagues published a review in 2014 examining the imbalance in the levels of leptin and adiponectin in individuals with metabolic syndrome. This imbalance (increase in leptin and decrease in adiponectin) is linked to obesity and insulin resistance, which has been shown to increase the risk of T2DM. It has been shown that IF has resulted in the reduction of leptin levels and increased levels of adiponectin, which leads to decreased insulin resistance and increased insulin sensitivity. -IF allows pancreatic beta-cells to rest by not having to secrete insulin constantly. This allows the beta-cells of the pancreas to improve in function over time. In addition, IF has been shown to lead to noticeable weight loss and loss in body fat, both of which play an important contribution in managing T2DM. Research demonstrates that this weight loss increases insulin sensitivity and decreases the need for insulin therapy, making IF a powerful approach for improving metabolic health. AMP-Activated Protein Kinase (AMPK) and Its Role in IF and T2DM Recent research has highlighted an important enzyme seen in IF, AMP-activated protein kinase (AMPK), which plays a vital role as an important energy sensor in cells. It is activated when cellular energy levels are low, such as during IF. A 2020 research study in Nature Reviews Endocrinology explains that activation of AMPK aids in suppressing gluconeogenesis and stimulates fatty acid oxidation, leading to optimal energy balance and reduction of visceral adipose tissue accumulation, a major contributor to insulin resistance and T2DM progression. AMPK is upregulated during fasting, which enhances glucose metabolism and reduces insulin resistance. This is imperative in managing T2DM, as it counters the effects of insulin resistance associated with T2DM.Exercise, which also promotes AMPK activation, complements IF and can promote a synergistic effect in improving insulin sensitivity and promoting fat burning, New Research Findings on IF and T2DM -The EARLY (Exploration of Treatment of Newly Diagnosed Overweight/Obese Type 2 Diabetes Mellitus) study is a randomized clinical trial published in JAMA Network Open (2024). Findings In this randomized clinical trial study found that a time-restricted eating window significantly improved fasting glucose levels and HbA1c levels in individuals with T2DM. The study examined the effect of a 16-week 5:2 meal replacement (5:2 MR) fasting plan that consisted of five days of normal eating and 2 days, nonconsecutive of restricted diet (500-600 calories). This group was examined alongside a group of patients who took metformin 0.5 g BID and empagliflozin 10 mg QD. The study wanted to investigate the changes in HbA1c in Chinese adults with early T2DM.-The study was a randomized clinical trial of 405 adults, and a study showed that the 5:2 MR approach led to better glycemic control at 16 weeks compared to the counter treatments with metformin and empagliflozin. The 5:2 MR group had the greatest reduction in HbA1c (-1.9%), followed by metformin (-1.6%), and empagliflozin (-1.5%). The 5:2 MR plan also revealed the greatest weight loss (-9.7 kg), followed by empagliflozin (-5.8 kg), and metformin (-5.5 kg). -This research suggests IF, such as 5:2 MR, can be a powerful tool in the management of T2DM and improving metabolic health. This study can potentially open doors for healthcare providers to provide the 5:2 MR approach for individuals as an effective initial lifestyle intervention. However, follow-up studies are needed to assess the effectiveness and durability of the 5:2 MR.Safety and Risks of IF in T2DM. -IF when combined with glucose-lowering medications (e.g., insulin, sulfonylureas, GLP-1 agonists) can increase the risk of hypoglycemia. Also, prolonged fasting can lead to nutrient deficiencies if not planned carefully. Patients should be counseled on maintaining a balanced, nutritious diet during non-fasting days. -IF is not suitable for everyone. Children under the age of 18 should not try IF due to needing proper calories for adequate development and proper growth. Also, it is recommended that pregnant or breastfeeding women do not undergo IF. It is advised that people with eating disorders should not try IF. -Individuals with certain medical conditions, such as kidney stones or gastroesophageal disease should speak with their doctor before trying IF. Also, patients on insulin or other glucose-lowering medications should adjust their dose and talk with their healthcare providers to prevent hypoglycemia during fasting. It is recommended that each person speak with their doctor to discuss the safety and risks of IF and see if it would benefit the individual before starting IF. -Many studies have explored the benefits of IF at the micro level revealing its cellular benefits and on a macro level of the body as a whole. However, more research is needed to confirm the long-term effects of IF on glycemic control and its sustainability as a therapeutic approach for T2DM. Conclusion:-IF shows potential for improving glycemic control, promoting weight loss, and enhancing metabolic health in individuals with T2DM. Despite its benefits, IF may present with risks, such as hypoglycemia, nutrition deficiencies, or dehydration in certain patients. Therefore, it may not be suitable for all individuals. It's important to monitor patients who engage in IF, especially for patients with T2DM. Patients should follow up with their doctor for individualized IF plans in patients with T2DM. ______________This week we thank Hector Arreaza and Cameron Carlisle. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Albosta, Michael, and Jesse Bakke. “Intermittent Fasting: Is There a Role in the Treatment of Diabetes? A Review of the Literature and Guide for Primary Care Physicians - Clinical Diabetes and Endocrinology.” BioMed Central, BioMed Central, 3 Feb. 2021, doi.org/10.1186/s40842-020-00116-1.Blumberg, Jack, et al. “Intermittent Fasting: Consider the Risks of Disordered Eating for Your Patient - Clinical Diabetes and Endocrinology.” BioMed Central, BioMed Central, 21 Oct. 2023, https://clindiabetesendo.biomedcentral.com/articles/10.1186/s40842-023-00152-7.De Cabo, Rafael, and Mark P. Mattson. “Effects of intermittent fasting on health, aging, and disease.” New England Journal of Medicine, vol. 381, no. 26, 26 Dec. 2019, pp. 2541–2551, https://doi.org/10.1056/nejmra1905136.Guo, Lixin, et al. “A 5:2 intermittent fasting meal replacement diet and glycemic control for adults with diabetes.” JAMA Network Open, vol. 7, no. 6, 21 June 2024, https://doi.org/10.1001/jamanetworkopen.2024.16786.Herz, Daniel, et al. “Efficacy of Fasting in Type 1 and Type 2 Diabetes Mellitus: A Narrative Review.” Nutrients, U.S. National Library of Medicine, 10 Aug. 2023, www.ncbi.nlm.nih.gov/pmc/articles/PMC10459496/. Herzig, S., & Shaw, R. J. (2018). AMPK: Guardian of metabolism and mitochondrial homeostasis. Nature Reviews Molecular Cell Biology, 19(2), 121-135.Longo, V. D., & Mattson, M. P. (2014). Fasting: Molecular mechanisms and clinical applications. Cell Metabolism, 19(2), 181-192. https://doi.org/10.1016/j.cmet.2013.12.008López-Jaramillo P, Gómez-Arbeláez D, López-López J, et al. The role of leptin/adiponectin ratio in metabolic syndrome and diabetes. Hormone Molecular Biology and Clinical Investigation. 2014;18(1):37–45.Mattson, Mark P., et al. “Impact of intermittent fasting on health and disease processes.” Ageing Research Reviews, vol. 39, Oct. 2017, pp. 46–58, https://doi.org/10.1016/j.arr.2016.10.005. Patikorn, Chanthawat, et al. “Intermittent fasting and obesity-related health outcomes.” JAMA Network Open, vol. 4, no. 12, 17 Dec. 2021, https://doi.org/10.1001/jamanetworkopen.2021.39558.Sharma, Suresh K, et al. “Effect of Intermittent Fasting on Glycaemic Control in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” TouchREVIEWS in Endocrinology, U.S. National Library of Medicine, May 2023, www.ncbi.nlm.nih.gov/pmc/articles/PMC10258621/#:~:text=In%20IF%2C%20eating%20habits%20are,the%20risk%20of%20developing%20T2DM.Xiaoyu, Wen, et al. “The effects of different intermittent fasting regimens in people with type 2 diabetes: A network meta-analysis.” Frontiers in Nutrition, vol. 11, 25 Jan. 2024, https://doi.org/10.3389/fnut.2024.1325894. Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

Featuring an interview with Dr Erika Hamilton, including the following topics: Pathophysiology and pharmacology of ER-positive breast cancer treatment (0:00) Clinical evidence available with oral selective estrogen receptor degraders (3:46) Mechanism of action of proteolysis-targeting chimeras (PROTACs) (13:22) PROTACs currently in clinical development (16:39) Case: A woman in her late 30s with HR-positive, HER2-negative metastatic breast cancer (mBC) experiencing progression on a CDK4/6 inhibitor (CDK4/6i) and an aromatase inhibitor (AI) (35:09) Case: A woman in her early 70s with HR-positive, HER2-negative mBC that progresses on a CDK4/6i and an AI (41:16) CME information and select publications

CardioNerds (Dr. Dan Ambinder and Dr. Rick Ferraro) join Dr. Mansi Oberoi and Dr. Mohan Gudiwada from the University of Nebraska Medical Center discuss a case of constrictive pericarditis. Expert commentary is provided by Dr. Adam Burdorf, who serves as the Program Director for the Cardiovascular Medicine Fellowship at the University of Nebraska Medical Center. The case discussed involves a 76-year-old woman with a history of monoclonal gammopathy of undetermined significance, chronic obstructive pulmonary disease, type 2 diabetes mellitus, and squamous cell carcinoma was admitted to the hospital for worsening shortness of breath, swelling in lower extremities, hyponatremia, and urinary tract infection. CT chest to evaluate for pulmonary embolism showed incidental pericardial calcifications; the heart failure team was consulted for the management of her decompensated heart failure. Echo images were nondiagnostic. Subsequent invasive hemodynamic monitoring showed elevated right and left-sided filling pressures, diastolic equalization of LV and RV pressures, and positive RV square root sign with ventricular interdependence. Cardiac MRI showed septal flattening on deep inspiration and septal bounce, suggestive of interventricular dependence. After a heart team discussion and with shared-decision making the patient opted for medical management owing to her comorbidities and frailty. Enjoy this 2024 JACC State-of-the-Art Review to learn more about pericardial diseases and best practices for pericardiectomy (Al-Kazac et al., JACC 2024) US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Case Media - Constrictive Pericarditis Echo: Left Ventricular ejection fraction = 55-60%. Unclear septal motion in the setting of atrial fibrillation MRI: Diastolic septal flattening with deep inspiration as well as a septal bounce suggestive of interventricular dependence and constrictive physiology  References Garcia, M. Constrictive Pericarditis Versus Restrictive Cardiomyopathy. Journal of the American College of Cardiology, vol. 67, no. 17, 2016, pp. 2061–2076. Pathophysiology and Diagnosis of Constrictive Pericarditis. American College of Cardiology, 2017. Geske, J., Anavekar, N., Nishimura, R., et al. Differentiation of Constriction and Restriction: Complex Cardiovascular Hemodynamics. Journal of the American College of Cardiology, vol. 68, no. 21, 2016, pp. 2329–2347. Constrictive Pericarditis. ScienceDirect. Constrictive Pericarditis. Journal of the American College of Cardiology, vol. 83, no. 12, 2024, pp. 1500-1512.

Introduction:Today, Dr. Rahul Damania, Dr. Pradip Kamat, and their guest, Dr. Jordan Dent, discuss a critical case involving a 15-year-old male who collapsed during football practice due to exertional heat stroke. The discussion emphasizes the clinical presentation, risk factors, pathophysiology, and evidence-based management of heat stroke and other heat-related illnesses in pediatric patients. The episode also delves into the role of rapid cooling interventions and long-term care to minimize mortality and morbidity.Case Summary: A 15-year-old male with ADHD collapsed during football practice on a hot, humid day. He presented with:Normotension (BP: 101/67 mmHg)Tachycardia (HR: 157 bpm)Tachypnea (RR: 40 breaths/min)Febrile (Rectal temp: 41.8°C/107.2°F)Dry, hot skin, GCS of 9Lab abnormalities: hyponatremia, hypokalemia, hypoglycemia, elevated creatinine, liver enzymes, lactate, CK, and troponinAfter suffering cardiac arrest and undergoing resuscitation, the patient developed multiorgan dysfunction, including seizures, encephalopathy, and cerebral edema. Despite severe initial complications, the patient demonstrated neurological improvement with left-side hemiparesis before discharge.Key Discussion Points:Etiology and Pathophysiology of Heat Stroke:Heat stroke occurs when the body's thermoregulatory mechanisms fail, leading to dangerous elevations in core body temperature. Exertional heat stroke is common during strenuous physical activity in hot, humid environments.Key physiological breakdowns include inadequate sweating, vasodilation dysfunction, and subsequent cellular damage due to hyperthermia.Risk Factors for Exertional Heat Stroke:Environmental factors: High temperature, humidity, lack of hydration, and breaks.Athlete-related factors: Hypohidrosis, dehydration, medical conditions, and medications (e.g., Adderall).Heat illness is the third leading cause of death in high school athletics, with American football players particularly at risk.Spectrum of Heat-Related Illness:Heat Cramps: Involuntary muscle contractions due to dehydration and electrolyte imbalance.Heat Syncope: Transient loss of consciousness due to heat exposure.Heat Exhaustion: Milder heat illness with core temperature < 104°F, potentially progressing to heat stroke if untreated.

Today the guys discuss the career of actor Kevin Bacon (2:41). They discuss when they were first exposed to him and his early career. Then then discuss his breakout role in ‘Footloose' and how afterwards he pivoted to become more of a character actor. After discussing his hit movies, then they chat about the party game ‘6 Degrees of Kevin Bacon'. They discuss the origin of the game, what a “Bacon Number” is and eventually determine how many degrees away Ali is from Kevin bacon!   Then they discuss Raynaud's phenomenon (22:26), which Bacon's daughter, Sosie, is reported to have. Asif talks about what it is and why it is called a “phenomenon”, how common it is and the main symptoms you can get. Aid then goes over the causes of Raynaud's. Ali then asks Asif about how it is diagnosed and treated.    The opinions expressed are those of the hosts, and do not reflect those of any other organizations. This podcast and website represents the opinions of the hosts. The content here should not be taken as medical advice. The content here is for entertainment and informational purposes only, and because each person is so unique, please consult your healthcare professional for any medical questions.    Music courtesy of Wataboi and 8er41 from Pixabay   Contact us at doctorvcomedian@gmail.com   Follow us on Social media: Twitter: @doctorvcomedian Instagram: doctorvcomedian   Show Notes: A Second Wind Is Blowing For Kevin Bacon: https://www.nytimes.com/1994/09/25/movies/a-second-wind-is-blowing-for-kevin-bacon.html 60 Facts About Kevin Bacon For Kevin Bacon's 60th Birthday: https://www.thrillist.com/entertainment/nation/kevin-bacon-trivia-things-you-didnt-know The exact history of 'Six Degrees of Kevin Bacon': https://www.nzherald.co.nz/entertainment/the-exact-history-of-six-degrees-of-kevin-bacon/NCVVAU73UZ4TNCZAK726ENOBBQ/ Who is Kevin Bacon's daughter with Kyra Sedgwick, Sosie Bacon? https://www.msn.com/en-xl/lifestyle/other/who-is-kevin-bacon-s-daughter-with-kyra-sedgwick-sosie-bacon-the-nepo-baby-is-dating-fellow-actor-scoot-mcnairy-and-is-set-to-star-alongside-liam-neeson-and-joe-keery-in-cold-storage/ar-AA1rBugE?ocid=BingNewsSerp Raynaud's phenomenon and related vasospastic disorders: https://journals.sagepub.com/doi/full/10.1177/1358863X20983455 A Review of Raynaud's Disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139949/ Raynaud's Phenomenon: Reviewing the Pathophysiology and Management Strategies: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8884459/ Raynaud Disease: https://www.ncbi.nlm.nih.gov/books/NBK499833/

Abstract: Centuries-long speculation continues regarding the circumstances surrounding the death of the Savior. Over the past century, the Savior's tribulations between the Last Supper and his death on the cross have been scrupulously examined from a medical viewpoint. In this article I review many of these studies and, using current medical acumen, propose additional inferences […] The post The Pathophysiology of the Death of Jesus the Christ first appeared on The Interpreter Foundation.

For today's episode, we discuss Autism with Dr. Yehezkel Ben-Ari. Dr. Ben-Ari is a pioneer in the field of human development with over five decades of academic and private research. He has over 520 publications with a strong passion for early detection and treatment of brain disorders. His work includes studying Human Development, Autism, Epilepsy, Parkinson's, and Brain Tumors. He is a leader in how science understands the roles GABA and Chloride during early development and the NCCK1 importer and KCC2 exporter during the Excitation/Inhibition shift.In 1986, he led INSERM Neurobiology and Pathophysiology of Development before shifting to Start-Up private investigation in 2008. He is the founder of Neurocholre, B & A Biomedical, B & A Oncomedical, INMED, and IBEN. Recently, Dr. Ben-Ari has made wonderful contributions towards Autism identification in the Placenta using the work of "Neuroarchaeology" and Machine Learning. Dr. Ben-Ari is the recipient of many awards including Grand Prix de l'INSERM, Grand Prix European Society of Epilepsy, and Grand Prix Gagne Van Heck Belgian National Scientific Research (FNRS), to name a few. His book, The First 1000 Days, will soon have an English version. Treating Autism with Bumetanide is available now.Dr. Yehezkel Ben-Ari https://www.inmed.fr/en/evenement/en-yehezkel-ben-ariNeurochlore https://www.neurochlore.fr/en/Machine Learning https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7994821/Excitatory Actions of GABA https://www.nature.com/articles/nrn920GABA https://journals.physiology.org/doi/full/10.1152/physrev.00017.2006Neuro-Archaeology https://pubmed.ncbi.nlm.nih.gov/18951639/eBooks: https://www.amazon.com/s?k=yehezkel+ben-ari&crid=1LZK6JWEBG4NC&sprefix=yehezkel+ben-ari%2Caps%2C196&ref=nb_sb_noss0:00 Dr. Yehezkel Ben-Ari3:08 Understanding Autism: Origins and Early Detection8:08 The Roles of Machine Learning Data Analysis in Identification14:56 The Impact of Environment and Autism23:18 Treatment Approaches and Efficacy, Bumetanide, and NKKC1 Inhibitors31:04 Challenges in Autism Research, including the Genetic Debate, Medical Paradigms, and Decision-Makers38:00 Future Direction and Innovative Research, Autism in the Placenta and the Environment during Pregnancy53:56 Wrap Up / Reviews and Ratings, Contact InfoX: https://x.com/rps47586Hopp: https://www.hopp.bio/fromthespectrumemail: info.fromthespectrum@gmail.com

Explore the critical role of specific blood tests in managing PCOS, focusing on fasting insulin, estradiol, DHEA-S, hs-CRP, and leptin. This episode dives deep into how these tests can guide treatments and lifestyle changes for better health outcomes. 5 KEY TAKEAWAYS  1. Fasting Insulin as a Foundation: Understanding insulin's role in PCOS is crucial, as it affects multiple bodily functions and is often elevated in affected individuals.  2. Importance of Estradiol Levels: Monitoring estradiol is essential for managing PCOS, as it influences ovarian function and overall hormonal balance.  3. Role of DHEA-S: Elevated levels can indicate adrenal involvement in PCOS, influencing the body's androgen levels and contributing to symptoms.  4. Significance of hs-CRP: This inflammatory marker can highlight underlying inflammation associated with PCOS and its impact on cardiovascular health.  5. Monitoring Leptin: Addresses leptin resistance often seen in PCOS, impacting appetite regulation and metabolic functions. FEATURED PRODUCT Liver Boost and Berberine are essential in managing PCOS due to their role in supporting liver health and regulating insulin levels. By enhancing liver function and insulin sensitivity, these supplements can mitigate some of the systemic effects of PCOS, aligning with the insights discussed about the importance of managing insulin and inflammation in PCOS. visit www.mswnutition.com for more info TIMESTAMPS  • 00:00 START  • 00:01:00 Introduction to PCOS and importance of proactive lab testing.  • 00:05:00 Detailed discussion on fasting insulin's role in PCOS.  • 00:10:00 The critical impact of estradiol and its management.  • 00:15:00 Exploring DHEA-S and its implications in adrenal health.  • 00:20:00 Understanding hs-CRP and its link to inflammation.  • 00:25:00 Leptin's role in appetite and weight regulation in PCOS.  • 00:30:00 Summary and key actionable advice on managing PCOS through targeted bloodwork. RESOURCES   1. Title: Insulin Resistance and the Polycystic Ovary Syndrome: Mechanism and Implications for Pathogenesis URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3277302/  2. Title: Recent Insights into the Pathophysiology of Polycystic Ovarian Syndrome: A Narrative Review URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9832677/  3. Title: Androgen Excess in Women: Experience with Over 1000 Consecutive Patients URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9705998/  4. Title: The Role of Insulin Resistance in the Polycystic Ovary Syndrome URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676075/  5. Title: Estrogen Signaling in the Pathobiology of Ovarian Cancer URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830311/  6. Title: Estrogen and Cardiovascular Disease: Is Timing Everything? URL: https://pubmed.ncbi.nlm.nih.gov/29224098/  7. Title: C-Reactive Protein: A Predictive Factor and Marker of Inflammation in Inflammatory Diseases URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647201/

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Julia Wattacheril is a physician scientist and director of the Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) program at Columbia University Irving Medical Center. In this episode, Julia delves deep into the complex world of liver health, beginning with a foundational overview of liver physiology. She provides an in-depth look at how alcohol impacts liver function, breaking down the metabolism of ethanol and its detrimental effects. Julia then shifts the focus to understanding liver function tests and optimal enzyme levels, providing a detailed explanation of AST and ALT and elucidating why fluctuations in these levels may or may not be concerning. She provides a primer on the four major stages of liver disease, discussing risk and emphasizing the importance of early diagnosis. Julia highlights the role of liver disease in increasing the risk of cancer and cardiovascular disease and covers in detail the various strategies for diagnosing, treating, and preventing the progression of liver disease. We discuss: Julia's training, the importance of liver health, and the challenges and innovations of hepatology [3:15]; The complex and crucial functionality of the liver, its four most essential functions, and more [8:45]; Liver injuries: historical and evolving understanding of causal factors, and the progression to liver diseases and cancer [13:15]; How the liver metabolizes nutrients and what happens in the presence of excess calories or alcohol [24:45]; Methods of diagnosing liver disease and how insights guide treatment and management strategies [33:30]; The poisonous nature of ethanol to the liver [40:30]; Varied responses to alcohol, damaging effects of alcohol beyond the liver, and the process of advising patients on their alcohol consumption [47:15]; Understanding liver enzymes AST and ALT—interpreting levels, lifestyle factors that affect them, and diagnostic approaches [58:30]; Interpreting liver function tests for fatty liver disease, and the challenges of diagnosing liver pathologies, particularly in children versus adults [1:13:15]; Comprehensive liver health assessments via imaging and various diagnostic tools to prevent overlooking potential liver pathologies [1:18:45]; Potential impact of recreational drugs, statins, and other medications on liver function test results [1:26:45]; Shifting nomenclature from NAFLD to MASLD to reflect accuracy in the underlying pathophysiology and understanding of liver diseases [1:30:30]; Pathophysiology of MASLD, the need for proactive screening, and the significance of liver fat percentage as an indicator of metabolic health [1:36:30]; The importance of screening for rare conditions alongside common metabolic diseases associated with fatty liver accumulation [1:42:45]; Practical strategies for managing MAFLD [1:45:30]; The impact of fructose consumption on liver health and the challenges of disentangling its effects from other factors like obesity and insulin resistance [1:52:45]; The potential of GLP-1 agonists for the treatment of MASLD [1:57:45]; How the four stages of liver disease have evolved [2:00:30]; Increased cancer and heart disease risk associated with early-stage MAFLD [2:05:15]; Emerging drugs and therapies for addressing fat accumulation and fibrosis related to MAFLD [2:12:15]; Peter's major takeaways [2:18:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube