Podcasts about PCP

Listen to this Pretty Comprehensive Pod on PCP. Alyssa and Callum cover:EpidemiologyTaxonomy (PCP vs PJP?)Diagnosis TreatmentNote this pod episode also includes some Positively Jolly Puns on PJPNotes for this episode here: https://idiots.notion.site/115-Yeasts-Pneumocystis-jirovecii-ac05a01902b8457688b40c07020f2c2cSend us a textSupport the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or on Bluesky @idiots-pod.bsky.socialPrep notes for completed episodes can be found here (Not all episodes have prep notes).If you are enjoying the podcast please leave a review on your preferred podcast app!Feel like giving back? Donations of caffeine gratefully received!https://www.buymeacoffee.com/idiotspod

Os dois blocos avançam, mas sem PCP nem Chega. Lisboa será palco de uma contenda entre frentes de esquerda e direita. Será inédito? José Manuel Fernandes, publisher do Observador, é o convidado.See omnystudio.com/listener for privacy information.

Os dois blocos avançam, mas sem PCP nem Chega. Lisboa será palco de uma contenda entre frentes de esquerda e direita. Será inédito? José Manuel Fernandes, publisher do Observador, é o convidado.See omnystudio.com/listener for privacy information.

Today's episode is with Dr. Averie Thayer who is an occupational therapist and the owner of Living Revived Therapy located in Nashville, TN.  She is a beautiful soul who shares her story on what made her choose this direction in her career, the history of OT, and much more.  She has experience in orthopedic rehab, neurological conditions, geriatric and memory care, pediatric and hand therapy.  What I absolutely love and admire about her is that she is a doctor who gets to the root cause and doesn't just focus on fixing the symptoms temporarily.  We talk about health insurance, direct primary care services, **then my damn SIM card in the sound board corrupts but after that we great audio :)**, insurance company corruption, why she started “Living Revved Therapy” and why she chose the name, the holistic healthcare movement, how to know if you have the right PCP and what are the red flags, aging the right way, I talked about my fainting spells as a child and the medication issues I had, Averie brings up a great point about the toxic part of this wellness journey, why gatorade is BAD, sourdough, morning routines, advice on how to live optimally so you FEEL good, the negatives of EMF, the importance of the sun and the difference in day time and night time rays, Barbara O'Neill (someone everyone should know), homemade remedies for cleaning, for the first time ever I share my vaccine injury, the MTHFR gene and it's importance especially for kids, folate vs. folic acid, pelvic floor therapy importance, + more.  Thank you SO much Averie for coming on and sharing all your knowledge and perspective on things.  I guarantee you this one episode will help so many people with a million different things and open their eyes to the importance of going back to what God gave us and living revived!!INSTA—https://www.instagram.com/averie_dunay/https://www.instagram.com/livingrevivedtherapy/Averie's Company— Living Revived Therapyhttps://www.livingrevivedtherapy.comHopewell Family care—integrative medicine based in Nashvillehttps://hopewellfamilycare.comCasey Means—GOOD ENERGY bookhttps://www.caseymeans.com/goodenergyElectroytes Averie Drinks—https://drinklmnt.comElectrolytes I drink (I don't use relyte anymore)—https://bodyhealth.com/collections/perfect-amino-electrolytesCREATE CREATINE20% off CAMILLATHEMOMZILLA code and https://trycreate.co/CAMILLATHEMOMZILLABarbara O'Neill Book “SUSTAIN ME--https://barbaraoneill.com/products/sustain-me-by-barbara-o-neill?srsltid=AfmBOorp_dkkXB_Yl1GSZgqa7uNcQZynofx383h-oRRuvskdj_gyRCCE

Na declaração inicial do PCP no debate do Estado da Nação, o líder Paulo Raimundo acusa Montenegro de estar com "saudades da troika" e "por isso quer mais precariedade, horas, tempo de trabalho".See omnystudio.com/listener for privacy information.

Con noi oggi Erika Guichardaz, consigliera regionale per PCP.

Samantha Rux from OSF HealthCare joined Wake Up Tri-Counties to talk about primary care services available through OSF HealthCare medical facilities and school physicals, sports physicals, and health wellness visits for kids returning to school in August. OSF HealthCare is emphasizing the value of consistent, compassionate primary care for all age groups. The organization highlights that Primary Care Providers (PCPs)—including doctors, nurse practitioners, and physician assistants—play a critical role in keeping families healthy, from annual physicals to managing chronic illnesses. By building relationships with a dedicated provider, patients benefit from continuity of care, personalized advice, and a trusted partner in their wellness journey. OSF HealthCare encourages community members to prioritize routine visits, ensuring both preventive care and timely attention to any developing health needs. Patients rely on them for annual checkups, preventative care like vaccines, and support during illness. This ongoing relationship helps detect issues early and ensures tailored, consistent care. While some PCPs are doctors, others bring advanced training as nurse practitioners or physician assistants. Choosing a primary care provider means having a dedicated partner in maintaining your overall well-being across life's many stages. For more information, contact your local OSF HealthCare facility or visit their website. If you need to establish a primary care provider, you can find a list of providers with OSF HealthCare here. Primary Care Providers can conduct physicals and wellness visits for schoolchildren. You can schedule an appointment with a PCP by calling 309-852-7500 or through the MyChart app. 

This week on Dopey! It's the long-awaited episode with Chasing Heroin host Jeanine Coulter, recorded live at Jeremy's house during Dopeywood!Janine tells the full, raw, and very dopey story of her descent into addiction: from being a straight-A Supreme Court hopeful, to getting obsessed with exercise and binge eating, to discovering coke in a redneck bar in Georgia, all the way to living in an abandoned cell phone store in Oceanside, California smoking heroin off foil.Janine talks about doing meth that was pink, accidentally getting strung out at 30, and finding herself in a cinderblock junkie jungle gym run by tweakers. She reflects on her arrest record, her failed attempts at controlled drinking, and how it all somehow led to a decade of recovery, a podcast, and a damn TED Talk on post-traumatic growth.PLUS: a touching email from a listener who outran the cops with a trunk full of weed and somehow lived to tell the tale. A beautiful PCP voicemail and much much more on a brand new epiksode of that good ol Dopey Show!Don't forget: DopeyCon 6 tickets are out on Patreon. Leave a review. Send a voicemail. And follow us on youtu

Listen as Michael S. Benninger, MD, describes his approach to the diagnosis and management of chronic cough and refractory chronic cough in the context of a clinically relevant case.PresenterMichael S. Benninger, MDProfessor of Otolaryngology-Head and Neck SurgeryLerner College of MedicineThe Cleveland ClinicPresident, International Association of PhonosurgeryCleveland, OhioLink to full program:https://bit.ly/4kweynG

Listen in as Joseph Kim, MD, MPH, MBA, and Colten Bracken, MD, FAAFP, discuss how to integrate comprehensive diabetes management to improve the quality of their obesity care delivery, including: Documenting obesity as a diagnosis for patients with diabetes when appropriateStreamlining processes to ensure patients return for follow-upDedicating a care manager to initiate patient outreachImplementing pharmacotherapy strategies to help patients control their A1C and achieve weight loss simultaneously.PresentersJoseph Kim, MD, MPH, MBAPresidentQ Synthesis, LLCNewtown, PennsylvaniaColten Bracken, MD, FAAFPBoard of Directors for RHAU & UAFPOwner/Medical DirectorMain Street Family Medicine, PLLCEnterprise, UtahLink to full program: https://bit.ly/3IBFZi5

Marc Sappington liked to get wet! Hey, who doesn't? The problem for Marc was that he smoked so much damn PCP that he started hearing voices. What were these voices saying? Well they weren't trying to get him to do his taxes I'll tell you that much. Support Lil Stinkers at https://www.patreon.com/lilstinkers to get every episode AD FREE and a week early PLUS weekly bonus content. Get your Lil Stinkers merch today at https://www.lilstinkerspod.com Follow us on Twitter and Instagram: Jon DelCollo: @jonnydelco Jake Mattera: @jakemattera Mike Rainey: @mikerainey82  

In this episode, Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGH​, discusses the most recent developments in primary biliary cholangitis (PBC) treatment, including cutting-edge data on new and emerging agents and how these updates may be integrated into your practice. Topics include:Steatotic liver disease and PBCVibration-controlled transient elastography (VCTE) and discordant biochemical responses in PBCPPAR agonists and IBATs for PBC treatment Presenter:Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGHAssociate ProfessorNIHR Birmingham BRCUniversity of BirminghamConsultant Hepatologist, Liver UnitUniversity Hospitals BirminghamBirmingham, United Kingdom Link to full program: https://bit.ly/44ySoL3Follow along with the slides: https://bit.ly/3IvwQrjGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.

In this episode, Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGH​, discusses the most recent developments in primary biliary cholangitis (PBC) treatment, including cutting-edge data on new and emerging agents and how these updates may be integrated into your practice. Topics include:Steatotic liver disease and PBCVibration-controlled transient elastography (VCTE) and discordant biochemical responses in PBCPPAR agonists and IBATs for PBC treatment Presenter:Palak J. Trivedi, BSc, MBBS, PhD, MRCP, ESEGHAssociate ProfessorNIHR Birmingham BRCUniversity of BirminghamConsultant Hepatologist, Liver UnitUniversity Hospitals BirminghamBirmingham, United Kingdom Link to full program: https://bit.ly/4lKaO2HFollow along with the slides: https://bit.ly/44PPBysGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify. 

It's another mixed bag of your questions, taking everything from investing in offshore funds to evening up pension funds between spouses and lots more besides! Shownotes: https://meaningfulmoney.tv/QA19  00:57  Question 1 Hello Pete & Roger I am a regular listener to you show, love it and keep up the good work. My question is… I have a full 6 months emergency fund, I have no credit card debt or personal loans, I have a mortgage and I have just started investing 5% of my wages every time I get paid into the Vanguard all world tracker fund (keeping it simple) I have a new car every 4 years on PCP (so I basically lease it) as I always chop in for a new car and never pay the balloon payment at the end, this PCP is at 8%. I would like to hear your thoughts on weather investing is still okay to do along side this, the reason for having a new car is that I use it until the warranty expires and then change due to rising repair costs and hassle free motoring. I have brought older cars outright in the past and always ended up costing me more in repairs over the years. I am planning on leasing my cars for the permanent future so if I do not start investing now I will never have a chance to invest, and I do not see leasing at car as a loan as such, more of a permanent lease. Feel free to shorten my message to suit and excited to hear your thoughts, all the best. Adam 10:10  Question 2 Hello Pete and Rog! First of all, a huge thank you for all the valuable content you share – I really appreciate it! Keep up the fantastic work!  I had a quick question that's a bit technical (apologies in advance!), but I was wondering if you might be able to cover the topic of UK-registered funds when investing in a GIA on the podcast? I've heard that non-UK registered funds are taxed at the income tax rate rather than the capital gains tax rate. Is the best approach to check the ISIN against the list of UK-registered funds, even if the investment is made through a non-UK exchange (e.g., Amsterdam or Ireland)? Also, when a new client comes to you with non-UK registered funds, how do you typically address this issue? Thanks again for all that you do – really appreciate it!  Best, your #1 Fan! 14:00  Question 3 Hi Pete / Roger Thank you for your great work with your Q&As. Your cashflow ladder idea is great advice but when I look at graphs of cautious, balanced, growth funds they all go up and down at the same time. Over the last 10 yrs every time there has been a big market fall all the funds I looked at (at all risk levels) recovered with 32 months max. If 2-3 years cash is held on the 1st rung of the ladder why shouldn't I hold the rest in growth/agg funds? The cash rung will ride out the fall / recovery so I may as well put my money in a fund with the most growth potential? What am I missing? Stephen 19:57  Question 4 Hi Pete and Roger, Thanks for all you do. Your Podcasts and YouTube content has helped me get to retirement early. I have a number of investments in my Pension which are there to continue to grow hopefully over time. I have a well diversified portfolio mainly using trackers. I want to try to drop a particular individual investment from my portfolio that forms part of the Magnificent Seven, and is therefore part of a lot of the trackers I have. Unless I buy the FTSE Global index as individual shares can you see a way I cannot be in this one companies shares? Not sure there is an answer. Much appreciated, Chris 24:11  Question 5 Hello Love your podcast, I thought I was fairly clued up on pensions/finances but I have learnt so much more from your podcast. I recommend it to everyone! Especially my husband, who has so far failed to do so, he leaves the finances to me (which is probably why we are in this position as he has not addressed his pension). My question is: Our pension pots are very unequal, we're both 47.  I have 2 DB pots (combined are due to pay out circa 14k from age 65). I am also on track to have around 750k in a private pension by the time I am 57, and am planning to retire at this point.  My husband currently only has around 18k in a private pension, and is retraining as a teacher so he will only have a small DB pension not accessible until 68. He will therefore need to continue working for a few years after I retire.  I will need around a 2k a month in retirement, but I am thinking I can take up to £67k per year from my pension (so to remain in the 20% tax band). Use 24k for myself, and then we pay the remaining 43k into husbands private pension (or however much his earnings allow). If he is a higher rate tax payer by then, he would gain a 40% uplift on this or if not he will still get the 20% uplift back so we aren't losing out.  One of the main reasons for doing it would be to even the pensions out so that we can both withdraw tax efficiently in future, rather than me having to withdraw from my pension for both of us and so paying more tax. It seems like a no brainer but please let me know if I have missed something really obvious. Thanks in advance! Sarah 29:02  Question 6 Hello gents, If you pay a charity and claim gift aid within a given tax year, does that take your income down when calculating benefit calculations? E.g. if I earn £101k p/a and I give £2k to charity and (gift aid it), does that effectively bring my income below the £100k threshold for child government support like free childcare hours? Thanks, David

António Filipe será o candidato apoiado pelo PCP às eleições presidenciais de Janeiro do próximo ano, anunciou o secretário-geral dos comunistas, Paulo Raimundo. Já entre os socialistas espera-se que Augusto Santos Silva avance para a corrida presidencial nesta quarta-feira. Será?See omnystudio.com/listener for privacy information.

O recuo de António Vitorino fez com que Augusto Santos Silva voltar ao terreno das presidenciais, anunciando que tornará pública uma decisão na quarta-feira. Entretanto, o PCP anunciou a candidatura de António Filipe e Sampaio da Nóvoa também continua a refletir. As presidenciais à esquerda vão-se arrumando. Na Comissão Política desta semana, João Pedro Henriques, que escreveu sobre a possibilidade de a candidatura de António Filipe desbravar caminhos à esquerda, e Paulo Baldaia, que vê nas presidenciais riscos de ainda maior irrelevância para o PS, debatem as decisões e indecisões à esquerda. A moderação desta reunião da Comissão Política é de Eunice Lourenço, a sonoplastia é de João Luís Amorim e a ilustração é de Carlos Paes.See omnystudio.com/listener for privacy information.

In this part 1 reflection episode we discuss how the evidence can guide us regarding many of the challenges neurodivergent kids face. We cover questions about masking, rejection sensitive dysphoria, neurodiversity and emotional sensitivity, fitting in, medication and many more. Thank you for the wonderful questions, reflections and advice that the amazing PCP community sent in. We hope you like it and we can't wait to dive into this topic even further in the next reflection episode.

Listen as expert faculty answer your most pressing questions on optimizing immunization in clinical practice.Topics covered include:Practical methods for improving confidence in vaccinesHow to educate patients on vaccine development and safety monitoring Effective strategies to tailor recommendations, such as motivational interviewingWays to navigate clinical encounters and address vaccine hesitancyPresenters:Robert H. Hopkins, Jr., MD, MACPProfessor of Internal Medicine and PediatricsUniversity of Arkansas for Medical SciencesCollege of MedicineLittle Rock, ArkansasLitjen (L.J.) Tan, MS, PhDChief Policy and Partnership Office, Immunize.orgChair, National Adult Influenza Immunization SummitCo-Chair, Global Influenza InitiativeSt Paul, MinnesotaLink to full program: https://bit.ly/3I5jBh0Get access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.

A Netlabelday 2025 special Bark At The Moon...with tracks by...Brooklyn Station, Tom Toms, One Dub Connection, Y. K. Beats, High Snow, Cheese N Pot-C, Dub Dillah, Iliaque, Marwood Williams, Bist, Vejas, B4, Brioskj, Sascha Müller, Goodmvn Records, Rootsman Selecta, Lyda Aguas, DDO, Floating Mind, Valovoima, Humona Brooklyn Station - The Bounce [Pharmacom Records] [...] The post PCP#864… Bark At The Moon…(Netlabel Day 2025 Part 1 of 2) appeared first on Pete Cogle's Podcast Factory.

Sydney has been doing stand-up for over 20 years, ever since he was left shirtless and feeling cheap after a Destiny's Child music video model audition. Sydney has written for all kinds of great shows like The BET Awards, CBS's The Neighborhood, HBO's Game Theory and many others. He recently just released his first full comedy special "My Cup is Full" which was put out by 800 Pound Gorilla Media. To celebrate the release, Sydney was nice enough to come on the show! Doc and Sydney talk about his family thinking he should go to the NBA, getting into modelling, moving to LA, starting stand-up, starting comedy writing, winning Funniest Wins, spending a lot of money, working with Ali Siddiq, working with Bomani Jones, and of course his stand-up special. Meanwhile on the rest of the show Doc and Mike plan their 4-part series on James Brown, his love of shotguns and PCP. Introduction: 0:00:18 Birthday Suit 1: 17:52 Ripped from the Headlines: 21:58 Shoutouts: 32:13 Sydney Castillo Interview: 39:09 Mike C Top 3: 1:39:39 Birthday Suit 2: 1:58:39 Birthday Suit 3: 2:00:31

Listen in as Joseph Kim, MD, MPH, MBA; Manish Shah, MD; Martha Grugel, MA, discuss how they manage the prior authorization process for antiobesity agents to improve the quality of their care delivery, including:The information to collect during patient visitsThe available resources to help you submit prior authorizationsThe supporting documents that are often necessary to accompany prior authorizationsHow to address denials and appealsWhen to access manufacturer-based or foundation-based financial assistancePresentersJoseph Kim, MD, MPH, MBAPresidentQ Synthesis, LLCNewtown, PennsylvaniaManish Shah, MDClinical Associate Faculty MS1 PreceptorUniversity of Florida College of MedicineGainesville, FloridaMartha Grugel, MAMedical AssistantWesley Chapel, FloridaLink to full program: https://bit.ly/45P0v8z

Going to the doctor regularly is an important part of maintaining a healthy life especially as you age. However, such trips can be difficult when taking an aging loved one or someone you may be caring for whom may not be comfortable with regular doctor visits. Fortunately there are some things you can do to make these trips more manageable and even enjoyable from start to finish for everyone involved. In This Episode You Will Learn: 1). The growing number of people in America who are now in charge of taking care of their parents and how this is affecting all areas of care including regular doctor visits. 2). When it's important to know if a primary caretaker should be involved with taking the aging adult to their regular check ups. 3). Why it's important to plan the trip ahead of time and know what to bring with you like a list of medications etc. to ensure smooth communication with the doctor or PCP. 4). Why having a checklist of items to cover with the doctor during the visit is important and how doing so can maximize check up experience for all parties. 5). Remember to be respectful of the person you are bringing to the appointment and treat them with kindness and patience to ensure a low stress environment. /// We hope the tips in this episode help you or someone you know who is caring for an aging adult. Feeling comfortable about taking regular trips to the doctor is important during our later years and making sure the right steps that are being taken before, during and after the visit is important to maintaining a regular checkup schedule. Team MeredithSee omnystudio.com/listener for privacy information.

Description: Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Anna Henderson, MD, a pediatric gastroenterologist at Northern Light Health in Maine, about bone mineral density in EoE patients. They discuss a paper she co-authored on the subject. Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship that exists between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:50] Co-host Ryan Piansky introduces the episode, brought to you thanks to the support of Education Partners Bristol Myers Squibb, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz.   [1:17] Holly introduces today's topic, eosinophilic esophagitis (EoE), and bone density.   [1:22] Holly introduces today's guest, Dr. Anna Henderson, a pediatric gastroenterologist at Northern Light Health in Maine.   [1:29] During her pediatric and pediatric gastroenterology training at Cincinnati Children's Hospital, she took a special interest in eosinophilic esophagitis. In 2019, Dr. Henderson received APFED's NASPGHAN Outstanding EGID Abstract Award.   [1:45] Holly, a feeding therapist in Maine, has referred many patients to Dr. Henderson and is excited to have her on the show.   [2:29] Dr. Henderson is a wife and mother. She loves to swim and loves the outdoors. She practices general pediatric GI in Bangor, Maine, at a community-based academic center.   [2:52] Her patient population is the northern two-thirds of Maine. Dr. Henderson feels it is rewarding to bring her expertise from Cincinnati to a community that may not otherwise have access to specialized care.   [3:13] Dr. Henderson's interest in EoE grew as a GI fellow at Cincinnati Children's. Her research focused on biomarkers for disease response to dietary therapies and EoE's relationship to bone health.   [3:36] As a fellow, Dr. Henderson rotated through different specialized clinics. She saw there were many unanswered questions about the disease process, areas to improve treatment options, and quality of life for the patients suffering from these diseases.   [4:00] Dr. Henderson saw many patients going through endoscopies. She saw the social barriers for patients following strict diets. She saw a huge need in EoE and jumped on it.   [4:20] Ryan grew up with EoE. He remembers the struggles of constant scopes, different treatment options, and dietary therapy. Many people struggled to find what was best for them before there was a good approved treatment.   [4:38] As part of Ryan's journey, he learned he has osteoporosis. He was diagnosed at age 18 or 19. His DEXA scan had such a low Z-score that they thought the machine was broken. He was retested.   [5:12] Dr. Henderson explains that bone mineral density is a key measure of bone health and strength. Denser bones contain more minerals and are stronger. A low bone mineral density means weaker bones. Weaker bones increase the risk of fracture.   [5:36] DEXA scan stands for Dual Energy X-ray Absorptiometry scan. It's a type of X-ray that takes 10 to 30 minutes. A machine scans over their bones. Typically, we're most interested in the lumbar spine and hip bones.   [5:56] The results are standardized to the patient's height and weight, with 0 being the average. A negative number means weaker bones than average for that patient's height and weight. Anything positive means stronger bones for that patient's height and weight.   [6:34] A lot of things can affect a patient's bone mineral density: genetics, dietary history, calcium and Vitamin D intake, and medications, including steroid use. Prednisone is a big risk factor for bone disease.   [7:07] Other risk factors are medical and auto-immune conditions, like celiac disease, and age. Any patient will have their highest bone density in their 20s to 30s. Females typically have lower bone mineral density than males.   [7:26] The last factor is lifestyle. Patients who are more active and do weight-bearing exercises will have higher bone mineral density than patients who have more of a sedentary lifestyle.   [7:56] Ryan was told his bone mineral density issues were probably a side-effect of the long-term steroids he was on for his EoE. Ryan is now on benralizumab for eosinophilic asthma. He is off steroids.   [8:36] Dr. Henderson says the research is needed to find causes of bone mineral density loss besides glucocorticoids.   [8:45] EoE patients are on swallowed steroids, fluticasone, budesonide, etc. Other patients are on steroids for asthma, eczema, and allergic rhinitis. These may be intranasal steroids or topical steroids.   [9:01] Dr. Henderson says we wondered whether or not all of those steroids and those combined risks put the EoE population at risk for low bone mineral density. There's not a lot published in that area.   [9:14] We know that proton pump inhibitors can increase the risk of low bone mineral density. A lot of EoE patients are on proton pump inhibitors.   [9:23] That was where Dr. Henderson's interest started. She didn't have a great way to screen for bone mineral density issues or even know if it was a problem in her patients more than was expected in a typical patient population.   [9:57] Holly wasn't diagnosed with EoE until she was in her late 20s. She was undiagnosed but was given prednisone for her problems. Now she wonders if she should get a DEXA scan.   [10:15] Holly hopes the listeners will learn something and advocate for themselves or for their children.   [10:52] If a patient is concerned about their bone mineral density, talking to your PCP is a perfect place to start. They can discuss the risk factors and order a DEXA scan and interpret it, if needed.   [11:11] If osteoporosis is diagnosed, you should see an endocrinologist, specifically to discuss therapy, including medications called bisphosphonates.   [11:36] From an EoE perspective, patients can talk to their gastroenterologist about what bone mineral density risk factors may be and if multiple risk factors exist. Gastroenterologists are also more than capable of ordering DEXA scans and helping their patients along that journey.   [11:53] A DEXA scan is typically the way to measure bone mineral density. It's low radiation, it's easy, it's fast, and relatively inexpensive.   [12:10] It's also useful in following up over time in response to different interventions, whether or not that's stopping medications or starting medications.   [12:30] Dr. Henderson co-authored a paper in the Journal of Pediatric Gastroenterology and Nutrition, called “Prevalence and Predictors of Compromised Bone Mineral Density in Pediatric Eosinophilic Esophagitis.” The study looked at potential variables.   [12:59] The researchers were looking at chronic systemic steroid use. They thought it was an issue in their patients, especially patients with multiple atopic diseases like asthma, eczema, and allergic rhinitis. That's where the study started.   [13:22] Over the years, proton pump inhibitors have become more ubiquitous, and more research has come out. The study tried to find out if this was an issue or not. There weren't any guidelines for following these patients, as it was a retrospective study.    [13:42] At the time, Dr. Henderson was at a large institution with a huge EoE population. She saw that she could do a study and gather a lot of information on a large population of patients. Studies like this are the start of figuring out the guidelines for the future.   [14:34] Dr. Henderson wanted to determine whether pediatric patients with EoE had a lower-than-expected bone mineral density, compared to their peers. [14:44] Then, if there were deficits, she wanted to determine where they were more pronounced. Were they more pronounced in certain subgroups of patients with EoE?   [14:59] Were they patients with an elemental diet? Patients with an elimination diet? Were they patients on steroids or PPIs? Were they patients with multiple atopic diseases? Is low bone mineral density just a manifestation of their disease processes?   [15:14] Do patients with active EoE have a greater propensity to have low bone mineral density? The study was diving into see what the potential risk factors are for this patient population.   [15:45] The study was a retrospective chart review. They looked at patients aged 3 to 21. You can't do a DEXA scan on a younger patient, and 21 is when people leave pediatrics.   [16:03] These were all patients who had the diagnosis of EoE and were seen at Cincinnati Children's in the period between 2014 and 2017. That period enabled full ability for chart review. Then they looked at the patients who had DEXA scans.   [16:20] They did a manual chart review of all of the patients and tried to tease out what the potential exposures were. They looked at demographics, age, sex, the age of the diagnosis of EoE, medications used, such as PPIs, and all different swallowed steroids.   [16:44] They got as complete a dietary history as they could: whether or not patients were on an elemental diet, whether that was a full elemental diet, whether they were on a five-food, six-food, or cow's milk elimination diet.   [16:58] They teased out as much as they could. One of the limitations of a retrospective chart review is that you can't get some of the details, compared to doing a prospective study. For example, they couldn't tease out the dosing or length of therapy, as they would have liked.   [17:19] They classified those exposures as whether or not the patient was ever exposed to those medications, whether or not they were taking them at the time of the DEXA scan, or if they had been exposed within the year before the DEXA scan.   [17:40] They also looked at whether the patients had other comorbid atopic disorders, to see if those played a role, as well.   [18:03] The study found that there was a slightly lower-than-expected bone mineral density in the patients. The score was -0.55, lower than average but not diagnostic of a low bone mineral density, which would be -2 or below.   [18:27] There were 23 patients with low bone mineral density scores of -2 or below. That was 8.6% of the study patients. Typically, only 2.5% of the population would have that score. It was hard to tease out the specific risk factors in a small population of 23.   [18:57] They looked at what the specific risk factors were that were associated with low bone mineral density, or bone mineral density in general.   [19:12] After moving from Colorado, Holly has transferred to a new care team, and doctors wanted her baseline Vitamin D and Calcium levels. No one had ever tested that on her before. Dr. Henderson says it's hard because there's nothing published on what to do.   [19:58] The biggest surprise in the study was that swallowed steroids, or even combined steroid exposure, didn't have any effect on bone mineral density. That was reassuring, in light of what is known about glucocorticoid use.   [20:16] The impact of PPI use was interesting. The study found that any lifetime use of PPIs did seem to decrease bone mineral density. It was difficult to tease out the dosing and the time that a patient was on PPIs.   [20:34] Dr. Henderson thinks that any lifetime use of PPIs is more of a representation of their cumulative use of PPIs. At the time of the study, from 2014 to 2017, PPIs were still very much first-line therapy for EoE; 97% of the study patients had taken PPIs at some time.   [21:02] There are so many more options now for therapy when a patient has a new diagnosis of EoE, especially with dupilumab now being an option.   [21:11] Dr. Henderson speaks of patients who started on PPIs and have stayed on them for years. This study allows her to question whether we need to continue patients on PPIs. When do we discuss weaning patients off PPIs, if appropriate?   [22:05] Ryan says these podcasts are a great opportunity for the community at large and also for the hosts. He just wrote himself a note to ask his endocrinologist about coming off PPIs.   [22:43] Dr. Henderson says that glucocorticoid use is a known risk factor for low bone mineral density and osteoporosis. In the asthma population, inhaled steroids can slightly decrease someone's growth potential while the patient is taking them.   [23:10] From those two facts, it was thought that swallowed steroids would have a similar effect. But since they're swallowed and not systemic, maybe things are different.   [23:23] It was reassuring to Dr. Henderson that what her study found was that the swallowed steroid didn't affect bone mineral density. There was one other study that found that swallowed steroids for EoE did not affect someone's height.   [23:51] Dr. Henderson clarifies that glucocorticoids include systemic steroids like prednisone and hydrocortisone.     [23:57] Based on Dr. Henderson's retrospective study, fluticasone as a swallowed steroid did not affect bone mineral density. It was hard to tease out the dosing, but the cumulative use did not seem to result in a deficit for bone mineral density.   [24:16] Holly shared that when she tells a family of a child she works with that the child's gastroenterologist will likely recommend steroids, she will now give them the two papers Dr. Henderson mentioned. There are different types of steroids. The average person doesn't know the difference.   [25:15] Dr. Henderson thinks that for patients who have multiple risk factors for low bone mineral density, it is reasonable to have a conversation about bone health with their gastroenterologist to see whether or not a DEXA scan would be worth it.   [25:56] If low bone mineral density is found, that needs to be followed up on.   [26:03] There are no great guidelines, but this study is a good start on what these potential risk factors are. We need some more prospective studies to look at these risk factors in more detail than Dr. Henderson's team teased out in this retrospective study.   [26:23] Dr. Henderson tells how important it is for patients to participate in prospective longitudinal studies for developing future guidelines.   [26:34] Holly points out that a lot of patients are on restrictive diets. It's important to think about the whole picture if you are starting a medication or an elimination, or a restricted diet. You have to think about the impact on your body, overall.   [27:11] People don't think of dietary therapy as medication, but it has risks and benefits involved, like a medication.   [27:50] Dr. Henderson says, in general, lifestyle management is the best strategy for managing bone health. Stay as active as you can with weight-bearing exercises and eating a well-balanced diet. If you are on a restrictive diet, make sure it's well-balanced.   [28:12] Dr. Henderson says a lot of our patients have feeding disorders, so they see feeding specialists like Holly. A balanced diet is hard when kids are very selective in their eating habits.   [29:10] Dr. Henderson says calcium and Vitamin D are the first steps in how we treat patients with low bone mineral density. A patient who is struggling with osteoporosis needs to discuss it with their endocrinologist for medications beyond supplementation.   [29:31] Ryan reminds listeners who are patients always to consult with their medical team. Don't go changing anything up just because of what we're talking about here. Ask your care team some good questions.   [29:47] Dr. Henderson would like families to be aware, first, that some patients with EoE will have bone mineral density loss, especially if they are on PPIs and restrictive diets. They should start having those discussions with their providers.   [30:04] Second, Dr. Henderson would like families to be reassured that swallowed steroids and combined steroid exposure didn't have an impact on bone mineral density. Everyone can take that away from today's chat.   [30:18] Lastly, Dr. Henderson gives another plug for patient participation in prospective studies, if they're presented with the opportunity. It's super important to be able to gather more information and make guidelines better for our patients. [30:35] Holly thanks Dr. Henderson for coming on Real Talk — Eosinophilic Diseases and sharing her insights on bone mineral density, and supporting patients in Maine.   [30:57] Dr. Henderson will continue to focus on the clinical side. She loves doing outreach clinics in rural Maine. It's rewarding, getting to meet all of these patients and taking care of patients who would otherwise have to travel hours to see a provider.   [32:01] Ryan thinks the listeners got a lot out of this. For our listeners who would like to learn more about eosinophilic disorders, please visit APFED.org and check out the links in the show notes.   [32:11] If you're looking to find specialists who treat eosinophilic disorders, we encourage you to use APFED's Specialist Finder at APFED.org/specialist.   [32:19] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at APFED.org/connections.   [32:28] Ryan thanks Dr. Henderson for joining us today for this great conversation. Holly also thanks APFED's Education Partners Bristol Myers Squibb, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode: Anna Henderson, MD, a pediatric gastroenterologist at Northern Light Health in Maine Cincinnati Children's “Prevalence and Predictors of Compromised Bone Mineral Density in Pediatric Eosinophilic Esophagitis.” Journal of Pediatric Gastroenterology and Nutrition   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections   Education Partners: This episode of APFED's podcast is brought to you thanks to the support of Bristol Myers Squibb, Sanofi, Regeneron, and Takeda.   Tweetables:   “DEXA scan stands for dual-energy X-ray absorptiometry scan. It's a type of X-ray where a patient lies down for 10 to 30 minutes. A machine scans over their bones. Typically, we're most interested in the lumbar spine and hip bones.” — Anna Henderson, MD   “We wondered whether or not all of those steroids and those combined risks even put our EoE population at risk for low bone mineral density. There's not a lot published in that area.” — Anna Henderson, MD   “If a patient is worried [about their bone mineral density], their PCP is a perfect place to start for that. They're more than capable of discussing the risk factors specific for that patient, ordering a DEXA scan, and interpreting it if need be.” — Anna Henderson, MD   “I think we need some more prospective studies to look at these risk factors in a little bit more detail than we were able to tease out in our retrospective review.” — Anna Henderson, MD   “Just another plug for the participation in prospective studies, if you're presented with the opportunity. It's super important to be able to gather more information and to be able to make guidelines better for our patients about these risks.” — Anna Henderson, MD

After a virus wipes out most of England, a few survivors fight off the infected and would-be rapists. Listen as we discuss watching comedies in theaters, clever graffiti during a zombie apocalypse, and the effects of PCP. Then we find out if 28 Days Later stands the Test of Time.

PCP#271… Good Luck, Mr. Gorsky!…. Urban Legend: Good Luck Mr Gorsky! Listen to Apollo 11 "live" 40 years later: https://www.nasa.gov/externalflash/apollo11_radio/ Snowday, by Petr Cech Didn't See It Coming. Haywards Heath, England. [Brighton Records] Nuclear Race (Applebim and Komonazmuk Dub), by Beat Pharmacy. New York, USA.[Promonet] Take Me, by 23 Million Miles From The [...] The post Rewind…PCP#271… Good Luck, Mr. Gorsky!…. appeared first on Pete Cogle's Podcast Factory.

Idiopathic intracranial hypertension (IIH) is characterized by symptoms and signs of unexplained elevated intracranial pressure (ICP) in an alert and awake patient. The condition has potentially devastating effects on vision, headache burden, increased cardiovascular disease risk, sleep disturbance, and depression.  In this episode, Teshamae Monteith, MD, FAAN speaks with Aileen A. Antonio, MD, FAAN, author of the article “Clinical Features and Diagnosis of Idiopathic Intracranial Hypertension” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Monteith is the associate editor of Continuum® Audio and an associate professor of clinical neurology at the University of Miami Miller School of Medicine in Miami, Florida. Dr. Antonio is an associate program director of the Hauenstein Neurosciences Residency Program at Trinity Health Grand Rapids and an assistant clinical professor at the Michigan State University College of Osteopathic Medicine in Lansang, Michigan. Additional Resources Read the article: Clinical Features and Diagnosis of Idiopathic Intracranial Hypertension Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @headacheMD Guest: @aiee_antonio Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Monteith: Hi, this is Dr Teshamae Monteith. Today I'm interviewing Dr Aileen Antonio about her article on clinical features and diagnosis of idiopathic intracranial hypertension, which appears in the June 2025 Continuum issue on disorders of CSF dynamics.  Hi, how are you? Dr Antonio: Hi, good afternoon. Dr Monteith: Thank you for being on the podcast. Dr Antonio: Thank you for inviting me, and it's such an honor to write for the Continuum. Dr Monteith: So why don't you start off with introducing yourself? Dr Antonio: So as mentioned, I'm Aileen Antonio. I am a neuro-ophthalmologist, dually trained in both ophthalmology and neurology. I'm practicing in Grand Rapids, Michigan Trinity Health, and I'm also the associate program director for our neurology residency program. Dr Monteith: So, it sounds like the residents get a lot of neuro-ophthalmology by chance in your curriculum. Dr Antonio: For sure. They do get fed that a lot. Dr Monteith: So why don't you tell me what the objective of your article was? Dr Antonio: Yes. So idiopathic intracranial hypertension, or IIH, is a condition where there's increased intracranial pressure, but without an obvious cause. And with this article, we want our readers---and our listeners right now---to recognize that the typical symptoms and learning about the IIH diagnostic criteria are key to avoiding errors, overdiagnosis, or sometimes even misdiagnosis or underdiagnosis. Thus, we help make the most of our healthcare resources. Early diagnosis and management are crucial to prevent disability from intractable headaches or even vision loss, and it's also important to know when to refer the patients to the appropriate specialists early on. Dr Monteith: So, it sounds like your central points are really getting that diagnosis early and managing the patients and knowing how to triage patients to reduce morbidity and complications. Is that correct? Dr Antonio: That is correct and very succinct, yes. Dr Monteith: And so, are there any more recent advances in the diagnosis of IIH? Dr Antonio: Yes. And one of the tools that we've been using is what we call the optical coherence tomography. A lot of people, neurologists, physicians, PCP, ER doctors; how many among those physicians are well-versed in doing an eye exam, looking at the optic disc? And this is a great tool because it is noninvasive, it is high resolution imaging technique that allows us to look at the optic nerve without even dilating the eye. And we can measure that retinal nerve fiber layer, or RNFL; and that helps us quantify the swelling that is visible or inherent in that optic nerve. And we can even follow that and monitor that over time. So, this gives us another way of looking at their vision and getting that insight as to how healthy is their vision still, along with the other formal visual tests that we do, including perimetry or visual field testing. And then all of these help in catching potentially early changes, early worsening, that may happen; and then we can intervene more easily. Dr Monteith: Great. So, it sounds like there's a lot of benefits to this newer technology for our patients. Dr Antonio: That is correct. Dr Monteith: So, I read in the article about the increased incidence of IIH, and I have to say that I completely agree with you because I'm seeing so much of it in my clinic, even as a headache specialist. And I had a talk with a colleague who said that the incidence of SIH and IIH are similar. And I was like, there's no way. Because I see, I can see several people with IIH just in one day. That's not uncommon. So, tell me what your thoughts are on the incidence, the rising incidence of IIH; and we understand that it's the condition associated with obesity, but it sounds like you have some other underlying drivers of this problem. Dr Antonio: Yes, that is correct. So, as you mentioned, IIH tends to affect women of childbearing age with obesity. And it's interesting because as you've seen that trend, we see more of these IIH cases recently, which seem to correlate with that rising rate of obesity. And the other thing, too, is that this trend can readily add to the burden of managing IIH, because not only are we dealing with the headaches or the potential loss of vision, but also it adds to the burden of healthcare costs because of the other potential comorbidities that may come with it, like cardiovascular risk factors, PCOS, and sleep apnea. Dr Monteith: So why don't we just talk about the diagnosis of IIH? Dr Antonio: IIH, idiopathic intracranial hypertension, is also called pseudotumor cerebri.  It's essentially a condition where a person experiences increased intracranial pressure, but without any obvious cause. And the tricky part is that the patients, they're usually fully awake and alert. So, there's no obvious tumor, brain tumor or injury that causes the increased ICP. It's really, really important to rule out other conditions that might cause these similar symptoms; again, like brain tumors or even the cerebral venous sinus thrombosis. Many patients will have headaches or visual disturbances like transient visual obscurations---we call them TVOs---or double vision or diplopia. The diplopia is usually related to a sixth nerve palsy or an abducens palsy. Some may also experience some back pain or what we call pulsatile tinnitus, which is that pulse synchronous ringing in their ears. The biggest sign that we see in the clinic would be that papilledema; and papilledema is a term that we only use, specifically use, for those optic nerve edema changes that is only associated with increased intracranial pressure. So, performing of endoscopy and good eye exam is crucial in these patients. We usually use the modified Dandy criteria to diagnose IIH. And again, I cannot emphasize too much that it's really important to rule out other secondary causes to that increased intracranial pressure. So, after that thorough neurologic and eye evaluation with neuroimaging, we do a lumbar puncture to measure the opening pressure and to analyze the cerebrospinal fluid. Dr Monteith: One thing I learned from your article, really just kind of seeing all of the symptoms that you mentioned, the radicular pain, but also- and I think I've seen some papers on this, the cognitive dysfunction associated with IIH. So, it's a broader symptom complex I think than people realize. Dr Antonio: That is correct. Dr Monteith: So, you mentioned TVOs. Tell me, you know, if I was a patient, how would you try and elicit that from me? Dr Antonio: So, I would usually just ask the patient, while you're sitting down just watching TV---some of my patients are even driving as this happens---they would suddenly have these episodes of blacking out of vision, graying out of vision, vision loss, or blurred vision that would just happen, from seconds to less than a minute, usually. And they can happen in one eye or the other eye or both eyes, and even multiple times a day. I had a patient, it was happening 50 times a day for her. It's important to note that there is no pain associated with it most of the time. The other thing too is that it's different from the aura that patients with migraines would have, because those auras are usually scintillating and would have what we call the positive phenomena: the flashing lights, the iridescence, and even the fortification that they see in their vision. So definitely TVOs are not the migraine auras. Sometimes the TVOs can also be triggered by sudden changes in head positions or even a change in posture, like standing up quickly. The difference, though, between that and, like, the graying out of vision or the tunneling vision associated with orthostatic hypotension, is that the orthostatic hypotension would also have that feeling of lightheadedness and dizziness that would come with it. Dr Monteith: Great. So, if someone feels lightheaded, less likely to be a TVO if they're bending down and they have that grain of vision. Dr Antonio: That is correct. Dr Monteith: Definitely see patients like that in clinic. And if they have fluoride IIH, I'm like, I'll call it a TVO; if they don't, I'm like, it's probably more likely to be dizziness-related. And then we also have patient migraines that have blurriness that's nonspecific, not necessarily associated with aura. But I think in those patients, it's usually not seconds long, it's usually probably longer episodes of blurriness. Would you agree there, or…? Dr Antonio: I would agree there, and usually the visual aura would precede the headache that is very characteristic of their migraine, very stereotypical for their migraines. And then it would dissipate slowly over time as well. With TVOs, they're brisk and would not last, usually, more than a minute. Dr Monteith: So, why don't we talk about routine imaging? Obviously, ordering an MRI, and I read also getting an MRV is important. Dr Antonio: It is very important because, one: I would say IIH is also a diagnosis of exclusion. We need to make sure that the increased ICP is not because of a brain tumor or not because of cerebral venous sinus thrombosis. So, it's important to get the MRI of the brain as well as the MRV of the head. Dr Monteith: Do you do that for all patients' MRV, and how often do you add on an orbital study? Dr Antonio: I usually do not add on an orbital study because it's not really going to change my management at that point. I really get that MRI of the brain. Now the MRV, for most of my patients, I would order it already just because the population that I see, I don't want to lose them. And sometimes it's that follow-up, and that is the difficult part; and it's an easy add on to the study that I'm going to order. Again, it depends with the patient population that you have as well, and of course the other symptoms that may come with it. Dr Monteith: So, why don't we talk a little bit about CSF reading and how these set values, because we get people that have readings of 250 millimeters of water quite frequently and very nonspecific, questionable IIH. And so, talk to me about the set value. Dr Antonio: Right. So, the modified Dandy criteria has shown that, again, we consider intracranial pressure to be elevated for adults if it's above 250 millimeters water; and then for kids if it's above 280 millimeters of water. Knowing that these are taken in the left lateral decubitus position, and assuming also that the patients were awake and not sedated during the measurement of the CSF pressure. The important thing to know about that is, sometimes when we get LPs under fluoroscopy or under sedation, then these can cause false elevation because of the hypercapnia that elevated carbon dioxide, and then the hypoventilation that happens when a patient is under sedation. Dr Monteith: You know, sometimes you see people with opening pressures a little bit higher than 25 and they're asymptomatic. Well, the problem with these opening pressure values is that they can vary somewhat even across the day. People around 25, you can be normal, have no symptoms, and have opening pressure around 25- or 250; and so, I'm just asking about your approach to the CSF values. Dr Antonio: So again, at the end of the day, what's important is putting everything together. It's the gestalt of how we look at the patient. I actually had an attending tell me that there is no patient that read the medical textbook. So, the, the important thing, again, is putting everything together. And what I've also seen is that some patients would tell me, oh, I had an opening pressure of 50. Does that mean I'm in a dire situation? And they're so worried and they just attach to numbers. And for me, what's important would be, what are your symptoms? Is your headache, right, really bad, intractable? Number two: are you losing vision, or are you at that cusp where your optic nerve swelling or papilledema is so severe that it may soon lead to vision loss? So, putting all of these together and then getting the neuroimaging, getting the LP. I tell my residents it's like icing on the cake. We know already what we're dealing with, but then when we get that confirmation of that number… and sometimes it's borderline, but this is the art of neurology. This is the art of medicine and putting everything together and making sure that we care and manage it accordingly. Dr Monteith: Let's talk a little bit about IIH without papilledema. Dr Antonio: So, let's backtrack. So, when a patient will fit most of the modified Dandy criteria for IIH, but they don't have the papilledema or they don't have abducens palsy, the diagnosis then becomes tricky. And in these kinds of cases, Dr Friedman and her colleagues, when they did research on this, suggested that we might consider the diagnosis of IIH. And she calls this idiopathic intracranial hypertension without papilledema, IIHWOP. They say that if they meet the other criteria for modified Dandy but show at least three typical findings on MRI---so that flattening of the posterior globe, the tortuosity of the optic nerves, the empty sella or the partially empty sella, and even the narrowing of the transverse venous sinuses---so if you have three of these, then potentially you can call these cases as idiopathic intracranial hypertension without papilledema. Dr Monteith: Plus, the opening pressure elevation. I think that's key, right? Getting that as well. Dr Antonio: Yes. Sometimes IIHWOP may still be a gray area. It's a debate even among neuro-ophthalmologists, and I bet even among the headache specialists. Dr Monteith: Well, I know that I've had some of these conversations, and it's clear that people think this is very much overdiagnosed. So, that's why I wanted to plug in the LP with that as well. Dr Antonio: Right. And again, we have not seen yet whether is, this a spectrum, right? Of that same disease just manifesting differently, or are they just sharing a same pathway and then diverging? But what I want to emphasize also is that the treatment trials that we've had for IIH do not include IIHWOP patients. Dr Monteith: That is an important one. So why don't you wrap this up and tell our listeners what you want them to know? Now's the time. Dr Antonio: So, the- again, with IIH, with idiopathic intracranial hypertension, what is important is that we diagnose these patients early. And I think that some of the issues that come into play in dealing with these patients with IIH is that, one: we may have anchoring bias. Just because we see a female with obesity, of reproductive age, with intractable headaches, it does not always mean that what we're dealing with is IIH. The other thing, too, is that your tools are already available to you in your clinic in diagnosing IIH, short of the opening pressure when you get the lumbar puncture. And I need to emphasize the importance of doing your own fundoscopy and looking for that papilledema in these patients who present to you with intractable headaches or abducens palsy. What I want people to remember is that idiopathic intracranial hypertension is not optic nerve sheath distension. So, these are the stuff that you see on neuroimaging incidentally, not because you sent them, because they have papilledema, or because they have new headaches and other symptoms like that. And the important thing is doing your exam and looking at your patients. Dr Monteith: Today, I've been interviewing Dr Aileen Antonio about her article on clinical features and diagnosis of idiopathic intracranial hypertension, which appears in the most recent issue of Continuum on disorders of CSF dynamics. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today. Thank you again. Dr Antonio: Thank you. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

After so many requests from the amazing PCP community we are diving back in to talk about neurodiversity and how we can better support these beautiful kids. We discuss how movies, beliefs and a deficit approach can cause harm and limit potential. We dive into how we can help neurodivergent children and teens feel safe and experience success using the science in the real world. We can not wait to hear your reflections, questions and advice on nurturing neurodiversity as it's our favourite part of the podcast.

O Programa do Governo será debatido amanhã e depois, com viabilização garantida, apesar da moção de rejeição apresentada pelo PCP. Os socialistas vão viabilizar o documento através da abstenção, mesmo depois de Carlos César ter acusado o executivo de ter avançado com “medidas para seduzir a IL e o Chega”. Algumas dessas medidas não estavam no programa eleitoral, nem foram debatidas em campanha. Neste episódio, conversamos com o jornalista Vítor Matos.See omnystudio.com/listener for privacy information.

Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks…   Lina: Hi Dr. Cabral, My neck has been feeling very fatigue for the past months. My spinal X-ray revealed a mild C5-6 disc space narrowing with endplate osteophyte formation. I am applying castor oil onto this area daily as I believe it help disintegrate bone spurs. Can you please provide guidance on what more I can do to break up these bone spurs and strengthen that area of my neck? Besides neck exercises which I am doing, are there any dietary suggestions or supplementation that would help. I am very grateful for all you do for us in this community. With much thanks, Lina                        Heather: Hello Dr. Cabral! I am a 47-year-old woman who has been experiencing double vision upon waking that usually lasts until around 11 AM, It does not happen every day but has been happening for a year and a half. It also happens when I have alcohol. I went to my optometrist and he said everything looked good, I went to my PCP and he wanted to run labs. No red flags, so he wanted to do an MRI on my brain. I decided to run the big five labs instead and found out I was low on all the B vitamins, had SIBO & Candida. I did The 21 day detox, completed the CBO protocol and will be starting a heavy metal detox next week. As of writing this I still am experiencing the double vision intermittently. Thank you!                                                                                                                                  Thomas: Thanks for all your work. It has been a very helpful resource for my family and I as we continue to improve our health. My question is about SPMs (specialized pro-resolving mediators). Can you speak about their efficacy or the lack thereof and whether you've personally used them or use them in your practice?          Michelle: Hi! Thank you for your show, I've learned so much from listening to your podcast! I'm just wondering your thoughts on a dental procedure. After my last dentist appointment I was told I needed two root canals or if I wanted to spend a little more I could have two implants. My question is, which one is safer? I've heard root canals can cause problems like low grade infections lasting a long time but I haven't heard anyone talk about any bad side affects from implants. Thank you for all you do. Michelle                                                                                                                                        Savannah: Hypothyroidism runs in my family both my mom and dad have it and both my grandmothers had it. I was diagnosed in my early 20's but I haven't been on medicine since having my son in 2023 and was wondering what's the best protocol of supplements and foods to help keep the thyroid healthy or heal it if possible. Thanks!   Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Show Notes and Resources: StephenCabral.com/3418 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

Listen in as Joseph Kim, MD, MPH, MBA, interviews Natalie, Orbach, PA-C, to learn about how she implemented patient-centered and individualized treatment plans to improve obesity care at her practice, includingDiscussing weight and how nutrition, physical activity, mental health, and pharmacotherapy strategies can helpMeeting patients where they are at and offering slow, incremental changes that support long-term outcomesReferring patients to community resources and other professionals as needSharing lessons learned for those interested in implementing similar strategies in their practice PresenterJoseph Kim, MD, MPH, MBAPresidentQ Synthesis, LLCNewtown, PennsylvaniaNatalie Orbach, PA-CPhysician AssistantFeirtag & Ramos, PALutherville, Maryland Link to full program: https://bit.ly/45P0v8z

PCP#56…Leeds Festival (Part 2)... Trash, by Pets In Trees. San Francisco, California, USA. Reinstalling Windows, by Graham Holland. Liverpool, England. Good Sensi, Zion Judah (featuring Alberto Dubscience on scratch guitar). Staten Island/NYC, Trinidad and Tobago Leeds Festival Review (Part Two): Send In the Boys, by Milburn. Sheffield, England. Keepsakes, by Sky Larkin. Leeds, [...] The post Rewind…PCP#56…Leeds Festival (Part 2)… appeared first on Pete Cogle's Podcast Factory.

PCP#136… Don't Tell Me That I Don't Care, by Mad Mush. London, England. [Jamendo] The Saracen, by Celt Islam Sound System. UK/Sweden. [Versionist] High, by Ottogono. Coventry, England. [Myspace] Vakna, by Svenska Akademien. [Promonet] A Dozen Bloody Roses, by Dust Rhinos. Winnipeg, Manitoba, Canada. [PMN] Words Can Kill, by Distemper. Moscow, Russia. [Jamendo] [...] The post Rewind… PCP#136… Against The Tide… appeared first on Pete Cogle's Podcast Factory.

PSD, Chega, PS, IL, Livre, PCP, CDS, Bloco, Pan, JPP. Nunca houve tantos micropartidos na AR. Nunca houve maioria constitucional sem o PS. Tudo parece novo exceto a incerteza: dura toda a legislatura?See omnystudio.com/listener for privacy information.

Se for esse o caminho de José Luís Carneiro é um “mau caminho”. Paula Santos do PCP considera que o PS deixou de ser uma força na esquerda e atira farpas às medidas da AD.See omnystudio.com/listener for privacy information.

In this reflection episode we go deeper into conflict resolution using reflections, questions and advice from the wonderful PCP community. We explore how we can support conflict resolution at different developmental stages from toddlers to teens, what schools can do and how we can work on this within ourselves. Thank you to everyone who sent in their messages and we hope you like the episode.

PCP#88… Botox, by Revolution 74.Chichester, Sussex, England. Nervous Again, by The Reel Banditos. Germany. String Of Blinking Lights, by Paper Moon. Winnipeg, Manitoba, Canada. (from Endearing Records) Power Of A Woman, by Elkysia. Brittany, France. Jedi Drinking Test, by The Dust Rhinos. Winnipeg, Manitoba, Canada. On The Borders Of New Mexico, by SPiVEY. [...] The post Rewind… PCP#88 appeared first on Pete Cogle's Podcast Factory.

Listen as Michael S. Blaiss, MD provides case-based perspectives on chronic cough recognition, burden, management, and pathophysiology and describes the evolving treatment landscape for refractory chronic cough.PresenterMichael S. Blaiss, MDClinical Professor of PediatricsDivision of Allergy-ImmunologyMedical College of Georgia at Augusta UniversityAugusta, GeorgiaLink to full program: https://bit.ly/4kweynG

Que farei quando tudo arde? A pergunta do vetusto e sempre actual Sá de Miranda ecoa agora nos corredores do Largo do Rato (metonímia em referência à sede do Partido Socialista, sita no largo do dito). A novela eleitoral revelou-nos um perdedor em toda a linha, um vencedorzinho convencido de ter tido uma grande vitória e um ganhador efectivo, que já sonha abocanhar tudo o resto. E, enquanto isso, nós, na bolha, cá nos vamos desentendendo à procura de explicações minimamente racionais. Como dizia o outro: boa sorte para isso.See omnystudio.com/listener for privacy information.

Stormy Weather...with tracks by....  The Frankenstone, Zengineers, Entertainment For The Braindead, Nick Pandolfi, Bagas Degol, VYTIS, Belkastrelka, Maxi Dread, Daizy, TerbujurKaku. You're Not A Baby Boy Anymore, by The Frankenstone. Yogyakarta, Indonesia. [YesNoWave] Clouds (Zengineers Remix), by Entertainment For The Braindead. Cologne/Berlin, Germany. [Id.EOLOGY] Great Storm Dubbin (feat. Brian), by Nick Pandolfi versus Bagas Degol [...] The post Rewind… PCP#424… Stormy Weather… appeared first on Pete Cogle's Podcast Factory.

Sousa Tavares faz a análise das legislativas sem esconder críticas a Pedro Nuno Santos. No futuro do PS veria, de preferência, um nome: Medina. José Luís Carneiro "seria o menos mal de todos os outros". Sobre o Chega, diz que continua a ser uma incógnita: "não tem ninguém. O que se destacou foi ter um deputado ladrão de malas". Já o PCP "faz lembrar a anedota de um condutor na autoestrada que ouve dizer que há um carro em contramão" See omnystudio.com/listener for privacy information.

A 19 de Maio de 1975, trabalhadores afetos ao PCP tomaram as instalações do jornal “República” e expulsaram a direção. O jornal que resistira a 40 anos de ditadura não resistiu a um ano de revoluçãoSee omnystudio.com/listener for privacy information.

Long Night in the Wild...with tracks by ...Kingdom of the Holy Sun, Lone Cosmonaut, Nest Egg, The Joke, Silence, Les Dead Boobs, Vivita and The Sufferings, Talking Dog, Lazy Legs, Mycatisgreen, Detaltactic, Tenth Cloud. Running Wild, by Kingdom of the Holy Sun. Seattle, Washington. [Dead Bees] Nacht, by Lone Cosmonaut. UK. [The Committee [...] The post Rewind… PCP#561… Long Night in the Wild…. appeared first on Pete Cogle's Podcast Factory.

(00:00-10:23) Greatest sitcom of all-time as voted on by InsideSTL. Panthers getting hot. Audio of Craig Berube after last night's debacle. Can we get a game 7 in Toronto? Stars can finish off the Jets tonight. Using burners to go after Min Woo Lee. Apologies to Chief.(10:31-22:06) Fun with audio. Starting with Joey Zanaboni's call from last night's match. What was the barking? So What'd Your Grandma Think? Connor McDavid wasn't happy. NBA vs. NHL playoffs. Luke Donald and Keegan Bradley. A late 9 with PCP.(22:16-33:31) The Jam Jams playlist. Lantern flies are taking over New York City. Audio of John Kruk not happy with Masyn Winn being happy about a walk. Pimping walks. More audio of Kruk unhappy with Ivan Herrera's framing. Stick it. Doug had the yips after a shot to the sack.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Antron Singleton, also known as Big Lurch, is a Dallas-born rapper and member of hip-hop group Cosmic Slop Shop. He is currently serving a life sentence for allegedly chomping a hoe back in ‘02 after/during an apparent PCP bender. I didn't know he liked to get wet. If you like Lil Stinkers and want to support us, you can do so by going to Patreon.com/lilstinkers. For either $4/month or $40/year, you get every episode early, ad-free episodes Patreon exclusive episodes, Mini Stinkers episodes, live AMAs, live episodes, road trip vlogs, live book club meetings and all the other weirdo nonsense that we engage in. If you'd like a Kustom Kumquat Hour, treat yourself and get one for yourself or the psychopath you love at OnPercs.com/store. We'll be happy to record an episode just for you. We're happy to discuss anything and everything you'd like for your own personal Trash Night. Also, once we hit 3500 Patrons, we're having a picnic at Spahn Ranch, the former home of the Manson Family. Follow us on Twitter and Instagram: Jon Delcollo: @jonnydelco Jake Mattera: @jakemattera Mike Rainey: @mikerainey82  

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Psychedelics are being studied for their therapeutic effects in mental illnesses, including major depressive disorder, post-traumatic stress disorder, anxiety, and many others Classic psychedelics include compounds like psilocybin, LSD, and ayahuasca MDMA and ketamine are often included in psychedelic research, but have a different mechanism of action than the others Their mechanism of action involves agonism of the 5HT2A receptor, among others Given their resurgence, there is an increase in recreational use of these substances A recent study assessed the risks of recreational users developing subsequent psychotic disorders Individuals who visited the ED for hallucinogen use had a greater risk of being diagnosed with a schizophrenia spectrum disorder in the following 3 years Hazard ratio (HR) of 21.32 After adjustment for comorbid substance use and other mental illness, the hazard ratio was 3.53 - still a significant increase compared with the general population They also found an elevated risk for psychedelics when compared to alcohol (HR 4.66) and cannabis (HR 1.47) The study did not assess whether patients received antipsychotics or other treatments in the ED References Lieberman JA. Back to the Future - The Therapeutic Potential of Psychedelic Drugs. N Engl J Med. 2021;384(15):1460-1461. doi:10.1056/NEJMe2102835 Livne O, Shmulewitz D, Walsh C, Hasin DS. Adolescent and adult time trends in US hallucinogen use, 2002-19: any use, and use of ecstasy, LSD and PCP. Addiction. 2022;117(12):3099-3109. doi:10.1111/add.15987 Myran DT, Pugliese M, Xiao J, et al. Emergency Department Visits Involving Hallucinogen Use and Risk of Schizophrenia Spectrum Disorder. JAMA Psychiatry. 2025;82(2):142-150. doi:10.1001/jamapsychiatry.2024.3532 Summarized & Edited by Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/  

Join us for part 2 of our informative discussion with Dr. David Vitale, a pediatric pancreatologist at Cincinnati Children's Hospital. In this episode, we dive deep into acute recurrent and chronic pancreatitis, distinguishing the two, and exploring the causes, genetic predispositions, and available treatments. Whether you're a budding pancreatologist or a PCP, this episode offers valuable insights into managing and treating this challenging condition.

Welcome Ginny Noce, the Women's Health RN with a masters in nutrition science & functional medicine, to The Hormone Genius Podcast. In Ginny's own words from a blog she wrote below, here is why Ginny became passionate about helping women balance their hormones! If her story speaks to you then you will NOT want to miss this episode. Ginny is a genius, really. She has an incredible amount of practical wisdom to share and free information that you can start implementing in your health journey today. It all started with a desire to: – Lose a little weight – Clear up my skin – Have regular bowel movements Back in high school, I was breaking out regularly, trying to lose ten pounds, and relying on laxatives just to go to the bathroom. That's what led me down the rabbit hole of conventional medicine, where I experienced things like: -Appointments with a gastroenterologist who told me to eat more Cheerios and take Miralax daily – Being prescribed birth control by my PCP for acne – Eating 1,200 calories a day and running 1–2 miles daily to drop weight And honestly, those things kind of worked. Yes, I lost weight—but my digestive issues got worse. My skin was only clear as long as I stayed on the pill. And overall, I just felt awful. So I stopped birth control cold turkey. That's when everything fell apart. My face broke out into full-blown, inflamed cystic acne. My cycles never regulated themselves. And I was still dependent on Miralax just to go to the bathroom. After two more years of struggling, I was finally diagnosed with PCOS (polycystic ovarian syndrome) and given three options: – Go back on birth control – Start spironolactone – Try a keto diet I was overwhelmed and frustrated. I didn't want to go back on medication, and I certainly didn't want to keep treating symptoms without getting to the root. I thought to myself, There has to be a better way. And it turns out—there was. That's when I discovered food as medicine. I won't get into every diet or supplement I experimented with, but from the start, I focused on real, whole foods. Slowly but surely, my symptoms began to improve. That progress ignited my deep, burning passion for nutrition and women's health. Some major turning points from there: – Reading Dr. Jolene Brighten's Beyond the Pill Learning about cycle charting through FEMM—and eventually working for them as the lead nurse in their endocrinology and fertility telehealth clinic, where I also became a certified Fertility Awareness Instructor. Diving deeper into functional medicine and root cause approaches, which led me to earn my Master's Degree in Functional Medicine and Human Nutrition from the University of Western States After years of struggling and researching endlessly, I can now say: – My skin is 99% clear, with only the occasional breakout – My digestion is solid—I haven't dealt with constipation or bloating in over two years – My cycles are regulated, my PCOS is in remission, and I was able to conceive naturally—twice (I now have 2 girls ages 4 & 1.5) Link to where you can find guides & applications to work with my team. https://www.instagram.com/thewomenshealthrn/ Get a ton of Ginny's Freebie Hormonal Health Guides here! https://thewomenshealthrn.myflodesk.com/freebie ✨MASTERING YOUR HORMONAL HEALTH

As a teenager, Chris Cornell was traumatized by a bad PCP trip that turned him into a recluse for years. Music pulled him out of the darkness when he discovered his four-octave voice by accident – A voice he used to incredible effect as the frontman for both Soundgarden and Audioslave. But the darkness never really went away – it was there in his hometown of Seattle, where tragedies closed the chapter on grunge, and in his music, which was authentic to the very end. This episode contains themes that may be disturbing to some listeners, including suicide. If you're thinking about suicide, or are worried about a friend or loved one, call the Suicide Prevention Lifeline at 800-273-8255. This episode was originally published on May 22, 2024. To see the full list of contributors, see the show notes at www.disgracelandpod.com. To listen to Disgraceland ad free and get access to a monthly exclusive episode, weekly bonus content and more, become a Disgraceland All Access member at disgracelandpod.com/membership. Sign up for our newsletter and get the inside dirt on events, merch and other awesomeness - GET THE NEWSLETTER Follow Jake and DISGRACELAND: Instagram YouTube X (formerly Twitter) Facebook Fan Group TikTok To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track! Check out today's questions:      Melissa: I am 43, 160lbs 5ft. 6 good amount of muscle. I eat completely clean as in grassfed fed, organic turkey, organic chicken occasionally brocolli, cauliflower, carrots, asparagus and arugula, pickles, saurkraut and kimchi and I only drink water. I do eat a good amount of protein 140ish grams a day. I just got bloodworm and my A1C was 5.6. All other markers were great just that one was high for me not dr. ...why when I don't eat sugar of any sorts! Just recently as in last few weeks started introducing some fruit back in such as apples, blueberries and strawberries but still so confused can you explain?                                                                                                                                                                                               Kelly: Hi Dr. Cabral, I just completed a 7 day detox, love it. Today I started the Heavy Metal detox. Really excited about detoxing my body from toxic metals. I have high Aluminum and mercury and mineral ratios are off. Anyway, Thank you for your protocols. I'm in menopause and suffering from a couple of symptoms. No libido, no sleep, irritable, brain fog, dryness, I'm not the person i used to be in terms of happiness. I used to be happy for no reason, but since menopause I changed. I'm 51. Do you offer help for those symptoms? I want to be a lovely wife as i used to be. At this point I'm even considering taking Bio Identical hormones. Thank you in advance.                                                                                                    Drew: For almost 2 years I have had a pain behind my right eye. It started as a flare up after cutting grass one day. Most of the pain comes in the morning right before I get out of bed. It is a dull ache and sometimes leaves my eye crusty. I have seen two different eye doctors, my PCP, an ear nose and throat doctor, and a neuro ophthalmologist all of which can find nothing wrong. I have had a CT scan as well as an MRI which revealed nothing. Hoping you could shed some light on next steps that I need to take or where I need to look. Thank you so much for all that you do.     AA: Hi Dr. Cabral, I am hoping that you might have some insight. In Oct. I got extremely sick ( maybe covid) with horrible respiratory issues high fever etc. every month since my period has been 3 weeks late and as of one month I cannot eat without pain. The worst symptom is no sleep because of abdominal cramping and severe full body chills ( tingling) the tingling happens all day but is more apparent after ingesting food. I have taken stool tests/blood tests which seemed normal except for low b12 (300/ml) and went for a colonoscopy ( which resulted in the doc. saying I had some inflammation at the bottom end of my colon and it could be ulcerative colitis but didn't say with certainty. ) I am at a loss its been three weeks without caffeine, sugar, wheat, dairy and the symptoms persist.                                                                 Kay: Hello Dr. Cabral- I really appreciate your very informative podcasts! I am taking pregnenolone capsules at night recommended by my physician to help make some of the hormones that decline with age, and also to enhance cognitive function.. I have 2 questions: 1) Should I discontinue this prior to taking my at-home Equilife Stress, Mood and Metabolism test, and if so, by how many days? 2) Is taking this supplement going to make my body "lazy" and produce less of my natural pregnenolone? I've noticed that this helps me sleep better at night- I take this and a very low dose of naltrexone compounded by a compounding pharmacy. I am hoping that the SM&M test will give me clues to rebalancing my hormones naturally so I do not always need to rely on exogenous (and expensive) compounds. Thx!                                        Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!    - - - Show Notes and Resources: StephenCabral.com/3361 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track! Check out today's questions:      Anonymous: Hello Dr. Cabral, Thank you so much for the invaluable insights you provide — I truly appreciate it! I have two unrelated questions: 1. Do you have any thoughts or ideas on the potential causes of snoring? My husband isn't overweight, so I'm thinking it may be related to positional factors or anatomy. He doesn't experience apnea, but the snoring does disrupt his sleep. 2. I have a product from a functional medicine supplement company containing 350mg of linolenic acid and 1400mg of linoleic acid, both derived from high-quality, cold-pressed oils. If someone has an imbalanced omega-3:omega-6 ratio, with a higher omega-6 …it seems like this product would not help balance the ratio on its own and additional omega-3 supplementation be necessary, is that correct? Thanks again for your time                     Sharon: Hello. I have been listening to various topics on your podcasts. I was curious about the citricidal drops. You have mentioned you can use two drops with a neti pot and use that for a nasal rinse. How often is it ok to do this? I also see it used as a urinary tract protocol and as part of the CBO protocol. But then in one podcast, you said you shouldn't use the drops longer than 3 weeks. I'm not sure how long you use it for the urinary tract protocol (didn't see that on website), but can you use it for that and the CBO if you do those protocols back to back? How long should you wait between uses of the drops? Is urinary tract protocol only for a UTI or is it also a general urinary health protocol? Thank you. (I asked about neti pot on FB but seems like no one has used it for nasal rinsing.)                                                                                                Terri: I have read a couple of studies about Berberine being contraindicated for those with Hashimoto's/hypothyroidism because it can interfere with absorption of thyroid hormone. There seem to be so many other benefits that I thought I'd come to you, the expert, the king and master of all things health, to answer my question…would you discourage someone with subclinical hypothyroidism and not taking any thyroid hormone from taking Berberine? Thank you for taking my question and for being so willing to help out the community with your wealth of knowledge. You truly are a blessing to so many!                                                                                                                                                                                                 Brooke: I've been doing coffee enemas for 2+ years now, once as often as 2-3 times and week and now 1-2 times a month. I used to have a much easier time holding the coffee, easily holding 10-15 minutes. I usually do two back to back rounds 10-15 minutes each (1-2cups each time). Lately I can't hold more than a few minutes, especially the first round. Also, I find that the day after a coffee enema I struggle to have a natural bowel movement. I'd say about 50% of the time I dont have a bowel movement the next day, is that okay?                                                                                                                 Bryna: Hi Dr. Cabral. About a year ago I came close to scheduling an appointment with your office and hope to do so again. Lately, I've been binge listening to your podcast making a list of questions and decided to send a message. What do you consider to be the healthiest frozen “treat”? I have reflux & gut issues and am always looking for ways to cool things down. After comparing ice cream / sorbet / gelato I concluded frozen yogurt was prob. the healthiest. Do you agree? Do you think frozen yogurt is a healthy snack in GEN? Could not find this topic when I searched the archives. Could ask a dozen more Q's but just want to say I found your podcast back in ‘17 and have been listening off and on ever since. I value your opinion and insight more than my PCP and appreciate any insight.         Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!    - - - Show Notes and Resources: StephenCabral.com/3340 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!     - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!