Podcasts about Peep

No Jerruh this week, so we decide to take a look at all the crazy news going on in the video game world! Hosted by Perry Burkum (@PBurkum), Casey Gibson (@case_jets), Alex Culafi (@culafia) (0:00:10) Hello! (0:14:21) News Talk (1:03:45) Goodbye! Thank you for listening! We can tell that you are a good-looking person. Peep the discord: https://discord.gg/XPByvgvByQ Please write in to the show at TNPmailbag@gmail.com Tweet us @TalkNintendoPod and Instagram us at talknintendopodcast Please consider supporting us on Patreon! For just $1 you can get access to tons of exclusive content! Check us out at www.patreon.com/nwr

Cosmic Boogie and Mancuso Discotheque have done teamed up again for another Cosmic Discotheque at the mighty Deadwax Enmore. Translate speakers, Analogue mixer, Vinyl only affair. This 1.5 hour recording was lovingly mixed by @earnestj repping Mancuso. A gorgeous ride, seamlessly blending Funk, Disco, Soul, Rare Groove and Boogie. Smooth as Butter and twice as rich. It's fair to say Earnest J is well and truly a treasured local DJ and selector. Peep the recording and jump into the comments for ID's or just to say G'day. XOXO Cosmic Boogie

Ever feel like you're doing everything right with your diabetes - carb counting, pre-bolusing, measuring your food, working out, AND your blood sugars still won't cooperate?! It's one of the most frustrating parts of living with Type 1 diabetes. You're putting in the effort. You're checking all the boxes. And yet the numbers just aren't reflecting it. In this episode of the Your Diabetes Insider Podcast, I break down why your blood sugar control might feel stuck even when you're "doing everything right." I've lived with Type 1 diabetes for over 20 years, and I've seen this pattern over and over - both in my own life and with the people I work with. There are often hidden factors at play that you don't even realize are affecting your numbers. Most importantly, I share how to build in a little cushion with your A1C and time in range so when life gets chaotic (because it will), your numbers don't completely spiral. There's no prize for perfect blood sugars - you're managing diabetes alongside real life. The goal is sustainability, not perfection. Want the best blood sugars you've ever had while enjoying great food? Peep this: https://www.yourdiabetesinsider.com/coaching   RESOURCES: Download these FREE guides that will help you on your diabetes, nutrition, and exercise journey! https://www.yourdiabetesinsider.com/free-stuff LET'S TALK! Instagram: @yourdiabetesinsider Tiktok: @yourdiabetesinsider  

The whole crew's here to talk Diablo 2, Nioh 3 and Gimmick 2! Hosted by Perry Burkum (@PBurkum), Casey Gibson (@case_jets), Alex Culafi (@culafia) (0:00:10) Hello! (0:07:20) Diablo 2 DLC (0:26:50) Gimmick 2 (0:37:00) Nioh 3 (0:49:00) Good Bye! Thank you for listening! We can tell that you are a good-looking person. Peep the discord: https://discord.gg/XPByvgvByQ Please write in to the show at TNPmailbag@gmail.com Tweet us @TalkNintendoPod and Instagram us at talknintendopodcast Please consider supporting us on Patreon! For just $1 you can get access to tons of exclusive content! Check us out at www.patreon.com/nwr

A tribute Paranormal Peep Show . Marcus Allen, the UK publisher of the alternative ideas magazine Nexus, passed away in January 2026. Back in 2018, The Paranormal Peep Show  invited him to speak about his Apollo Moon hoax theories, covering the rocketry, the Van Allen radiation belts, the luna photography issues and much more. In tribute to Marcus, we repeat this episode here for all those that missed it and perhaps wanted to know a little more about the moon hoax ideas.This later led to a second episode of a debate with a NASA proponent, Peter Bassett and we then branched out and produced around 10 plus episodes of The Apollo Detectives where Marcus was joined with other invited guests to take part in hoax theories and problems that faced the NASA missions of the late 1960s, early 70s.  We send our condolences out to Marcus's family, friends and colleagues. He will be greatly missed by all, and perhaps now, he is able to soar to the moon and beyond and check out if Neil Armstrong actually did land on the moon or not. This episode first aired on our channel in August 2018.Our other episodes for your consideration, with Marcus and Peter Bassett https://www.youtube.com/watch?v=WbTAuYtspsI&t=7268sThe very first Apollo Detectives episode produced on this channel with Marcus and guests https://www.youtube.com/watch?v=blJ-mxE0FFo&t=9sMarcus presenting his talk, Apollo: Fact or Fiction at High Wycombe Paranormal Meet up group, which I started and ran for around 5 years https://www.youtube.com/watch?v=VE5-na1SvfA&t=245sNexus Magazine, of which Marcus was the UK publisher https://nexusmagazine.com/?v=79cba1185463Our friend and guest, Andy Thomas, wrote a wonderful tribute to Marcus on his own web site here https://truthagenda.org/2026/01/19/marcus-allen-1942-2026-a-personal-reflection/Become a supporter of this podcast: https://www.spreaker.com/podcast/paranormal-uk-radio-network--4541473/support.

In this episode of the Your Diabetes Insider Podcast, we're talking about something people think about… but don't always say out loud: care team horror stories. I'm not here to bash doctors. I'm not here to call anyone out. But if you've ever left an endocrinologist appointment feeling anxious, rushed, judged, or straight-up defeated… we need to talk. Because your diabetes care team is supposed to support you - not stress you out. We're officially in the thick of 2026. The New Year's motivation wave has worn off. This is the part of the year where real progress happens… or where people fall back into the same cycle. And if your care team isn't actually helping you move forward, that's a problem! Want the best blood sugars you've ever had while enjoying great food? Peep this: https://www.yourdiabetesinsider.com/coaching   RESOURCES: Download these FREE guides that will help you on your diabetes, nutrition, and exercise journey! https://www.yourdiabetesinsider.com/free-stuff LET'S TALK! Instagram: @yourdiabetesinsider Tiktok: @yourdiabetesinsider

In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Maureen Madden, DNP, RN, CPNP-AC, CCRN, FCCM, speaks with Javier Varela, MD, MSc, about his study, “Acute Bronchiolitis in Infants on Invasive Mechanical Ventilation: Physiology Study of Airway Closure,” published in the September 2025 issue of Pediatric Critical Care Medicine. The study revealed new insights into airway pathophysiology in infants with severe bronchiolitis who require mechanical ventilation, a population that comprises a substantial portion of winter pediatric intensive care unit (PICU) admissions worldwide. Dr. Varela is an intensivist in the PICU in the Department of Pediatrics at Clínica Alemana de Santiago, in Santiago, Chile. Differing ventilatory strategies and the heterogeneous phenotypes of bronchiolitis motivated Dr. Varela's team to investigate airway closure, which was detected in seven of the 12 patients included in the study. Airway opening pressure frequently exceeded the set positive end-expiratory pressure (PEEP) levels—highlighting a potential gap in traditional ventilator management. Dr. Varela explains that respiratory mechanics, particularly driving pressure and respiratory system compliance, can be misinterpreted when airway opening pressure is not considered. Study limitations included bacterial coinfection in nearly half the patients and the constraints of a single-center design, but Dr. Varela said that these factors did not appear to alter the physiologic observations. Although more research is needed before making clinical recommendations, the study established a foundational understanding of airway closure in patients with bronchiolitis and underscores the need for future work on personalized ventilation strategies, PEEP titration, and the potential heterogeneity of airway behavior in this population. Resources referenced in this episode: Acute Bronchiolitis in Infants on Invasive Mechanical Ventilation: Physiology Study of Airway Closure (Varela J, et al. Pediatr Crit Care Med. 2025;26:e1096-e1104) Airway Closure in Acute Respiratory Distress Syndrome: An Underestimated and Misinterpreted Phenomenon (Chen L, et al. Am J Respir Crit Care Med. 2018;197:132-136)

Perry played a Final Fantasy?! Bawahh!! That's not all, we got Bomberman Collection and Romeo Is A Dead Man impressions too! Hosted by Perry Burkum (@PBurkum), Casey Gibson (@case_jets), Alex Culafi (@culafia) (0:00:10) Hello! (0:11:00) VII RPGs (0:34:40) Bombman Collection (0:41:39) Romeo Is A Dead Man (0:57:38) Good Bye! Thank you for listening! We can tell that you are a good-looking person. Peep the discord: https://discord.gg/XPByvgvByQ Please write in to the show at TNPmailbag@gmail.com Tweet us @TalkNintendoPod and Instagram us at talknintendopodcast Please consider supporting us on Patreon! For just $1 you can get access to tons of exclusive content! Check us out at www.patreon.com/nwr

Ok ok! Next time we'll do more riddlesStarring:Adal RifaiJohn Patrick CoanErin KeifEditing by: Casey ToneyTheme by: Arne ParrottLogo by: Emily Kardamis & Emmaline MorrisWant more? Get Weekly Bonus Eps on Patreon!JPC's Guided Meditations Volume 1, available now at our Patreon digital store!Want merch? Visit our Dashery Store!Want to mail us something? Hey Riddle Riddle 6351 W Montrose Ave #267Chicago, IL, 60634Want to leave us a voicemail? Call (805) RIDDLE-1 or (805-743-3531)Want to advertise on the show? Check out Hey Riddle Riddle via Gumball.fmThis episode is brought to you by BetterHelp. Give online therapy a try at betterhelp.com/RIDDLE and get on your way to being your best self.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

This week’s Pulm PEEPs Pearls episode is all about spontaneous breathing trials (SBTs). SBTs are a standard part of the daily practice in the intensive care unit, but the exact methods vary across ICUs and institutions. Listen in to hear about the most common methods of SBTs, the physiology of each method, and what the evidence says. Contributors This episode was prepared with research by Pulm PEEPs Associate Editor George Doumat. Dustin Latimer, another Pulm PEEPs Associate Editor, assisted with audio and video editing. Key Learning Points What an SBT is really testing An SBT is a stress test for post-extubation work of breathing, not just a ventilator check. The goal is to balance sensitivity and specificity: Too hard → unnecessary failures and delayed extubation Too easy → false positives and higher risk of reintubation Common SBT modalities and how they compare T-piece No inspiratory support and no PEEP Highest work of breathing Most “physiologic” but often too strict Pressure support (PS) + PEEP (e.g., 5/5 or 8/5) Offsets ETT resistance and provides modest assistance Easier to pass than T-piece CPAP (0/5) No inspiratory help, but provides PEEP to counter ETT resistance Sits between PS and T-piece in difficulty Evidence favors pressure-supported SBTs for most patients Large meta-analysis (~6,000 patients, >40 RCTs): Pressure-supported SBTs increase successful extubation (~7% absolute benefit) No increase in reintubation rates Trials (e.g., FAST trial): Patients pass SBTs earlier Leads to earlier extubation and fewer ventilator-associated risks Bottom line: A 30-minute PS 5/5 SBT is evidence-based and appropriate for most stable ICU patients When a T-piece still makes sense T-piece SBTs are useful when: Cost of reintubation is high Difficult airway Prior failed extubation Pretest probability of success is low Prolonged or difficult weaning Tracheostomy vs extubation decisions Need to mimic physiology without positive pressure In LV dysfunction or pulmonary edema even small amounts PEEP may significantly improve physiology Some centers use a hybrid approach: PS SBT → short confirmatory T-piece before extubation CPAP as a middle ground Rationale: Allows full patient effort while compensating for ETT resistance Evidence: Fewer and smaller trials Possible modest improvement in extubation success No clear mortality or LOS benefit Reasonable option based on patient physiology, institutional protocols, and clinician comfort No single “perfect” SBT mode Across PS, T-piece, CPAP, and newer methods (e.g., high-flow via ETT) there are no consistent differences in mortality or length of stay What matters most: Daily protocolized screening Thoughtful bedside clinical judgment Matching SBT difficulty to patient-specific risk Institutional variation is normal—and acceptable Examples: PS 10/5 in postoperative surgical ICU patients PS 5/0 as an intermediate difficulty option Key question clinicians should ask: What does passing or failing this specific SBT tell me about this patient's likelihood of post-extubation success? Take-home pearls SBTs are stress tests of post-extubation physiology. PS 5/5 for 30 minutes is a strong default for most ICU patients. T-piece trials are valuable when false positives are costly or physiology demands it. CPAP is reasonable but supported by less robust data. Consistency, daily screening, and judgment matter more than the exact mode. References and Further Reading Burns KEA, Khan J, Phoophiboon V, Trivedi V, Gomez-Builes JC, Giammarioli B, Lewis K, Chaudhuri D, Desai K, Friedrich JO. Spontaneous Breathing Trial Techniques for Extubating Adults and Children Who Are Critically Ill: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2024 Feb 5;7(2):e2356794. doi: 10.1001/jamanetworkopen.2023.56794. PMID: 38393729; PMCID: PMC10891471. Burns KEA, Sadeghirad B, Ghadimi M, Khan J, Phoophiboon V, Trivedi V, Gomez Builes C, Giammarioli B, Lewis K, Chaudhuri D, Desai K, Friedrich JO. Comparative effectiveness of alternative spontaneous breathing trial techniques: a systematic review and network meta-analysis of randomized trials. Crit Care. 2024 Jun 8;28(1):194. doi: 10.1186/s13054-024-04958-4. PMID: 38849936; PMCID: PMC11162018. Subirà C, Hernández G, Vázquez A, Rodríguez-García R, González-Castro A, García C, Rubio O, Ventura L, López A, de la Torre MC, Keough E, Arauzo V, Hermosa C, Sánchez C, Tizón A, Tenza E, Laborda C, Cabañes S, Lacueva V, Del Mar Fernández M, Arnau A, Fernández R. Effect of Pressure Support vs T-Piece Ventilation Strategies During Spontaneous Breathing Trials on Successful Extubation Among Patients Receiving Mechanical Ventilation: A Randomized Clinical Trial. JAMA. 2019 Jun 11;321(22):2175-2182. doi: 10.1001/jama.2019.7234. Erratum in: JAMA. 2019 Aug 20;322(7):696. doi: 10.1001/jama.2019.11119. PMID: 31184740; PMCID: PMC6563557. Burns KEA, Wong J, Rizvi L, Lafreniere-Roula M, Thorpe K, Devlin JW, Cook DJ, Seely A, Dodek PM, Tanios M, Piraino T, Gouskos A, Kiedrowski KC, Kay P, Mitchell S, Merner GW, Mayette M, D’Aragon F, Lamontagne F, Rochwerg B, Turgeon A, Sia YT, Charbonney E, Aslanian P, Criner GJ, Hyzy RC, Beitler JR, Kassis EB, Kutsogiannis DJ, Meade MO, Liebler J, Iyer-Kumar S, Tsang J, Cirone R, Shanholtz C, Hill NS; Canadian Critical Care Trials Group. Frequency of Screening and Spontaneous Breathing Trial Techniques: A Randomized Clinical Trial. JAMA. 2024 Dec 3;332(21):1808-1821. doi: 10.1001/jama.2024.20631. PMID: 39382222; PMCID: PMC11581551. Mahul M, Jung B, Galia F, Molinari N, de Jong A, Coisel Y, Vaschetto R, Matecki S, Chanques G, Brochard L, Jaber S. Spontaneous breathing trial and post-extubation work of breathing in morbidly obese critically ill patients. Crit Care. 2016 Oct 27;20(1):346. doi: 10.1186/s13054-016-1457-4. PMID: 27784322; PMCID: PMC5081985. Yi LJ, Tian X, Chen M, Lei JM, Xiao N, Jiménez-Herrera MF. Comparative Efficacy and Safety of Four Different Spontaneous Breathing Trials for Weaning From Mechanical Ventilation: A Systematic Review and Network Meta-Analysis. Front Med (Lausanne). 2021 Nov 22;8:731196. doi: 10.3389/fmed.2021.731196. PMID: 34881255; PMCID: PMC8647911.​

If you're on an insulin pump and feel like your sites just randomly stop working, this episode is for you. We're talking about one of the most frustrating (and under-discussed) parts of diabetes: pump site issues, scar tissue, inflammation, and failed infusion sets - and why they seem to get worse the longer you've had diabetes! This isn't meant to scare you off pump therapy - it's meant to help you get better results from the technology you're already using. If you've ever changed a site, done everything "right," and still watched your blood sugar skyrocket… you're not alone. Got questions? DM us @yourdiabetesinsider on Instagram or TikTok. If the podcast helps you feel more confident managing diabetes, a 5-star review on Apple or Spotify would mean the world! Want the best blood sugars you've ever had while enjoying great food? Peep this: https://www.yourdiabetesinsider.com/coaching   RESOURCES: Download these FREE guides that will help you on your diabetes, nutrition, and exercise journey! https://www.yourdiabetesinsider.com/free-stuff LET'S TALK! Instagram: @yourdiabetesinsider Tiktok: @yourdiabetesinsider  

We're talking Final Fantasy VII Remake, Dragon Quest VII, DKC Returns and more! Hosted by Perry Burkum (@PBurkum), Casey Gibson (@case_jets), Alex Culafi (@culafia) (0:00:10) Hello! (0:02:17) Yappin/Final Fantasy VII Remake on Switch 2 (0:06:18) Dragon Quest VII Demo Chat (0:21:20) Donkey Kong Country Returns HD/Dixie Kong Update (0:32:11) Steel Century Groove (on PC) (0:42:47) More Yappin (0:58:34) Goodbye! Thank you for listening! We can tell that you are a good-looking person. Peep the discord: https://discord.gg/XPByvgvByQ Please write in to the show at TNPmailbag@gmail.com Tweet us @TalkNintendoPod and Instagram us at talknintendopodcast Please consider supporting us on Patreon! For just $1 you can get access to tons of exclusive content! Check us out at www.patreon.com/nwr

🧭 REBEL Rundown 📌 Key Points 💨 HFNC met criteria for non-inferiority to BPAP for preventing intubation or death within 7 days in four of the five ARF subgroups.🧪 Bayesian dynamic borrowing increased power across subgroups but created variable certainty, especially in smaller groups such as COPD.🫁 The immunocompromised hypoxemia subgroup did not meet non-inferiority, leading to early trial stopping for futility.️ Rescue BPAP use, subgroup-specific exclusion criteria, and non-standardized BPAP delivery are important contextual factors that influence how subgroup results should be interpreted. Click here for Direct Download of the Podcast. 📝 Introduction Bilevel Positive Airway Pressure (BPAP) has long been a foundational modality in the management of acute respiratory failure (ARF), particularly in COPD exacerbations and cardiogenic pulmonary edema, where it can rapidly reduce work of breathing and improve gas exchange. It remains a core tool in our respiratory support arsenal.High-flow nasal cannula (HFNC), however, has expanded what we can offer patients by delivering many of the same physiologic benefits through a far more comfortable interface. With high flows, modest PEEP, and effective dead-space washout, HFNC can improve oxygenation and decrease work of breathing while preserving the ability to talk, cough, eat, and interact with staff and family. This combination of physiologic support and tolerability makes HFNC especially attractive in patients where comfort, anxiety, or cardiovascular stability are key considerations, and in settings where prolonged noninvasive support may be needed. Rather than competing with BPAP, HFNC broadens our options in ARF and allows us to better match the modality to the patient and their underlying disease process.The RENOVATE trial set out to answer a high-impact question across five distinct etiologic groups: Is HFNC non-inferior to BPAP (NIV) for preventing intubation or death in acute respiratory failure? 🧾 Paper Azoulay É, et al. High-Flow Nasal Oxygen vs Noninvasive Ventilation in Patients With Acute Respiratory Failure: The RENOVATE Randomized Clinical Trial. JAMA. 2025 PMID: 39657981 🔙Previously Covered On REBEL: HFNC: Part 1 – How It WorksHFNC: Part 2 – Adult and Pediatric IndicationsFLORALI and AVOID TrialFLORALI-2: NIV vs HFNC as Pre-Oxygenation Prior to IntubationThe Pre-AeRATE Trial – HFNC vs NC for RSI ️ What They Did CLINICAL QUESTION Is HFNC non-inferior to BPAP for rate of endotracheal intubation or death at 7 days in patients with acute respiratory failure due to a variety of causes? STUDY DESIGN Multicenter, randomized non-inferiority trial33 Brazilian hospitalsNov 2019 – Nov 2023Adaptive Bayesian hierarchical modeling with dynamic borrowingOpen label, outcome adjudicators blindedPatients were classified into 5 subgroups SUBGROUPS 1. Non-immunocompromised hypoxemiaSpO₂ < 90% on room air orPaO₂ < 60 mm Hg on room air plusIncreased respiratory effort (accessory muscle use, paradoxical breathing, thoracoabdominal asynchrony) orRespiratory rate > 25 breaths/min2. Immunocompromised hypoxemiaDefined as:Use of immunosuppressive drugs for >3 monthsOR high-dose steroids >0.5 mg/kg/dayOR solid organ transplantOR solid tumors or hematologic malignancies (past 5 years)OR HIV with AIDS / primary immunodeficiency3. COPD exacerbation with acidosisHigh clinical suspicion of COPD as primary diagnosisRR >25 with accessory muscle use, paradoxical breathing, and/or thoracoabdominal asynchronyABG: pH 454. Acute cardiogenic pulmonary edema (ACPE)Sudden onset dyspnea and rales± S3 heart soundNo evidence of aspiration, infection, or pulmonary fibrosisCXR consistent with pulmonary edema5. Hypoxemic COVID-19 (added June 2023)Added due to deviations between expected and observed outcome proportionsAny patient across the other 4 groups with PCR-confirmed SARS-CoV-2 infection in any of the above groups POPULATION Inclusion Criteria:≥18 yrs with ARF* in one of 5 pre-defined subgroups excluding COPD was defined by the following:Hypoxemia with SpO₂

What's good, Pitmasters?! The Dynamic Duo wrap up the year of our lord 2025 the only way they can! They introduce a new segment in order to discuss the sudden love of Snoop Dogg by people who hated him a few years back, share a few clips that had them laughing in "What Did I Just Watch?", and end the night with the last entry in 2025's "Who's Manz Is This?!"Tap in with the homies, and Happy New Year!So Y'all Love Snoop Now, Huh? (08:06)What Did I Just Watch? (35:11)Who's Manz: Nicki Minaj (1:11:13)Peep the website: https://thedfpn.com/the-smokepit Wanna join in on the discussion? Join our Facebook Group: https://www.facebook.com/groups/thesmokepitpodcastfangroup/ Catch everything the DFPN has to offer over on their Facebook Page: https://www.facebook.com/datfeelinpodcast Thanks to our sponsor, Con's Custom Creations: https://www.facebook.com/profile.php?id=100093656943078 Support the Brand:Patreon: patreon.com/datfeelinpodcast Bandcamp: datfeelin.bandcamp.com

🧭 REBEL Rundown 🗝️ Key Points 💉 Hydrocortisone Saves Lives:The 2023 Cape Cod Trial (NEJM) showed a clear mortality benefit and reduced need for intubation in severe CAP patients treated with hydrocortisone.📊 Guidelines Are Catching Up:The SCCM (2024) and ERS now recommend steroids for severe CAP, while ATS/IDSA updates are still pending.🔥 Redefining “Severe”:Patients requiring high FiO₂ (>50%), noninvasive or mechanical ventilation, or PSI >130 meet criteria for steroid therapy — even outside the ICU.🍬 Main Risk = Hyperglycemia:Elevated glucose was the most consistent adverse effect, but rates of GI bleed and secondary infection were not increased.🧭 Early, Targeted Use Matters:Start hydrocortisone within 24 hours of identifying severity — especially in patients with high CRP (>150) or strong inflammatory response. Click here for Direct Download of the Podcast. 📝 Introduction Corticosteroids have long sparked debate in the treatment of bacterial pneumonia — once viewed with skepticism, now increasingly supported by high-quality evidence. In this episode, Dr. Alex Chapa joins the REBEL Core Cast team to explore how the 2023 Cape Cod Trial (NEJM) reshaped practice and guideline recommendations for severe community-acquired pneumonia (CAP). 📖 Historical Context & Long-Standing Skepticism For decades, the use of steroids in pneumonia was controversial.Early Use: Steroids entered practice in the 1940s and 50s for autoimmune inflammation, but there was immediate hesitation regarding secondary superinfections.Mixed Data: From the 1980s to the 2000s, small studies emerged on severe pneumonia and ARDS, but the data was inconsistent. Different trials used varying definitions of “severe” pneumonia and different C-reactive protein (CRP) cutoffs, making the data “spread” and easy to “cherry pick” to support or deny a benefit.Past Guidelines: This uncertainty was reflected in official guidelines:2007 (ATS/IDSA): The American Thoracic Society and the Infectious Diseases Society of America did not address the topic due to insufficient data.2019 (ATS/IDSA): Pre-COVID, the guidelines recommended against using corticosteroids in severe CAP. They acknowledged no benefit for non-severe pneumonia, but the data for severe pneumonia was considered too weak to endorse.Pre-Trial Consensus: Prior to 2023, the consensus was to avoid steroids in non-severe pneumonia, while severe pneumonia remained a “gray area” with no treatment showing a clear mortality difference. 📜 The Landmark Cape Cod Trial (NEJM 2023) The Cape Cod trial, published in the New England Journal of Medicine in 2023, reignited the discussion by providing robust, positive data.Trial Design: Phase 3, multi-center, double-blind, randomized, controlled trial.Intervention: 800 patients randomized to two groups, Hydrocortisone as a continuous infusion (200mg/day) versus a placebo infusion.Taper: On day 4, clinicians would decide whether to continue the infusion or begin a taper based on clinical response.Population: Patients with severe CAP, defined by meeting at least one of the following criteria:Pneumonia Severity Index (PSI) > 130.O2 by FiO2 ratio < 300.Need for mechanical or non-invasive ventilation (with PEEP ≥ 5).Need for high FiO2 (>50%) via non-rebreather or heated high flow.Primary Outcomes: Death for any cause 6.2% (hydrocortisone) vs 11.9% (placebo)Secondary outcomes:Death from any cause at 90 days 9.3% (hydrocortisone) vs 14.7% (placebo)Endotracheal intubation 18% (hydrocortisone) vs 29% (placebo)Hospital-acquired infections 9.8% (hydrocortisone) vs 11.1% (placebo)Gastrointestinal bleeding 2.3% (hydrocortisone) vs 3.3% (placebo)Vasopressor initiation by day 28 15.3% (hydrocortisone) vs 25.0% (placebo)Key Findings: The trial demonstrated superiority for hydrocortisone 📋 Updated Guidelines & Current Practice The Cape Cod trial, along with subsequent meta-analyses, has begun to change official recommendations.Society of Critical Care Medicine (SCCM): In 2024, an SCCM expert panel, reviewing the Cape Cod trial and 18 others, strongly recommended corticosteroids for severe CAP. They concluded that steroids reduce mortality and the need for mechanical ventilation.Meta-Analysis (Smit et al.): A 2024 meta-analysis in Lancet Respiratory confirmed the 30-day mortality benefit.European Respiratory Society (ERS): The ERS has issued a recommendation to use steroids for severe pneumonia but still urges caution regarding side effects.ATS/IDSA: As of the podcast recording, the ATS/IDSA had not yet updated their 2019 guidelines. 🛠️ Practical Application for Clinicians Defining “Severe” CAP: The key is to identify patients who qualify as “severe”. This can be done using:Scoring Tools: The PSI is the best validated tool for mortality but is cumbersome. Simpler tools like CURB-65 or SMART-COP are practical and acceptable for defining severity. 2023 meta-analysis from by Zaki et al showed both work well, but CURB-65 has better mortality prediction early on.Cape Cod Criteria: Any patient meeting the trial’s inclusion criteria (e.g., high-flow O2, non-invasive ventilation) qualifies, regardless of location (ED, floor, or ICU).Biomarkers: While not required, a CRP level was used in many studies. A CRP > 150 (Cape Cod) or > 204 (Smit meta-analysis) strongly indicates severe inflammation that would benefit from steroids.Clinical Judgment: A patient who looks “sick,” has “soft” blood pressure, or has dense infiltrates and high oxygen needs (e.g., >50% FiO2 on high flow) is a candidate.Adverse Effects:Hyperglycemia: This was the most significant risk identified, with rates between 6-12%. This is a primary concern, especially in patient populations with high BMI.GI Bleed & Secondary Infection: Fears of these side effects, which contributed to historical skepticism, were not borne out in the Cape Cod trial. The data does not support being overly concerned.Other Side Effects: Mood changes, delirium, insomnia, and agitation in the elderly are known side effects of steroids that were not specifically addressed in the trial but remain clinical concerns. 🔄 Clinical Pathway for Steroids in Severe CAP Unanswered Questions & Future Research Possible remaining questions:Biomarkers: Can we find a more precise CRP level to distinguish moderate from severe disease? Could other markers like ferritin or IL-6 be used? Dosing & Tapering: How much immunomodulation is needed, and when is it truly safe to taper?Gender Differences: Early data suggests females may respond better to steroids and experience fewer side effects. The question of female patients with severe CAP require less corticosteroids needs further exploration. 👉 Clinical Bottom Line The current literature, spearheaded by the Cape Cod trial, now supports the use of corticosteroids in severe community-acquired pneumonia. The best evidence currently points to hydrocortisone, started early (within 24 hours) after severity is identified using a validated tool. While hyperglycemia is a risk, the previous fears of GI bleeding and secondary infections were not substantiated in recent, rigorous trials. 📚 References Chapa-Rodriguez A, Abou-Elmagd T, O’Rear C, Narechania S. Do patients with severe community-acquired bacterial pneumonia benefit from systemic corticosteroids?. Cleve Clin J Med. 2025;92(10):600-604. PMID: 41033846Dequin PF, Meziani F, Quenot JP, et al. Hydrocortisone in Severe Community-Acquired Pneumonia. N Engl J Med. 2023;388(21):1931-1941. PMID: 36942789Chaudhuri D, Nei AM, Rochwerg B, et al. 2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia. Crit Care Med. 2024;52(5):e219-e233. PMID: 38240492 Post Peer Reviewed By: Marco Propersi, DO (Twitter/X: @Marco_propersi), and Mark Ramzy, DO (X: @MRamzyDO) 👤 Show Notes Alex Chapa, MD PGY 5 Pulmonary Critical Care Fellow Cape Fear Valley Medical Center Fayetteville NC 🔎 Your Deep-Dive Starts Here REBEL Core Cast 149: Review of Corticosteroids in Community-Acquired Pneumonia Corticosteroids have long sparked debate in the treatment of bacterial ... Thoracic and Respiratory Read More The post REBEL Core Cast 149: Review of Corticosteroids in Community-Acquired Pneumonia appeared first on REBEL EM - Emergency Medicine Blog.

The Staying Relevant Productions family is officially expanding with the launch of the 'He Said She Said' podcast under the Staying Relevant umbrella - and that's not the only big announcement... BIG NEWS: the Staying Relevant newsletter is coming, and did Sam and Pete make it to this weeks Monday meeting?Pete is more relevant than ever after being impersonated by Chris Pratt (yes, really), while Sam's sister Louise admitted on her podcast that she fancies Pete

We're answering real diabetes questions straight from social media in this episode of the Your Diabetes Insider Podcast - and yeah… some of them are insightful, some are wildly confusing, and a few left me absolutely speechless! We're talking net carbs vs total carbs, whether caffeine actually spikes blood sugar, what happens if your phone controls your insulin pump (and you lose it

Jack and Annie get a special visit from someone very....special....'Peep!'. Now that Jack and Annie have finished helping Teddy and Kathleen save Penny, what will Merlin and Morgan have for them next?_______________________⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Subscribe to our Podcast!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠_______________________Thanks for being here! We're the Holtzem Family. We love our family, and we love Jesus. We're hoping to bring some of our personal favorite things as a family, and some of our humor to you in hopes that it makes you smile, and maybe gives you something you can connect with.⁠⁠⁠⁠⁠⁠⁠Find more Magic Tree House Books Here⁠⁠⁠⁠⁠⁠⁠Connect with us further at;⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠The Holtzem Family on YouTube⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Recipes and more about us online at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Our Wholesome House⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Beverly Holtzem Art on Etsy

We hope you enjoy RPGs because we got 'em by the spades. Balex has been busy with Inazuma Eleven: Victory Road while Carseat's been working through a pair of Final Fantasy games! Hosted by Perry Burkum (@PBurkum), Casey Gibson (@case_jets), Alex Culafi (@culafia) (0:00:10) Hello! (0:17:53) Inazuma Eleven: Victory Road (0:36:50) Final Fantasy 7 Remake (0:47:35) Dragon Quest 7 Demo (0:52:15) Final Fantasy Tactics (1:08:30) Outie Thank you for listening! We can tell that you are a good-looking person. Peep the discord: https://discord.gg/XPByvgvByQ Please write in to the show at TNPmailbag@gmail.com Tweet us @TalkNintendoPod and Instagram us at talknintendopodcast Please consider supporting us on Patreon! For just $1 you can get access to tons of exclusive content! Check us out at www.patreon.com/nwr

Carbs and diabetes.

We got some Mystery History fun this week! Hosted by Perry Burkum (@PBurkum), Casey Gibson (@case_jets), Alex Culafi (@culafia) (0:00:10) Hello! (0:06:45) Mystery History (0:06:56) Mystery History (0:49:20) Hyrule Warriors Age of Imprisonment (1:05:00) Thank You! Thank you for listening! We can tell that you are a good-looking person. Peep the discord: https://discord.gg/XPByvgvByQ Please write in to the show at TNPmailbag@gmail.com Tweet us @TalkNintendoPod and Instagram us at talknintendopodcast Please consider supporting us on Patreon! For just $1 you can get access to tons of exclusive content! Check us out at www.patreon.com/nwr

YERRRR!! We Got the homie Renzo finally pulling up to Push some Narratives! We start by breaking down the NBA all-star starters and predict who will be left out of the reserves (1:58) Next, we stay in the NBA realm and discuss everything going on with in the NBA Eastern Conference and if the Knicks or the Celtics can leapfrog the Pistons (25:33) Afterwards, we shift over to the NFL as we recap the games from Divisional Weekend (33:54) And then we predict who will come out victorious on Championship Sunday and play in Super Bowl 60 (1:00:42)FOLLOW THE BRAND!SUPPORT THE BRAND!Youtube: Pushing Narratives W/The Narrative GawdTiktok: Pushing NarrativesApple Podcasts/Spotify Podcasts: Get Ya Bars Off NetworkFollow Suplex Dinner Club:IG: @SuplexDinnerClubYoutube: Suplex Dinner Club

On today's 1.22.26 show we talked about some of the 49ers injury theories that are going around, Green bay has cancelled their Winterfest, new Peep flavors for Easter, Kim K may be a Swifty, multiple viruses are circulating the Bay Area, the appropriate age for kids to cuss, the 24 hr rule, more Taylor Swift and Blake Lively text messages revealed, public proposals and more!

Cheesus christ. DJs can be shady as hell. Peep show. See omnystudio.com/listener for privacy information.

If you've already blown your New Year's goals… good. This episode is for you. Everyone starts the year talking about weight loss, better blood sugars, keto, fasting, vegan, carnivore, and most of it lasts about five days. Instead of doing another "New Year, new me" reset, I decided to actually test something I've talked about for years but never committed to. I went gluten-free and dairy-free - not for weight loss, not because it's trendy, but to see what would actually happen to my blood sugars, insulin resistance, inflammation, and body as someone living with diabetes. This isn't diet culture. This isn't perfection. And I'm definitely not saying everyone with diabetes should quit gluten and dairy forever. This episode will give you a grounded, real-world way to think about it! Want the best blood sugars you've ever had while enjoying great food? Peep this: https://www.yourdiabetesinsider.com/coaching   RESOURCES: Download these FREE guides that will help you on your diabetes, nutrition, and exercise journey! https://www.yourdiabetesinsider.com/free-stuff   LET'S TALK! Instagram: @yourdiabetesinsider Tiktok: @yourdiabetesinsider  

We're fielding some Listener Mail and looking at the the forecast of releases coming in 2026! Hosted by Perry Burkum (@PBurkum), Casey Gibson (@case_jets), Alex Culafi (@culafia) (0:00:10) Hello! (0:14:28) Listener Mail (0:41:29) The Year Ahread in Games (1:19:38) Adios! Thank you for listening! We can tell that you are a good-looking person. Peep the discord: https://discord.gg/XPByvgvByQ Please write in to the show at TNPmailbag@gmail.com Tweet us @TalkNintendoPod and Instagram us at talknintendopodcast Please consider supporting us on Patreon! For just $1 you can get access to tons of exclusive content! Check us out at www.patreon.com/nwr

Have you ever wondered why kilns have peep holes? Today Matt, Rose, and Kathy debate the function and necessity of peep holes, while also tackling a question about glazing only the interior of a pot. They also start the episode talking about the research Kathy is doing at Harvard Ceramics into the historic use of graphite as a ceramic sealer. Do you have questions or need advice on glazes? Drop us a line at ForFluxSakePodcast@gmail.com and you could be featured on an upcoming show.   Have you checked out the new For Flux Sake Patreon? This is a great way to show your support and have access to discounted merch, live hangouts, and extra episodes. Head over to Patreon and sign up today.    Today's episode is brought to you by Monkey Stuff, The Rosenfield Collection, Cornell Studio Supply, and Ceramic Materials Workshop's Making Glaze Make Sense.   This week's episode features the following topics: Peep hole, kiln venting, glaze tension, glaze compression, dunting, vitrification  

The Paranormal Peep Show with Ben Emlyn-Jones Jan 2026.Is the strange comet passing through our Solar System just a comet or is it something more alien? Certainly it has many differences to other comets, but this one is not from our solar neck of the woods, but from deep in our own Milly Way galaxy. It has performed strange movements, given off strange gasses, has a tail in the opposite direction to what it should be, it arrived almost level on the plane of our own solar system planets. Could it be a craft? Is it some kind of remote probe about to drop off smaller craft or transmit signals to Earth?Regular host, Ben Emlyn-Jones, breaks down what we know so far about Comet 3i Atlas in this new year edition of The Paranormal Peep Show, with your hosts, Neil Ward, Andy Chaplin and his cat!The Paranormal Peep Show is a regular monthly podcast that goes out on the Paranormal UK Radio Network www.paukradio.com, Spreaker and other audio platforms.Ben Emlyn-Jones is available via his web site at https://hpanwo.blogspot.com/ and you can keep up with his adventures at conferences, live streams, and tours at his Youtube Channel at    / @benthejrporter  Andy Chaplin is a medium and helps run Tuned In Events, for psychic and medium events around North London area, follow him on Facebook for tunedinevents.com.Neil Ward is an artist and author, recent publications available on Amazon include True Tales of the Paranormal and Modern Unsolved Mysteries www.neilwardart.co.uk     Ben refers to scientist Avi Loeb who's work on 3i Atlas can be viewed at / avi-loeb Also mentioned is Youtuber The Angry Astronaut who can be viewed at    / @theangryastronaut  Subscribe and like for more of the Paranormal Peep Show and thanks for watchingBecome a supporter of this podcast: https://www.spreaker.com/podcast/paranormal-uk-radio-network--4541473/support.

This week the gang gets into some gourmet marshmallows and  rings in the New Year with Peeps in the snews! Support this podcast at https://www.patreon.com/LetsTalkAboutSnacks     -- Snack News: Pepperidge Farm Fans Have 'High Hopes' for New Milano Flavor: 'You Have My Attention': https://parade.com/food/pepperidge-farm-milano-new-white-chocolate-mango-flavor  New Lindor Truffle Valentine's Day Flavor Just Revealed!: https://sporked.com/article/new-lindor-truffle-valentines-day-flavor-2025-news/  World's First Monopoly Steakhouse Set to Open in 2026: https://parade.com/news/worlds-first-monopoly-steakhouse-set-to-open-in-2026 Peeps Releases Nostalgic Flavor & '90s Kids Say It's a 'Must Try': https://www.remindmagazine.com/article/38669/peeps-sunnyd-nostalgic-flavor-90s-kids-so-excited/ Locate Lauren on Twitter (@rawrglicious) and Bluesky(@rawrglicious.bsky.social‬)! Find Conrad on Twitter (@ConradZimmerman) and peruse his other projects on this Linktree thing. Linda can be located on Instagram (@shoresofpluto)! Logo by Cosmignon! See more of her cool art at https://www.cosmignon.info/  Music by Michael "Skitch" Schiciano. Hear more of his work at https://skitch.bandcamp.com/ 

🧭 REBEL Rundown 🗝️ Key Points 💨 NIV = Support without a tube: CPAP, BiPAP, and HFNC improve oxygenation and reduce the work of breathing.🫁 CPAP = Continuous pressure: Best for hypoxemic patients (e.g., pulmonary edema, OSA).️ BiPAP = Two pressures (IPAP/EPAP): Great for hypercapnic failure (e.g., COPD, obesity hypoventilation).🌬️ HFNC = Heated, humidified high flow: Reduces effort, improves comfort, and enhances oxygen delivery.🩺 Supportive, not definitive: NIV stabilizes patients while the underlying cause is treated. Click here for Direct Download of the Podcast. 📝 Introduction Non-invasive ventilation (NIV) refers to respiratory support provided without endotracheal intubation. The most common modalities include continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP), and high-flow nasal cannula (HFNC). These therapies aim to improve oxygenation, reduce the work of breathing, and potentially prevent invasive mechanical ventilation. 💨 CPAP and BiPAP CPAP delivers a single, continuous pressure during inspiration and expiration. This pressure (commonly 5–10 cm H₂O) helps recruit atelectatic alveoli, reduce shunt, and improve oxygenation. It is commonly used for conditions like pulmonary edema, obstructive sleep apnea, or mild hypoxemia without significant ventilatory failure.BiPAP alternates between two pressures:Inspiratory positive airway pressure (IPAP), augments tidal volume and unloads inspiratory muscles.Expiratory positive airway pressure (EPAP), maintains alveolar recruitment and improves oxygenation.The differential between IPAP and EPAP is critical for reducing hypercapnia in patients with COPD exacerbations or acute hypercapnic respiratory failure.IndicationsCPAP: hypoxemia without major ventilatory failure (e.g., cardiogenic pulmonary edema, atelectasis, OSA).BiPAP: hypercapnia with increased work of breathing (e.g., COPD exacerbation, neuromuscular weakness, obesity hypoventilation).A helpful way to conceptualize CPAP and BiPAP is through the hairdryer analogy. Imagine placing a hairdryer in your mouth: 🩺 Clinical Considerations Masks can be uncomfortable, impair secretion clearance, and limit oral intake.Some patients require sedation to tolerate NIV, but this carries risks in patients with unprotected airways.NIV is thus a high-stakes intervention requiring close monitoring.Common starting dose to understand titration, but start at the level appropriate for your patient:  IPAP 10 cm H₂O / EPAP 5 cm H₂O (“10/5”) and are titrated:Increase IPAP to improve tidal volume and CO₂ clearance.Increase EPAP to recruit alveoli and improve oxygenation.Both may be raised simultaneously if the patient is both hypoxemic and hypercapnic. 🚀 High-Flow Nasal Cannula (HFNC) H: Heated & humidified – improves mucociliary clearance, prevents airway drying, and enhances tolerance. I: Inspiratory flow – high flow meets or exceeds patient demand, reducing respiratory rate and effort.F: Functional residual capacity – modest generation of positive end-expiratory pressure (PEEP), promoting alveolar recruitment.L: Lighter – generally more comfortable and less restrictive than mask-based NIV.O: Oxygen dilution – minimizes entrainment of room air, delivering higher and more predictable FiO₂.W: Washout – flushes anatomical dead space, reducing CO₂ rebreathing.HFNC delivers heated, humidified oxygen at high flow rates (30–60 L/min) through wide-bore nasal prongs. A mnemonic, H-I-F-L-O-W, helps summarize its mechanisms:Indications: Traditionally used for acute hypoxemic respiratory failure (e.g., pneumonia), HFNC is increasingly studied for hypercapnic failure as well, with trials suggesting non-inferiority to BiPAP in select populations. Post Peer Reviewed By: Marco Propersi, DO (Twitter/X: @Marco_propersi), and Mark Ramzy, DO (X: @MRamzyDO) 👤 Show Notes Syed Moosi Raza, MD PGY 3 Internal Medicine Resident Cape Fear Valley Internal Medicine Residency Program Fayetteville NC Aspiring Pulmonary Critical Care Fellow 🔎 Your Deep-Dive Starts Here REBEL Core Cast – Pediatric Respiratory Emergencies: Beyond Viral Season Welcome to the Rebel Core Content Blog, where we delve ... Pediatrics Read More REBEL Core Cast 143.0–Ventilators Part 3: Oxygenation & Ventilation — Mastering the Balance on the Ventilator When you take the airway, you take the wheel and ... Thoracic and Respiratory Read More REBEL Core Cast 142.0–Ventilators Part 2: Simplifying Mechanical Ventilation – Most Common Ventilator Modes Mechanical ventilation can feel overwhelming, especially when faced with a ... Thoracic and Respiratory Read More REBEL Core Cast 141.0–Ventilators Part 1: Simplifying Mechanical Ventilation — Types of Breathes For many medical residents, the ICU can feel like stepping ... Thoracic and Respiratory Read More REBEL Core Cast 140.0: The Power and Limitations of Intraosseous Lines in Emergency Medicine The sicker the patient, the more likely an IO line ... Procedures and Skills Read More REBEL Core Cast 139.0: Pneumothorax Decompression On this episode of the Rebel Core Cast, Swami takes ... Procedures and Skills Read More The post REBEL Core Cast 148.0–Demystifying Non-Invasive Ventilation & HiFlow appeared first on REBEL EM - Emergency Medicine Blog.

Diabetes doesn't care about your routine because honestly, there is no routine. In this episode of the Your Diabetes Insider Podcast, I break down exactly how I manage my blood sugars when life throws curveballs. I'm talking long days of competitive sports, messed-up eating schedules, adrenaline spikes, a jammed and bruised thumb, and even a surprise pump site failure… all in the same week! This isn't about being perfect - it's about adapting, using past data, and making intentional decisions so diabetes doesn't run the show. If you travel, play sports, work unpredictable hours, or feel like your "routine" constantly falls apart… this episode is for you. Want the best blood sugars you've ever had while enjoying great food? Peep this: https://www.yourdiabetesinsider.com/coaching   RESOURCES: Download these FREE guides that will help you on your diabetes, nutrition, and exercise journey! https://www.yourdiabetesinsider.com/free-stuff Watch my food breakdowns here → https://www.youtube.com/@yourdiabetesinsider   LET'S TALK! Instagram: @yourdiabetesinsider Tiktok: @yourdiabetesinsider  

It's that time of the year, the Annual Jimmy Awards! Once again we have the National Treasure joining us for a super fun episode talking about the best and worst of 2025! Hosted by Perry Burkum (@PBurkum), Casey Gibson (@case_jets), Alex Culafi (@culafia) (0:00:10) The Jimmies! Thank you for listening! We can tell that you are a good-looking person. Peep the discord: https://discord.gg/XPByvgvByQ Please write in to the show at TNPmailbag@gmail.com Tweet us @TalkNintendoPod and Instagram us at talknintendopodcast Please consider supporting us on Patreon! For just $1 you can get access to tons of exclusive content! Check us out at www.patreon.com/nwr

Captivating headlines from my time off including a terrific story about The Pope Peep…yes, the candy…..take a listen!

Trying to lose weight with diabetes in 2026 and hoping this is finally the year it works? You're not alone. Every January, weight loss goals come roaring back - new diets, gym memberships, fresh motivation and then… by mid-January, it all falls apart. If you're living with diabetes, it can feel even harder. In this episode of the Your Diabetes Insider Podcast, we talk honestly about why weight loss with diabetes keeps failing for so many people and what actually needs to change if you want real, sustainable results this year! This isn't about crash diets, extreme deficits, or white-knuckling your way through another failed January. It's about building a strategy that actually works for people living with diabetes WITHOUT burnout, shame, or giving up (again). If 2026 is the year you want to stop starting over and finally see progress, this episode is for you! Want the best blood sugars you've ever had while enjoying great food? Peep this: https://www.yourdiabetesinsider.com/coaching   RESOURCES: Download these FREE guides that will help you on your diabetes, nutrition, and exercise journey! https://www.yourdiabetesinsider.com/free-stuff Watch my food breakdowns here → https://www.youtube.com/@yourdiabetesinsider   LET'S TALK! Instagram: @yourdiabetesinsider Tiktok: @yourdiabetesinsider  

We got a special episode featuring Perruh and Danny "The Bivs" Bivens! Hosted by Perry Burkum (@PBurkum), Casey Gibson (@case_jets), Alex Culafi (@culafia) (0:00:10) Welcome (0:03:00) Final Fantasy Tactics, Football Games (0:46:29) Real of Fake (1:14:45) So Long Farewell Thank you for listening! We can tell that you are a good-looking person. Peep the discord: https://discord.gg/XPByvgvByQ Please write in to the show at TNPmailbag@gmail.com Tweet us @TalkNintendoPod and Instagram us at talknintendopodcast Please consider supporting us on Patreon! For just $1 you can get access to tons of exclusive content! Check us out at www.patreon.com/nwr

Wow, 2025 has felt like a decade, right? In this final episode of the year on Your Diabetes Insider Podcast, we're recapping all the highs, lows, and lessons from the past 12 months. I share my personal struggles with stress, sleep, and tech (Dexcom mishaps anyone?), and why self-care isn't just a buzzword - it's a blood sugar lifesaver! If this year tested you, you made it - and there's a lot to be grateful for. And don't worry, there's hope: new tech, studies, and breakthroughs in diabetes are coming in 2026 that you'll want to know about. Let's close out 2025 with reflection, gratitude, and a plan for a stronger, calmer, healthier year ahead! Want the best blood sugars you've ever had while enjoying great food? Peep this: https://www.yourdiabetesinsider.com/coaching   RESOURCES: Download these FREE guides that will help you on your diabetes, nutrition, and exercise journey! https://www.yourdiabetesinsider.com/free-stuff Watch my food breakdowns here → https://www.youtube.com/@yourdiabetesinsider   LET'S TALK! Instagram: @yourdiabetesinsider Tiktok: @manoftzeel

Jerruh Claus has bestowed upon us many packs for rippin! Plus a whole slew of gifts on our annual Christmas exchange! Hosted by Perry Burkum (@PBurkum), Casey Gibson (@case_jets), Alex Culafi (@culafia) (0:00:10) Gifts! Thank you for listening! We can tell that you are a good-looking person. Peep the discord: https://discord.gg/XPByvgvByQ Please write in to the show at TNPmailbag@gmail.com Tweet us @TalkNintendoPod and Instagram us at talknintendopodcast Please consider supporting us on Patreon! For just $1 you can get access to tons of exclusive content! Check us out at www.patreon.com/nwr

We linked up over the weekend to run that Monopoly game back. Originally recorded over the weekend, we had a lot of fun just playing the game. Whether you're chilling at home for the holidays or spending it with friends and family, we want you to know we appreciate you!!!  Happy Holidays from Three Angry Black People! Need more content? Peep our Patreon

🧭 REBEL Rundown 🗝️ Key Points 💨 Peak vs. Plateau Pressures: PIP reflects total airway resistance and compliance, while Pplat isolates alveolar compliance—elevations in both suggest decreased lung compliance (e.g., ARDS, pulmonary edema, pneumothorax).🧱 PEEP Protects Alveoli: Maintains alveolar recruitment and prevents collapse; typical range 5–8 cmH₂O, but higher levels may benefit moderate–severe ARDS.️ Driving Pressure (ΔP = Pplat − PEEP): Lower ΔP reduces atelectrauma and improves outcomes; optimize by adjusting PEEP thoughtfully.💥 Prevent VILI: Keep Pplat < 30 cmH₂O, use low tidal volumes (6 mL/kg IBW), and monitor for barotrauma, volutrauma, atelectrauma, and biotrauma.📚 Evidence-Based Practice: ARDSNet and subsequent trials confirm that lung-protective ventilation—low Vt, limited pressures, and individualized PEEP—improves survival in ARDS. Click here for Direct Download of the Podcast. 📝 Introduction This episode reviews essential ventilator pressures and how to interpret them during ICU rounds. 🚀 Under Pressure Peak Inspiratory Pressure (PIP)Definition: Total pressure required to deliver a breath.Reflects: Airway resistance + lung/chest wall compliance.Common Causes of ↑ PIP:Mucus pluggingBiting the endotracheal tubeKinked tubing or bronchospasmPlateau Pressure (Pplat)Definition: Alveolar pressure measured after an inspiratory hold.Reflects: Lung compliance (stiffness of lung tissue).When Both PIP & Pplat Are Elevated:→ Indicates poor compliance (e.g., ARDS, pulmonary edema, pneumothorax).Positive End-Expiratory Pressure (PEEP)Definition: Pressure remaining in airways at end-expiration to prevent alveolar collapse.Typical Range: 5–8 cmH₂O but needs to titrated to meet patient requirements Notes:Provides physiologic “glottic” PEEP in intubated patients.Using high PEEP strategy shows mortality benefit only in moderate–severe ARDS in meta-analysis.Driving Pressure (ΔP)Definition: ΔP = Pplat − PEEP.Reflects: Pressure needed to keep alveoli open during the respiratory cycle.Goal: Lower ΔP → less atelectrauma & improved outcomes.Optimize: Increase PEEP to reduce ΔP and alveolar cycling. 📖 Interpreting High PIP/High Pplat ↑ PIP & ↑ PplatInterpretation: ↓ ComplianceCommon Causes: ARDS, pulmonary edema, pleural effusion, pneumothorax↑ PIP & Normal/Low PplatInterpretation: ↑ Airway ResistanceCommon Causes: Mucus plug, bronchospasm, tube obstruction or biting 🤕 Ventilator-Associated Lung Injury (VILI) Barotrauma:Mechanism: Excessive airway pressure damages alveoli.Prevention: Keep Pplat < 30 cmH₂O.Volutrauma:Mechanism: Overdistension from excessive tidal volumes.Prevention: Use low tidal volume ventilation (6 mL/kg ideal body weight).ARDSNet trial: 6 mL/kg → lower mortality compared to 12 mL/kg.Ideal Body Weight: Based on height and sex, not actual weight.Typical patient: Tidal Volume: 6–8 mL/kg IBWARDS: Tidal Volume: 4–6 mL/kg IBWAtelectrauma:Mechanism: Repeated opening/collapse of unstable alveoli.Prevention: Optimize PEEP to keep alveoli open and reduce driving pressure.Biotrauma:Mechanism: Inflammatory cascade (↑ IL-6, TNF-α) from mechanical injury.Effect: Can trigger systemic inflammation & multiorgan dysfunction.Prevention: Minimize all other forms of VILI. Post Peer Reviewed By: Marco Propersi, DO (Twitter/X: @Marco_propersi), and Mark Ramzy, DO (X: @MRamzyDO) 👤 Show Notes Joel Rios Rodriguez, MD PGY 3 Internal Medicine Resident Cape Fear Valley Internal Medicine Residency Program Fayetteville NC Aspiring Pulmonary Critical Care Fellow 🔎 Your Deep-Dive Starts Here REBEL Core Cast – Pediatric Respiratory Emergencies: Beyond Viral Season Welcome to the Rebel Core Content Blog, where we delve ... Pediatrics Read More REBEL Core Cast 143.0–Ventilators Part 3: Oxygenation & Ventilation — Mastering the Balance on the Ventilator When you take the airway, you take the wheel and ... Thoracic and Respiratory Read More REBEL Core Cast 142.0–Ventilators Part 2: Simplifying Mechanical Ventilation – Most Common Ventilator Modes Mechanical ventilation can feel overwhelming, especially when faced with a ... Thoracic and Respiratory Read More REBEL Core Cast 141.0–Ventilators Part 1: Simplifying Mechanical Ventilation — Types of Breathes For many medical residents, the ICU can feel like stepping ... Thoracic and Respiratory Read More REBEL Core Cast 140.0: The Power and Limitations of Intraosseous Lines in Emergency Medicine The sicker the patient, the more likely an IO line ... Procedures and Skills Read More REBEL Core Cast 139.0: Pneumothorax Decompression On this episode of the Rebel Core Cast, Swami takes ... Procedures and Skills Read More The post REBEL Core Cast 147.0–Ventilators Part 5: Key Mechanical Ventilator Pressures & Definitions Made Simple appeared first on REBEL EM - Emergency Medicine Blog.

Christmas is right around the corner, and if you live with diabetes, this holiday comes with a few extra curveballs! Different foods, weird schedules, closed gyms, late nights, and a lot of temptation. In this episode, I walk you through how to actually prepare for Christmas Eve and Christmas Day without stressing or wrecking your blood sugars. We talk workouts when the gym is closed, why movement matters even more than Thanksgiving, how fat and protein sneak up hours later, medication timing, portion control, sleep, and how to enjoy the holiday without feeling out of control. This isn't about being perfect or skipping your favorite foods. It's about having a simple game plan so you can enjoy the holidays, stay mostly in range, and feel good doing it! Want the best blood sugars you've ever had while enjoying great food? Peep this: https://www.yourdiabetesinsider.com/coaching   RESOURCES: Download these FREE guides that will help you on your diabetes, nutrition, and exercise journey! https://www.yourdiabetesinsider.com/free-stuff Watch my food breakdowns here → https://www.youtube.com/@yourdiabetesinsider   LET'S TALK! Instagram: @yourdiabetesinsider Tiktok: @manoftzeel  

Down a man, but that won' stop us. We're talking Pokemon ZA DLC and some Skate Story! Hosted by Perry Burkum (@PBurkum), Casey Gibson (@case_jets), Alex Culafi (@culafia) (0:00:10) Welcome (0:07:29) We talk a lot of Mega Dimension DLC (0:22:30) Skate Story (0:33:50) So Long Farewell Thank you for listening! We can tell that you are a good-looking person. Peep the discord: https://discord.gg/XPByvgvByQ Please write in to the show at TNPmailbag@gmail.com Tweet us @TalkNintendoPod and Instagram us at talknintendopodcast Please consider supporting us on Patreon! For just $1 you can get access to tons of exclusive content! Check us out at www.patreon.com/nwr

Relationship Anarchy rejects rules and expectations in how we relate to each other. It's mentioned more and more in the media, but what is it exactly? In this lively conversation, therapist Nicole Thompson explains that while RA can turn our relationships on their heads, it can also bring freedom. Don't miss our next live show: Valentine's Kick-Off – Sunday, Feb. 8, 2026, 6-7:30pm at Lincoln Lodge ChicagoOur sexperts will chat about “Living Out Your Fantasies–solo or partnered.” Burlesque and more. Biggest polycule of the night gets a prize!Use Code: IRL3 for $3 off till Jan 10 GET TIXIn this episode:Therapist and podcaster Nicole Thompson Host, sex educator, and energy worker Karen Yates Relationship Anarchy ManifestoRelationship Smorgasbord Get Say It Better in Bed, Karen's free guide to upping your intimacy pleasure. Download here!Show your love for Wild & Sublime: Leave a tip!The Afterglow, our Patreon membership group, brings you regular bonus content, early alerts, and discounts to live shows! Be Wild & Sublime out in the world!  Check out our new tees and accessories for maximum visibility. Peep our Limited Collection and let your inner relationship anarchist run free… Prefer to read the convo? Full episode transcripts are available on our website.Support the showSupport the showFollow Wild & Sublime on Instagram and Facebook!

The Paranormal Peep Show, Christmas 2025. Returning guest, Philip Kinsella, medium and ufo researcher comes on the Paranormal Peep Show with his new co-author of their book The Eternal Avatar. Hosted by Neil Ward and Andy Chaplin. The new book asks who and what are we really beyond our biological construct? Is the universe, along with all creation merely the result of some cosmic fluke, and whereby science refutes any suggestion of ‘order,' and more in favour of the classic ‘chaos' theory? What is the bigger picture regarding the very nature of the human ‘self' which (and contrary to what science promotes as its official narrative) appears to transcend both space and time, inherent with what we consider as supernatural abilities which our system of governance has tried to suppress since ages past? Why has the powers-that-be taken such steps in misinforming the masses, even when subjects surrounding life after death, cryptids and UFOs are very much evident, but which themselves are at pains to deny? The authors consider there are connections to be made within these areas of contemplation, and which may well tell us more about ourselves as the evolving Avatar. In ‘The Eternal Avatar,' both Philip Kinsella and Chris John Mayes take a deeper look into the amazing individual you represent beyond your current material self, along with establishing those inherent powers which you harbour, and which the system sees as a threat in their overall mission to thwart the very nature of our eternal essence. They also make connections within varied areas of paranormal/UFO research which indicates that such alternate dimensions of reality are much closer to home than once thought! Hosted by Neil Ward and Andy Chaplin, Christmas edition Dec 2025Philip Kinsella is a widely acclaimed Clairvoyant Medium.  He won the British Mediumship Award in Portsmouth in 2008.  Apart from taking to platform work, he has also appeared on stage and is very much in demand for his Soul Survival Evidence. He is also the author of numerous books, some of which have been co-authored with his identical twin brother, Ronald, who is also an author and illustrator.  Apart from dozens of published articles on the Paranormal, Philip has also appeared on Channel 4, Central, Live TV and Digital, Anglia News, along with radio interviews.  He has also had books published on the UFO phenomena and researched the Rendlesham Forest Incident which occurred in Suffolk, England in 1980, along with the first investigator/author on the case, Brenda Butler. Philip was also credited in publishing an article concerning a revolutionary speculation with regards to the UFO problem. He is currently working on more books. www.philipkinsella.comChris Mayes - Since a young age I have discovered through many various spiritual experiences that we are much more than this physical body existing in this material world. We are all connected to a greater source of power and knowledge that is waiting for all of us to understand and live by.  It has grown to become a large part of my life and how I see the world, that makes it incredibly magical.  I am so grateful to be able to start writing about this subject and having the opportunity to express and continue to learn alongside everyone else as we try to understand more about the potentiality of our true selves and our innate abilities to be so much more powerful than we are led to believe. From living my childhood by a seaside town and moving to Hertfordshire and now London, I have been lucky to live by sea, countryside and now city. My career has spanned from manufacturing to a university simulation technician. My art has been one of my main passions since childhood and It has always seemed to integrate itself throughout my whole working life in many ways. Although I have only included just a few samples here,  I am dedicated to creating a broader portfolio to provide a better platform to showcase my work. I produce personal artwork as well as commissioned pieces. Being creative feels intrinsic to me and I like to apply it as much as I can in all areas of my life. From art, design, photography and writing - I believe we all have that unique creative quality within ourselves that should always be accessed and expressed in whatever capacity that suits the individual. https://www.chrismayes.uk/www.tunedinevents.co.uk ( Andy's web site for psychic suppers, mediumship and paranormal nights) www.neilwardart.co.uk Neil's web site featuring his artwork. Neil Ward is the author of True Tales of the Paranormal and Modern Mysteries of the UnexplainedBecome a supporter of this podcast: https://www.spreaker.com/podcast/paranormal-uk-radio-network--4541473/support.

In this episode of Your Diabetes Insider Podcast, we're diving into a super important question: Can you actually trust your CGM right now? With recent headlines about the Freestyle Libre 3 recall - including reports of inaccurate readings, injuries, and even deaths PLUS ongoing Dexcom G7 issues like failed alerts, sensor errors, and big accuracy swings, it's no wonder people with type 1 and type 2 diabetes are feeling unsure about their devices. I'm breaking down what's really going on with CGMs, why your readings might be 25–100 points off, how that impacts dosing decisions (especially with pumps and automated systems), and what you can do to protect yourself. From calibrating new sensors, to "soaking" them before activation, to keeping a backup meter (non-negotiable!), this episode gives you practical, real-life tips to stay safe and confident using your Dexcom, Libre, or any CGM. If you've ever looked at your number and thought, "There's no way that's right," this one's definitely for you! Want the best blood sugars you've ever had while enjoying great food? Peep this: https://www.yourdiabetesinsider.com/coaching   RESOURCES: Download these FREE guides that will help you on your diabetes, nutrition, and exercise journey! https://www.yourdiabetesinsider.com/free-stuff Watch my food breakdowns here → https://www.youtube.com/@yourdiabetesinsider   LET'S TALK! Instagram: @manoftzeel Tiktok: @manoftzeel  

It's finally happened, Metroid Prime 4 is upon us and we've been playing! Hosted by Perry Burkum (@PBurkum), Casey Gibson (@case_jets), Alex Culafi (@culafia) (0:00:10) Welcome (0:03:40) We talk a lot of Metroid Prime 4 (0:44:57) Dispatch (0:48:57) No Longer Welcome (jk) Thank you for listening! We can tell that you are a good-looking person. Peep the discord: https://discord.gg/XPByvgvByQ Please write in to the show at TNPmailbag@gmail.com Tweet us @TalkNintendoPod and Instagram us at talknintendopodcast Please consider supporting us on Patreon! For just $1 you can get access to tons of exclusive content! Check us out at www.patreon.com/nwr

🧭 REBEL Rundown 🗝️ Key Points ❌ Don’t chase perfect numbers: Adequate and safe is often better than “perfect but harmful.”💨 Oxygenation levers: Start with FiO₂ and PEEP, but remember MAP is the true driver.🫁 Ventilation levers: Adjust RR and TV, tailored to underlying physiology.🚫 Watch your obstructive patients: Sometimes less RR is more. Click here for Direct Download of the Podcast. 📝 Introduction Ventilator management can feel overwhelming—there are so many knobs to turn, numbers to watch, and changes to make. But before adjusting any settings, it’s crucial to understand why the patient is in distress in the first place, because the right strategy depends on the underlying cause. In this episode, we’ll walk through three different cases to see how the approach changes depending on the problem at hand. ️ The 4 Main Ventilator Settings Tidal Volume (Vt) 🌬️ Amount of air delivered with each breath Typically set based on ideal body weight (6–8 mL/kg for lung protection) Respiratory Rate (RR) ⏱️ Number of breaths delivered per minute Adjusted to control minute ventilation and manage CO₂ FiO₂ (Fraction of Inspired Oxygen) ⛽ Percentage of oxygen delivered Adjusted to maintain adequate oxygenation (goal SpO₂ 92–96%, PaO₂ 55–80 mmHg). PEEP (Positive End-Expiratory Pressure) 🎈 Pressure maintained in the lungs at the end of exhalation to prevent alveolar collapse and improve oxygenation 🧮 Modes of Ventilation AC/VC (Assist Control – Volume Control)How it Works: Delivers a set tidal volume with each breath (whether patient- or machine-triggered).When It’s Used / Pros: Most common initial mode; guarantees minute ventilation; good for patients with variable effort.Limitations / Cons: May cause patient–ventilator dyssynchrony if set volumes don’t match patient’s demand.AC/PC (Assist Control – Pressure Control)How it Works: Delivers a set inspiratory pressure for each breath; tidal volume varies depending on lung compliance/resistance.When It’s Used / Pros: Useful in ARDS (lung-protective strategy), limits peak airway pressures.Limitations / Cons: Tidal volume not guaranteed; must closely monitor volumes and minute ventilation.PRVC (Pressure-Regulated Volume Control)How it Works: Hybrid: set target tidal volume, ventilator adjusts inspiratory pressure breath-to-breath to achieve it (within limits).When It’s Used / Pros: Common default mode on newer vents; combines benefits of VC (guaranteed volume) + PC (pressure limitation).Limitations / Cons: Can increase pressures if compliance worsens.SIMV (Synchronized Intermittent Mandatory Ventilation)How it Works: Delivers set breaths, but allows spontaneous patient breaths in between (without guaranteed volume).When It’s Used / Pros: Used for weaning; allows patient effort.Limitations / Cons: Risk of increased work of breathing if spontaneous breaths are inadequate.PSV (Pressure Support Ventilation)How it Works: Every breath is patient-initiated; ventilator provides preset pressure support to overcome airway resistance.When It’s Used / Pros: Weaning trials; patients with intact drive who just need assistance.Limitations / Cons: Not a full-support mode; not for unstable patients without spontaneous drive. ♟️ Ventilation Strategies Airway ProtectionLow GCS, seizure, strokeLoss of gag/cough reflexHigh aspiration risk (vomiting, GI bleed, poor mental status)Hypoxemic Respiratory FailureSevere pneumoniaARDSPulmonary edemaInhalation injuryVentilatory (Hypercapnic) Failure / Increased Ventilation DemandSevere metabolic acidosis (DKA, sepsis, renal failure) → need high minute ventilationCOPD, asthma (if decompensating)Neuromuscular weakness (myasthenia, Guillain–Barré, spinal cord injury)Airway Obstruction / Anticipated Loss of AirwayTumor, anaphylaxis, angioedemaFacial or airway traumaPre-op / anticipated deterioration Post Peer Reviewed By: Marco Propersi, DO (Twitter/X: @Marco_propersi), and Mark Ramzy, DO (X: @MRamzyDO) 👤 Show Notes Priyanka Ramesh, MD PGY 1 Internal Medicine Resident Cape Fear Valley Internal Medicine Residency Program Fayetteville NC Aspiring Pulmonary Critical Care Fellow 🔎 Your Deep-Dive Starts Here REBEL Core Cast – Pediatric Respiratory Emergencies: Beyond Viral Season Welcome to the Rebel Core Content Blog, where we delve ... Pediatrics Read More REBEL Core Cast 143.0–Ventilators Part 3: Oxygenation & Ventilation — Mastering the Balance on the Ventilator When you take the airway, you take the wheel and ... Thoracic and Respiratory Read More REBEL Core Cast 142.0–Ventilators Part 2: Simplifying Mechanical Ventilation – Most Common Ventilator Modes Mechanical ventilation can feel overwhelming, especially when faced with a ... Thoracic and Respiratory Read More REBEL Core Cast 141.0–Ventilators Part 1: Simplifying Mechanical Ventilation — Types of Breathes For many medical residents, the ICU can feel like stepping ... Thoracic and Respiratory Read More REBEL Core Cast 140.0: The Power and Limitations of Intraosseous Lines in Emergency Medicine The sicker the patient, the more likely an IO line ... Procedures and Skills Read More REBEL Core Cast 139.0: Pneumothorax Decompression On this episode of the Rebel Core Cast, Swami takes ... Procedures and Skills Read More The post REBEL Core Cast 146.0–Ventilators Part 4: Setting up the Ventilator appeared first on REBEL EM - Emergency Medicine Blog.

Pre-Prime 4 but ready to "prime" up a new podcast for you, eh? Hosted by Perry Burkum (@PBurkum), Casey Gibson (@case_jets), Alex Culafi (@culafia) (0:00:10) Welcome (0:18:21) Pre-Prime 4 Yapping (0:24:31) Marvel Cosmic Invasion (0:48:57) Nintendo Switch Sports (0:59:29) Outro and Goodbyes Thank you for listening! We can tell that you are a good-looking person. Peep the discord: https://discord.gg/XPByvgvByQ Please write in to the show at TNPmailbag@gmail.com Tweet us @TalkNintendoPod and Instagram us at talknintendopodcast Please consider supporting us on Patreon! For just $1 you can get access to tons of exclusive content! Check us out at www.patreon.com/nwr

Hope everyone had an awesome Thanksgiving and are ready for some more PokeTalk! Hosted by Perry Burkum (@PBurkum), Casey Gibson (@case_jets), Alex Culafi (@culafia) (0:00:10) Welcome (0:02:00) PokeTalk ZA (0:38:20) ICQATIWBNRN (0:47:45) No Longer Welcome Thank you for listening! We can tell that you are a good-looking person. Peep the discord: https://discord.gg/XPByvgvByQ Please write in to the show at TNPmailbag@gmail.com Tweet us @TalkNintendoPod and Instagram us at talknintendopodcast Please consider supporting us on Patreon! For just $1 you can get access to tons of exclusive content! Check us out at www.patreon.com/nwr

In today's episode, Danielle tells some tales from the psych ward, while Zee (with help from listener Aricka!) covers the disappearance of 5 year old LeeAnna Warner. Stalk us here!Merch - ghosts-n-heauxsTwitter - ghostsnheauxsInstagram - ghosts_n_heauxsFacebook - GhostsnHeauxsPodcastAnd don't forget to send your stories to ghostsnheauxs@gmail.com

Insert those earbuds at your own peril, listener, for it's the spookiest one-shot of the year! The cast is here to make your spine tingle with tales of inscrutable costumes, ghoulish hangovers, and discontinued candy bar recipes! Peep the costume photos.  Lovingly researched and sound-described transcripts are embedded in every episode page on missiontozyxx.space!