Podcasts about pmid

Child immune system support isn't about stopping every cold — it's about knowing which ones are normal. Nurse Doza breaks down how a school-age immune system actually develops, what's worth a closer look, and five things you can do at home: sleep, food, the right supplements, movement, and nervous system care. Plus the one nutrient that keeps coming back low on lab work. Featured Product The D (4-Month Supply) — $75 Vitamin D receptors sit on immune cells throughout the body — in the gut, the sinuses, the lungs — and vitamin D is one of the most commonly low results on a standard lab panel. The D pairs vitamin D3 (cholecalciferol) with vitamin K2 as MK-7 in a single daily capsule, and one bottle runs four months. One habit, one bottle, the whole season covered.

Send us Fan MailThis week on The Incubator Podcast, Ben and Daphna dig into four studies reshaping bedside decisions. They open questioning whether routine DAT screening for ABO and RhD incompatibility still earns its place, finding transcutaneous bilirubin alone predicts phototherapy need just as well. Next, a Swedish national registry of over two million births links missed intramuscular vitamin K, and rising oral substitution, to a near-doubling of bleeding and intracranial hemorrhage risk. Ben then presents the PHILODENDRON pilot trial out of Milan, testing initial delivery-room CPAP of 5 versus 8 cmH2O in infants under 30 weeks, feasible and safe, but not yet enough to settle the physiology question. Daphna closes Journal Club with a SART-linked study tying IVF conception to significantly higher odds of VACTERL association. The week wraps with Ben and Eli on Neo News, unpacking a study showing birth certificates miss nearly 40% of true NICU admissions, with troubling racial disparities.----Utility of DAT in Low-Risk Neonates With ABO or RhD Incompatibility. Tsai TL, Ma T, Nester T.Pediatrics. 2026 Sep 1;158(3):e2026076989. doi: 10.1542/peds.2026-076989.PMID: 42642037Vitamin K Prophylaxis in Newborns and Bleeding in Infancy. Simatou E, Tsamantioti E, Hallström A, Stephansson O, Razaz N, Persson M, Bolk J.JAMA Pediatr. 2026 Sep 1;180(9):995-1004. doi: 10.1001/jamapediatrics.2026.2606.PMID: 42440325Initial CPAP of 5 versus 8 cmH2O during delivery room stabilisation of very preterm infants: the PHILODENDROOM pilot randomised trial. Cavigioli F, Bresesti I, Castoldi F, Gatto S, Lupo E, Rossi S, La Verde A, Bianchi S, Meneghin F, Viaroli F, Pivetti V, Manfredini V, Cannata G, Bastrenta P, Fontana P, Stucchi I, Daniele I, Chiera M, Lista G.Eur J Pediatr. 2026 Aug 17;185(9):673. doi: 10.1007/s00431-026-07322-6.PMID: 42608615 Free PMC article. Clinical Trial.In Vitro Fertilization and VACTERL Birth Defects. Tark JY, Richard MA, Schraw JM, Fisher SC, Betancourt D, Stone SL, Forestieri NE, Baker VL, Cameron K, Eisenberg ML, Belva F, Lu Y, Williams CL, Sutcliffe AG, Lupo PJ, Luke B.JAMA Netw Open. 2026 Aug 3;9(8):e2629355. doi: 10.1001/jamanetworkopen.2026.29355.PMID: 42616500 Free PMC article.Birth certificate data substantially misrepresent actual NICU admissions, including among most vulnerable. Hughes CS, Lorch SA, Schmitt S, Passarella M, Phibbs CS.J Perinatol. 2026 Jul;46(7):1307-1312. doi: 10.1038/s41372-026-02726-6. Epub 2026 May 27.PMID: 42204354Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Did you know there's a whole scientific field that just studies friction?? It's true! And we can apply a lot of those findings to help us stick better to the pole.In this episode we'll dig into why you might be too slippery or too sticky by focusing on friction and research from tribology (much of it drawn from prosthetics studies). We'll talk about how skin, fat and muscle all contribute to grip and how to navigate each. I also break down all the different types of grips and when/why you might want to use each one.Want to train with me? Check out the Science of Slink membership: https://scienceofslink.com/Citations: Gerhardt LC, Strässle V, Lenz A, Spencer ND, Derler S. Influence of epidermal hydration on the friction of human skin against textiles. J R Soc Interface. 2008 Nov 6;5(28):1317-28. doi: 10.1098/rsif.2008.0034. PMID: 18331977; PMCID: PMC2607440. Xu, Z., Sun, H., Tang, W., Fang, X., Kosimov, A. A., & Mamadamon, A. (2026). Influence of muscle fatigue on pain based on friction and brain activation. Tribology International, 112362. (I didn't talk about it, but this is a fun blog post about tribology: https://www.stle.org/files/TLTArchives/2024/12_December/Feature.aspx)Chapters:00:00 Sticky vs Slippery 00:38 Science of Slink Membership02:17 Friction and Tribology Basics03:34 Skin Layers and Hydration06:16 Body Fat and Surface Area10:10 Muscle Tension and Fatigue15:32 Grip Aids Explained20:25 Wrap Up

There are a number of ways you can "crack" a joint.  Some are relevant to urgent care, and some are just interesting.     Check out the paper mentioned Unger DL. Does knuckle cracking lead to arthritis of the fingers? Arthritis Rheum. 1998 May;41(5):949-50. doi: 10.1002/1529-0131(199805)41:53.0.CO;2-3. PMID: 9588755. https://pubmed.ncbi.nlm.nih.gov/9588755/ Rizvi A, Loukas M, Oskouian RJ, Tubbs RS. Let's get a hand on this: Review of the clinical anatomy of "knuckle cracking". Clin Anat. 2018 Sep;31(6):942-945. doi: 10.1002/ca.23243. Epub 2018 Oct 18. PMID: 30080300. https://pubmed.ncbi.nlm.nih.gov/30080300/  Deweber K, Olszewski M, Ortolano R. Knuckle cracking and hand osteoarthritis. J Am Board Fam Med. 2011 Mar-Apr;24(2):169-74. doi: 10.3122/jabfm.2011.02.100156. PMID: 21383216. https://pubmed.ncbi.nlm.nih.gov/21383216/        www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice, always consult your usual doctor

Send us Fan MailBen and Daphna  dig into a large, population-based study linking IVF conception to VACTERL association, a rare but serious pattern of congenital anomalies spanning the vertebral, anal, cardiac, tracheoesophageal, renal, and limb systems. Drawing on over 1.5 million births across four US states and linked SART registry data, the study finds IVF-conceived infants face significantly higher odds of VACTERL and related multiple anomaly syndromes compared to naturally conceived infants. Daphna and Ben unpack what this means for clinical suspicion at the bedside, why some VACTERL phenotypes may be easy to miss, and how better tracking of conception history through delivery could change how NICU teams approach anomaly workups in IVF-conceived infants.----In Vitro Fertilization and VACTERL Birth Defects. Tark JY, Richard MA, Schraw JM, Fisher SC, Betancourt D, Stone SL, Forestieri NE, Baker VL, Cameron K, Eisenberg ML, Belva F, Lu Y, Williams CL, Sutcliffe AG, Lupo PJ, Luke B.JAMA Netw Open. 2026 Aug 3;9(8):e2629355. doi: 10.1001/jamanetworkopen.2026.29355.PMID: 42616500 Free PMC article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Send us Fan MailBen and Daphna dig into a pilot RCT that asks a deceptively simple delivery-room question: should very preterm infants start on CPAP of 5 or CPAP of 8 cmH2O? The PHILODENDRON trial, out of Milan's Buzzi Children's Hospital, randomized 56 babies born between 26 and 29 weeks to find out — testing feasibility, safety, and early physiological adaptation before committing to a larger multicenter trial. No major safety signals emerged, but babies on lower CPAP reached surfactant thresholds faster, while higher CPAP trended toward fewer air leaks and shorter ventilation. Ben and Daphna weigh the physiology against the data, and ask whether trials like this even test the right question in the first place.----Initial CPAP of 5 versus 8 cmH2O during delivery room stabilisation of very preterm infants: the PHILODENDROOM pilot randomised trial. Cavigioli F, Bresesti I, Castoldi F, Gatto S, Lupo E, Rossi S, La Verde A, Bianchi S, Meneghin F, Viaroli F, Pivetti V, Manfredini V, Cannata G, Bastrenta P, Fontana P, Stucchi I, Daniele I, Chiera M, Lista G.Eur J Pediatr. 2026 Aug 17;185(9):673. doi: 10.1007/s00431-026-07322-6.PMID: 42608615 Free PMC article. Clinical Trial.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

If you've been following health and medical headlines over the past few weeks, you've likely seen a renewed and urgent conversation around postpartum depression—a condition that affects millions of new mothers worldwide, often with devastating consequences. While we've long understood that postpartum depression is deeply multifactorial—shaped by a complex web of hormonal shifts, psychological stressors, and socio-economic factors—a compelling wave of new data points to a key physical variable that might be playing a far bigger role than we previously realized: how we manage pain during cesarean deliveries. Specifically, emerging studies are highlighting a striking potential association between the use of general anesthesia during C-sections and a higher risk of subsequent postpartum depression compared to neuraxial options like epidurals or spinal blocks. Why would the choice of anesthetic in the operating room ripple into neurochemical changes weeks or months later? In today's episode, we're going to dive deep into this latest data. We'll break down what the numbers actually tell us, examine the clinical nuances, and explore the potential biological and neuroendocrine mechanisms of action—from acute inflammatory cascades to neurotransmitter disruption—that could explain this link.1. Oh TK, Song IA. Neuraxial versus General Anesthesia for Cesarean Delivery and the Risk of Postpartum Depression: A Nationwide Population-Based Study. Anaesth Crit Care Pain Med. 2026 Jun 3:101871. doi: 10.1016/j.accpm.2026.101871. Epub ahead of print. PMID: 42242358.2. Fagan JJ, Dufour SI, Duet SJ, Downs EM, Siddaiah H, Viswanath O, Shekoohi S, Kaye AD. Influence of Neuraxial Anesthesia Technique During Vaginal and Cesarean Delivery and Association with Postpartum Depression: A Narrative Review of Literature. Neuropsychiatr Dis Treat. 2026 Apr 14;22:579920.3. Guglielminotti J, Monk C, Russell MT, Li G. Association of General Anesthesia for Cesarean Delivery with Postpartum Depression and Suicidality. Anesth Analg. 2025 Sep 1;141(3):618-628. 4. Xie SC, Liu CH, Hung YT. Association between postpartum depression and anaesthesia methods in women undergoing caesarean section: A systematic review and meta-analysis. Eur J Anaesthesiol. 2026 Jan 1;43(1):66-73. doi: 10.1097/EJA.0000000000002252. Epub 2025 Aug 6. PMID: 40771157.

Chuck and Chris briefly review challenges with the US healthcare system but spend most of the episode discussing difficult hand fracture cases.Meyer ZI, Goldfarb CA, Calfee RP, Wall LB. The Central Slip Fracture: Results of Operative Treatment of Volar Fracture Subluxations/Dislocations of the Proximal Interphalangeal Joint. J Hand Surg Am. 2017 Jul;42(7):572.e1-572.e6. doi: 10.1016/j.jhsa.2017.03.030. Epub 2017 May 3. PMID: 28476538; PMCID: PMC5510930.See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities.The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/.As always, thanks to @iampetermartin for the amazing introduction and concluding music.For additional links, the catalog.  Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

In this first episode of Busting Myths with Laura and Dinesh, Dr Laura Hamill and Dr Dinesh Deonarain consider whether spider bites always require antibiotics and the evidence around the need to split plaster casts.   Check out the papers Laura and Dinesh recommend you read.   Isbister GK, Gray MR. White-tail spider bite: a prospective study of 130 definite bites by Lampona species. Med J Aust. 2003 Aug 18;179(4):199-202. doi: 10.5694/j.1326-5377.2003.tb05499.x. PMID: 12914510. Link to paper   Zaino CJ, Patel MR, Arief MS, Pivec R. The effectiveness of bivalving, cast spreading, and webril cutting to reduce cast pressure in a fiberglass short arm cast. J Bone Joint Surg Am. 2015 Mar 4;97(5):374-80. doi: 10.2106/JBJS.N.00579. PMID: 25740027. Abstract   Barvelink B, Reijman M, Smidt S, Miranda Afonso P, Verhaar JAN, Colaris JW; CAST study group; CAST study group; van Beek F, Bouwhuis MG, Bruijninckx MMM, Greeven APA, Gosens T, Kok MJ, Kokke MC, Kraan GA, van Lakwijk K, Leijnen M, van Loon M, van Rijssel DA, Schep NWL, Scholtens L, Wijffels MME, Slebioda N, van der Zwaal P, Zwets E. Redisplacement of reduced distal radius fractures in adults: does the type of casting play a role? The CAST study, a multicentre cluster randomized controlled trial. Bone Joint J. 2024 Jul 1;106-B(7):696-704. doi: 10.1302/0301-620X.106B7.BJJ-2024-0014.R1. Erratum in: Bone Joint J. 2024 Sep 1;106-B(9):1032. doi: 10.1302/0301-620X.106B9.BJJ-2024-00050. PMID: 38945541. Abstract   Wik TS, Aurstad AT, Finsen V. Colles' fracture: dorsal splint or complete cast during the first 10 days? Injury. 2009 Apr;40(4):400-4. doi: 10.1016/j.injury.2008.08.044. Epub 2009 Feb 4. PMID: 19195651. Abstract   Bullen M, Kinealy J, Blanchard R, Rodda C, Pivonka P. Comparison of the moulding ability of Plaster of Paris and polyester cast material in the healthy adult forearm. Injury. 2017 Nov;48(11):2586-2589. doi: 10.1016/j.injury.2017.08.010. Epub 2017 Aug 16. PMID: 28870625. Abstract   If you have any comments or suggestions of myths for their future consideration, email podcast@rnzcuc.org.nz Always follow your local guidelines and policies.  These discussions are designed to encourage you to engage with the literature.     www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music by Karl Casey @White Bat Audio. Second Life from the Album White Bat 48 - available at Bandcamp   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice, always consult your usual doctor

Ultrasound-guided nerve blocks are no longer just a niche skill for fellowship-trained ultrasound specialists—they are a core component of modern multimodal pain management in the ED. Endorsed by ACEP, nerve blocks can offer rapid, targeted pain relief without relying solely on systemic opioids, making everything from rest to imaging and procedural workups significantly more comfortable for patients. Today, Dr. Carlos Mikell, UC Davis Emergency Ultrasound Faculty and nerve block expert, joins us to share why every emergency physician should adopt nerve blocks as part of their practice. We'll break down the top ED blocks, explore innovative indications like genicular nerve blocks for knee pain, and discuss essential safety protocols and how to get started – or become more comfortable – with blocks in your ED. Why Nerve Blocks Belongs in the ED Targeted Relief: Delivers effective, localized pain management as part of a multi-modal pain control approach, sparing patients some of the systemic side effects of opioids. Facilitates ED Workup: Relieves movement-related pain, making imaging, patient transport, and local procedures far easier and more comfortable for the patient. ACEP Endorsement: ACEP's policy statement formalizes ultrasound-guided nerve blocks as an essential skill for all emergency physicians—not just ultrasound fellowship graduates. Analgesia, Not Complete Anesthesia: The goal in the ED is regional analgesia (taking pain down to a manageable, functional level safely) rather than dense, surgical anesthesia. The Most Common ED Nerve Blocks According to data from the National Ultrasound Guided Nerve Block Registry: Fascia Iliaca Plane / Femoral Nerve Block (~36%): Indications: Hip fractures, mid-shaft/distal femur fractures, hip dislocations, and severe thigh trauma. Safety Profile: Highly safe; target plane is centimeters away from the main neurovascular bundle in a easily compressible site. Erector Spinae Plane (ESP) Block: Indications: Back pain, renal colic, shingles, and rib fractures. Forearm Blocks (Median, Ulnar, Radial): Indications: Distal forearm fractures, complex lacerations, and hand procedures. Serratus Anterior Plane (SAP) Block (~7%): Indications: Rib fractures, pre/post-chest tube insertion pain, and chest wall abscesses. Tip: Hydro-dissect with normal saline first to identify the fascial plane before injecting local anesthetic, and consider adding dexamethasone to extend duration. Innovative Block Spotlight: Genicular Nerve Block Target: Three of the primary sensory branches of the sciatic/femoral nerves supplying the anterior knee. Indications: Acute knee trauma/fractures, acute-on-chronic knee pain, and severe osteoarthritic flare-ups. Safety & Execution: Low-volume block (~10 mL total). Pearl: Omit the inferior-lateral genicular injection to avoid unintentional peroneal nerve block and foot drop. Streamlining Nerve Blocks in Your Department To move nerve blocks from a rare procedure to a routine clinical tool: ED Infrastructure: Build standardized EMR order sets, procedure note templates, and dedicated nerve block supply carts/kits. Departmental Support: Designate a point person to coordinate credentialing, interdisciplinary pathways (e.g., trauma, orthopedics), and physician/nurse/tech education. Hands-on Training: Utilize cadaver labs, simulation, and scanning shifts to build faculty and resident confidence. Non-Negotiable Safety Guidelines & LAST Prevention Nerve blocks are generally low-risk, but vigilance is critical to avoid complications like Local Anesthetic Systemic Toxicity (LAST) or direct nerve injury: Patient Selection: Avoid in uncommunicative patients (who cannot report paresthesias or tinnitus), areas at high risk for compartment syndrome, or pre-existing severe nerve deficits. Monitoring: Keep patients on cardiac telemetry for 30–60 minutes post-block for central or high-volume blocks (>10 mL or above the elbow/knee). Dosing Buffer: Calculate maximum weight-based local anesthetic doses every time; stay within 60–70% of the maximum dose to maintain a safety buffer. Intralipid Availability: Ensure 20% Intralipid is immediately accessible in the ED pharmacy or brought directly to the bedside. Injection Technique: Never point the needle directly at a nerve. Inject into the fascial plane, stop immediately if you encounter resistance, and perform frequent aspirations every 3–5 mL. What is your favorite ultrasound-guided nerve block? What barriers do you encounter to doing blocks in the ED? We'd love to hear form you! Connect with us on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Carlos Mikell, Assistant Professor of Emergency Medicine and Ultrasound Faculty at UC Davis Resources: ACEP Policy Satement: Ultrasound Guidelines: Emergency, Point-of-care, and Clinical Ultrasound Guidelines in Medicine, June 2016 ACEP Now: How To Build an Ultrasound-Guided Nerve Block Program By Arun Nagdev, MD; Kaitlen Howell, MD; Akash Desai, MD; David Martin, MD; and Daniel Mantuani, MD, MPH | on January 6, 2023  ACEP Sonoguide: Nerve Blocks NURVE Block Registry Brown J, Milgrim F, Driver L, et al. Efficacy and Safety of Adjunct Medications in ED Ultrasound-Guided Nerve Blocks: A National Ultrasound-Guided NeRVE (NURVE) Block Registry Study. Acad Emerg Med. 2025 Dec;32(12):1299-1308. doi: 10.1111/acem.70128. Epub 2025 Aug 27. PMID: 40873157. Goldsmith A, Driver L, Duggan NM, et al. Complication Rates After Ultrasonography-Guided Nerve Blocks Performed in the Emergency Department. JAMA Netw Open. 2024 Nov 4;7(11):e2444742. doi: 10.1001/jamanetworkopen.2024.44742. Erratum in: JAMA Netw Open. 2024 Dec 2;7(12):e2455847. doi: 10.1001/jamanetworkopen.2024.55847. PMID: 39535792; PMCID: PMC11561692. *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services. Disclaimer: The opinions expressed on this podcast are those of the hosts or guests and do not necessarily reflect the views of UC Davis Department of Emergency Medicine, UC Davis Health, or their parent organizations.

Revisit a previous episode where hosts Tiffany Cruikshank and Katja Bartsch dive into a 2025 study analyzing more than 145,000 symptom logs from nearly 4,800 women pre- peri- and post-menopause. They discuss how symptoms can vary widely between individuals and across different stages of the transition, while also highlighting why emerging research should be interpreted with curiosity rather than certainty. "The research is really making an effort to understand how women experience their transition on a daily basis." — Katja Bartsch. What You'll Learn: The study: more than 145,000 symptom logs from almost 5,000 users [02:15] Symptoms differ between pre-menopause, perimenopause, and post-menopause [04:19] Top symptoms in each stage [06:53] Greater granularity is needed when studying individual symptoms [10:17] How research like this informs future studies [12:26] Links Mentioned: Watch this episode on YouTube Yoga Medicine Live Online Menopause Teacher Training Read the research here: Aras SG, Grant AD, Konhilas JP. Clustering of > 145,000 symptom logs reveals distinct pre, peri, and menopausal phenotypes. Sci Rep. 2025 Jan 3;15(1):640. doi: 10.1038/s41598-024-84208-3. PMID: 39753725; PMCID: PMC11699220. — Learn More: Find the full show notes at YogaMedicine.com/podcast-175. Learn more about insider tips, online classes or information on our teacher trainings at YogaMedicine.com. To support our work, please leave us a 5 star review with your feedback on iTunes/Apple Podcasts or wherever you listen to podcasts. 

In this Complex Care Journal Club podcast episode, Dr. Jason Zamkoff discusses a quality-improvement cohort study of a surgical hospitalist co-management program (Surgical Hospitalist Assisted Recovery/SHARe Team, or “Pink Team”) for children with medical complexity at Children's Hospital Colorado. They describe how patients are selected using an internal complexity score and the institutional trust-building needed to launch the program, resulting in fewer post-operative emergency transfers to intensive care. Next steps include developing an externally validated complexity scoring tool and extending hospitalist involvement into the pre-operative period.‌ SPEAKER Jason Zamkoff, MD Professor of Pediatrics University of Colorado School of Medicine Pediatric Hospitalist Children's Hospital Colorado HOST Kilby Mann, MD Associate Professor, Director of Pediatric Rehabilitation University of North Carolina School of Medicine DATE Initial publication date: September 8, 2026. JOURNAL CLUB ARTICLE Zamkoff J, Acker SN, Martin A, Anderson L, Bennett H, Thysens J, Thomas JJ, Conant M, Kurtz M, Gupta R, Scarberry J, Burke M, Koehler R, Rolison E, Whitney G, Ziniel SI, Carney KP, Wilcox D, Lockwood JM. Surgical Hospitalist Assisted REcovery (SHARe): Preventing Post-Operative Emergency Transfers. Hosp Pediatr. 2026 Jul 21:e2025008778. doi: 10.1542/hpeds.2025-008778. Epub ahead of print. PMID: 42476571. OTHER ARTICLES REFERENCED Martin A, Acker S, Hankinson TC, Zamkoff J. Perspectives on Interdisciplinary Perioperative Care for Children with Medical Complexity. Pediatr Clin North Am. 2026 Apr;73(2):513-524. doi: 10.1016/j.pcl.2025.12.003. Epub 2026 Feb 26. PMID: 42020046.‌ TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/9c5mmqqq86knpmsgss5xrm8/Zamkoff_transcript_9-1-26‌ Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6. Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Zamkoff J, Mann K. The Pink Team Effect: Reducing Postoperative Emergency Transfers in Complex Care. 08/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/the-pink-team-effect-reducing-postoperative-emergency-transfers-in-complex-care

MASH is often called a silent disease, but its impact can be significant. Join Dr. Gerry Clancy and University of Iowa liver specialists Dr. Marta Tejedor Bravo and Dr. Alan Gunderson as they explore risk factors, screening, disease progression, and emerging therapies that are reshaping care for patients with metabolic liver disease. Liver Wellness | The University of Iowa Iowa Liver Wellness Symposium: Cirrhosis Care in Motion 2026 5k Race - Run for Your Liver, Run for Your life (and last year's video Run for Your Liver, Run for Your Life) Episode Transcript CE Credit Available Host: Gerard Clancy, MD Senior Associate Dean for External Affairs Professor of Psychiatry and Emergency Medicine University of Iowa Carver College of Medicine Guests: Alan E. Gunderson, MD Clinical Associate Professor of Internal Medicine-Gastroenterology and Hepatology University of Iowa Carver College of Medicine Marta Tejedor Bravo, MD, MSc, PhD Clinical Associate Professor of Internal Medicine-Gastroenterology and Hepatology University of Iowa Carver College of Medicine Financial Disclosures:   Dr. Clancy, Dr. Tejedor Bravo, and the members of the Rounding@IOWA planning committee have disclosed no relevant financial relationships. Dr. Gunderson has disclosed the following relationships: CymaBay Therapeutics, Inc.; GigaGen, Inc.; LISCure Biosciences, Inc. - Sponsored Research Relevant financial relationships have been mitigated. Nurse: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this activity for a maximum of 1.00 ANCC contact hour. Pharmacist and Pharmacy Tech: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this knowledge-based activity for a maximum of 1.00 ACPE contact hours. Credit will be uploaded to the NABP CPE Monitor within 60 days after the activity completion. Pharmacists must provide their NABP ID and DOB (MMDD) to receive credit. JA0000310-0000-26-058-H01 Physician: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this enduring material for a maximum of 1.00 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other Health Care Providers: A certificate of completion will be available after successful completion of the course. (It is the responsibility of licensees to determine if this continuing education activity meets the requirements of their professional licensure board.) References:  Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, Abdelmalek MF, Caldwell S, Barb D, Kleiner DE, Loomba R. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023 May 1;77(5):1797-1835. doi: 10.1097/HEP.0000000000000323. Epub 2023 Mar 17. PMID: 36727674; PMCID: PMC10735173. European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol. 2024 Sep;81(3):492-542. doi: 10.1016/j.jhep.2024.04.031. Epub 2024 Jun 7. PMID: 38851997. Younossi ZM, Zelber-Sagi S, Lazarus JV, Wong VW, Yilmaz Y, Duseja A, Eguchi Y, Castera L, Pessoa MG, Oliveira CP, El-Kassas M, Tsochatzis E, Fan JG, Spearman CW, Tacke F, Castellanos Fernandez MI, Alkhouri N, Schattenberg JM, Romero-Gómez M, Noureddin M, Allen AM, Ong JP, Roberts SK, Shubrook JH, Burra P, Kohli R, Kautz A, Holleboom AG, Lam B, Isaacs S, Macedo P, Gastaldelli A, Henry L, Ivancovsky-Wajcman D, Nader F, de Avila L, Price JK, Mark HE, Villota-Rivas M, Barberá A, Kalligeros M, Gerber LH, Alqahtani SA. Global Consensus Recommendations for Metabolic Dysfunction-Associated Steatotic Liver Disease and Steatohepatitis. Gastroenterology. 2025 Oct;169(5):1017-1032.e2. doi: 10.1053/j.gastro.2025.02.044. Epub 2025 Apr 11. PMID: 40222485. Mladenić K, Lenartić M, Marinović S, Polić B, Wensveen FM. The "Domino effect" in MASLD: The inflammatory cascade of steatohepatitis. Eur J Immunol. 2024 Apr;54(4):e2149641. doi: 10.1002/eji.202149641. Epub 2024 Feb 5. PMID: 38314819. Harrison SA, Bedossa P, Guy CD, Schattenberg JM, Loomba R, Taub R, Labriola D, Moussa SE, Neff GW, Rinella ME, Anstee QM, Abdelmalek MF, Younossi Z, Baum SJ, Francque S, Charlton MR, Newsome PN, Lanthier N, Schiefke I, Mangia A, Pericàs JM, Patil R, Sanyal AJ, Noureddin M, Bansal MB, Alkhouri N, Castera L, Rudraraju M, Ratziu V; MAESTRO-NASH Investigators. A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis. N Engl J Med. 2024 Feb 8;390(6):497-509. doi: 10.1056/NEJMoa2309000. PMID: 38324483. Sanyal AJ, Newsome PN, Kliers I, Østergaard LH, Long MT, Kjær MS, Cali AMG, Bugianesi E, Rinella ME, Roden M, Ratziu V; ESSENCE Study Group. Phase 3 Trial of Semaglutide in Metabolic Dysfunction-Associated Steatohepatitis. N Engl J Med. 2025 Jun 5;392(21):2089-2099. doi: 10.1056/NEJMoa2413258. Epub 2025 Apr 30. PMID: 40305708.  

Cette semaine on décortique une étude un peu farfelue sur le lien entre la consommation de fruits et légumes et le teint de la peau. On vous explique ce que la science dit réellement sur cet effet et son lien avec l'attraction perçue, ce que ça vient jouer dans votre motivation à mieux manger, et pourquoi ce type de motivation ne suffit pas à lui seul pour tenir dans le temps.Référence :Cairns P, Ozakinci G, Perrett DI. Reactions to an Online Demonstration of the Effect of Increased Fruit and Vegetable Consumption on Appearance: Survey Study. J Med Internet Res. 2020 Jul 14;22(7):e15726. doi: 10.2196/15726. PMID: 32459626; PMCID: PMC7388035.

In this episode of *PICU Doc on Call*, Drs. Pradip Kamat and Rahul Damania dive into the topic of beta-blocker toxicity. They walk through a case of a 15-year-old who comes in with bradycardia, hypotension, hypoglycemia, and altered mental status after an intentional ingestion. Using a board-style question, they break down how to tell the difference between beta-blocker and calcium channel blocker poisoning and review key points about cardiac physiology and receptor signaling.Drs. Kamat and Damania discuss management strategies, including glucagon, high-dose insulin therapy, vasopressors, calcium, and ECMO as a last resort. They also spend some time focusing on specific agents like propranolol and sotalol, highlighting what makes their toxicologic profiles unique. This is a high-yield episode packed with pearls for pediatric intensivists!Show Highlights:Clinical case of a 15-year-old patient with bradycardia and hypotension due to intentional drug ingestionBeta-blocker toxicity and its clinical featuresDifferentiation between beta-blocker and calcium channel blocker toxicityKey physiological concepts related to cardiac action potentials and beta receptor functionClinical presentation and diagnostic workup for beta-blocker toxicityManagement strategies for beta blocker overdose, including airway control and fluid resuscitationSpecific toxicologic profiles of common beta-blockers (e.g., propranolol, sotalol, metoprolol)Importance of recognizing hypoglycemia and CNS effects in beta-blocker toxicitySummary of critical management steps and take-home points for pediatric intensivistsEncouragement for further learning and engagement on related topicsReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter 126. Toxidromes and their treatment. Joshi P. Pages 1504-1505Reference 1: Rogers textbook of Pediatric Intensive Care: Chapter 36: Poisoning. Nares M, Jeyapalan A, Weisman R: pages 525-543Reference 2: Lavonas EJ, Akpunonu PD, Arens AM, Babu KM, Cao D, Hoffman RS, Hoyte CO, Mazer-Amirshahi ME, Stolbach A, St-Onge M, Thompson TM, Wang GS, Hoover AV, Drennan IR; American Heart Association. 2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2023 Oct 17;148(16):e149-e184. doi: 10.1161/CIR.0000000000001161. Epub 2023 Sep 18. PMID: 37721023.Suarez F, Koyfman A, Long B. Pearls and Pitfalls for the Emergency Clinician: Beta Blocker and Calcium Channel Blocker Toxicity. J Emerg Med. 2026 May;84:1-11. doi: 10.1016/j.jemermed.2026.01.021. Epub 2026 Jan 27. PMID: 41833262.

"It is a community to be seen and to be heard." Military-connected children make up a community of friends, advocates, caregivers, and leaders, and today we sit down with Seylah Stephens to hear what that looks like in her own life. Her honest, encouraging words are a reminder that no one has to go it alone, and that being recognized as you are may be one of the greatest gifts there is. Seylah shares her story of finding her place, first within her family, and then alongside other young people who understood her experience, and how that sense of belonging became the foundation for her own leadership. SHOW NOTES   Biography for Seylah Stephens:  Seylah tells us: "I am currently studying clinical psychology at University of California, San Diego. In my free time, I really enjoy being out in nature and practicing self care! Connecting with others is a huge part of my life, and hanging with my loved ones such as my family and friends keeps me grounded and motivated."   Resources: Military Child Education Coalition Website   David Nguyễn, Mr. International Student Self-Efficacy of Leadership: A Within-Group Analysis. 2015. Dugan, J. P., Garland, J. L., Jacoby, B., & Gasiorski, A. (2008). Understanding Commuter Student Self-Efficacy for Leadership: A Within-Group Analysis. NASPA Journal, 45(2), 282–310. https://doi.org/10.2202/1949-6605.1951 Oberle E. Social-emotional competence and early adolescents' peer acceptance in school: Examining the role of afternoon cortisol. PLoS One. 2018 Feb 20;13(2):e0192639. doi: 10.1371/journal.pone.0192639. PMID: 29462163; PMCID: PMC5819800.  Parkhill, C.L. Deans, L.A. Chapin. Pre-leadership processes in leadership training for adolescents. Children and Youth Services Review, Volume 88, 2018, Pages 375-379. Shah EN, Szwedo DE and Allen JP (2024) Adolescent close friendships, self-perceived social acceptance, and peer-rated likeability as predictors of wellbeing in young adulthood. Front. Dev. Psychol. 2:1435727. doi: 10.3389/fdpys.2024.1435727     This episode is provided by generous funding from the USAA Foundation.   Mixed and mastered by Concentus, Media, Inc., Temple, Texas, USA.   Related MCEC Podcast Episodes: The Other Kind of Service - Caregiving Youth published 9.2.26 Military Kids as Caregivers published 4.29.25 S2S: Students Supporting Students published 5.25.25      

Before school. After school. In the middle of the night when something goes wrong. Liz, Kasen, and Audrey have all learned to carry weight most of their peers never have to think about. They show up and care for a family member who needs them, again and again, in ways that rarely get noticed and even more rarely get thanked. They're not alone: an estimated 3.4-5.4 million youth provide essential caregiving in the U.S., and yet there's no national system in place at schools, hospitals, or doctor's offices to even recognize a child as a caregiver. In this episode, these three incredible young people open up about what that invisible work actually looks like day to day: the responsibility that arrives too early, the exhaustion that goes unspoken, and just how rare it was to feel truly understood — until they found other kids living the same reality. They talk about what changed when they found each other at MCEC, and what it means to finally feel seen and heard by people who simply get it. Julie Coffey, who helps lead the Caregiving Youth Student Leadership Program, joins the conversation to share how the program gives these young caregivers something they didn't know they were missing — a peer community built around the kind of service no one sees, but everyone needs.   SHOW NOTES Guests:  Liz. Kasen. Audrey. Julie Coffey: our beloved Student Well-Being Manager at MCEC. Julie manages the Caregiving Youth Student Leadership Program, as well as many of our other student initiatives, like Student-2-Student (s2s) and the Frances Hesselbein Leadership Program. As a former educator, counselor, and a military-connected Caregiving Youth herself, Julie dedicates herself to helping military-connected students recognize their place of belonging in this world. Resources: https://militarychild.org   Information about the Caregiving Youth Student Leadership Program: https://militarychild.org/programs-and-initiatives/caregiving-youth-student-leadership-program/   Citations: Armstrong-Carter E, Siskowski C, Cornish NR, Olson E. Adolescents' caregiving for family: Associations with mental health and academic performance. J Res Adolesc. 2025 Sep;35(3):e70045. doi: 10.1111/jora.70045. PMID: 40586181; PMCID: PMC12221208.   Miller KEM, Hart JL, Useche Rosania M, Coe NB. Youth Caregivers of Adults in the United States: Prevalence and the Association Between Caregiving and Education. Demography. 2024 Jun 1;61(3):829-847. doi: 10.1215/00703370-11383976. PMID: 38785364; PMCID: PMC11539003.   Mixed and mastered by Concentus Media, Inc., Temple, Texas, USA.   This episode is made possible by generous funding from the USAA Foundation.   Related MCEC Podcast Episodes: Military Kids as Caregivers published 4.29.25 S2S: Students Supporting Students published 5.25.25 S2S: Helping Students Succeed published 8.20.24  

What happens when the stress of being a first responder doesn't just stay in your head but starts showing up in your gut?Today, we're joined by Police Chief Michael Assad Jr. of the Rochester, Massachusetts Police Department for an honest conversation about the often-overlooked connection between first responder stress, gut health, IBS, and nutrition.From high-pressure calls and long shifts to those unexpected “code brown” moments, chronic stress can take a serious toll on the digestive system. We'll talk about recognizing those warning signs, why gut health deserves more attention in the first responder community, and how nutrition, stress management and everyday habits can play a role in feeling better and performing at your best.This is a conversation about stress, resilience, and taking care of the part of your body that may be trying to tell you it's time to slow down and pay attention.We share practical ways to build a culture where officers can recover from adrenaline, fuel better on shift, and get support without stigma. • why shift work and disrupted routines can trigger IBS symptoms • the “SHIT” acronym: shift work, high octane habits, irregular nutrition, tactical stress • how energy drinks, dehydration, and gas station food can backfire fast • simple leadership moves that normalize wellness and real help seeking • fitness incentives, workout on duty, and building a wellness room • on scene tools like box breathing and diaphragmatic breathing • gentle diet cleanup basics: adjusting caffeine, alcohol, hydration, and fiber, per tolerance• nicotine pouches and stress habits that can worsen gut symptoms • when to see a doctor and what red flags to watch for • why a clear diagnosis can lower stress and improve symptoms Don't forget to subscribe, rate, and leave us a comment. You can also follow us on social media @TheGutHealthPodcast, where we'd love for you to share your thoughts, questions, and experiences. This podcast was sponsored by Ardelyx.Sorry for Kate's raspy voice, she's just getting over a cold! And a big thank-you to Megan for holding down the fort. ❤️References:Hartley TA, Violanti JM, Mnatsakanova A, Andrew ME, Burchfiel CM. Military experience and levels of stress and coping in police officers. Int J Emerg Ment Health. 2013;15(4):229-39. PMID: 24707586; PMCID: PMC4734366.Shin A, Xu H, Imperiale TF. The Prevalence, Humanistic Burden, and Health Care Impact of Irritable Bowel Syndrome Among United States Veterans. Clin Gastroenterol Hepatol. 2023 Apr;21(4):1061-1069.e1. doi: 10.1016/j.cgh.2022.08.005. Epub 2022 Aug 11. PMID: 35964894; PMCID: PMC9918609.Demo of diaphragmatic breathing.Learn more about Kate and Dr. Riehl:Website: www.katescarlata.com and www.drriehl.comInstagram: @katescarlata @drriehl and @theguthealthpodcastOrder Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.  The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment.  Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

Today, we are tackling a massive grey area in obstetrics/maternal-fetal medicine: What happens after early fetal growth restriction resolves? When a baby bounces back on the growth chart during the second or third trimester, are they completely out of the woods? Or is there a hidden, lingering risk we aren't talking about enough? To find out, we're doing a deep dive into two major publications that dropped just this month, in August 2026 in sister journals (AJOG and AJOG MFM). Both are retrospective, both ask the exact same burning question…and get this: they arrive at completely opposing conclusions. How is that possible? Listen in for details. 1. Melamed B, Mei-Dan E, Aviram A. Sonographic fetal weight estimation percentiles should be interpreted with caution in the second trimester. Int J Gynaecol Obstet. 2026 May;173(2):930-939. doi: 10.1002/ijgo.70693. Epub 2025 Nov 25. PMID: 41288086.2. Ramos SZ, Has P, Gimovsky AC, Danilack VA, Savitz DA, Lewkowitz AK. Outcomes among Neonates after a Diagnosis of Persistent or Transient Fetal Growth Restriction Delivered at Term. Am J Perinatol. 2024 May;41(S 01):e1470-e1477. doi: 10.1055/a-2051-3859. Epub 2023 Mar 9. Erratum in: Am J Perinatol. 2024 May;41(S 01):e1478. doi: 10.1055/s-0044-1786526. PMID: 36894159; PMCID: PMC10562520.3. Keller N, Jackson F, Abelman S .Neonatal morbidity following resolution of fetal growth restriction diagnosed at second-trimester anatomy ultrasound. American Journal of Obstetrics & Gynecology MFM, 2026; Aug 8. 4. Cenac LA, Wodoslawsky S, Patel V, McLaren Jr. R, Aghai ZH, Makhamreh MM, Al-Kouatly HB, Persistent, Resolved, and Absent Fetal Growth Restriction: A Comparison of Neonatal Outcomes, American Journal of Obstetrics and Gynecology (2026), doi: https:// doi.org/10.1016/j.ajog.2026. Aug 19

What does it mean to be free? That is one of life's biggest questions, and has occupied the minds of philosophers for time immemorial. But what does it mean to be metabolically free? Hangry? Post-meal slumps? Type II diabetic? These are all examples of the opposite - metabolic imprisonment. That's why we decided to revisit this episode with Ben Azadi to rediscover what it means to be free of this "prison", some of you find yourselves in.Ben is an incredible advocate for metabolic health, someone who walks the talk with his own pain to purpose story and someone who has made a personal impact on a member of my family.In 2008, Ben Azadi was an obese man who went through a personal health transformation of releasing 80 pounds of extra weight, and getting metabolically healthy. Ever since, Ben Azadi, FDN-P, has been on a mission to help 1 billion people live a healthier lifestyle. Ben has over 15 years of experience in the health industry, and he's the author of four best-selling books, including his latest Keto Flex. Ben has been the go-to source for intermittent fasting and the ketogenic diet since 2013. He is known as ‘The Health Detective' because he investigates dysfunction, and he educates, not medicates, to bring the body back to normal function. Ben is the founder of Keto Kamp; a global brand bringing awareness to ancient healing strategies such as the keto diet and fasting. Get his new book “Metabolic Freedom: A 30-Day Guide to Restore Your Metabolism, Heal Hormones & Burn Fat” NOW, https://tinyurl.com/metabolic-freedomJoin us as we explore:Everything about metabolism - what it is, how it works, can it be “slow” or “fast”, why it becomes dysfunctional and the most important signals of sub-optimal metabolism.An incredible study that exposes the “I'm getting old equals weight gain” myth, and why you can actually have the same metabolism at 90 as you had in your 20s.Fasting insulin, why it's critically important in metabolism and the difference between being metabolically free and being an imprisoned “sugar burner”. The scientifically-proven power of “vitamin G”.Ben's top biohacks to bolster metabolism.Contact:Website: www.benazadi.com  Instagram: @thebenazadi Mention:Study - Pontzer H, et al,. Daily energy expenditure through the human life course. Science. 2021 Aug 13;373(6556):808-812. doi: 10.1126/science.abe5017. PMID: 34385400; PMCID: PMC8370708. Study - Kobayashi LC, Hagan KA, Trudel-Fitzgerald C, et al.Gratitude and Mortality Among Older US Female Nurses.JAMA Psychiatry. Published online July 3, 2024. doi:10.1001/jamapsychiatry.2024.1610Study - Picard M, Prather AA, Puterman E, Cuillerier A, Coccia M, Aschbacher K, Burelle Y, Epel ES. A Mitochondrial Health Index Sensitive to Mood and Caregiving Stress. Biol Psychiatry. 2018 Jul 1;84(1):9-17. doi: 10.1016/j.biopsych.2018.01.012. Epub 2018 Feb 3. PMID: 29525040; PMCID: PMC6014908.Support the showFollow Steve's socials: Instagram | LinkedIn | YouTube | Facebook | Twitter | TikTokSupport the show on Patreon:As much as we love doing it, there are costs involved and any contribution will allow us to keep going and keep finding the best guests in the world to share their health expertise with you. I'd be grateful and feel so blessed by your support: https://www.patreon.com/MadeToThriveShowSend me a WhatsApp to +27 64 871 0308. Disclaimer: Please see the link for our disclaimer policy for all of our content: https://madetothrive.co.za/terms-and-conditions-and-privacy-policy/

Send us Fan MailThyroid Talk with Dr. Angela Mazza, DOShow Notes Episode 50; Recorded: August 8, 2026The Iron Paradox: Iron, Thyroid Health, and FerroptosisHost: Dr. Angela Mazza, DOCo-host: Dawn Sheffield I'm Dr. Angela Mazza, D.O., a thyroid, endocrine, and metabolism specialist with a private practice in Central Florida.  My goal for this podcast is to define and demystify the thyroid gland, and thyroid-related medical conditions.  By providing information in an easy-to-understand format, we hope to help patients better understand the ways in which their bodies work, and to help them thrive.  My goal is to help us live more fulfilling lives by taking control of our health, to feel our best.  I do this podcast to provide life-saving education and encourage patients to see a doctor in time to prevent or minimize damage.  That's deeply fulfilling.  I enjoy helping folks understand how all aspects of their lives are tied to both thyroid and overall health.  That's why I went into endocrinology.  It's a medical art that combines science with the study of our lives—and all that they encompass.  Here's some of what we covered in episode 50, not necessarily in this order: ·        Iron is involved in some of the most fundamental processes in human physiology.·        What is ferroptosis?  Is it science fiction--or science fact?·        Iron may play a big role in inflammation, oxidative stress, aging biology, & longevity.·        Iron is an essential mineral that the body requires for survival.·        Iron helps us form hemoglobin--the protein in red blood cells that carries oxygen throughout the body.·        When iron levels are inadequate, cells may struggle to produce energy efficiently.·        Symptoms of low iron may mimic those of hypo--that is, low--thyroid. ·        Iron deficiency can directly affect thyroid physiology itself.·        Who tends to be most vulnerable to iron deficiency?·        And best of all we learned that we CAN impact our thyroid health!My book, Thyroid Talk: An Integrative Guide to Optimal Thyroid Health, is available on Amazon.  Visit the Wellness Store at metaboliccenterforwellness.com regarding supplements mentioned in various episodes of this podcast.  Please stay in touch!  Send your comments, show ideas, and questions to thyroidtalk.mazza@gmail.com  We may disclose your general location on air (the city or town, for example), but we will not read your name nor your address on the show.  We reserve the right to edit your input as necessary.  See the website at metaboliccenterforwellness.com; our YouTube channel (Dr. Angela Mazza), Facebook, and Instagram.   Ask your healthcare provider about specific questions regarding your wellness.  This podcast is meant for educational purposes only.  Citations, references, additional information:Mazza AD. Iron at the Crossroads of Thyroid Function and Detoxification in Women: Clinical Implications for Diagnosis and Management. Integr Med (Encinitas). 2026 Jun;25(3):15-21. PMID: 42491815; PMCID: PMC13377770.Mazza AD. Thyroid Hormones and Aging: Modulators of Mitochondrial Health, Metabolic Flexibility, and Longevity Pathways. Horm Metab Res. 2026 Feb;58(2):50-55. doi: 10.1055/a-2698-0521. Epub 2025 Sep 8. PMID: 40921197.Mazza A.  Thyroid Talk: An Integrative Guide to Optimal Thyroid Health.  Available now on Amazon.Copyright 2026 Dr. Angela Mazza DO.  Thyroid Talk with Dr. Angela Mazza, DO.  All rights reserved.Check out our YouTube channel - Dr. Angela Mazza, our website at Metabolic Center for Wellness, our FaceBook and our Instagram page.

Post-race recovery is not the avoidance of training. Rather, it is a crucial component of a well-periodized training plan, especially for a marathon or half marathon. In this episode, we first examine the physiological impact of racing a marathon or half marathon on the body. Then, we detail how to approach a recovery phase, including what can enhance or impair recovery after a race.In this episode, you'll learn:✅ What happens to your body after you run a marathon✅ Should you do a recovery run after the race?✅ How to structure a recovery phase after a half marathon✅ How to recover after a marathon✅ How to improve your post-race recovery✅ Health risks during the recovery phaseTread Lightly Running is hosted and researched by Amanda Brooks and Laura Norris, MSc. Production, show notes, and graphics by Laura Norris.References

¿De verdad necesitamos una casa enorme o un armario infinito para vivir bien?

Daniela DiMarco, MD, MPH is joined by guest speaker Valeria Cantos, MD for this episode of “Conversations with CEI.” Dr. Valeria Cantos is an Associate Professor at the Division of Infectious Diseases at Emory. She is an investigator at the Emory Ponce Clinical research site, where she leads HIV prevention and HIV vaccine clinical trials from the HPTN and HVTN networks. Herpes simplex virus (HSV) infection is one of the most common STIs worldwide. This episode covers a brief overview of herpes simplex virus (HSV) mucocutaneous infections including current recommendations for testing, diagnosis, treatment, and preventing perinatal HSV transmission. They also discuss managing more challenging scenarios to provide practical guidance and address common clinical questions. Related Content: CEI Line: 1-866-637-2342 www.ceitraining.org www.hivguidelines.org Plunkett M, Neville CT, Chang JG. Genital Herpes: Rapid Evidence Review. Am Fam Physician. 2024 Nov;110(5):487-492. PMID: 39556630. Gnann JW Jr, Whitley RJ. CLINICAL PRACTICE. Genital Herpes. N Engl J Med. 2016 Aug 18;375(7):666-74. doi: 10.1056/NEJMcp1603178. PMID: 27532832. Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187. doi: 10.15585/mmwr.rr7004a1. Erratum in: MMWR Morb Mortal Wkly Rep. 2023 Jan 27;72(4):107-108. doi: 10.15585/mmwr.mm7204a5. PMID: 34292926; PMCID: PMC8344968.

Fancy schmancy topic today! Psychological Flexibility. Sounds complicated and it is in a way! But in this episode, you will easily be able to see the importance of developing psychological flexibility in order to lose weight and keep it off. Listen in… see if you're on the hamster wheel of the unhealthy, psychologically INFLEXIBLE diet mentality and learn how to get away from that going-nowhere-good train of negativity.The Weight Loss Winformation Podcast gives you essential psychological information to help you lose weight and more importantly, to help keep you at a healthy weight for your body! No matter how you are working to lose weight and no matter how much weight you want to lose, Weight Loss Winformation will keep you moving in a positive direction. Let's get started because well… Why Weight? (get it? Pun intended… )?Resources:·      BariAfterare: www.bariaftercare.com·      Connie Stapleton PhD website: www.conniestapletonphd.com·      BariAftercare website: https://www.conniestapletonphd.com/bariaftercare·      BariAftercare Facebook page (for members only): https://www.facebook.com/groups/BariAftercare·      Kevin Stephens: Your Bariatric Buddy   https://www.facebook.com/groups/yourbariatricbuddy/people·      Instagram: @ (Caleshia Haynes)·      Instagram: @therealbariboss (Tabitha Johnson)·      Instagram @drsusanmitchell (Dr. Susan Mitchell)·      Instagram: @lauraleepreston (Laura Preston)·      ProCare Vitamins (10% off with code ConnieStapleton)·      Rob DiMedio: https://www.busybariatrics.com/·      Dr. Joan Brugman: drjbrugman@outlook.com·      Solving the Mystery of Weight Loss Failures by Kristen A. Carter MS https://www.psychologytoday.com/us/blog/health-and-human-nature/202108/solving-the-mystery-weight-loss-failures·      Do Overweight People Have Worse Cognitive Flexibility?o   Song S, Li Q, Jiang Y, Liu Y, Xu A, Liu X, Chen H. Do Overweight People Have Worse Cognitive Flexibility? Cues-Triggered Food Craving May Have a Greater Impact. Nutrients. 2022 Jan 6;14(2):240. doi: 10.3390/nu14020240. PMID: 35057421; PMCID: PMC8779446.·      3 Ways to Improve Your Cognitive Flexibility by Jennifer Verdolin Ph.D.https://www.psychologytoday.com/us/blog/wild-connections/201912/3-ways-to-improve-your-cognitive-flexibility·      Think Different: 10 Ideas for More Mental Flexibility by Meg Selighttps://www.psychologytoday.com/us/blog/changepower/202206/think-different-10-ideas-more-mental-flexibility·      Cognitive Processes and the Treatment of Obesity By Riccardo Dalle Grave, MD·      Cognitive Processes and the Treatment of Obesity By Riccardo Dalle Grave, MDhttps://www.psychologytoday.com/us/blog/eating-disorders-the-facts/202404/cognitive-processes-and-the-treatment-of-obesity

Contributor: Aaron Lessen, MD Educational Pearls: Big question in cardiac arrest: is the rhythm shockable? Shockable: ventricular fibrillation (VF) and pulseless ventricular tachycardia Non-shockable: asystole and pulseless electrical activity (PEA) Rhythm classification is typically based on ECG, but echocardiography can directly visualize myocardial fibrillation Occult VF: a rhythm that appears non-shockable on ECG but demonstrates VF on echocardiography A 2025 multicenter prospective study looked at 811 patients with out-of-hospital cardiac arrest 5.3% had occult VF detected by echocardiography Of the patients with occult VF:  81.4% had PEA on ECG 18.6% had asystole on ECG Patients with occult VF were less likely to receive defibrillation because their ECG suggested a nonshockable rhythm Clinical takeaway: echocardiography during cardiac arrest may reveal a potentially shockable rhythm hiding behind an apparently nonshockable ECG This identifies a subset of cardiac arrest patients who would otherwise be managed as PEA or asystole based on ECG   References Gaspari R, Adhikari S, Gleeson T, Kapoor M, Lindsay R, Noble V, Nomura JT, Weekes A, Theodoro D. Occult Ventricular Fibrillation Visualized by Echocardiogram During Cardiac Arrest: A Retrospective Observational Study From the Real-Time Evaluation and Assessment for Sonography-Outcomes Network (REASON). J Am Coll Emerg Physicians Open. 2025 Jan 13;6(1):100028. doi: 10.1016/j.acepjo.2024.100028. PMID: 40012664; PMCID: PMC11853361.   Summarized by Meg Joyce, MS3 | Edited by Meg Joyce & Ahmed Abdel-Hafiz, NREMT-P   Donate: https://emergencymedicalminute.org/donate/  

Citicoline and Stroke Recovery: What the Major Clinical Trials Actually Found If you’re recovering from a stroke or brain injury, there’s a familiar, exhausting question that shows up once the rehab schedule is set: is there anything else a supplement, a nutrient, something that could genuinely support the brain while it rebuilds itself? Citicoline comes up in that search constantly, across nootropic forums, supplement stores, and even some hospital protocols. It also happens to have one of the largest clinical trial records of any brain-recovery compound available. So rather than trusting a product label, it’s worth going straight to what those trials actually found, including the parts that didn’t work. What Citicoline Is Citicoline (cytidine diphosphate-choline, or CDP-choline) is a compound your body already produces. It’s a building block for phosphatidylcholine, a major structural component of neuronal cell membranes. The theory behind supplementing it is straightforward: give the brain more raw material to repair damaged membranes and support neurotransmitter production after an injury. It’s sold over the counter as a supplement (often branded as “Cognizin”), and in some countries it’s used clinically, including intravenously, in hospital stroke and TBI protocols. What the Major Trials Actually Show This is a case where the size of the evidence base is unusually large, and the results are humbling rather than triumphant. The ICTUS trial, published in The Lancet in 2012 with 2,298 patients, tested citicoline for acute ischemic stroke and found no significant benefit over placebo for global recovery at 90 days; the trial was stopped early for futility (PMID 22691567). The COBRIT trial, published in JAMA the same year with 1,213 traumatic brain injury patients, tested a higher dose of 2,000 mg per day for 90 days and again found no meaningful difference in functional or cognitive outcomes at 90 or 180 days (PMID 23168823). A 2020 Cochrane review pooling ten randomized trials and more than 4,000 stroke patients concluded there was little to no difference between citicoline and placebo in mortality, disability, or neurological recovery, and rated the overall evidence quality as low, noting six of the ten trials were industry-sponsored (PMID 32860632). Here’s where the picture becomes more interesting. A separate trial gave stroke survivors citicoline continuously for twelve months, rather than just during the acute phase, and found real improvements in attention, executive function, and temporal orientation compared to usual care, along with a non-significant trend toward better long-term functional outcome (PMID 23406981). A broader 2020 systematic review across neurological conditions similarly found citicoline useful for slowing dementia progression and enhancing cognition in healthy adults, while describing its effect on TBI specifically as “unclear” (PMID 33053828). A separate meta-analysis of twelve trials found citicoline significantly improved functional outcomes overall, even while showing no significant difference on several other individual outcome measures a genuinely mixed result rather than a clean positive or negative (PMID 28458415). The pattern that emerges: as a short-term rescue treatment for acute stroke or acute TBI, the largest, best-designed trials say no, it doesn’t move the needle. As a longer-term support for post-stroke cognitive function, taken consistently over months, there’s a more modest but real signal. What This Means for Stroke Survivors – The Honest Limits Citicoline is not an acute miracle treatment, and the largest trials in the field say so plainly. If you were hoping for a supplement that meaningfully changes outcomes in the days or weeks after a stroke, the evidence doesn’t support that expectation. The more genuine finding of better attention and executive function with twelve months of continuous use comes from a single open-label trial that wasn’t blinded, so it deserves a more cautious read than the large, definitive negative trials. There’s also a dosing gap worth knowing about before anyone assumes a supplement bottle reflects the research: clinical trials used 500 to 2,000 mg per day, often for months, while most over-the-counter citicoline products are dosed at 250 to 500 mg per day, meaningfully lower than the doses that produced the modest cognitive signal. Practical Takeaways – Questions to Bring to Your Treating Team Ask your neurologist or doctor whether citicoline makes sense for your specific recovery stage. Acute stroke support and long-term cognitive support are different questions with different evidence behind them. If you’re considering a supplement, check the label dose against what was actually studied. A product dosed well below 500 mg per day is not comparable to the trials that showed a cognitive benefit. Search “ICTUS citicoline,” “COBRIT trial,” or “citicoline cognitive stroke” on PubMed yourself, and form your own view. The honest picture here is nuanced enough that it’s worth reading past the marketing copy. The value of citicoline, if it exists for you, isn’t as a substitute for rehab, sleep, movement, and nutrition; it’s a small addition on top of everything else you’re already doing well, chosen because you understand the actual trial record rather than a supplement label. For the broader framework I used to separate genuine evidence from supplement hype throughout my own recovery, see my book: https://recoveryafterstroke.com/book. If breakdowns like this one are useful to you, the Recovery After Stroke Patreon (https://patreon.com/recoveryafterstroke) directly funds more of them. This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. The post Citicoline for Brain Recovery: What the Major Trials Actually Found appeared first on Recovery After Stroke.

You have likely encountered the advice that all you need to do to run better is to run more. Is training really that simple? In this episode, we discuss high volume running: why people do it, who it works for, and who should skip it. We examine the research and assess unique situations such as busy athletes, beginners, masters athletes, and injury-prone runners. You will also learn how to safely increase and support high volume training, so that you can secure the biggest driver: consistent training over years.Thank you to our sponsors:✨ Tailwind: Complete sport nutrition made simple, including hydration mixes, high-carb sport drinks, endurance fuel, and recovery mixes. Use code TREADLIGHTLY20 at https://tailwindnutrition.com/TREADLIGHTLY for 20% off your first purchase.In this episode, you'll learn:✅ How “high volume” running is defined (and why pace impacts it)✅ The benefits of high volume training✅ How to safely increase running volume✅ Who will not benefit from higher volume training?✅ Is there a point where you should lower your training volume?Tread Lightly Running is hosted and researched by Amanda Brooks and Laura Norris, MSc. Production, show notes, and graphics by Laura Norris.References

Curcumin and Brain Bleed Recovery: What the Research Actually Shows If you’re recovering from a hemorrhagic stroke or a ruptured aneurysm, you’ve probably noticed that most “brain health supplement” advice online is written for the other kind of stroke: the clot type. It rarely addresses what’s actually happening inside a bleed injury: blood breaking down inside brain tissue, swelling, and a wave of secondary inflammation that can do as much damage as the bleed itself. So when someone in this community asked whether there’s any real research behind supplements for healing the brain after a bleed, it was worth digging into properly. One compound kept surfacing: curcumin, the active constituent in turmeric. What Curcumin Is and Why It Showed Up in This Search Curcumin is the primary bioactive compound in turmeric, long studied for its anti-inflammatory and antioxidant properties. It’s an unusual candidate for brain-bleed research because most stroke supplement research focuses on ischemic stroke clots where the biology is different. A bleed involves blood pooling in or around brain tissue; as red blood cells break down, iron released from hemoglobin triggers an inflammatory cascade that increases swelling and pressure inside the skull. Anything that can interrupt that cascade is scientifically interesting, at least in principle. What the Evidence Actually Shows The research specific to bleed-type brain injury is more developed than you might expect, but it comes with an important caveat covered below. In animal models of intracerebral hemorrhage, curcumin reduced swelling by blocking aquaporin-4 and aquaporin-9, water-channel proteins involved in brain edema, and by calming the NF-kB inflammatory pathway that drives secondary damage after a bleed (PMID 26119880). A separate mouse study found that curcumin given within six hours of an induced brain bleed helped shrink the resulting hematoma, reduced inflammatory gene activity, and improved neurological recovery scores compared to untreated animals (PMID 21417704). The finding most relevant to aneurysm-type bleeds specifically comes from a mouse model of subarachnoid hemorrhage, the same category of bleed caused by a ruptured aneurysm. Curcumin, administered shortly after the bleed, reduced brain water content and improved neurological scores, apparently by protecting the integrity of the blood-brain barrier (PMID 27979493). On the human side, the picture shifts. There is currently no published human clinical trial testing curcumin specifically for hemorrhagic stroke or brain-bleed recovery. What does exist is human evidence in an adjacent area: two separate placebo-controlled trials in older adults found that a bioavailable (“lipidated”) form of curcumin improved working memory and helped prevent the cognitive decline seen in the placebo group over time (PMID 27102361; PMID 32512782). That’s genuinely encouraging evidence for brain health broadly, but it is not the same as proof that curcumin aids recovery from a bleed specifically. A 2024 systematic review pooling curcumin and traumatic brain injury research examined eighteen studies. Every one of them was an animal study (PMID 38798711). That single fact is the most important piece of context in this entire topic. What This Means for Stroke Survivors – The Honest Limits Here is the line between promising and proven: everything specific to brain-bleed recovery hematoma size, inflammation, neurological scores after hemorrhage comes from mouse studies, not human trials. Mice are not small humans, and preclinical results routinely fail to replicate in people, particularly in stroke research, where decades of promising animal data have not translated into approved acute therapies. There is also a safety consideration that matters more here than in most supplement discussions: curcumin has a mild blood-thinning effect. If you are recovering from a bleed, on anticoagulant medication, or scheduled for any procedure, that is not a detail to skip past; it is the single most important thing to raise with your medical team before considering curcumin or turmeric extract in any form. Practical Takeaways – Questions to Bring to Your Treating Team Ask directly about bleeding risk before considering any curcumin or turmeric supplement, especially if you are on blood thinners or still in the early recovery window after a hemorrhage. Ask whether the standard turmeric found in food or basic capsules is even comparable to the “bioavailable” or “lipidated” curcumin formulations used in the human trials. Standard turmeric is poorly absorbed, and the studies that showed a benefit did not use it. Ask your doctor, or check ClinicalTrials.gov yourself, whether any human trials specific to your diagnosis are currently recruiting or have published results since this was written; the evidence base here is still moving. The goal isn’t to decide for or against curcumin based on a YouTube video. It’s to walk into your next appointment with a specific, well-informed question instead of a vague one about “brain supplements” so your medical team can give you a real answer. If you want to go deeper on evidence-based approaches to stroke recovery, my book covers the broader framework I used to rebuild my own recovery plan: https://recoveryafterstroke.com/book. And if this kind of research breakdown is useful to you, the Recovery After Stroke Patreon (https://patreon.com/recoveryafterstroke) directly funds more of it. This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. The post Curcumin and Brain Bleed Recovery: What the Research Actually Shows appeared first on Recovery After Stroke.

Every child faces some level of stress, and for many, that includes Adverse Childhood Experiences, or ACEs, which can increase the risk of mental health struggles down the road. In this episode, we talk with Dr. Whitney Raglin Bignall, Associate Clinical Director at The Kids Mental Health Foundation, about how protective factors like strong relationships, a sense of belonging, and yes, JOY, can help buffer kids against that risk. We explore what protective factors actually are, how they work alongside joy to build real resilience, and simple ways caregivers, educators, and communities can strengthen them in a child's everyday life. It's a grounded, hopeful conversation about turning joy into more than just a nice moment, but a genuine source of protection for kids facing hard things.   Show Notes: Mixed and mastered by Concentus Media, Temple, Texas, USA. This show is provided by generous funding by the USAA Foundation. Biography for Dr. Whitney Raglin Bignall:  Dr. Raglin Bignall is the Associate Clinical Director of The Kids Mental Health Foundation and the Director of Community Impact and Evaluation, where she utilizes her expertise in mental health disparities, cultural factors, and community partnerships to drive the foundation's mission to give expert-created resources to all U.S. communities so everyone can understand and promote children's mental health. Her vision is to build a world where mental health is a part of the upbringing of every single child. She enjoys having the opportunity to build relationships that break stigma and provide care that includes the whole child, family and community. She strives to become part of a family's village and network of care because she knows how essential and influential each member of that network can be.   Resources: https://www.kidsmentalhealthfoundation.org/   https://militarychild.org   https://www.cdc.gov/aces/about/index.html   Broaden & Build Theory: Fredrickson BL. What Good Are Positive Emotions? Rev Gen Psychol. 1998 Sep;2(3):300-319. doi: 10.1037/1089-2680.2.3.300. PMID: 21850154; PMCID: PMC3156001. Fredrickson, B. L. (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56(3), 218–226.   Related MCEC Podcasts for Deeper Listening: The Power of Positive Childhood Experiences, published 7.30.2024 Mental Health Care and Military Families, published 9.10.2024 Mental Health Education in Schools, published 9.19.2023  

Do you listen to your bees? Beekeepers rely heavily on sight when inspecting a colony, along with touch and even smell. But in this installment of Bee Science with Dr. Dewey Caron, Dewey asks us to consider another source of information—the remarkable world of sound and vibration produced by honey bees. Honey bees live in an acoustic world that extends well beyond the familiar buzz we hear around a colony. Dewey explores how bees produce sound through their flight muscles and how they perceive airborne vibrations through their antennae and substrate-borne vibrations through their legs. He also explains why a queenless colony can sound noticeably different from a queenright colony and how experienced beekeepers can sometimes recognize changes within a colony simply by listening. Dewey then returns to the waggle dance, exploring research showing that sound and vibration are important components of honey bee communication. Recruits aren't simply following a dancer—they are receiving vibroacoustic information that helps communicate the distance to a food source. The science gets even more fascinating as Dewey examines stop signals, predator warnings, learning among young dancers, and acoustic communication in other honey bee species. Finally, Dewey traces the history of using colony sounds to understand bee behavior, from Eddie Woods' pioneering Apidictor in the 1950s to today's digital sensors, sophisticated microphones, and machine-learning systems designed to interpret what's happening inside a colony without unnecessarily opening the hive. The next time you're working your bees, don't just look. Listen. Your colony may be telling you more than you realize. This is Part One of Dewey's exploration of sound in honey bees. In Part Two, he'll return to some of the specialized sounds associated with swarming and communication. Notes and references: Mea McNeil https://americanbeejournal.com/sounds-of-the-hive-part-1/ Towne W.F., Kirchner, W,H. 1989. Hearing in honey bees: detection of air-particle oscillations. Science. 12;244(4905):686-8. doi: 10.1126/science.244.4905.686. PMID: 17740340. Mario Vallejo-Marín. 2018. Buzz pollination: studying bee vibrations on flowers. https://doi.org/10.1111/nph.15666 Claudi Roller. 2025. Honey  Bee Sensory Superpowers: Hearing. https://www.buddhabeeapiary.com/blog/honey-bee-sound Ferrari, S., Silva, M., Guarino, M., Berckmans, D. 2008.  Monitoring of swarming sounds in bee hives for early detection of the swarming period. Computers and Electronics in Agriculture 64(1), 72–77 Arnia Discussion: https://forum.honeyflow.com/t/want-to-spy-on-your-bees-the-arnia-is-coming-the-arnia-is-coming/7669 ______________ Brought to you by Betterbee – your partners in better beekeeping.   Betterbee is the presenting sponsor of Beekeeping Today Podcast. Betterbee's mission is to support every beekeeper with excellent customer service, continued education and quality equipment. From their colorful and informative catalog to their support of beekeeper educational activities, including this podcast series, Betterbee truly is Beekeepers Serving Beekeepers. See for yourself at www.betterbee.com _______________ We hope you enjoy this podcast and welcome your questions and comments in the show notes of this episode or: questions@beekeepingtodaypodcast.com Thank you for listening!  Podcast music: Be Strong by Young Presidents; Epilogue by Musicalman; Faraday by BeGun; Walking in Paris by Studio Le Bus; A Fresh New Start by Pete Morse; Wedding Day by Boomer; Christmas Avenue by Immersive Music; Red Jack Blues by Daniel Hart; Bolero de la Fontero  by Rimsky Music; Perfect Sky by Graceful Movement; Original guitar background instrumental by Jeff Ott. Beekeeping Today Podcast is an audio production of Growing Planet Media, LLC ** As an Amazon Associate, we may earn a commission from qualifying purchases Copyright © 2026 by Growing Planet Media, LLC

Chuck and Chris review 6 recent Journal of Hand Surgery articles with a variety of topics.  Tune in and see below.1) Arends GR, van Kooij YE, Stern BZ, Hovius SER, Wouters RM; Hand-Wrist Study Group; de Ridder WA. Understanding Why Certain Patients With Hand and Wrist Conditions Are Dissatisfied Despite Achieving Their Expressed Personal Improvement Goals Anchored at Satisfaction: A Qualitative Study. J Hand Surg Am. 2026 Jun;51(6):687-697. doi: 10.1016/j.jhsa.2025.12.009. Epub 2026 Jan 29. PMID: 41609542.2) Lee SH, Kim MB, Lee YH. Surgical Management of Delayed Mallet Finger Fractures Using Combined Two-Extension Block Kirschner Wire and Dorsal Counterforce Techniques. J Hand Surg Am. 2026 May;51(5):555-563. doi: 10.1016/j.jhsa.2025.12.019. Epub 2026 Jan 29. PMID: 41609545.3) Lunasin RM, Capell W, Kaufman KR, Shin AY. Rethinking Muscle Testing: Dynamic EMG Studies of Elbow Positioning as a Differentiator of Pronator Teres and Quadratus Functions. J Hand Surg Am. 2026 Apr;51(4):437.e1-437.e8. doi: 10.1016/j.jhsa.2025.09.013. Epub 2025 Oct 29. PMID: 41159989.4) Morisaki S, Yoshii K, Tsuchida S, Oda R, Takahashi K. Comparison of Manual Tie and Knotless Suture Anchor Techniques in Arthroscopic Transosseous Foveal Repair of the Triangular Fibrocartilage Complex. J Hand Surg Am. 2026 May;51(5):503-510. doi: 10.1016/j.jhsa.2026.01.021. Epub 2026 Mar 4. PMID: 41778936.5) Mwangi J, Henriquez AR, Varney CR, Yu R, Kim JK, Baker RL Jr, Pidgeon T, Hammert WC. Suture-Button Suspensionplasty Does Not Provide a Sustained Functional Advantage Over Ligament Reconstruction and Tendon Interposition for Thumb Carpometacarpal Arthritis. J Hand Surg Am. 2026 Jun;51(6):623-630. doi: 10.1016/j.jhsa.2026.02.019. Epub 2026 Apr 3. PMID: 41934451.6) Surke C, Del Rosario PA, Huntington LS, Ek ETH, Tham SK, Ackland D. Fracture Fixation in an Unstable Scaphoid Fracture Model: A Biomechanical Comparison of Double Screw Osteosynthesis With Two Common Bone Graft and Fixation Techniques. J Hand Surg Am. 2026 Apr;51(4):391.e1-391.e8. doi: 10.1016/j.jhsa.2025.09.007. Epub 2025 Oct 25. PMID: 41137815.See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities.The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/.As always, thanks to @iampetermartin for the amazing introduction and concluding music.For additional links, the catalog.  Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Send us Fan MailThe full week of Journal Club in one place. Monday, the PLaNT trial of prophylactic CPAP for late preterm infants born by cesarean, with senior author Dr. Edgardo Szyld. Tuesday, whether parental holding during therapeutic hypothermia changes feeding and length of stay. Wednesday, the Connection Study, the first live biotherapeutic product tested under an IND, and what it means for probiotics returning to the NICU. Thursday, a handheld light probe that reads bowel through the skin to catch NEC before the X-ray does. Friday, Dr. Dinushan Kaluarachchi on the respiratory severity score and what its trajectory tells us.----First-in-human pilot study of broadband optical spectroscopy (BOS) as noninvasive surveillance for necrotizing enterocolitis (NEC). Dodd AC, Lehane AJ, Lee A, Hurlock A, Su Y, Ilahi I, Lautz TB, Backman V, Goldstein SD.J Pediatr Surg. 2026 May;61(5):162978. doi: 10.1016/j.jpedsurg.2026.162978. Epub 2026 Feb 3.PMID: 41643767Association of parental holding during therapeutic hypothermia and NICU outcomes for infants with hypoxic-ischemic encephalopathy. Nguyen TT, Glass HC, Chan N, Taketa E, Pineda R, Cornet MC, Miller MJ.J Perinatol. 2026 Jun 22. doi: 10.1038/s41372-026-02753-3. Online ahead of print.PMID: 42332041Live biotherapeutic product IBP-9414 (L. reuteri) in very low birth weight infants: the Connection Study. Neu J, Del Moral T, Guthrie SO, Hudak ML, Indrio F, Kim JH, Kronström A, Martin CR, Modi N, Rastad J, Schnitzer TJ, Singh R, Strömberg S, Szajewska H, Thuresson M, Caplan M.Pediatr Res. 2026 Feb 20. doi: 10.1038/s41390-026-04826-7. Online ahead of print.PMID: 41721054Prophylactic CPAP at Cesarean Birth in Late-Preterm Newborns: A Multicenter RCT. Shah BA, DeShea L, Schmölzer GM, Josephsen JB, Fabres J, Wetzel EA, Rykovich H, Thomas A, Law B, Garrido C, Szyld E.Pediatrics. 2026 Aug 1;158(2):e2025070998. doi: 10.1542/peds.2025-070998.PMID: 42457181 Clinical Trial.Association Between Delivery Room Continuous Positive Airway Pressure and Neonatal Outcomes in Late Preterm and Term Infants: A Systematic Review and Meta-Analysis. Chin Y, Hill M, Sett A, Thomas N, Razak A.J Paediatr Child Health. 2026 Jul 28. doi: 10.1111/jpc.70516. Online ahead of print.PMID: 42517258 Review.Bronchopulmonary Dysplasia Definition Based on Respiratory Severity Score. Kaluarachchi DC, Peebles PJ, Lasarev MR, Guthrie SO, Laughon MM.Pediatr Pulmonol. 2026 Jul;61(7):e71750. doi: 10.1002/ppul.71750.PMID: 42478108 Free PMC article. No abstract available.Respiratory severity score patterns by birth gestational age among a cohort of extremely preterm infants. Peebles PJ, Lasarev MR, Guthrie SO, Laughon MM, Keller RL, Kaluarachchi DC.J Perinatol. 2026 Jun 29. doi: 10.1038/s41372-026-02778-8. Online ahead of print.PMID: 42374145 No abstract available.Respiratory severity score as a predictor for need for tracheostomy in infants with severe bronchopulmonary dysplasia. Kaluarachchi NM, Afah Annah S, Lasarev MR, Peebles PJ, Kaluarachchi DC.J Perinatol. 2026 Jun 25. doi: 10.1038/s41372-026-02720-y. Online ahead of print.PMID: 42350618 No abstract available.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Send us Fan MailThe respiratory severity score is one multiplication most of us already do in our heads, mean airway pressure times FiO2. This week Dr. Dinushan Kaluarachchi joins Journal Club to walk through three papers built on it, RSS trajectories across gestational age in the PROP cohort, an RSS based grading of BPD at 36 weeks, and RSS after 40 weeks as a predictor of tracheostomy. He also talks about writing that last paper with his son, a high school junior, and why a brief communication is a realistic on-ramp for students. Plus a preview of two upcoming trials, including surfactant given through a supraglottic airway.https://www.nature.com/collections/ejaffajdhi----Bronchopulmonary Dysplasia Definition Based on Respiratory Severity Score. Kaluarachchi DC, Peebles PJ, Lasarev MR, Guthrie SO, Laughon MM.Pediatr Pulmonol. 2026 Jul;61(7):e71750. doi: 10.1002/ppul.71750.PMID: 42478108 Free PMC article. No abstract available.Respiratory severity score patterns by birth gestational age among a cohort of extremely preterm infants. Peebles PJ, Lasarev MR, Guthrie SO, Laughon MM, Keller RL, Kaluarachchi DC.J Perinatol. 2026 Jun 29. doi: 10.1038/s41372-026-02778-8. Online ahead of print.PMID: 42374145 No abstract available.Respiratory severity score as a predictor for need for tracheostomy in infants with severe bronchopulmonary dysplasia. Kaluarachchi NM, Afah Annah S, Lasarev MR, Peebles PJ, Kaluarachchi DC.J Perinatol. 2026 Jun 25. doi: 10.1038/s41372-026-02720-y. Online ahead of print.PMID: 42350618 No abstract available.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

O sarampo voltou a preocupar: os casos estão em alta no Brasil, especialmente em São Paulo. Neste episódio, Frederico Amorim e Lucca Cirilo discutem o cenário atual dessa doença altamente contagiosa e o que o profissional de saúde precisa saber para reconhecer e conduzir os casos, abordando:O que está acontecendo: o cenário atual, por que os casos voltaram e as recomendações de vacinaçãoQuando suspeitar: padrão de lesões, sintomas associados e como o quadro muda no paciente já vacinado, complicaçõesComo diagnosticar e manejar o quadro: exames diagnósticos, uso de EPIs, notificação Tratamento de suporteIsolamento e profilaxia para contactantes: tempo de isolamento, vacinação de bloqueio, indicação de imunoglobulina. Referências:1. Ministério da Saúde. Ministério da Saúde reforça vacinação de crianças e adolescentes em São Paulo [Internet]. Brasília: Ministério da Saúde; 2026 [citado 2026 ago 13]. 2. Ministério da Saúde. Nota Técnica nº 85/2026-CGICI/DPNI/SVSA/MS [Internet]. Brasília: Ministério da Saúde; 2026.3. Prefeitura de São Paulo, Secretaria Municipal da Saúde. Uso de imunoglobulina humana na profilaxia pós-exposição ao sarampo [Internet]. São Paulo; 2026. Versão 2.4. Do LAH, Mulholland K. Measles 2025. N Engl J Med. 2025 Dec 18;393(24):2447-2458. PMID: 40561553.5. Leung J et al. Clin Infect Dis. 2025 Mar 17;80(3):663-672. PMID: 39271123

Today on the Yoga Medicine Podcast, Tiffany Cruikshank and co-host Katja Bartsch explore the latest research on strength training during pre- and post-menopause. Using a newly published systematic review and meta-analysis of 126 studies involving more than 4,000 women, they unpack what the evidence actually says about building strength and improving body composition in different stages of reproductive aging. Together, Tiffany and Katja separate common myths from current research, discussing progressive overload, lean muscle, body composition, estrogen, and why strength gains remain possible well into midlife and beyond. They also explore why consistency and enjoyment may be just as important as the specific type of resistance training you choose, offering practical takeaways for yoga practitioners, teachers, and anyone looking to age well.  "When we intervene, when we start to create a plan... the capacity to build strength is the same." — Tiffany Cruikshank. — What You'll Learn: Overview of the latest research on strength training across the female lifespan [01:25] Why strength gains remain possible after menopause [08:47] Body composition changes with strength training [16:25] Why enjoyment and consistency are key to long-term success [21:36] Current research gaps and unanswered questions [27:07] Shifting the focus from weight loss to feeling and functioning your best [31:08] How yoga complements strength training for lifelong health [32:34] — Links Mentioned: Watch this episode on YouTube Isenmann E, Geisler S, Havers T, Siegert F, Hemke F, Held S. It's never too late: The impact of resistance training on strength and body composition in females across the lifespan - A systematic review and meta-analysis. J Sci Med Sport. 2026 Mar 18:S1440-2440(26)00096-4. doi: 10.1016/j.jsams.2026.03.002. Epub ahead of print. PMID: 41963141. — Learn More: Find the full show notes at YogaMedicine.com/podcast-173. Learn more about insider tips, online classes or information on our teacher trainings at YogaMedicine.com. To support our work, please leave us a 5 star review with your feedback on iTunes/Apple Podcasts or wherever you listen to podcasts. 

In this Wellness Tech installment, Jonathan Mendoza, DC, APRN, NP-C — Nurse Doza — explains why red light panels have become a daily fixture in his clinic and his home. He covers how red and near-infrared wavelengths reach the mitochondria to support healthy ATP production, why panels deliver solar-style input without UV exposure, how he personally uses violet light to wind down at night, and what the emerging 40Hz gamma-frequency research does and does not yet show in humans. FEATURED PARTNER LightpathLED builds veteran-owned red and near-infrared light therapy panels. Nurse Doza uses one daily and highlights this brand specifically because it offers more than a single red setting — it includes violet-spectrum output and adjustable frequency, including a 40Hz option he notes he hasn't found on other consumer panels. Shop: https://lightpathled.com Code: NURSEDOZA (discount applied at checkout) Current promo:Select Diesel Gen3 panels ship with a free stand — verify at checkout, promos change Join the School of Doza The School of Doza is a paid health-education community with live group consults every **Wednesday at 1 PM Central**, plus courses, protocols, and direct access to Nurse Doza. Start your free trial: https://www.schoolofdoza.com --- 5 Key Takeaways 1. Red and near-infrared light interact with your mitochondria, not just your skin.These wavelengths are absorbed by cytochrome c oxidase in the electron transport chain, which supports healthy ATP production — the mechanism researchers call photobiomodulation. 2. A panel delivers solar-style light input without the UV load.Most people spend the majority of daylight hours indoors under light their cells don't recognize. Red light panels are one way to add that input without the burn risk that comes with UV exposure. 3. Panels are low-friction to use. No undressing required — Nurse Doza sits in front of his and lets it hit his forehead. He uses sessions in the two-to-five-minute range as his own personal routine, not a prescribed protocol. 4. Violet light sits at the opposite end of the visible spectrum from red. Nurse Doza reports using violet output in the evening as part of his wind-down. This is his subjective experience — violet-specific calming effects are not yet well established in the peer-reviewed literature. 5. The 40Hz frequency setting is an area of active research, not settled science. Gamma-frequency entrainment at 40Hz has been studied for its effects on brain activity, but the most-cited amyloid findings are from animal models and have published author corrections. Interesting, worth following — not a treatment. Citations: 1. de Freitas LF, Hamblin MR. **Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy.** *IEEE Journal of Selected Topics in Quantum Electronics.* 2016. PMID: 28070154 — https://pubmed.ncbi.nlm.nih.gov/28070154/ 2. Hamblin MR. **Mechanisms and Mitochondrial Redox Signaling in Photobiomodulation.** *Photochemistry and Photobiology.* 2018. PMID: 29164625 — https://pubmed.ncbi.nlm.nih.gov/29164625/ 3. Maghfour J, Ozog DM, Mineroff J, Jagdeo J, Kohli I, Lim HW. **Photobiomodulation CME Part I: Overview and Mechanism of Action.** *Journal of the American Academy of Dermatology.* 2024. PMID: 38309304 — https://pubmed.ncbi.nlm.nih.gov/38309304/ 4. Nairuz T, Cho S, Lee JH. **Photobiomodulation Therapy on Brain: Pioneering an Innovative Approach to Revolutionize Cognitive Dynamics.** *Cells.* 2024. PMID: 38891098 — https://pubmed.ncbi.nlm.nih.gov/38891098/ 5. Iaccarino HF, Singer AC, Martorell AJ, et al. **Gamma frequency entrainment attenuates amyloid load and modifies microglia.** *Nature.* 2016;540:230–235. PMID: 27929004 · PMCID: PMC5656389 — https://pmc.ncbi.nlm.nih.gov/articles/PMC5656389/    *Note: animal-model study. Two author corrections have since been published (2018, 2024).* Bonus — sleep and LED light therapy: Liao YH, Tai CJ, Ming JL, Lin LH, Chien LY. **The Effectiveness of Low-Level LED Light Therapy for Sleep Problems, Psychological Symptoms, and Heart Rate Variability in Shift-Work Nurses: A Randomized Controlled Trial.** *Journal of Nursing Management.* 2025. PMID: 40557249 — https://pubmed.ncbi.nlm.nih.gov/40557249/

Have you experienced False Hope Syndrome? Without telling you exactly what that is, I'm going to let you know chances are good that you have. I have certainly done so in more than one area of my life! False Hope Syndrome runs rampant in relation to weight loss. Listen in, learn exactly what it is and how to keep yourself safe from falling into the disappointment associated with False Hope Syndrome as you move forward in losing and maintaining weight loss.The Weight Loss Winformation Podcast gives you essential psychological information to help you lose weight and more importantly, to help keep you at a healthy weight for your body! No matter how you are working to lose weight and no matter how much weight you want to lose, Weight Loss Winformation will keep you moving in a positive direction. Let's get started because well… Why Weight? (get it? Pun intended… )?Resources:·      BariAfterare: www.bariaftercare.com·      Connie Stapleton PhD website: www.conniestapletonphd.com·      BariAftercare website: https://www.conniestapletonphd.com/bariaftercare·      BariAftercare Facebook page (for members only): https://www.facebook.com/groups/BariAftercare·      Kevin Stephens: Your Bariatric Buddy   https://www.facebook.com/groups/yourbariatricbuddy/people·      Instagram: @ (Caleshia Haynes)·      Instagram: @therealbariboss (Tabitha Johnson)·      Instagram @drsusanmitchell (Dr. Susan Mitchell)·      Instagram: @lauraleepreston (Laura Preston)·      ProCare Vitamins (10% off with code ConnieStapleton)·      Rob DiMedio: https://www.busybariatrics.com/·      Dr. Joan Brugman: drjbrugman@outlook.com·      Dr. Nestor de la Cruz-Munoz on Linked In: https://www.linkedin.com/in/drdelacruzmunoz/From: How Much Weight Will You Lose After Bariatric Surgery? Nestor de la Cruz-Munoz MD, FACS, DABOMJuly 12, 2026 The Evidence Is Clear — And It's Not What Most Patients Expecto    The AACE/TOS/ASMBS guidelines are explicit: Very few preoperative factors are sufficiently predictive to give a precise individual weight loss number.This means the honest answer is not a number — it's a range.The Real Weight Loss Ranges by ProcedureThe most reliable metric is total weight loss percentage (TWL) — not excess weight loss.Sleeve Gastrectomy (SG)·       23–25% TWL at 1 year·       17–19% TWL at 5 years·       PCORnet (65,000+ patients): 18.8% TWL at 5 yearsRoux‑en‑Y Gastric Bypass (RYGB)·       28–31% TWL at 1 year·       21–26% TWL at 5 years·       20–27% TWL at 10 years·       PCORnet: 25.5% TWL at 5 years·       SM‑BOSS RCT: 27.5% TWL at 10 yearsOne‑Anastomosis Gastric Bypass (OAGB)·       Highest early TWL·       Emerging evidence suggests greater long‑term durability than SG and RYGB·       Randomized TrialsBy‑Band‑Sleeve RCT (3‑year outcomes):·       RYGB: 26.8% TWL·       Sleeve: 19.4% TWL·       Band: 14.0% TWLWeight regain after cessation of medication for weight management: systematic review and meta-analysiso   West S, Scragg J, Aveyard P, Oke JL, Willis L, Haffner SJP, Knight H, Wang D, Morrow S, Heath L, Jebb SA, Koutoukidis DA. Weight regain after cessation of medication for weight management: systematic review and meta-analysis. BMJ. 2026 Jan 7;392:e085304. doi: 10.1136/bmj-2025-085304. PMID: 41500720; PMCID: PMC12776922.o   https://pubmed.ncbi.nlm.nih.gov/41500720/·       The primary anti-obesity medications (AOMs) highlighted in this high-level study are newer incretin mimetics, specifically:o   Semaglutide (a GLP-1 receptor agonist)o   Tirzepatide (a GIP/GLP-1 receptor co-agonist)The Rebound Effect: High-Level EvidenceThis January 2026 systematic review and meta-analysis published in The BMJ synthesized data from 37 studies involving 9,341 participants, providing robust, high-level clinical evidence on what happens after stopping these medications:·       Rapid Return to Baseline: On average, patients return to their baseline weight within 1.7 years after stopping any weight management medication.·       Accelerated Regain for GLP-1/GIP Drugs: For those stopping semaglutide or tirzepatide, the rebound is even faster—returning to baseline weight in just 1.5 years.·       Faster than Behavioral Programs: The rate of weight regain after medication cessation is significantly faster than the regain observed after finishing behavioral weight management programs.·       Reversal of Health Benefits: Stopping these therapies also rapidly reverses their positive, beneficial effects on cardiometabolic markers.·       These findings emphasize that using these medications short-term without a more comprehensive, long-term approach to weight management leads to a rapid reversal of both weight loss and cardiometabolic improvements, and this is the real benefit we can offer to our patients: a long-term plan that can and should be updated on the course of their chronic disease and its natural course. Nothing in obesity treatment should be absolutely static.·      How to overcome past dieting failures. By Kristen A. Carter MSo   https://www.psychologytoday.com/us/blog/health-and-human-nature/202103/false-hope-syndrome-reveals-big-problem-dieting·      Getting Real: Warning Signs of False Hope Syndrome. by Dan J. Tomasulo PhD., TEP, MFA, MAPPo   https://www.psychologytoday.com/us/blog/the-healing-crowd/202209/getting-real-warning-signs-of-false-hope-syndrome·      Expected Weight Loss From Gastric Bypass – Calculatoro   https://www.obesitycoverage.com/weight-loss-surgeries/gastric-bypass/how-much-can-i-expect-to-lose·      Expected Weight Loss (after Sleeve)o   https://www.obesitycoverage.com/gastric-sleeve-reference-manual/

CardioNerds (Dr. Apoorva Gangavelli, Dr. Rebecca Garber, and Dr. Tina Reddy), discuss pre-pregnancy risk stratification and counseling with Dr. Katy Young across a range of risks.  This episode was produced as part of the CardioNerds Academy curriculum by House Einthoven under the guidance of House Chief, Dr. Apoorva Gangavelli and Academy Program Director, Dr. Gurleen Kaur. A matching review article will be published in US Cardiology Review, the official journal of CardioNerds. This discussion was planned in collaboration with the Mayo Clinic Cardiovascular Board Review Course. Audio editing by CardioNerds intern, Dr. Patrick Pekyi-Boateng. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Notes:  Why is pregnancy considered a “physiologic stress test,” and why does risk extend beyond delivery? Blood volume, heart rate, and cardiac output rise while systemic vascular resistance falls, peaking in the late second/early third trimester; underlying (even undiagnosed) heart disease can be unmasked or worsened. Postpartum (“fourth trimester”) is a high-risk period, not a safe zone – fluid shifts, rising SVR, and bleeding risk can precipitate decompensation in patients with heart failure, pulmonary hypertension, valvular disease, or aortopathy. Adverse pregnancy outcomes (hypertensive disorders, gestational diabetes, preterm birth, fetal growth restriction, peripartum cardiomyopathy) are markers of future cardiovascular risk and warrant long-term preventive follow-up. What is the practical framework for approaching pre-pregnancy cardiovascular risk? Four broad categories: (1) patients who may need cardiac screening before pregnancy, (2) patients needing risk-factor/medication optimization, (3) known cardiovascular disease where pregnancy is reasonable with structured risk stratification, and (4) high-risk disease where pregnancy may need to be delayed, modified by intervention, or discouraged. Testing should be targeted, not blanket – reserved for symptoms, abnormal exam, concerning family history, or reduced functional capacity. How is risk stratified in patients with known cardiovascular disease? Use a combination of tools per 2025 ESC guidelines: mWHO 2.0 (broad maternal risk category), CARPREG II (additional predictors of maternal cardiac events), and ZAHARA (useful in congenital heart disease). Key lesion-specific factors: aortic size/growth, valve severity, ventricular function, symptoms, blood pressure, and family history of dissection. Translate risk into practical terms for patients rather than leading with a numerical score. Which cardiovascular medications require review before conception? ACE inhibitors, ARBs, and ARNIs should be transitioned off before pregnancy; statins, MRAs, and SGLT2 inhibitors also need review. DOACs are contraindicated in pregnancy and lactation; mechanical valve anticoagulation requires individualized shared decision-making, as no strategy is risk-free for mother and fetus. Medication changes are best made proactively, before conception, rather than reactively. This is not an exhaustive list! The medication list needs to be reviewed carefully. Which conditions carry high or prohibitive risk in pregnancy? Pulmonary arterial hypertension, Eisenmenger syndrome, severe ventricular dysfunction, prior peripartum cardiomyopathy with residual LV dysfunction, severe left-sided obstructive valve disease (e.g., severe mitral stenosis), mechanical valves, significant aortopathy, cyanotic congenital heart disease, and Fontan physiology. Common theme: limited cardiovascular reserve and high risk of decompensation, thrombosis, arrhythmia, heart failure, aortic dissection, or death. These patients need expert multidisciplinary evaluation before pregnancy. Severe mitral stenosis is poorly tolerated because tachycardia shortens diastolic filling time and raises left atrial pressure, risking pulmonary edema and decompensation. When should genetic testing or counseling be offered? Consider when a diagnosis may be inherited or affect the patient, pregnancy, or family members: inherited cardiomyopathies, aortopathies, channelopathies, select congenital heart disease, and some pulmonary hypertension syndromes. Recurrence risk of congenital heart disease in offspring is roughly 6-10% when the mother has CHD; fetal echocardiography should be offered. How should contraception be approached in high-risk cardiac patients? Frame contraception as part of the cardiac care and reproductive safety plan to prevent unplanned high-risk pregnancy. Long-acting reversible contraception is often preferred; progestin-only methods are generally safer than estrogen-containing options with thrombosis risk, pulmonary hypertension, or mechanical valves. What are key delivery-planning considerations for cardiac patients? Vaginal delivery is preferred unless there is an obstetric indication for cesarean or a specific cardiac reason (e.g., unstable maternal status, therapeutic INR) to avoid labor. Planning should address delivery location, anesthesia involvement, telemetry needs, fluid management, and postpartum monitoring, clearly communicated across the multidisciplinary team in advance. How should clinicians counsel patients when pregnancy is discouraged but strongly desired? Acknowledge the patient’s goals and the emotional weight of the conversation; separate the goal (family building) from the timeline (safety now vs. after optimization). If pregnancy remains prohibitively risky, discuss alternatives for family building and ensure adequate patient support. What are the key gaps and future directions in cardio-obstetric risk stratification? Current risk tools (mWHO, CARPREG II, ZAHARA) provide common language but do not fully capture functional status, prior pregnancy history, or how risk evolves over time. Future direction: individualized, dynamic risk prediction incorporating imaging, biomarkers, exercise capacity, and social drivers of health, with better long-term links between pregnancy complications and cardiovascular prevention. References 1. European Society of Cardiology. 2025 ESC Guidelines for the management of cardiovascular disease and pregnancy. 2. Mehta LS, et al. Cardiovascular Considerations in Caring for Pregnant Patients: A Scientific Statement From the American Heart Association. Circulation. 2020;141:e884-e903. PMID: 32362133. doi:https://doi.org/10.1161/CIR.0000000000000772 3. ACOG Practice Bulletin No. 212. Pregnancy and Heart Disease. Obstet Gynecol. 2019;133(5):e320-e356. PMID: 31022123. doi:https://doi.org/10.1097/AOG.0000000000003243

In this Complex Care Journal Club podcast episode, Ms. Emily Johnson and Dr. Florence Gagné discuss a scoping review of interventions to assess social needs for children with medical complexity. They describe the different approaches to screening and intervention in the five included studies, implications for practice, and opportunities to engage social workers in research. SPEAKERS Emily Johnson, MSW, LICSW Clinical Social Worker Boston Children's Hospital Florence Gagné, MD Pediatrician Montréal Children's Hospital HOST Kristina Malik, MD Assistant Professor of Pediatrics Medical Director Pediatrician, Special Care Clinic‌‌ ‌University of Colorado School of Medicine KidStreet Children's Hospital Colorado DATE Initial publication date: August 11, 2026. JOURNAL CLUB ARTICLE Johnson ER, Hadge SM, Wachter SM, Gagné F. Interventions to assess social needs for children with medical complexity and their families: A scoping review. Patient Educ Couns. 2026;148:109555. doi:10.1016/j.pec.2026.109555. OTHER ARTICLES REFERENCED Ming DY, Jones KA, Sainz E, Tkach H, Stewart A, Cram A, Morreale MC, Dizon S, deJong NA. Feasibility of implementing systematic social needs assessment for children with medical complexity. Implement Sci Commun. 2021 Nov 21;2(1):130. doi: 10.1186/s43058-021-00237-3. PMID: 34802465; PMCID: PMC8606226. TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/3sgvpf2qjsvt9zqxvf37xspz/Gagne_and_Johnson_Final_Transcript_8-3-26 Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6. Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Johnson ER, Gagné F, Malik K. Screen and Intervene: Meeting Social Needs for Children with Medical Complexity. 08/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/screen-and-intervene-meeting-social-needs-for-children-with-medical-complexity.

Digital surgery has morphed from buzzword into ubiquitous high-impact technology. In this episode, the BTK MIS team steps into the rapidly evolving ecosystem of cameras, sensors, robotics, and software that are turning surgical operations into structured, analyzable datasets. From AI segmentation to real-time telepresence, don't miss this opportunity to catch up on what's new and what's next, what's exciting and what's terrifying, just on the horizon of your surgical career. Hosts: ·      James Jung, MD, PhD, Assistant Professor of Surgery, Duke University·      Jacob Greenberg, MD, EdM, MIS Division Chief and Vice Chair for Education, Duke University·      Zachary Weitzner, MD, Minimally Invasive and Bariatric Surgery Fellow, Duke University, @ZachWeitznerMD·      Joey Lew, MD, MFA, Surgical resident PGY-3, Duke University, @lew__actuallyLearning Goals: By the end of this episode, listeners will be able to:·      Define “digital surgery” and describe its core components, including video capture, instrumentation, robotics, data analytics, and system connectivity. ·      Discuss current and emerging applications of digital surgery in surgical education, including video-based self-assessment, procedural segmentation, and structured feedback models. ·      Describe how digital tools can be used to improve OR efficiency and resource utilization, including instrumentation usage, operative time analysis, and workflow optimization. ·      Summarize current telepresence and teleproctoring technologies and their clinical use cases, including augmented reality–based collaboration across institutions and geographic boundaries. ·      Identify key ethical, legal, and operational challenges in digital and tele-surgery, including credentialing, cross-state licensure, liability, and trust in remote expertise. ·      Discuss how digital surgery may reshape surgical training and competency-based assessment, including implications for autonomy, deliberate practice, and feedback frequency. ·      Recognize future directions of digital surgery integration, including predictive analytics, simulation using patient-specific imaging, and AI-assisted intraoperative decision support.References:  Balvardi S, Semsar-Kazerooni K, Kaneva P, et al. Validity of video-based general and procedure-specific self-assessment tools for surgical trainees in laparoscopic cholecystectomy. Surg Endosc. 2023;37(3):2281-2289. doi:10.1007/s00464-022-09466-6 [https://pubmed.ncbi.nlm.nih.gov/36307525/] Hospital Utilizes Intraoperative Idle Time Metrics to Improve Surgical Safety and Efficiency. Theator | The Surgical Intelligence Company. Accessed March 20, 2026. https://theator.io/customer-story/hospital-utilizes-intraoperative-idle-time-metrics-to-improve-surgical-safety-and-efficiency/ Campbell KK, Abreu AA, Zeh HJ, et al. Using OR Black Box Technology to Determine Quality Improvement Outcomes for In-situ Timeout and Debrief Simulation. Ann Surg. 2026;283(1):122. doi:10.1097/SLA.0000000000006438 [https://pubmed.ncbi.nlm.nih.gov/38317208/] Al Abbas AI, Meier J, Daniel W, et al. Impact of team performance on the surgical safety checklist on patient outcomes: an operating room black box analysis. Surg Endosc. 2024;38(10):5613-5622. doi:10.1007/s00464-024-11064-7 [https://pubmed.ncbi.nlm.nih.gov/39069926/] Proximie's telepresence platform helps surgeons across the globe grow and exchange experience in real-time. World Health Expo Insights. Accessed March 20, 2026. https://www.worldhealthexpo.com/insights/telemedicine/proximie-s-telepresence-platform-helps-surgeons-across-the-globe-grow-and-exchange-experience-in-real-time Hassan AE, Desai SK, Georgiadis AL, Tekle WG. Augmented reality enhanced tele-proctoring platform to intraoperatively support a neuro-endovascular surgery fellow. Interv Neuroradiol. 2022;28(3):277-282. doi:10.1177/15910199211035304 [https://pubmed.ncbi.nlm.nih.gov/34538166/] SAGES Digital Surgery Working Group; Ali JT, Yang G, Green CA, Reed BL, Madani A, Ponsky TA, Hazey J, Rothenberg SS, Schlachta CM, Oleynikov D, Szoka N. Defining digital surgery: a SAGES white paper. Surg Endosc. 2024 Feb;38(2):475-487. doi: 10.1007/s00464-023-10551-7. Epub 2024 Jan 5. PMID: 38180541. [https://pubmed.ncbi.nlm.nih.gov/38180541/] Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewOBGYN Oral Board Review Coures: https://behindtheknife.org/course/obgyn-oral-board-reviewEPA Playbook: https://behindtheknife.org/course/epa-playbookSurgical Instrument Flashcards: https://behindtheknife.org/course/surgical-instrument-flashcardsABSITE Review: https://behindtheknife.org/course/absite-2026-exam-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Send us Fan MailLate preterm babies born by cesarean fill our NICUs, and most of them are there for respiratory distress that resolves in a day or two. Could 20 minutes of CPAP in the operating room keep them out? This week on Journal Club, Ben and Daphna break down the PLaNT trial, a five center randomized pilot of prophylactic CPAP at 5 to 6 cm of water in spontaneously breathing infants born at 34 to 36 weeks by cesarean. They then sit down with senior author Dr. Edgardo Szyld to talk pneumothorax risk, the 35 to 36 week subgroup, consenting families, and what PLaNT 2 must prove.----Prophylactic CPAP at Cesarean Birth in Late-Preterm Newborns: A Multicenter RCT. Shah BA, DeShea L, Schmölzer GM, Josephsen JB, Fabres J, Wetzel EA, Rykovich H, Thomas A, Law B, Garrido C, Szyld E.Pediatrics. 2026 Aug 1;158(2):e2025070998. doi: 10.1542/peds.2025-070998.PMID: 42457181 Clinical Trial.Association Between Delivery Room Continuous Positive Airway Pressure and Neonatal Outcomes in Late Preterm and Term Infants: A Systematic Review and Meta-Analysis. Chin Y, Hill M, Sett A, Thomas N, Razak A.J Paediatr Child Health. 2026 Jul 28. doi: 10.1111/jpc.70516. Online ahead of print.PMID: 42517258 Review.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Dr. Kurt Olding shares with us the latest published recommendations for conservative treatment for spinal stenosis. Dr. Kurt Olding has been in practice for over 40 years, opening Minster Chiropractic Center in 1986 after graduating from National College of Chiropractic in Lombard, IL in 1984. Through the years Dr. Kurt has enjoyed treating all age groups, from infants to athletes and parents to grandparents. He took special interest in sports medicine during his early years in practice, completing 300 hours of continuing education through the Certified Chiropractic Sports Physician program. Dr. Kurt earned Cox® Technic certification in 2009. In 2012 he began co-instructing the technique, and since 2015 has been a full-time instructor alongside Dr. James Cox, Dr. Ralph Kruse, and Dr. George Joachim. Through his work with Cox® Technic, Dr. Kurt has had several exciting opportunities. In March of 2016, he taught Cox® Technic in Bern, Switzerland as part of the Swiss Chiropractic Academy's "technique series" program. Later that month, he presented research on Cox® Technic with his mentor Dr. James Cox at the annual Association of Chiropractic Colleges Research Agenda Conference. Dr. Kurt co-authored a paper published in the June 2016 edition of the Journal of Chiropractic Medicine titled Chiropractic Distraction Spinal Manipulation on Post-surgical Continued Low Back and Radicular Pain patients: A Retrospective Case Series. In 2015, Dr. Kurt became board certified as a Chiropractic Orthopedist, and a Fellow of the Academy of Chiropractic Orthopedists (FACO). He is also a board member of the Academy of Chiropractic Orthopedists, serving since early 2016. Dr. Kurt and his wife Jackie are Minster natives. They have three children: Sunni, Kregg, and Jack. Sunni and her husband Tyler joined the practice in 2014. Resources: Minster Chiropractic Center kurt.olding@gmail.com Find a Back Doctor thebackdoctorspodcast.com The Cox 8 Table by Haven Medical References: Young I, Dunning J, Butts R, Bliton P, Zacharko N, Garcia J, Mourad F, Charlebois C, Gorby P, Fernández-de-Las-Peñas C. Spinal manipulation and electrical dry needling as an adjunct to conventional physical therapy in patients with lumbar spinal stenosis: a multi-center randomized clinical trial. Spine J. 2024 Apr;24(4):590-600. doi: 10.1016/j.spinee.2023.12.002. Epub 2023 Dec 14. PMID: 38103739. Ammendolia C, Hofkirchner C, Plener J, Bussières A, Schneider MJ, Young JJ, Furlan AD, Stuber K, Ahmed A, Cancelliere C, Adeboyejo A, Ornelas J. Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review. BMJ Open. 2022 Jan 19;12(1):e057724. doi: 10.1136/bmjopen-2021-057724. PMID: 35046008; PMCID: PMC8772406.   Schneider MJ, Ammendolia C, Murphy DR, Glick RM, Hile E, Tudorascu DL, Morton SC, Smith C, Patterson CG, Piva SR. Comparative Clinical Effectiveness of Nonsurgical Treatment Methods in Patients With Lumbar Spinal Stenosis: A Randomized Clinical Trial. JAMA Netw Open. 2019 Jan 4;2(1):e186828. doi: 10.1001/jamanetworkopen.2018.6828. PMID: 30646197; PMCID: PMC6324321.   Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE, Chernish G, Cox JM, Gliedt JA, Haskett D, Jensen RK, Marchand AA, Tomkins-Lane C, O'Shaughnessy J, Passmore S, Schneider MJ, Shipka P, Stewart G, Stuber K, Yee A, Ornelas J. Non-Surgical Interventions for Lumbar Spinal Stenosis Leading To Neurogenic Claudication: A Clinical Practice Guideline. J Pain. 2021 Sep;22(9):1015-1039. doi: 10.1016/j.jpain.2021.03.147. Epub 2021 Apr 12. PMID: 33857615.   Comer C, Williamson E, McIlroy S, Srikesavan C, Dalton S, Melendez-Torres GJ, Lamb SE. Exercise treatments for lumbar spinal stenosis: A systematic review and intervention component analysis of randomised controlled trials. Clin Rehabil. 2024 Mar;38(3):361-374. doi: 10.1177/02692155231201048. Epub 2023 Sep 16. PMID: 37715644; PMCID: PMC10829420.   Bise CG, Schneider M, Freburger J, Fitzgerald GK, Switzer G, Smyda G, Peele P, Delitto A. First Provider Seen for an Acute Episode of Low Back Pain Influences Subsequent Health Care Utilization. Phys Ther. 2023 Sep 1;103(9):pzad067. doi: 10.1093/ptj/pzad067. PMID: 37379349.   Hernandez-Martínez J, Cid-Calfucura I, Vásquez-Carrasco E, Perez-Carcamo J, Herrera-Valenzuela T, Aravena-Sagardia P, Barramuño-Medina M, Valdés-Badilla P. Timed Up-and-Go as a predictor of fracture risk: a systematic review and meta-analysis in a population of over 1.6 million people. Front Public Health. 2026 May 11;14:1841017. doi: 10.3389/fpubh.2026.1841017. PMID: 42200137; PMCID: PMC13199231.   Henn MC, Rae A, Fecker AL, McIntyre M, Larsen A, Wright J. A Nationwide Survey of the Spine Education of Medical Students. Cureus. 2026 Apr 4;18(4):e106443. doi: 10.7759/cureus.106443. PMID: 42093772; PMCID: PMC13139429.   James G, Ahern B, Goodwin W, Goss B, Hodges P. ISSLS Prize in Basic Science 2025: Structural changes of muscle spindles in the multifidus muscle after intervertebral disk injury are resolved by targeted activation of the muscle. Eur Spine J. 2025 May;34(5):1600-1613. doi: 10.1007/s00586-025-08646-x. Epub 2025 Jan 15. Erratum in: Eur Spine J. 2025 May;34(5):2046. doi: 10.1007/s00586-025-08744-w. PMID: 39810036.   Gong G, Yan Z, Lai Q, You P, Yu P, Li X, Wang Z, Lin S, Dai Y, Jiang H, Liu J. Inflammation preservation strategy: reconciling pain control and disc resorption in lumbar disc herniation. Front Immunol. 2025 Sep 2;16:1653681. doi: 10.3389/fimmu.2025.1653681. PMID: 40963597; PMCID: PMC12436131.

The noise in women's fitness has never been louder—and if you're wondering who to trust, you're not alone.  Every scroll seems to deliver a new expert, a new rule, or a new warning that contradicts the last one, leaving many women feeling more confused than confident.  Let's cut through the hype to help you understand why these conflicting messages exist and how to evaluate them without getting pulled into the latest trend. You'll learn a practical way to separate evidence from opinion so you can make informed decisions that actually support your health, strength, and longevity.  Instead of adding to the noise in women's fitness, this conversation gives you the clarity and confidence to focus on what truly matters If this episode made you flip your workout routine — share it!

Alexander Aarvold from the University Hospital Southampton joins the show this month to discuss his eagerly anticipated publication on the outcomes of the incomplete acetabuloplasty (or “pelletoplasty”) as an adjunctive treatment during open reduction of developmental hip dislocations. The group also discusses recent publications on treatment of infant femur fractures, open forearm fractures, and the outcomes of periacetabular osteotomy in skeletally immature patients. Your hosts are Carter Clement from Children's Hospital Colorado, Julia Sanders from Children's Hospital Colorado, and Will Morris from Scottish Rite in Dallas. Music by A.A. Aalto.  Aarvold A, Uren N, Rhodes A, Elliott KG, Lindisfarne EA, Carsi B, Clarke NMP. Growth Stimulating Minimal Acetabuloplasty, Alongside Hip Open Reduction: A Simpler One-stop Operative Treatment for Developmental Dysplasia of the Hip. J Pediatr Orthop. 2026 Apr 16. doi: 10.1097/BPO.0000000000003259. Epub ahead of print. PMID: 41988894. https://pubmed.ncbi.nlm.nih.gov/41988894/  Murphy-Zane MS, Keeter C, Baumann A. Hip Abduction Brace Is an Effective Treatment Alternative for Femur Fractures in Infants 12 Months and Younger. J Pediatr Orthop. 2026 Jul 1;46(6):e535-e541. doi: 10.1097/BPO.0000000000003172. Epub 2025 Nov 25. PMID: 41490478; PMCID: PMC13232693.  https://pubmed.ncbi.nlm.nih.gov/41490478/ Kronk TA, Steiner RP, Ritzman TF, Floccari LV. Surgical Treatment of Pediatric Open Forearm Fractures: A Comparison of Outcomes With or Without Internal Fixation. J Pediatr Orthop. 2026 Jul 1;46(6):e524-e528. doi: 10.1097/BPO.0000000000003159. Epub 2025 Nov 5. PMID: 41191825. https://pubmed.ncbi.nlm.nih.gov/41191825/ Pun SY, Kha ST, Park MO, Richey AE, Pham NS, Millis MB. Is the Bernese Periacetabular Osteotomy Safe for the Treatment of Acetabular Dysplasia When the Triradiate Cartilage is Still Open? A Preliminary Study. J Pediatr Orthop. 2026 Jul 1;46(6):335-341. doi: 10.1097/BPO.0000000000003275. Epub 2026 May 5. PMID: 42084192. https://pubmed.ncbi.nlm.nih.gov/42084192/

In this School of Doza episode, Nurse Doza opens the Metabolic Series with the adrenal glands — and why you may feel tired all day, crash between 2 and 4 PM, and wake up unrested. He explains how chronic stress can keep the body stuck in fight-or-flight, why that pattern is hard to shift, and the daily levers he leans on: belly breathing, less screen time at night, and morning sunlight. Then he breaks down Zen by MSW Nutrition — adrenal glandular plus four adaptogens — for stress support. FEATURED PARTNER Zen by MSW Nutrition is built in three layers rather than a single botanical: **125 mg of adrenal glandular tissue** (bovine, sourced from Argentina), **four standardized adaptogens** — Asian ginseng, rhodiola, eleuthero, and schisandra — plus **cofactor nutrients** (vitamin C, B6 as P5P, and pantothenic acid). Licorice rounds out the 9-ingredient formula. It's the supplement Nurse Doza reaches for when the goal is supporting the adrenal glands and the body's stress response, instead of layering more caffeine on top of a depleted system.

Cannabinoid Hyperemesis Syndrome (CHS) continues to be a major clinical challenge in the emergency department. Patients present with severe abdominal pain, intractable vomiting, and significant fluid and electrolyte derangements. CHS often affects people who have been using cannabis routinely for months to years – it can be difficult for patients to understand that their symptoms are related to cannabis.  Today, emergency pharmacist Haley Burhans joins us to discuss first-line treatments, fluid management, discharge strategies, and how to navigate these tough bedside conversations. First-Line Therapies: Haldol vs. Droperidol Haloperidol (Haldol): Supported by the HAVOC trial (haloperidol vs. placebo), which showed a reduction in symptoms and ED length of stay. Droperidol: Highly effective alternative with similar dopaminergic mechanism of action. May carry a lower risk of extrapyramidal symptoms compared to haloperidol.  Capsaicin Cream: addresses the TRPV1 pathway thought to drive CHS. Patients often dislike it as it causes a burning sensation on the skin and can be inadvertently spread to eyes or face. Can be an option if symptoms persist after trying the above meds and hot showers aren't feasible.  Backup Options & Anti-Emetics Alternative Dopaminergic Agents: Metoclopramide or prochlorperazine can be used. Standard Anti-Emetics (e.g., Ondansetron): Serotonergic anti-emetics generally fail to address the underlying CHS pathway. However, a single dose of ondansetron given alongside a butyrophenone (haloperidol/droperidol) is reasonable if you suspect co-existing etiologies. QTc Prolongation Warning: Chronic vomiting leads to electrolyte depletion. Combining anti-emetics and haloperidol or droperidol increases the risk of QTc prolongation. Baseline EKG: Not strictly required for every low-risk patient, but strongly recommended for patients with multiple risk factors (e.g., co-ingestion/use of methadone, history of heart failure, or severe baseline bradycardia). Fluid Resuscitation & Electrolyte Management CHS patients can vomit to the point of severe dehydration and profound electrolyte/acid-base derangements. Fluid Selection: Normal Saline (NS): A solid choice for initial volume resuscitation when sodium and chloride are severely depleted. Lactated Ringer's (LR): Ideal as a follow-up or maintenance fluid because it contains a small amount potassium. Potassium Repletion: Oral repletion may not be tolerated in the acute setting. Consider IV potassium repletion in the ED, followed by oral home supplementation once nausea is controlled. Magnesium: While acute vomiting primarily drives potassium loss, consider IV magnesium if Mg is low or there is concern for QTc prolongation. Discharge Planning: What to Send Home Low-Dose Olanzapine ODT: Send the patient home with 2.5 mg Olanzapine ODT (orally disintegrating tablets). Why it works: It dissolves instantly on the tongue, bypassing the stomach, and provides extended dopaminergic coverage over the multi-day washout period.  Pharmacokinetics Pearl: Infrequent user THC half-life: ~1.3 hours (cleared in 5–6 hours). Chronic user THC half-life: THC accumulates in adipose tissue. In heavy users, therapeutic levels can persist for up to 2 weeks, driving prolonged receptor dysregulation even after cessation. Navigating the Bedside Conversation Explaining to a chronic user that their daily cannabis—the very thing they use to relieve nausea—is causing their illness requires empathy and validation. Explain the Neurological Link: Cannabis acts on receptors throughout the entire body, including the brain's nausea center and the nervous system of the gut. Chronic, heavy saturation can paradoxically overload these pathways. Validate Their Experience: Acknowledge how counterintuitive it feels: “I know it's hard to believe that something you've used for years to feel better is causing this, but long-term daily use can change how your body processes it.” Set Realistic Expectations: Reiterate that symptoms will not resolve overnight. Even after stopping, it takes time for the pathways to recalibrate. What do you find most helpful for treating CHS? How do you have these difficult conversaions with your patients? Share your experience with us on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis Resources: Borgundvaag B, Bellolio F, Miles I, et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. Acad Emerg Med. 2024 May;31(5):425-455. doi: 10.1111/acem.14911. PMID: 38747203. Rech MA, Shalaby M, Gage KA, Gottlieb M. Managing Cannabinoid Hyperemesis Syndrome. Ann Emerg Med. 2026 Jun;87(6):717-722. doi: 10.1016/j.annemergmed.2025.12.024. Epub 2026 Feb 3. PMID: 41632059. *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

In a world where technology promises to simplify our lives, how do those of us with ADHD – notorious for our resistance to structure – harness that promise without abandoning our critical thinking or our humanity? Join me for this conversation with my client, Elizabeth Meyer - professor, coach, and self-described AI skeptic, who offers a roadmap for experimenting wisely with AI-powered tools, while staying loyal to our own brains, values, and need for connection. When Elizabeth was first offered the opportunity to sign up for my digital clone, Di AI, she hesitated. Then she did something unexpected - she designed an experiment to put Di AI and herself to the test. Elizabeth brought a scientist's rigor to the experience – scheduling regular sessions, setting clear goals, and running timers to structure her use, all to observe how the tool impacted her behaviors and mindset. The episode explores:How Elizabeth structured the experiment (including the infamous decision matrix and her “wildly unrealistic expectations”)Surprising (sometimes maddening) moments where AI reflected “stupid common sense” she'd never consideredWhat ghosting an AI tool taught her about the difference between digital and human accountabilityThe unexpected role of values alignment and motivation for us “rebels”Cautionary tales about outsourcing too much trust—or too much of ourselves—to technologyWhy critical thinking and intentionality are the only way these tools ever work for ADHD-ish brainsElizabeth and I share both the wins and the “facepalm” moments, plus an actionable tip sheet for anyone skeptical (or hopeful) about using AI for habit-building and organization.Her pro tip: Judge the tool by the quality of questions it asks youDon't Miss:Elizabeth's three-question framework (adapted from Naturalistic Decision-Making) for deciding when and how to engage with AI tools—so you never cede too much power to an algorithm If you're tired of empty promises from productivity apps—or want a peek at what a scientifically-minded ADHD brain learns from kicking the tires on new tech—this episode is for you.Fun FactElizabeth shared a story about her 15-year-old niece who, when asked where they should go for dinner, responded: “I don't know. Let me ask Chat.” The future is here and apparently it's hungry for chatbot inputYour turn! Make it practical: Use Di AI to help implement a tactic you picked up from the podcast, track specific goals, and follow up on progress.Know your “why”: Consider the reason you are looking for accountability and fit AI into your schedule where you need a champion (hello, bookkeeping!) If you haven't signed up for Di AI yet - what are you waiting for? Here is the link to sign up for free. Grab Elizabeth's Tip Sheet for making the most of Di AI (or any AI app)About today's guest:Elizabeth Meyers is an informatics professor, consultant, and owner of Deep Dive Strategies, where she advises early-stage startups and small companies on strategy and product design.Driven by a fascination with how humans navigate complex environments, Elizabeth specializes in Naturalistic Decision Making (NDM), studying how experts make high-stakes choices in real-world settings. As an entrepreneur who respects both human expertise and technology, she blends her deep background in technology and information science to explore how experts interact with AI. Mentioned in this episode:Conditions for intuitive expertise: a failure to disagree. Kahneman D, Klein G. Am Psychol. 2009 Sep;64(6):515-26. doi: 10.1037/a0016755. PMID: 19739881. Naturalistic Decision Making Conference Michael Webb PresentationAdam Mastroianni - “Bag of Words” post on SubstackDALL- E AI image generator Ep #281: Find Your Flow: 3 Focus Days Models for ADHD Brains Ep #212: Get More Done: How to Focus with ADHD & Take Real ActionThe Four Tendencies - Elizabeth is a Rebel. What are YOU? Identifying Your Core Values - self assessment Jodie Cook, Founder of Coach Vox Your ADHD-ish™ host, Diann Wingert Diann Wingert is a former therapist turned coach, speaker, and consultant who blends her expertise in entrepreneurship and neurodiversity to help others thrive. Host of the top-rated ADHD-ish™ podcast and creator of The ADHD-ish™ Method, Diann works with ADHD-ish™ business owners who are ready to create stand-out, sought-after, profitable businesses based on their unique brilliance.Loved this episode? Leave a review and tell us why! © 2026 ADHD-ish™ Podcast. Intro music by Ishan Dincer / Melody Loops / Outro music by Vladimir / Bobi Music / All rights reserved.

In this episode, we bring a nuanced, science-based approach to many hot topics in running right now. What causes muscle cramps? Does Pilates count as strength training? Should slower runners wear carbon plated shoes? Is it possible to overfuel on long runs? Our goal is to provide individualized guidance, rather than click-baity universalized proclamations. In this episode, we provide our informed takes on:✅ What actually causes muscle cramps (according to science)✅ If taking walk breaks discounts a marathon effort✅ If back of pack and midpack runners benefit from carbon plated shoes✅ Why Pilates does not replace resistance training✅ Is there such a thing as overfueling on long runs?Tread Lightly Running is hosted and researched by Amanda Brooks and Laura Norris, MSc. Production, show notes, and graphics by Laura Norris.References

Send us Fan MailIn this prospective study, Adrianne and Nim dig into an area with almost no normative pediatric data: right ventricular diastolic function. Comparing 57 infants with RV pressure overload after intervention for pulmonic stenosis or tetralogy of Fallot to 134 healthy controls, the authors found a consistent pattern, reduced beat-to-beat variability, a higher atrial contribution to filling, and an E/A ratio inversion that was nearly universal in the CHD group versus about half of controls. It's one of the first real attempts to define what a right-sided diastolic pattern actually looks like in this population. But without a comparison against cardiac catheterization, the hosts agree the findings are hypothesis-generating at best, a starting point for a multi-parametric approach, not a reason to skip an invasive workup.----Echocardiographic Markers of Right Ventricle Diastolic Dysfunction in Neonates and Infants with Congenital Heart Disease. Cantinotti M, Capponi G, Scalese M, Palladino E, Giordano R, Franchi E, Viacava C, Corana G, Marchese P, Pizzuto A, Assanta N, Santoro G. J Clin Med. 2025 Dec 23;15(1):98. doi: 10.3390/jcm15010098. PMID: 41517351 Free PMC article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!