Podcasts about pmid

Traditionally, we have learned that any imbalance in the estrogen: progesterone relationship can trigger irregular uterine bleeding. That makes sense, right? During anovulation, prolonged unopposed estrogen can result in HMB. In such a case, we give progesterone as both a therapeutic as well as diagnostic intervention. On the contrary, with progestin only contraception, we consider estrogen predominant products when progesterone breakthrough bleeding (BTB) occurs to restore endometrial stabilization. But a new RCT (AJOG) adds credence to adding MORE progesterone in cases of progesterone associated BTB. Listen in for details.1. Zigler RE, Madden T, Ashby C, Wan L, McNicholas C. Ulipristal Acetate for Unscheduled Bleeding in Etonogestrel Implant Users: A Randomized Controlled Trial. Obstet Gynecol. 2018 Oct;132(4):888-894. doi: 10.1097/AOG.0000000000002810. PMID: 30130351; PMCID: PMC6153077.2.ANDRADE MCR, et al. Norethisterone for Prolonged Uterine Bleeding Associated with Etonogestrel Implant (IMPLANET): A Randomized Controlled Trial, American Journal of Obstetrics and Gynecology (2025), doi: https://doi.org/10.1016/j.ajog.2025.08.029.

Zone 2 is the most popular training zone - but is it the only training zone you need? We delve into all five training zones and their unique benefits. You'll learn how to determine each zone by heart rate, rate of perceived exertion (RPE), and talk test, plus how to use them in training. *Laura misspoke around minute 23. The Cori cycle converts lactate into glucose, not glycogen, to then be shuttled back into the muscles to undergo anaerobic glycolysis. Thank you to our sponsors:✨ Upstep: Custom orthotics, molded from the comfort of your home. Use code RUNTOTHEFINISH at https://www.upstep.com/?ref=cajmuang for $20 off your purchase. ✨ Previnex: Previnex creates clinically effective, third-party tested supplements made with high-quality ingredients, including Muscle Health Plus (creatine). Use the code treadlightly for 15% off your first order at previnex.comIn this episode, you will learn:✅ Why you need to train at intensities beyond zone 2✅ How to calculate your training zones✅ Is it worth running in zone 1?✅ Is zone 3 really “the gray zone”?✅ The value of threshold/zone 4 workouts✅ The benefits of training in zone 5 (interval training)✅ Why heart rate monitoring is less reliable in zone 5✅ Can heart rate zones be used on race day?References:

If you've ever doubted your ability to make muscle mass and strength gains after menopause, this episode is for you. It's not too late to gain strength and lean muscle mass can be gained at any age—even after 85.   Based on a 2024 Study on Resistance Training in Older Adults by Int. Journal of Sports Nutrition & Exercise Metabolism, here's what happened and the results: Participants:  17 adults aged 65–75. 12 adults aged 85+. Program:  Duration: 12 weeks, 3x per week Structure: Warm-up  4 lower body sets 3 upper body exercises (2 sets each) Stretching Results: Quadriceps strength increased in all participants 65–75 group: 1–18%  85+ group: 6–21%  1RM leg extension increased in all participants 65–75 group: 38% ± 20%  85+ group: 46% ± 14%  Improvements were seen in lean mass, strength and functional activities like chair stands, gait speed, timed up-and-go.   Defining Muscle Mass and Strength Gains After Menopause Exercise intensity is based on decreasing repetitions to muscular fatigue.  Exercise volume is based on the number of sets.   Considerations for Exercise Volume in Women in Menopause Volume = sets x reps x weight or total weekly workload. Start small (1–2 sets, 2x per week if inactive). Build to 3x only once consistent. Balance recovery: not just alternating workout/rest days, but also factoring in life stress. Menopausal women may need 48–72 hours between resistance sessions, per muscle group.   For women post menopause; increasing the number of days per week to reach greater exercise volume can be problematic because of the need for balance with recovery days. We don't mean 1 day work, 1 day rest. It can mean 1 day of high intensity work and 2 or 3 days light or moderate exercise for another type for recovery.   Start Your Strength Gains After Menopause The beginning phases of exercise should last longer for a woman starting in her 60s or 70s. Muscle, ligaments and tendons collectively are not as resilient at 60 as they were at 20. Since most early improvements are due to neural adaptations and heavier weights don't accelerate that, progress at a pace so you know you've exercised muscles but aren't sore or uncomfortable. You're in this for life. There's time.   The adaptive response to resistance training is preserved even in males and females over 85.   Protein & Resistance Training Two drivers of muscle protein synthesis: Resistance Training Adequate Protein. For metabolic health: ~100g/day (for 160 lb woman). For optimal fitness: closer to 160g/day. Protein recommendation for a 160lb adult is 60 grams of protein day. Only 46% of older adults get that.   5-Step Protein & Resistance Training Process: Track your current protein intake. Compare with recommendations based on age, weight, activity. Identify gaps without judgment. Close the gap gradually. Set short-term goals, especially starting with breakfast protein.   Muscle Mass and Strength Gains After Menopause are Dependent On… Relative Strength Training Power decreased significantly after the age of 50 years and was negatively and strongly associated with mobility limitations.   Mobility & Longevity Connection Strength must be paired with mobility to prevent limitations. Key focus areas: ankles, hips, upper back. Loss of mobility = harder to regain later. More… much more on mobility in upcoming posts. References:  Journal of Cachexia Sarcopenia and Muscle. 2021, PMID: 34216098. Journal of Nutrition, Health and Aging. 2019, PMID: 30932132. International Journal of Sport Nutrition and Exercise Metabolism. 2023, PMID: 37875254.   Other Episodes You Might Like: Previous Episode - Aging with Power, (Without an Outage) with Vonda Wright Next Episode - 80 Lb Perimenopausal Weight Loss After Corporate Burnout More Like This: What Is Sarcopenia and How to Avoid Sarcopenia In Menopause What's Best Total Body or Split Routine in Menopause   Resources for Strength Gains After Menopause:  Join the Hot, Not Bothered! Challenge to learn why timing matters and why what works for others is not working for you. Get the Flipping 50 STRONGER 12-week program for your at-home safe, sane, simple exercises. Get your lean, clean Flipping 50 Protein Powders to maintain muscle and support metabolism.  

LISTENER DISCRETION IS ADVISED. References: Buxton. Sustained Monomorphic VT: Clinical Manifestations, Diagnosis, and Evaluation. Up-to-Date. Farré J, Rubio JM, Sternick EB. Confounding factors leading to misdiagnosing ventricular tachycardia as supraventricular in the emergency room. Indian Pacing Electrophysiol J. 2023;23(1):1-13. doi:10.1016/j.ipej.2022.11.002 Kashou AH, Evenson CM, Noseworthy PA, et al. Differentiating wide complex tachycardias: A historical perspective. Indian Heart J. 2021;73(1):7-13. doi:10.1016/j.ihj.2020.09.006 Salim Rezaie, "SVT With Aberrancy Versus VT", REBEL EM blog, November 22, 2013. Available at: https://rebelem.com/svt-aberrancy-versus-vt/. 
Steinman RT, Herrera C, Schuger CD, Lehmann MH. Wide QRS tachycardia in the conscious adult. Ventricular tachycardia is the most frequent cause. JAMA. 1989 Feb 17;261(7):1013-6. PMID: 2915409. Vereckei A. Current algorithms for the diagnosis of wide QRS complex tachycardias. Curr Cardiol Rev. 2014 Aug;10(3):262-76. doi: 10.2174/1573403x10666140514103309. PMID: 24827795; PMCID: PMC4040878.

Life doesn't always follow your training plan, and that's okay. In this episode, I'll teach you how to pivot your strength and cycling workouts when work, family, or stress throw curveballs. You'll learn my “3 R Framework” (Reduce, Replace, Reschedule) so you can stay consistent, avoid burnout, and actually build resilience as a busy professional who loves to ride. We'll cover: Why adaptable training beats rigid plans for long-term success How to pivot when you're short on time, energy, or equipment The mindset shift that separates thriving athletes from frustrated ones Actionable steps to create your own adaptable training toolkit Whether you're balancing a demanding career or just navigating life's chaos, this episode will help you train smarter, stay consistent, and feel empowered.

Breast cancer is an hormone responsive malignancy, meaning it may use estrogen and progesterone, reduced in high quantities during a pregnancy, for growth. However, as medical evidence evolves quickly, physicians have come to understand that breast cancer diagnosis during pregnancy doesn't always mean worse prognoses. While older studies- including meta analysis-reflected worse prognoses for pregnancy related breast cancer compared to non-pregnancy related cases, these studies either included studies from the 1960s and 70s when diagnosis and treatment were radically different, had inconsistent definitions of PABC, and/or were poorly age and staged matched. Therefore, as stated in the new UK (Aug 2025) guidance, “the applicability to modern day practice of the findings from these reports is limited”. The more updated clinical stance is that, “By using diagnostic and treatment pathways for women with {pregnancy related breast cancer} which are as close as possible to women with non-pregnancy related breast cancer, similar outcomes can be achieved” (RCOG Green Top recommendations No 12). In this episode, we will summarize key points from the recently released Green Top Guidance No 12 (25 Aug 2025) which has shifted the perspective on treating breast cancer DURING pregnancy. 1. Cubillo A, Morales S, Goñi E, Matute F, Muñoz JL, Pérez-Díaz D, de Santiago J, Rodríguez-Lescure Á. Multidisciplinary consensus on cancer management during pregnancy. Clin Transl Oncol. 2021 Jun;23(6):1054-1066. doi: 10.1007/s12094-020-02491-8. Epub 2020 Nov 16. PMID: 33191439; PMCID: PMC8084770.2. https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/pregnancy-and-breast-cancer-green-top-guideline-no-12/3. Sundermann AC, Cate JM, Campbell AK, Dotters-Katz SK, Myers ER, Federspiel JJ. Maternal morbidity and mortality among patients with cancer at time of delivery. Am J Obstet Gynecol. 2023 Sep;229(3):324.e1-324.e7. doi: 10.1016/j.ajog.2023.06.008. Epub 2023 Jun 7. PMID: 37295633; PMCID: PMC10593119.

Episode 107 of Trail Society kicks off with life updates from Keely and Hillary, before diving into listener-submitted news and research. They discuss a BBC story where undercover officers highlighted the prevalence of street harassment, with 94% of local women reporting experiences of catcalling. This transitions into a conversation around exercise during pregnancy, sparked by a listener question about heart rate guidelines. The hosts review current research showing that, for athletes already active, higher intensity exercise can be safe and even beneficial during pregnancy, lowering risks like gestational diabetes and improving newborn Apgar scores. They emphasize that heart rate is an imprecise measure, and individualized approaches are important. The main feature of the episode is an interview with Anne Flower, an ER physician and elite trail runner who recently won and set a new course record at the Leadville 100, her debut 100-mile race. Anne shares how she balances training at a world-class level with her demanding medical career, and how lessons from the ER and ultrarunning inform each other. She reflects on her road-to-trail transition, the highs and lows of Leadville, and her mindset of tackling hard things as practice for resilience. Anne also discusses her role as Chief Medical Officer for Mountains to Mountains, her future racing goals, and offers advice for women entering the sport. The episode closes with listener shoutouts, stories of recovery after long races, training adaptations for different terrains, and heartfelt community support, reinforcing the podcast's commitment to uplifting women in endurance sports.   SPONSORSHIP:  We are so excited to be partnering with rabbit as our primary apparel sponsor this year! Send us some DMS about your favorite apparel and what you would like to see built for the trail running space!  So snag some of the new Trail Society x rabbit line before it's gone! New Code through the end of August—> HOPPER10   Keep sliding into our DMs with your messages, they mean so much to us!  FOLLOW US on Instagram: @trail.society And go follow our NEW youtube channel @trailsociety_podcast   Pregnancy and Exercise Research Citations:  Dalhaug EM, Sanda B, Bø K, Brown WJ, Sundgot-Borgen J, Haakstad LAH. Exceeding the guidelines: A descriptive study of exercise, pregnancy, maternal and neonatal health outcomes in elite and recreational athletes. BMC Pregnancy Childbirth. 2025 Apr 23;25(1):475. doi: 10.1186/s12884-025-07572-6. PMID: 40269794; PMCID: PMC12020307. Worska A, Laudańska-Krzemińska I, Ciążyńska J, Jóźwiak B, Maciaszek J. New Public Health and Sport Medicine Institutions Guidelines of Physical Activity Intensity for Pregnancy-A Scoping Review. J Clin Med. 2024 Mar 18;13(6):1738. doi: 10.3390/jcm13061738. PMID: 38541963; PMCID: PMC10971148.  

Weighted vests can be useful, but let's be honest about the benefits.Topics discussed:(00:06) - Who's excited about a weighted vest? (00:48) - Why is Lindsay not jumping on getting a weighted vest? (02:46) - Does it help with bone density? (03:28) - Does it build more muscle and strength? (05:54) - Does it burn more body fat? (13:56) - The nuance of the studies being used to justify weighted vests (21:08) - I love food! (26:43) - I appreciate your words of encouragement Walking alone is not a strong enough stimulus for muscle or bone.Inactive postmenopausal women who walked with or without a vest for 18 months had no significant bone density changes (PMID: 22338922). Full breakdown belowEven wearing a vest for 8 hours/day (PMID: 40540267) or 10 hours/day (PMID: 30095153) showed minimal skeletal benefit.The muscle and bone gains you see in the research?They're mostly in untrained individuals doing loaded exercises like squats, lunges, and jumps with the vest (PMID: 10995045, 9467434, 17724395).In these cases, the vest is just a hands-free way to add weight — not magic. As people progress, they'll need more load than a vest alone can provide.And for fat loss?Calorie burn from vest-walking is only ~10–15% higher than without it. That's 30–50 kcal for an hour walk — about a single untracked bite of food.Long-term fat loss comes from managing intake, not chasing small increases in burn. Your diet is the real game changer.If you lift weights regularly, walk, and are mindful about food, a weighted vest probably isn't a “must-have” for you. it's most effective in the right context.Study Overview: Walking With vs. Without a Weighted Vest  PMID: 22338922Authors & Journal: Tantiwiboonchai N., Kritpet T., Yuktanandana P. in Journal of the Medical Association of Thailand, 2011 (EurekaMag).Participants: 48 working women aged 30–60, randomly split into two groups: one walking with a weighted vest, the other walking without, on a treadmill 3×/week for 12 weeks (EurekaMag).Protocol: Vest group started walking without it for the first 2 weeks, then began adding 2% of body weight weekly until reaching 8% by week 6 (EurekaMag).FindingsBone Markers: Both groups showed large decreases in bone resorption (β-CrossLaps)—~19.1% for the vest group vs. ~21.8% for the non-vest group—no significant difference between them (EurekaMag).Physical Fitness: Improvements in leg and arm strength, endurance, and VO₂ max were seen in both groups—again, no significant differences between vest vs. non-vest walkers (EurekaMag).Bottom Line—What This MeansWalking, with or without a weighted vest, helped with fitness and reduced bone resorption—but wearing the vest didn't offer any extra benefit. So if you're thinking the vest is a cheat code for stronger bones or muscles… this study says otherwise.

Send us a textAssociation of patent ductus arteriosus treatment in extremely low gestational age neonates with two year kidney outcomes: a secondary analysis of the preterm erythropoietin neuroprotection trial (PENUT).Condit PE, Guillet R, Kaluarachchi D, Griffin RL, Menon S, Askenazi DJ, Harer MW.BMC Nephrol. 2025 Mar 19;26(1):138. doi: 10.1186/s12882-025-04065-8.PMID: 40108500 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!

Send us a textKidney Health Monitoring in Neonatal Intensive Care Unit Graduates: A Modified Delphi Consensus Statement.Starr MC, Harer MW, Steflik HJ, Gorga S, Ambalavanan N, Beck TM, Chaudhry PM, Chmielewski JL, Defreitas MJ, Fuhrman DY, Hanna M, Joseph C, Kwiatkowski DM, Krawczeski CD, Liberio BM, Menon S, Mohamed TH, Rumpel JA, Sanderson KR, Schuh MP, Segar JL, Slagle CL, Soranno DE, Vuong KT, Charlton JR, Gist KM, Askenazi DJ, Selewski DT; Neonatal Kidney Health Consensus Workshop.JAMA Netw Open. 2024 Sep 3;7(9):e2435043. doi: 10.1001/jamanetworkopen.2024.35043.PMID: 39269711 Free 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!

Ready for a deep dive into a real-life pediatric ICU situation? Today, Dr. Pradip Kamat, Dr. Monica Gray, and Dr. Rahul Damania will walk you through the case of a seven-year-old girl with Hemoglobin SC (HbSC) disease, who presents with abdominal swelling, pneumonia, low oxygen, and pain.In this episode, our team unpacks the spleen's anatomy and its crucial role in immunity, then zooms in on how sickle cell disease can throw a wrench in splenic function. You'll hear how they approach the diagnosis and management of acute splenic sequestration crisis, sharing clinical pearls along the way. Plus, they'll break down why quick recognition is so important and discuss strategies for both immediate and long-term care in pediatric sickle cell patients. Don't miss these practical insights from the frontlines of pediatric critical care!Show Highlights:Case study of a seven-year-old girl with hemoglobin SC diseasePresentation of symptoms: abdominal distension, pneumonia, hypoxia, and body painDiscussion of acute splenic sequestration crisis as a complication of sickle cell diseaseAnatomy and physiology of the spleenThe role of the spleen in sickle cell disease and how sickled cells affect splenic functionAcute splenic sequestration crisis, including clinical features and laboratory evaluationsManagement strategies for acute splenic sequestration crisis in the ICUImportance of blood transfusions and supportive care in treatmentProphylactic measures to prevent recurrence of splenic sequestrationEducational emphasis on recognizing clinical signs and the need for timely interventionReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter 88. Hemoglobinopathies. Baender, MA, Marsh Anne. Pages: 1457-1470Rogers' textbook of pediatric intensive care: Hematologic Emergencies. McCory MC, Bhar S, and Blaine E. Pages 2003-2005Brousse V, Buffet P, Rees D. The spleen and sickle cell disease: the sick(led) spleen. Br J Haematol. 2014 Jul;166(2):165-76. doi: 10.1111/bjh 12950. Epub 2014 May 26. PMID: 24862308.Waleed S, Aldabsa M, Gouher S. Splenic Sequestration Induced by Parvovirus B19: A Case Report. Cureus. 2024 May 23;16(5):e60937. doi: 10.7759/cureus. 60937. PMID: 38915956; PMCID: PMC11195323.Solanki DL, Kletter GG, Castro O. Acute splenic sequestration crises in adults with sickle cell disease. Am J Med. 1986 May;80(5):985-90. doi: 10.1016/0002-9343(86)90649-2. PMID: 3706382.Karna B, Jha SK, Al Zaabi E. Hemoglobin C Disease. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559043/

What happens if ChatGPT makes you a training plan? Will wearing a weighted vest protect you from the symptoms of perimenopause? Are continuous glucose monitors the tool for improving your nutrition? We tackle several social media trends and give our unfiltered, evidence-based hot takes.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 purpose.✨ Previnex: Previnex creates clinically effective, third-party tested supplements made with high-quality ingredients, including Muscle Health Plus (creatine). Use the code treadlightly for 15% off your first order at previnex.comIn this episode, you will learn:✅ Do you need electrolytes?✅ Our hot take on AI coaching✅ Do nasal strips improve running performance?✅ Are continuous glucose monitors beneficial?✅ Do carbon plated shoes increase your injury risk?✅ Should you change your workouts based on your menstrual cycle (cycle syncing)?✅ Does weighted vest training help perimenopausal athletes?References:

Contributor: Aaron Lessen, MD Educational Pearls: Recorded March 2025 What is the best treatment for a fever? Tylenol? Ibuprofen? Combined? Alternating the two? The journal Pediatrics aimed to answer this question with a meta-analysis of 31 randomized controlled trials including 5,009 febrile children. Results showed that both combined and alternating acetaminophen/ibuprofen regimens were significantly more effective at reducing fever at 4 and 6 hours compared with acetaminophen alone, with numbers needed to treat (NNT) of 3 and 4, respectively. High-dose ibuprofen alone also offered modest benefit (NNT 8). What dose should I use? Oral acetaminophen 10 to 15 mg/kg Every 4–6 hours as needed Do not exceed 75 mg/kg/day (or 4,000 mg/day maximum for older/larger kids) Oral ibuprofen 5 to 10 mg/kg Every 6–8 hours as needed Do not exceed 40 mg/kg/day (or 2,400 mg/day maximum for older/larger kids) References De la Cruz-Mena JE, Veroniki AA, Acosta-Reyes J, Estupiñán-Bohorquez A, Ibarra JA, Pana MC, Sierra JM, Florez ID. Short-term Dual Therapy or Mono Therapy With Acetaminophen and Ibuprofen for Fever: A Network Meta-Analysis. Pediatrics. 2024 Oct 1;154(4):e2023065390. doi: 10.1542/peds.2023-065390. PMID: 39318339. Summarized by Jeffrey Olson, MS4 | Edited by Jeffrey Olson and Jorge Chalit, OMS4 Get your tickets to Tox Talks Event, Sept 11, 2025: https://emergencymedicalminute.org/events-2/ Donate: https://emergencymedicalminute.org/donate/

Drs. Whitney Hartlage (@whithartlage11) and Sam Windham join Dr. Ryan Moenster to discuss updates in the diagnosis and management of community-acquire pneumonia. Hear from our guests on the role of rapid diagnostic tests such as multiplex PCR and urinary antigen tests in the inpatient and outpatient setting, considerations for initiating steroids and withholding macrolides, and when to use short antibiotic durations. Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/. Visit our website! https://breakpoints-sidp.org/ References: Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, Cooley LA, Dean NC, Fine MJ, Flanders SA, Griffin MR, Metersky ML, Musher DM, Restrepo MI, Whitney CG. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST. PMID: 31573350; PMCID: PMC6812437. Chaudhuri D, Nei AM, Rochwerg B, Balk RA, Asehnoune K, Cadena R, Carcillo JA, Correa R, Drover K, Esper AM, Gershengorn HB, Hammond NE, Jayaprakash N, Menon K, Nazer L, Pitre T, Qasim ZA, Russell JA, Santos AP, Sarwal A, Spencer-Segal J, Tilouche N, Annane D, Pastores SM. 2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia. Crit Care Med. 2024 May 1;52(5):e219-e233. doi: 10.1097/CCM.0000000000006172. Epub 2024 Jan 19. PMID: 38240492. Odeyemi Y, Tekin A, Schanz C, Schreier D, Cole K, Gajic O, Barreto E. Comparative effectiveness of azithromycin versus doxycycline in hospitalized patients with community acquired pneumonia treated with beta-lactams: A multicenter matched cohort study. Clin Infect Dis. 2025 May 16:ciaf252. doi: 10.1093/cid/ciaf252. Epub ahead of print. PMID: 40378193. Butler AM, Nickel KB, Olsen MA, Sahrmann JM, Colvin R, Neuner E, O'Neil CA, Fraser VJ, Durkin MJ. Comparative safety of different antibiotic regimens for the treatment of outpatient community-acquired pneumonia among otherwise healthy adults. Clin Infect Dis. 2024 Oct 23:ciae519. doi: 10.1093/cid/ciae519. Epub ahead of print. PMID: 39442057; PMCID: PMC12355227. Furukawa Y, Luo Y, Funada S, Onishi A, Ostinelli E, Hamza T, Furukawa TA, Kataoka Y. Optimal duration of antibiotic treatment for community-acquired pneumonia in adults: a systematic review and duration-effect meta-analysis. BMJ Open. 2023 Mar 22;13(3):e061023. doi: 10.1136/bmjopen-2022-061023. PMID: 36948555; PMCID: PMC10040075 Schober T, Wong K, DeLisle G, et al. Clinical outcomes of rapid respiratory virus testing in emergency departments. JAMA Intern Med. 2024;184(5):528-536. Clark T, Lindsley K, Wigmosta T, et al. Rapid multiplex PCR for respiratory viruses reduces time to result and improves clinical care: results of a systematic review and meta-analysis. J Infect. 2023;86(5):462-475. May L, Robbins EM, Canchola JA, Chugh K, Tran NK. A study to assess the impact of the cobas point-of-care RT-PCR assay (SARS-CoV-2 and Influenza A/B) on patient clinical management in the emergency department of the University of California at David Medical Center. J Clin Virol. 2023:168:105597. Cartuliares MB, Rosenvinge FS, Mogensen CB, Skovsted TA, Andersen SL, Østergaard C, et al. Evaluation of point-of-care multiplex polymerase chain reaction in guiding antibiotic treatment of patients acutely admitted with suspected community-acquired pneumonia in Denmark: a multicentre randomised controlled trial. PLoS Med. 2023;20:e1004314. doi: 10.1371/ journal.pmed.1004314. Vaughn VM, Dickson RP, Horowitz JK, Flanders SA. Community-acquired pneumonia: a review. JAMA. 2024;332(15):1282-1295. Davis MR, McCreary EK, Trzebucki AM. Things we do for no reason – ordering Streptococcus pneumoniae urinary antigen in patients with community-acquired pneumonia. Open Forum Infect Dis. 2024;11(3):ofae089. Centers for Disease Control and Prevention. Laboratory Testing for Legionella. Updated June 9, 2025. Accessed July 13, 2025. https://www.cdc.gov/legionella/php/laboratories/index.html. Jain S, Self WH, Wunderink RG. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med. 2015;373(5):415-427. Kamat IS, Ramachandram V, Eswaran H, Guffey D, Musher DM. Procalcitonin to distinguish viral from bacterial pneumonia: a systematic review and meta-analysis. Clin Infect Dis. 2020;70(3):538-542. Christ-Crain M, Jaccard-Stolz D, Bingisser R, Gencay MM, Huber PR, Tamm M, et al. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single blinded intervention trial. Lancet. 2004;363:600–7. doi: 10.1016/S0140- 6736(04)15591-8. Schuetz P, Christ-Crain M, Thomann R, Falconnier C, Wolbers M, Widmer I, et al. Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial. JAMA. 2009;302:1059–66. Schuetz P, Muller B, Christ-Crain M, Stolz D, Tamm M, Bouadma L, et al. Procalci- € tonin to initiate or discontinue antibiotics in acute respiratory tract infections. Cochrane Datab System Rev. 2017;10(10):CD007498. doi: 10.1002/14651858. cd007498.pub2. Huang DT, Yealy DM, Filbin MR, Brown AM, Chang C-CH, Doi Y, et al. Procalcitonin-guided use of antibiotics for lower Respiratory tract infection. New Engl J Med. 2018;379:236–49. doi: 10.1056/NEJMoa1802670. Dequin PF, Meziani F, Quenot JP, et al. Hydrocortisone in severe community-acquired pneumonia. N Engl J Med. 2023;389(19):1623-1634. doi:10.1056/NEJMoa2215145. Gupta AB, Flanders SA, Petty LA, et al. Inappropriate diagnosis of pneumonia among hospitalized adults. JAMA Intern Med. 2024;184(5):548-556. Jones BE, Chapman AB, Ying J, et al. Diagnostic Discordance, Uncertainty, and Treatment Ambiguity in Community-Acquired Pneumonia: A National Cohort Study of 115 U.S. Veterans Affairs Hospitals. Ann Intern Med. 2024;177(9):1179-1189. doi:10.7326/M23-2505. Hartlage W, Imlay H, Spivak ES. The role of empiric atypical antibiotic coverage in non-severe community-acquired pneumonia. Antimicrob Steward Healthc Epidemiol. 2024;4(1):e214. doi:10.1017/ash.2024.453. Dinh A, Barbier F, Bedos JP, et al. Update of guidelines for management of community acquired pneumonia in adults by the French Infectious Disease Society (SPILF) and the French-Speaking Society of Respiratory Diseases (SPLF). Endorsed by the French Infectious Disease Society (SPILF) and the French-Speaking Society of Respiratory Diseases (SPLF); endorsed by the French Intensive Care Society (SRLF), the French Microbiology Society (SFM), the French Radiology Society (SFR), and the French Emergency Society (SFMU). Respir Med and Res. 2025. El Moussaoui R, de Borgie CAJM, van den Broek P, et al. Effectiveness of discontinuing antibiotic treatment after three days versus eight days in mild to moderate-severe community acquired pneumonia: randomised, double blind study. BMJ. 2006;332(7554):1355. doi:10.1136/bmj.332.7554.1355. Dinh A, Ropers J, Duran C, et al. Discontinuing β-lactam treatment after 3 days for patients with community-acquired pneumonia: a randomized, non-inferiority trial. Lancet. 2021;397(10280):1195-1203.

In the last 2 episodes we covered new updates in menopausal hormone therapy. However, we did not address TESTOSTERONE use. This episode idea comes from one our podcast family members and good friend, Eric. Eric is 100% correct: Testosterone replacement, when done correctly, has come along way. When is this indicated? Is this endorsed by professional medical/endocrine groups? What's the dose? We have fun stuff to review, so listen in!1. Davis SR, Baber R, Panay N, Bitzer J, Perez SC, Islam RM, Kaunitz AM, Kingsberg SA, Lambrinoudaki I, Liu J, Parish SJ, Pinkerton J, Rymer J, Simon JA, Vignozzi L, Wierman ME. Global Consensus Position Statement on the Use of Testosterone Therapy for Women. J Clin Endocrinol Metab. 2019 Oct 1;104(10):4660-4666. doi: 10.1210/jc.2019-01603. PMID: 31498871; PMCID: PMC6821450.2. Sharon J. Parish, James A. Simon, Susan R. Davis, Annamaria Giraldi, Irwin Goldstein, Sue W. Goldstein, Noel N. Kim, Sheryl A. Kingsberg, Abraham Morgentaler, Rossella E. Nappi, Kwangsung Park, Cynthia A. Stuenkel, Abdulmaged M. Traish, Linda Vignozzi, International Society for the Study of Women's Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women, The Journal of Sexual Medicine, Volume 18, Issue 5, May 2021, Pages 849–867, https://doi.org/10.1016/j.jsxm.2020.10.0093. Levy, Barbara MD, MSCP; Simon, James A. MD, MSCP. A Contemporary View of Menopausal Hormone Therapy. Obstetrics & Gynecology 144(1):p 12-23, July 2024. | DOI: 10.1097/AOG.00000000000055534. NAMS The 2022 hormone therapy position statement of The North American Menopause Society: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://menopause.org/wp-content/uploads/professional/nams-2022-hormone-therapy-position-statement.pdf

In this episode, we're diving headfirst into the world of baby wearing with Jordan Morillo, a perinatal health OT, certified babywearing consultant, and toddler mom. We're talking everything from the ABCs of carrier choices to spotting a perfect carry (and avoiding the not-so-perfect ones). You'll learn how to safely position your baby, back carry like a pro, tandem wear without losing your mind, and even breastfeed on the go. We tackle fears, hot-weather hacks, and ethical carrier picks, so whether you're a newbie or a seasoned wearer, you'll walk away confident, informed, and ready to rock that baby wearing life. 00:00 Introduction and Importance of Baby Wearing 05:42 Key Safety Components: The ABCs of Baby Wearing 08:53 Understanding the M Position for Baby's Legs 15:21 Choosing the Right Baby Carrier 20:59 Addressing Common Concerns and Misconceptions 25:03 Risks and Benefits of Baby Wearing 29:36 Special Considerations for NICU and Preemie Babies 33:40 Misleading Marketing and Safety Testing 39:22 Addressing Baby's Discomfort with Carriers 39:45 Tips for Easing Baby into Baby Wearing 41:05 Understanding Baby's Resistance to Carriers 45:14 Debunking Myths: Baby Wearing and Clinginess 48:52 Breastfeeding Benefits and Baby Wearing 50:55 Toddler Wearing: Tips and Techniques 54:44 Tandem Wearing: Managing Two Kids 56:21 Forward Facing: When and How 01:00:21 Favorite Carriers for Different Scenarios 01:07:44 Water Safe Baby Wearing 01:11:22 Final Thoughts and Takeaways   Guest Bio: Jordan Morillo is a perinatal health OT, certified babywearing consultant, and toddler mom, who is passionate about empowering families with the knowledge they need to babywear safely, comfortably, and with confidence. She provides parent support through worldwide virtual 1:1 consultations, home health services, and by sharing free resources and tutorials on social media. INSTAGRAM: Connect with HeHe on IG  Connect with HeHe on YouTube   Connect with Jordan on IG    BIRTH EDUCATION: Join The Birth Lounge here for judgment-free childbirth education that prepares you for an informed birth and how to confidently navigate hospital policy to have a trauma-free labor experience!   Download The Birth Lounge App for birth & postpartum prep delivered straight to your phone!   LINKS MENTIONED: Visit Motherhoodtherapyservices.janeapp.com to book a consultation with Jordan!  Babywearing Resources Everyday Carriers Hoppediz Primeo – https://hoppediz.de/en/baby-carriers/primeo A buckle carrier that's perfect for smaller babies. Neko Tiny – https://www.nekoslings.com/en/ A stretchy wrap–buckle hybrid carrier for newborns. Solly Baby – https://sollybaby.com/ Lightweight stretchy wraps designed for comfort in the early months. Boba – https://boba.com/ Known for soft structured carriers and stretchy wraps. Ring Slings – Popular ones are from Sakura Bloom https://sakurabloom.com/collections/ring-sling and Mama & Roos https://www.mama-roo.com/collections/ring-slings Easy to adjust and stylish for on-the-go babywearing. Onbuhimo Buckle Carrier Strap-and-back-only carrier, ideal for toddlers who want up and down often. Forward Facing Options – ErgoBaby Omni https://ergobaby.com/omni-breeze-baby-carrier and Tula Explore https://babytula.com/products/explore-baby-carrier Safe forward-facing carry for older babies. Jordan's favorite ethical/organic brands:  Ethically made, sustainable carriers with thoughtful design. Hope & Plum https://www.hopeandplum.co/collections/baby-carriers Heritage Baby Designs https://heritagebaby.ca/ LoveHeld https://loveheld.com/collections/shop-all-baby-carriers  Beluga Baby https://belugababy.ca/ Size Inclusive Carriers Ring Slings – Sakura Bloom https://sakurabloom.com/collections/ring-sling, Mama & Roos https://www.mama-roo.com/collections/ring-slings Adjustable and versatile for all body types. Woven Wraps – Didymos https://www.didymos.de/en/Baby-Wraps/, Oscha Slings https://oschaslings.com/collections/baby-wraps Endless tying options for perfect fit and comfort. Keep Close(r) – https://keepcloser.com/ Designed specifically with plus-size parents in mind. Kinderpack – https://kindercarry.com/ Extended sizes and supportive structure for all bodies. Integra Baby – https://integrababy.co.uk/ Lightweight carriers with adjustable straps for inclusivity. Hope & Plum – https://www.hopeandplum.co/collections/baby-carriers Ring slings made for every parent's comfort. LoveHeld – https://loveheld.com/collections/shop-all-baby-carriers Soft, ethically made carriers with flexible sizing. Tula Belt Extenders – https://babytula.com/products/tula-waistband-extenders Expand Tula carriers for a more inclusive fit. Meh Dai Carriers – Didymos https://www.didymos.de/en/Meh-Dai/, BabyHawk https://babyhawk.com/ Tie-on carriers with a customizable fit. Lamb (Europe) – https://lamb-babycarriers.com/ European-made woven carriers, size-friendly. WildBird – https://wildbird.co/ Long-tail ring slings for flexible carrying options. Water Wearing Carriers Integra Solar – https://integrababy.co.uk/collections/integra-solar Quick-drying, lightweight carrier for water activities. Hope & Plum Hemp Sling – https://www.hopeandplum.co/collections/baby-carriers Breathable sling, perfect for summer and pool days. LoveHeld Hemp Carrier – https://loveheld.com/collections/shop-all-baby-carriers Durable hemp blend, suitable for water and sun. Aloha & Light Eco Silk Hemp Blend – https://alohaandlight.com/ Soft, eco-friendly slings designed for hot climates. Beachfront Baby – https://beachfrontbabywraps.com/ Mesh Meh Dais and wraps made for swimming and beach days. Gustine Mesh Sling – https://gustinebabycarriers.com/ Breathable mesh sling perfect for water play. RESEARCH: Study on reduction of PMADs: Randomized controlled trial to prevent postpartum depressive symptomatology: An infant carrier intervention. Little EE, Bain L, Hahn-Holbrook J. J Affect Disord. 2023 Nov 1;340:871-876. doi: 10.1016/j.jad.2023.08.044. Epub 2023 Aug 15. PMID: 37586649. Study on decreased cry time when worn: Increased Carrying Reduces Infant Crying: A Randomized Controlled Trial.Urs A. Hunziker; Ronald G. Barr. Pediatrics (1986) 77 (5): 641–648 Vital signs regulation:  https://pubmed.ncbi.nlm.nih.gov/39369660/ 

[12] Avoid the trap of false growth mindset This episode was first released on February 18, 2025. Description: - In this episode, Adam discusses the complexities of growth mindset in medical education with guests Milad Memari and Katie Gavinski. They explore the differences between growth and fixed mindsets, the dangers of misapplying mindset theory, and the trap of false growth mindset. The conversation emphasizes practical strategies for educators to promote a growth mindset among learners, the challenges of assessment in medical training, and the need for systemic changes informed by mindset theory to support learner development.  Length of Episode:   45:09 Resources to check out :    Memari M, Gavinski K, Norman MK. Beware False Growth Mindset: Building Growth Mindset in Medical Education Is Essential but Complicated. Acad Med. 2024 Mar 1;99(3):261-265.  https://pubmed.ncbi.nlm.nih.gov/37643577/   PISA 2018 Results (Volume I): https://www.oecd.org/en/publications/pisa-2018-results-volume-i_5f07c754-en/full-report.html   A national experiment reveals where a growth mindset improves achievement: https://pubmed.ncbi.nlm.nih.gov/31391586/   Yeager DS, Dweck CS. What can be learned from growth mindset controversies? Am Psychol. 2020 Dec;75(9):1269-1284. doi: 10.1037/amp0000794. PMID: 33382294; PMCID: PMC8299535. https://pmc.ncbi.nlm.nih.gov/articles/PMC8299535/  @MemariMD   @katiegavinski     Contact us: keylime@royalcollege.ca     Follow: Dr. Adam Szulewski https://x.com/Adam_Szulewski   

Jasmine Gonzalvo, PharmD, MPH, CDCES, FADCES, joins this episode to discuss the importance of curiosity, effective communication and cultural sensitivity in diabetes care. She shares her personal approach to exploring barriers to insulin in clients and highlights how motivational interviewing can be a powerful tool in navigating treatment conversations—especially when addressing common misconceptions about insulin. The conversation emphasizes the importance of open-ended questions, recognizing personal biases, and creating safe spaces for honest dialogue. By nurturing relationships and meeting patients where they are, diabetes care and education specialists can better support lasting behavior change and improve health outcomes.This episode is sponsored by Lilly. ResourcesA link to the insulin myths tip sheet mentioned in this episode is coming soon. ReferencesNahid Dehghan-Nayeri, Fatemeh Ghaffari, Tahereh Sadeghi, Naser Mozaffari; Effects of Motivational Interviewing on Adherence to Treatment Regimens Among Patients With Type 1 Diabetes: A Systematic Review. Diabetes Spectr 1 May 2019; 32 (2): 112–117.Guy E H M Rutten, Heidi Van Vugt, Eelco de Koning - Person-centered diabetes care and patient activation in people with type 2 diabetes: BMJ Open Diabetes Research & Care 2020;8:e001926.Entwistle VA, Carter SM, Cribb A, McCaffery K. Supporting patient autonomy: the importance of clinician-patient relationships. J Gen Intern Med. 2010 Jul;25(7):741-5. doi: 10.1007/s11606-010-1292-2. Epub 2010 Mar 6. PMID: 20213206; PMCID: PMC2881979. Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.Learn more about ADCES and the many benefits of membership at adces.org/join.

Primary hyperparathyroidism is an underdiagnosed condition which leads to decreased bone mineral density, fracture, renal disease, among other symptoms that can decrease the quality of a patient's life. Moreover, once diagnosed, only a small fraction of patients with the diease end up being offered surgery. Whether it is because of misunderstood indications and benefits of surgery, non-localization of disease, or various other reasons, we thought it was worthwhile to review relevant literature. Hosts: Dr. Becky Sippel is an endowed professor of surgery at Division Chief of endocrine surgery at University of Wisconsin Madison and she is the most recent past president of the AAES.  She is an internationally recognized leader in the field of endocrine surgery. She has over 250 publications. She was the PI for a RCT which studies prophylactic central neck dissections which is a widely read and quoted study in endocrine surgery. Dr. Amanda Doubleday is a fellowship trained endocrine surgeon in private practice with an affiliation to UW Health. Her primary practice is with Waukesha Surgical Specialists in Waukesha WI.  Dr. Simon Holoubek is a fellowship trained endocrine surgeons affiliated with UW Health. He works for UW Health with privileges at UW Madison and UW Northern Illinois. His clinical interests are aggressive variants of thyroid cancer, parathyroid autofluorescence, and nerve monitoring.  Learning Objectives: 1 Understand the natural history of primary hyperparathyroidism and how the disease process can affect bone mineral density. 2 Learn about fracture risk associated with primary hyperparathyroidism. 3 Learn about decreased fracture risk in patients with primary hyperparathyroidism who have parathyroidectomy compared to those who are observed.  References: 1 Rubin MR, Bilezikian JP, McMahon DJ, Jacobs T, Shane E, Siris E, Udesky J, Silverberg SJ. The natural history of primary hyperparathyroidism with or without parathyroid surgery after 15 years. J Clin Endocrinol Metab. 2008 Sep;93(9):3462-70. doi: 10.1210/jc.2007-1215. Epub 2008 Jun 10. PMID: 18544625; PMCID: PMC2567863. https://pubmed.ncbi.nlm.nih.gov/18544625/ 2 Frey S, Gérard M, Guillot P, Wargny M, Bach-Ngohou K, Bigot-Corbel E, Renaud Moreau N, Caillard C, Mirallié E, Cariou B, Blanchard C. Parathyroidectomy Improves Bone Density in Women With Primary Hyperparathyroidism and Preoperative Osteopenia. J Clin Endocrinol Metab. 2024 May 17;109(6):1494-1504. doi: 10.1210/clinem/dgad718. PMID: 38152848. https://pubmed.ncbi.nlm.nih.gov/38152848/ 3 VanderWalde LH, Liu IL, Haigh PI. Effect of bone mineral density and parathyroidectomy on fracture risk in primary hyperparathyroidism. World J Surg. 2009 Mar;33(3):406-11. doi: 10.1007/s00268-008-9720-8. PMID: 18763015. https://pubmed.ncbi.nlm.nih.gov/18763015/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

This is a requested follow up to our most recent episode. Menopausal hormone therapy (HT) prescribing practices have evolved over the last few decades guided by the changing understanding of the treatment's risks and benefits. We know that dose, route of administration, and choice of agent (estradiol versus a more synthetic option, and micronized progesterone over other progestins.) alter the risk benefit ratio. Compared to natural progesterone, synthetic progestins have 10-100- fold greater activity. Synthetic MPA is vasoconstrictive while natural progesterone and drospirenone cause vasodilation and lower blood pressure. Micronized progesterone is bioidentical to the hormone made endogenously and has efficient oral absorption. Progestogens come in oral and transdermal forms, and it can also be given vaginally. Is there data that micronized progesterone is safer for the breast for a menopausal hormone therapy? This podcast topic recommendation comes from one of our podcast family members. Listen for details. 1. Gompel A. Micronized progesterone and its impact on the endometrium and breast vs. progestogens. Climacteric. 2012 Apr;15 Suppl 1:18-25. doi: 10.3109/13697137.2012.669584. PMID: 22432812.2. Stute P, Wildt L, Neulen J. The impact of micronized progesterone on breast cancer risk: a systematic review. Climacteric. 2018 Apr;21(2):111-122. doi: 10.1080/13697137.2017.1421925. Epub 2018 Jan 31. PMID: 29384406.3. Eden J. The endometrial and breast safety of menopausal hormone therapy containing micronised progesterone: A short review. Aust N Z J Obstet Gynaecol. 2017 Feb;57(1):12-15. doi: 10.1111/ajo.12583. PMID: 28251642.4. Asi N, Mohammed K, Haydour Q, Gionfriddo MR, Vargas OL, Prokop LJ, Faubion SS, Murad MH. Progesterone vs. synthetic progestins and the risk of breast cancer: a systematic review and meta-analysis. Syst Rev. 2016 Jul 26;5(1):121. doi: 10.1186/s13643-016-0294-5. PMID: 27456847; PMCID: PMC4960754.5.AHA J Circulation: Rethinking Menopausal Hormone Therapy: For Whom, What, When, and How Long? 2023

In the second half of this two part episode, Dr. David Leon unpacks some of the most hotly debated topics in resuscitation—fluids, blood products, ECMO, and post-arrest care. He breaks down the pros and cons of crystalloids (yes, even the “pasta water” debate), explains why lactated Ringer's is often preferred over normal saline, and dips into the use of albumin and colloids. Dr. Leon also discusses the promise and challenges of extracorporeal life support (ECLS), the evolving role of targeted temperature management (TTM), and even peeks into what advances the future might hold. It's a thoughtful, forward-looking conversation every resuscitationist should hear. What do you think of Dr. Leon's tips? Are you using these tools in your practice? We'd love to hear from you. Share them 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 Emergency Medicine at UC Davis Guest: Dr. David Leon, Assistant Professor of Emergency Medicine and Anesthesia at UC Davis Resources: American Heart Association (AHA) Algorithms Perman SM, Elmer J, Maciel CB, Uzendu A, May T, Mumma BE, Bartos JA, Rodriguez AJ, Kurz MC, Panchal AR, Rittenberger JC; American Heart Association. 2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2024 Jan 30;149(5):e254-e273. doi: 10.1161/CIR.0000000000001194. Epub 2023 Dec 18. PMID: 38108133. **** 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 this episode of the Saving Lives Podcast, Eddy Joe breaks down a 2025 Journal of Critical Care study examining how the choice of the internal jugular vein for initial central line placement impacts outcomes when patients later need hemodialysis catheters. You'll learn why using the left IJV first may reduce the need for repeat procedures and complications. Essential insights for optimizing central line strategy in the ICU.The Vasopressor & Inotrope HandbookAmazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/47qJZe1⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Affiliate Link)My Store: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Use "podcast" to save 10%)Citation: Gharaibeh KA, Abdelhafez MO, Guedze KEB, Siddiqi H, Hamadah AM, Verceles AC. Impact of initial jugular vein insertion site selection for central venous catheter placement on hemodialysis catheter complications. J Crit Care. 2025 Jun;87:155011. doi: 10.1016/j.jcrc.2024.155011. Epub 2025 Jan 3. PMID: 39755012.

Send us a textFenton Third-Generation Growth Charts of Preterm Infants Without Abnormal Fetal Growth: A Systematic Review and Meta-Analysis.Fenton TR, Elmrayed S, Alshaikh BN.Paediatr Perinat Epidemiol. 2025 Jun 19. doi: 10.1111/ppe.70035. Online ahead of print.PMID: 40534585 Review.Birth weight and head circumference for 22-29 weeks gestation neonates from an international cohort.Fenton TR, Alshaikh B, Kusuda S, Helenius K, Modi N, Norman M, Lui K, Lehtonen L, Battin M, Klinger G, Vento M, Lastrucci V, Gagliardi L, Adams M, Marba STM, Isayama T, Hakansson S, Bassler D, Shah PS; International Network for Evaluation of Outcomes (iNeo) of Neonates Investigators.Arch Dis Child Fetal Neonatal Ed. 2025 Jun 19;110(4):401-408. doi: 10.1136/archdischild-2024-327845.PMID: 39762001Support 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 a textWhole-Body Hypothermia for Neonatal Encephalopathy in Preterm Infants 33 to 35 Weeks' Gestation: A Randomized Clinical Trial.Faix RG, Laptook AR, Shankaran S, Eggleston B, Chowdhury D, Heyne RJ, Das A, Pedroza C, Tyson JE, Wusthoff C, Bonifacio SL, Sánchez PJ, Yoder BA, Laughon MM, Vasil DM, Van Meurs KP, Crawford MM, Higgins RD, Poindexter BB, Colaizy TT, Hamrick SEG, Chalak LF, Ohls RK, Hartley-McAndrew ME, Dysart K, D'Angio CT, Guillet R, Kicklighter SD, Carlo WA, Sokol GM, DeMauro SB, Hibbs AM, Cotten CM, Merhar SL, Bapat RV, Harmon HM, Sewell E, Winter S, Natarajan G, Mosquera R, Hintz SR, Maitre NL, Benninger KL, Peralta-Carcelen M, Hines AC, Duncan AF, Wilson-Costello DE, Trembath A, Malcolm WF, Walsh MC; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.JAMA Pediatr. 2025 Apr 1;179(4):396-406. doi: 10.1001/jamapediatrics.2024.6613.PMID: 39992674 Free PMC article. Clinical Trial.EBNEO Commentary: Is Therapeutic Hypothermia Beneficial to Infants Born Between 33 and 35 Weeks Gestation?Spahic H, Zoubovsky SP, Dietz RM.Acta Paediatr. 2025 Jul;114(7):1742-1743. doi: 10.1111/apa.70098. Epub 2025 Apr 18.PMID: 40251839 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 a textRetinopathy of Prematurity and Risk of Structural Brain Abnormalities on Magnetic Resonance Imaging at Term Among Infants Born at Less Than or Equal to 32 Weeks of Gestation.Roy S, Peterson L, Kline-Fath B, Parikh NA; Cincinnati Infant Neurodevelopment Early Prediction Study (CINEPS) Investigators.J Pediatr. 2025 Jun 27;286:114711. doi: 10.1016/j.jpeds.2025.114711. Online ahead of print.PMID: 40582695 Free 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 a textEarly Neurodevelopment of Extremely Preterm Infants Administered Autologous Cord Blood Cell Therapy: Secondary Analysis of a Nonrandomized Clinical Trial.Zhou L, Razak A, McDonald CA, Yawno T, McHugh DT, Whiteley G, Connelly K, Sackett V, Miller SL, Jenkin G, Novak I, Hunt RW, Malhotra A.JAMA Netw Open. 2025 Jul 1;8(7):e2521158. doi: 10.1001/jamanetworkopen.2025.21158.PMID: 40608334 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!

Send us a textDiaphragm Position on Chest Radiograph to Estimate Lung Volume in Neonates.Dahm SI, Sett A, Gunn EF, Ramanauskas F, Hall R, Stewart D, Koeppenkastrop S, McKenna K, Gardiner RE, Rao P, Tingay DG.JAMA Pediatr. 2025 Jul 21:e252108. doi: 10.1001/jamapediatrics.2025.2108. Online ahead of print.PMID: 40690243 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!

You can't scroll social media without seeing someone tell you how you have to hit a 180 spm cadence, stop overstriking, or do these exercises for better running form. But do you really need to change your running form? We dive into the science and discuss whether or not changing form is beneficial - plus offer some practical tips if you do want to improve your own natural running form. 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. ✨ Shokz: Open ear headphones so you can enjoy your music or audiobook while staying safe and aware of your surroundings. Use code RUNTOTHEFINISH for $10 off at https://shokz.com?utm_source=TLR&utm_medium=website&utm_campaign=podcastIn this episode, you will learn:✅ Should you change your running form?✅ Is strength training the most effective way to improve running form?✅ Should you change your foot strike?✅ Does your running form vary with your pace?✅ What changes in your running form can tell you about fatigue✅ Should your cadence be 180?✅ Drills to improve your running formReferences:

There's a lot of fear and misinformation around HRT, and one of the biggest myths is that HT is a highly significant cause of breast cancer. That is not the case. This is a remnant concept from 2002, with MANY caveats. Calls for the removal of the black box warning on hormone replacement therapy (HRT) stems primarily from the outdated and limited nature of the data from the Women's Health Initiative (WHI) study published in 2002. The WHI, while groundbreaking at the time, focused predominantly on a specific formulation of conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA) in older, postmenopausal women, leading to concerns about its generalizability to the broader population of women considering HRT. This is why on July 17, 2025, the FDA met with a panel of experts, in open forum, to hear the petition of removing the black box warning on hormone replacement therapy. Listen in for details. 1. Writing Group for the Women's Health Initiative Investigators. Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women's Health Initiative Randomized Controlled Trial. JAMA.2002;288(3):321–333. doi:10.1001/jama.288.3.3212. Manson JE, Crandall CJ, Rossouw JE, Chlebowski RT, Anderson GL, Stefanick ML, Aragaki AK, Cauley JA, Wells GL, LaCroix AZ, Thomson CA, Neuhouser ML, Van Horn L, Kooperberg C, Howard BV, Tinker LF, Wactawski-Wende J, Shumaker SA, Prentice RL. The Women's Health Initiative Randomized Trials and Clinical Practice: A Review. JAMA. 2024 May 28;331(20):1748-1760. doi: 10.1001/jama.2024.6542. PMID: 38691368.3. NAMS: The 2022 hormone therapy position statement of The North American Menopause Society (Menopause)

Fast fat loss in menopause is not really the goal. Let's be realistic and say this right out of the gate. Fast fat loss is a myth.  You may, however, drop inflammation fairly quickly with the right type of exercise.    Part 1: The Fat Burning Fundamentals Let's start with the basics. When we talk about fat burning during exercise, we need to understand two key concepts:  Percentage of Fat Used for Fuel  Total Calories Burned Here's something surprising: At rest, we burn about 85% fat for fuel. Your body is already a fat-burning machine when you're sitting on the couch!  Here's where it gets interesting.. During low-intensity exercise like walking, you burn a higher percentage of fat for fuel, but you're burning calories at a slower rate overall. During high-intensity exercise like running, you burn a lower percentage of fat for fuel, but you're torching calories much faster. Part 2: The EPOC Effect - Your Metabolic Afterburn EPOC or Excess Post-Exercise Oxygen Consumption, but I like to call it your metabolic afterburn. This is the energy your body continues to burn AFTER your workout is over. High-intensity exercise creates a significant EPOC effect. Your body keeps burning calories for hours after you finish your workout as it works to restore oxygen levels, repair tissues, and return to its normal state. It's like your metabolism stays revved up long after you've stopped moving. Low-intensity exercise produces minimal EPOC. Once you stop walking, your metabolism pretty quickly returns to baseline. You burned calories during the activity, but the party's over when you stop. This is where high-intensity exercise starts to look really appealing for fat loss. You're not just burning calories during the workout - you're creating a metabolic boost that lasts for hours. Know the Best Strategy for Fast Fat Loss in Menopause May Surprise You Part 3: Sprints vs Steady-State Running - The Game Changer When we compare running at a slow to moderate pace versus doing sprint intervals, the sprint work wins hands down for fat loss.  Sprint intervals create a massive EPOC effect. Your body works harder to recover from intense bursts, burning calories long after you're done. Sprint intervals are incredibly effective at burning both total body fat AND visceral belly fat. The beauty of sprints is that you can get incredible results in much less time. A 15-20 minute sprint session can be more effective for fat loss than an hour of steady jogging. For busy women in menopause, this efficiency factor is huge. Part 4: The Cortisol Connection - Why This Matters in Menopause Now we need to talk about cortisol, because this is where things get really important for women in menopause. High-intensity exercise creates a greater rise in cortisol compared to low-intensity exercise. This isn't necessarily bad! This cortisol response is actually normal and necessary. It's how your body releases blood sugar to be used as fuel and creates energy for exercise. Low-intensity exercise like walking creates little rise in cortisol. Comfortable walking, dancing, yoga, or tai chi often actually REDUCE cortisol levels. The problem isn't the acute cortisol rise from exercise itself. The problem is chronic elevated cortisol combined with high-intensity exercise when your system is already overloaded. If your stress bucket is already overflowing from work, relationships, poor sleep, and hormonal changes, adding high-intensity exercise makes it spill over. When cortisol is chronically elevated, it can sabotage your adrenal function and ultimately affect your thyroid. This is particularly relevant during menopause when our hormone systems are already in flux.  Choosing the Right Cardio for Fast Fat Loss in Menopause The Hot Not Bothered is open for enrollment as this episode goes live. If you need support getting a start, restart or reset, now is the time! Learn More Here   Part 5: The Real Running vs Walking Debate Here's where I want to challenge the traditional running versus walking debate. Maybe it's less about the percentage of fat burned for fuel and more about not burning yourself out. Let me give you a practical example from my own experience: Walking at a 5.0 pace on the treadmill is NOT comfortable for me. It's an effort - I'm breathing hard, I'm sweating, I'm working. But jogging at 5.8? That's actually quite slow for running. It's likely harder on my knees while not really providing enough impact to benefit my bone density. Here's a crucial point: Every time you run - meaning both feet leave the ground - you add four times your body weight in impact to your knee joints. Yet ironically, this repetitive impact isn't the kind of stimulus that optimally benefits bone density once you do it regularly. While jumping and purposeful impact exercises do provide bone density benefits, repetitive exercise loads like jogging don't create additional stress - they just create more of the same stress. So sometimes, a challenging walk might actually give you better results than an easy jog, with less wear and tear on your joints. The sad myth about running vs walking is that it will result in fast fat loss in menopause - or any time for that matter. Smarter Workouts for Fast Fat Loss in Menopause — Without Burnout Part 6: When Your Body Is Telling You to Slow Down Chronic cortisol elevation is often linked to inadequate recovery - particularly nutrition - than to workout intensity itself. If you're on a chronically low-carbohydrate or low-calorie diet, you may experience prolonged cortisol elevations regardless of your exercise. When your body lacks fuel, it compensates by releasing more cortisol to break down fat, muscle, and even bone tissue for energy. Chronic cortisol is more likely under these conditions: Too much too soon (occasional overreaching isn't a problem, but repeated overreaching is) Undereating before, during, or after exercise Lack of rest time between workouts for repair Inadequate sleep Planned diet or fasting state Lower intensity workouts may work better because you're not eating enough, not sleeping enough, or not managing your overall stress load. The biggest problem? Not eating enough. Going too low carb. Making statements like "my body loves this" when it's giving you signs you're exhausted, holding onto weight, or failing to gain muscle. No, it doesn't love it. Part 7: Making the Right Choice for YOU How do you decide between running and walking, or between steady-state and sprint work? Assess your current stress load: How's your sleep? Are you eating enough, especially carbohydrates? How are your energy levels throughout the day? Are you seeing the results you want? If you're well-rested, well-fed, and managing stress effectively, higher intensity work including sprints is incredibly effective for fat loss. If you're stressed, under-fueled, or sleep-deprived, walking or other lower-intensity activities is better right now.  That's not settling for less - that's being smart about working WITH your body instead of against it. The best exercise program is what you can do consistently while feeling energized and strong, not depleted and exhausted. Fast Fat Loss in Menopause Differs for Every Body in Every Stage Part 8: Practical Applications For sprint work: Start with just 1-2 sprint sessions per week. These could be 15-30 second all-out efforts followed by as much time needed for recovery, repeated 4-6 times. This gives you maximum fat-burning benefit with minimal time investment. For steady-state work: If you choose to run steadily, make sure it's at an intensity that's appropriately challenging. If you choose to walk, don't be afraid to make it challenging - hills, speed, or resistance can all increase the demand. For recovery: Always prioritize adequate nutrition and sleep. Your results happen during recovery, not just during the workout. Listen to your body's feedback. If you're consistently tired, holding onto weight despite "doing everything right," or feeling burnt out, it might be time to dial down the intensity and focus on recovery. Conclusion The bottom line? Both running and walking can be effective for fat loss, but the devil is in the details.  Sprint work offers incredible efficiency and targets visceral fat effectively. Steady-state cardio has its place, especially when recovery demands are high. The key is matching your exercise intensity to your body's current capacity for stress and recovery. During menopause, this becomes even more critical as our hormone systems are already adapting to change. Your exercise program should energize you, not exhaust you. It should work with your lifestyle, not against it. And it should leave you feeling strong and capable, not depleted and overwhelmed.   Remember, there's no real magic trick for fast fat loss in menopause. However, you can get there faster - sometimes by slowing down and sometimes by sprinting. But always by weight lifting.    References for Fast Fat Loss in Menopause:  Psychoneuroendocrinology. 2022, PMID: 35777076. Front Public Health, 2019, PMID: 31921741. Experimental Physiology, 2020, PMID: 32613697. Journal of Exercise Science & Fitness, 2023, PMID: 37927356. Diabetes & Metabolism, 2016, DOI: 10.1016/j.diabet.2016.07.031.   Other Episodes You Might Like: Previous Episode - Take Up Space: A Perimenopause BodyBuilder on Her Strength Journey Next Episode - The New Menopause Therapy: Confessions of a Femme Fatale More Like This What's Better Running or Walking for Midlife Fat Loss (and why) 8 Ways to Make Walking in Menopause MORE Beneficial   Resources:  Join the Hot, Not Bothered! Challenge to learn why timing matters and why what works for others is not working for you. Use Flipping 50 Scorecard & Guide to measure what matters with easy at-home self-assessment test you can do in minutes. Don't know where to start? Book your Discovery Call with Debra.

Episode 200: All About Ascites.     Jesica Mendoza explains the pathophysiology, diagnosis and management of ascites. Dr. Arreaza adds input about early detection and prevention of spontaneous bacterial peritonitis. Written by Jesica Mendoza, OMS IV, Western University, College of Osteopathic Medicine of the Pacific. Edits and comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Welcome to our episode 200! It is an honor to welcome back a wonderful medical student, her name is Jesica, and she has prepared this topic, and she is excited to share this information with us. Jesica presented in June this year an episode about gestational diabetes (episode 193) and today she will talk about ascites. Jesica, please tell us who you are again. What is ascites?Ascites is the buildup of fluid in between the visceral peritoneum and the parietal peritoneum in the abdomen. This is often caused by cirrhosis of the liver due to the increased portal HTN which leads to increased nitrous oxide (NO) and prostaglandins which then causes splanchnic vasodilation and decreased effective arterial volume. The decrease in arterial volume then causes an increase in the renin–angiotensin–aldosterone system (RAAS) and antidiuretic hormone (ADH) from the renal system which leads to sodium and water retention. This then causes a net reabsorption of fluids and ascites.Evaluation of ascites.Once someone has been found to have ascites the next step will be a diagnostic paracentesis. This includes removing fluid from the peritoneal cavity in order to determine the SAAG (Serum Ascites Albumin Gradient) score. SAAG : (serum albumin) − (albumin level of ascitic fluid). The two values should be measured at the same time.This score helps determine the cause of the ascites with a score >1.1 g/dL indicating portal hypertension usually due to liver disease such as cirrhosis. A SAAG score of 250 PMNS/mL. Fluid should be sent to the lab for culture and then antibiotics should be started. IV 3rd generation cephalosporins are typically used. Fluoroquinolones are also used to prevent the recurrence of SBP.If you desire to learn more about SBP, listen to our episode 123. By the way, propranolol is a frequently used medication to prevent GI bleeding from esophageal varices in cirrhosis and also to decrease the development of ascites. It should be used in patients who have compensated cirrhosis and must be avoided in patients with refractory ascites, hypotension, renal dysfunction or active infection. So, to wrap things up we should remember that once we identify ascites with our physical exam of the patient, we should make sure to obtain a paracentesis as these results will be the main guide for our treatment. The treatment can then range from medical treatment such as spironolactone and/or loop diuretics to TIPS procedures, PleurX or even liver transplant. Always be on the lookout for SBP in patients with ascites and always remember to obtain a culture on the ascitic fluid prior to starting antibiotics. Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Ascites, Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/14792-ascites.Huang LL, Xia HH, Zhu SL. Ascitic Fluid Analysis in the Differential Diagnosis of Ascites: Focus on Cirrhotic Ascites. J Clin Transl Hepatol. 2014 Mar;2(1):58-64. doi: 10.14218/JCTH.2013.00010. Epub 2014 Mar 15. PMID: 26357618; PMCID: PMC4521252. https://pmc.ncbi.nlm.nih.gov/articles/PMC4521252/.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

How does genetic testing help doctors treat patients? How accurate are private companies like 23andMe? Does knowing your genetic risk help people lead healthier lives or is it just a waste of time and money? Sophie had a bunch of questions about how genetic testing is used in everyday medical practice and Chris was here to answer!   Become a supporter of our show today either on Patreon or through PayPal! Thank you! http://www.patreon.com/thebodyofevidence/ https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE   Email us your questions at thebodyofevidence@gmail.com.   Editor:    Robyn Flynn Theme music: “Fall of the Ocean Queen“ by Joseph Hackl Rod of Asclepius designed by Kamil J. Przybos Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer   Obviously, Chris is not your doctor (probably). This podcast is not medical advice for you; it is what we call information. References: Studies evaluating the accuracy of Direct to Consumer genetic testing companies: Ng PC, Murray SS, Levy S, Venter JC. An agenda for personalized medicine. Nature. 2009 Oct 8;461(7265):724-6. doi: 10.1038/461724a. PMID: 19812653. Imai K, Kricka LJ, Fortina P. Concordance study of 3 direct-to-consumer genetic-testing services. Clin Chem. 2011 Mar;57(3):518-21. doi: 10.1373/clinchem.2010.158220.  Studies looking at how knowing the results of genetic testing affect medical treatment and lifestyle factors. Mega JL, et al. Genetic risk, coronary heart disease events, and the clinical benefit of statin therapy: an analysis of primary and secondary prevention trials. Lancet. 2015 Jun 6;385(9984):2264-2271. doi: 10.1016/S0140-6736(14)61730-X Khera AV, Emdin CA, Drake I, Natarajan P, Bick AG, Cook NR, Chasman DI, Baber U, Mehran R, Rader DJ, Fuster V, Boerwinkle E, Melander O, Orho-Melander M, Ridker PM, Kathiresan S. Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease. N Engl J Med. 2016 Dec 15;375(24):2349-2358. doi: 10.1056/NEJMoa1605086.  The Cochrane review and MI-GENES study which showed that genetic information did not change lifestyle behavior Hollands GJ, French DP, Griffin SJ, Prevost AT, Sutton S, King S, Marteau TM. The impact of communicating genetic risks of disease on risk-reducing health behaviour: systematic review with meta-analysis. BMJ. 2016 Mar 15;352:i1102. doi: 10.1136/bmj.i1102.  Kullo IJ, et al. Incorporating a Genetic Risk Score Into Coronary Heart Disease Risk Estimates: Effect on Low-Density Lipoprotein Cholesterol Levels (the MI-GENES Clinical Trial). Circulation. 2016 Mar 22;133(12):1181-8. doi: 10.1161/CIRCULATIONAHA.115.020109  

In this episode, Mo and Marc are joined by special guest Professor Ted Miclau (Orthopaedic Trauma Institute International Chair, UCSF Department of Orthopaedic Surgery) in a discussion focusing on innovations and recent work in fracture-healing.    Link  Gouhari F, Shariatpanahi ZV, Talebi S, Mehrvar A, Momeny M, Ehsani A, Ahmadi-Abdashti A, Zandi R. Therapeutic Effects of Bovine Colostrum on Bone Healing, Rehabilitation, and Postoperative Complications: A Prospective, Randomized, Double-Blinded Comparative Trial. J Bone Joint Surg Am. 2025 Apr 18;107(12):1307-1315. doi: 10.2106/JBJS.24.00542. PMID: 40249794. https://www.jbjs.org/reader.php?rsuite_id=bf628643-fcfe-4fc5-9f9e-b46db1bd70d2&source=The_Journal_of_Bone_and_Joint_Surgery/107/12/1307&topics=hp+ta#info    Subspecialties:  Basic Science  Hip  Orthopaedic Essentials  Trauma  Chapters (00:00:03) - Orthojoe Podcast(00:00:49) - Bovine Colostrum and Bone Healing(00:03:23) - Mental Fitness: Ted McLow(00:03:52) - Osteomyelitis and fracture healing(00:09:48) - Breastfeeding and hip fracture(00:11:20) - Hip Fracture and the International RCT

In this episode, we dive into a new pilot RCT exploring the addition of acetazolamide to furosemide in critically ill patients. We break down the study's methods, findings, and practical implications for fluid management in the ICU. Could this inexpensive, decades-old drug be the key to sustaining diuresis and preventing metabolic alkalosis? Tune in to find out.The Vasopressor & Inotrope HandbookAmazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/47qJZe1⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Affiliate Link)My Store: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Use "podcast" to save 10%)Citation: Maeda A, Brown A, Spano S, Chaba A, Phongphithakchai A, Hikasa Y, Pattamin N, Kitisin N, Nübel J, Nielsen B, Holmes J, Peck L, Young H, Eastwood G, Bellomo R, Neto AS. Furosemide with adjunctive acetazolamide vs furosemide only in critically ill patients: A pilot two-center randomized controlled trial. J Crit Care. 2025 Apr;86:155002. doi: 10.1016/j.jcrc.2024.155002. Epub 2024 Dec 16. PMID: 39689380.

Deep Dive in DDH is a three part limited series where experts in the field of DDH have been invited to discuss the controversies in the management of hip dysplasia. Episode 1 discusses the management of DDH in infants under 6 months of age from stable sonographic dysplasia through refractory developmental hip dislocation. We are joined by Kishore Mulpuri from BC Children's hospital, Simon Kelley from Texas Children's Hospital, and Wudbhav Sankar from Children's hospital of Philadelphia as we discuss areas of consensus and discord in Pavlik harness treatment, second line therapy, and what to do when problems arise. Hosted by Will Morris (Scottish Rite for Children). Edited by Carter Clement (Manning Family Children's Hospital). Music by A. A. Aalto. Referenced Publications Behman AL, Bradley CS, Maddock CL, Sharma S, Kelley SP. Testing of an Ultrasound-Limited Imaging Protocol for Pavlik harness Supervision (TULIPPS) in developmental dysplasia of the hip: a randomized controlled trial. Bone Joint J. 2022 Sep;104-B(9):1081-1088. doi: 10.1302/0301-620X.104B9.BJJ-2022-0350.R2. PMID: 36047018. Gans I, Flynn JM, Sankar WN. Abduction bracing for residual acetabular dysplasia in infantile DDH. J Pediatr Orthop. 2013 Oct-Nov;33(7):714-8. doi: 10.1097/BPO.0b013e31829d5704. PMID: 23812157. Swarup I, Talwar D, Sankar WN. Part-time Abduction Bracing in Infants With Residual Acetabular Dysplasia: Does Compliance Monitoring Support a Dose-dependent Relationship? J Pediatr Orthop. 2021 Feb 1;41(2):e125-e129. doi: 10.1097/BPO.0000000000001704. PMID: 33165268. Striano B, Schaeffer EK, Matheney TH, Upasani VV, Price CT, Mulpuri K, Sankar WN; International Hip Dysplasia Institute. Ultrasound Characteristics of Clinically Dislocated But Reducible Hips With DDH. J Pediatr Orthop. 2019 Oct;39(9):453-457. doi: 10.1097/BPO.0000000000001048. PMID: 31503230. Harper P, Joseph BM, Clarke NMP, Herrera-Soto J, Sankar WN, Schaeffer EK, Mulpuri K, Aarvold A; International Hip Dysplasia Institute (IHDI). Even Experts Can Be Fooled: Reliability of Clinical Examination for Diagnosing Hip Dislocations in Newborns. J Pediatr Orthop. 2020 Sep;40(8):408-412. doi: 10.1097/BPO.0000000000001602. PMID: 32555048; PMCID: PMC7458090. Murnaghan ML, Browne RH, Sucato DJ, Birch J. Femoral nerve palsy in Pavlik harness treatment for developmental dysplasia of the hip. J Bone Joint Surg Am. 2011 Mar 2;93(5):493-9. doi: 10.2106/JBJS.J.01210. PMID: 21368082.

Contributor: Aaron Lessen, MD Educational Pearls: There are many techniques for reducing a shoulder dislocation A recent study discussed a new variation of closed reduction technique: wrist-clamping shoulder-lifting The patient is in a sitting position The provider holds the wrist of the injured arm with both hands and slowly rotates the arm to 90 degrees of abduction and 60 degrees of external rotation After this traction, the arm is slowly moved to 45 degrees of abduction and 60 degrees of external rotation The provider then secures the patient's wrist between the provider's knees and places their hand on the axilla to gently lift the shoulder upward for successful reduction There were 36 patients with shoulder dislocations in this study, and all 36 dislocations were successfully reduced with this technique There were no neurovascular complications or fractures No sedation or medication was required All procedures were performed by a single provider without assistance References Dai W, Liu L, Zong S, Zhou Y, Zheng J, Li X. An original closed reduction technique for acute shoulder dislocation: the wrist-clamping and shoulder-lifting. Int J Emerg Med. 2025 Mar 26;18(1):60. doi: 10.1186/s12245-025-00866-8. PMID: 40140973; PMCID: PMC11948627. Summarized by Meg Joyce, MS2 | Edited by Meg Joyce & Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/  

Welcome to "PICU Doc on Call," the podcast where real cases meet real expertise at the bedside! Join Dr. Monica Gray, Dr. Pradip Kamat, and Dr. Rahul Damania as they unravel the mysteries of pediatric critical care. In today's episode, our team dives into the compelling case of a previously healthy seven-year-old girl who arrives with seizures, right arm weakness, and sudden respiratory failure. Together, they'll break down the diagnosis and management of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease, also known as MOGAD. This autoimmune demyelinating disorder can challenge even the most seasoned clinicians. Tune in as our experts walk you through the clinical features, essential diagnostic workup, and the critical importance of early immunosuppressive therapy. Whether you're at the bedside or on the go, this episode is packed with practical pearls and a multidisciplinary approach to recognizing and treating acute pediatric neuroimmunological emergencies in the PICU. Let's get started!Show Highlights:Presentation of a complex pediatric case involving a seven-year-old girl with new-onset seizures and acute respiratory failureDiscussion of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) as an autoimmune demyelinating disorderOverview of the clinical presentation and diagnostic criteria for autoimmune encephalitisImportance of a broad differential diagnosis, including infectious and autoimmune causes, in pediatric patients with seizures and neurological deficitsDiagnostic approach involving MRI, lumbar puncture, and antibody testing for MOGADManagement strategies for MOGAD, including stabilization, seizure control, and immunosuppressive therapyNeurocritical care considerations for monitoring and treating elevated intracranial pressureLong-term management challenges and the need for multidisciplinary care in pediatric patients with MOGADDiscussion of potential outcomes and the risk of relapse in children with MOGAD.Emphasis on the importance of early and comprehensive diagnostic testing to avoid misdiagnosisReferences:Fuhrman & Zimmerman - Pediatric Critical Care 6th Edition, Chapter 64Gole S, Anand A. Autoimmune Encephalitis. [Updated 2023 Jan 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK578203/Salama S, Khan M, Pardo S, Izbudak I, Levy M. MOG antibody-associated encephalomyelitis/encephalitis. Mult Scler. 2019 Oct;25(11):1427-1433. doi: 10.1177/1352458519837705. Epub 2019 Mar 25. PMID: 30907249; PMCID: PMC6751007Lancaster E. The Diagnosis and Treatment of Autoimmune Encephalitis. J Clin Neurol. 2016 Jan;12(1):1-13. doi: 10.3988/jcn.2016.12.1.1. PMID: 26754777; PMCID: PMC4712273.Fisher KS, Illner A, Kannan V. Pediatric neuroinflammatory diseases in the intensive care unit. Semin Pediatr Neurol. 2024 Apr;49:101118. Doi: 10.1016/j.spen.2024.101118. Epub 2024 Feb 1. PMID: 38677797.Hébert J, Muccilli A, Wennberg RA, Tang-Wai DF. Autoimmune Encephalitis and Autoantibodies: A Review of Clinical Implications. J Appl Lab Med. 2022 Jan 5;7(1):81-98. Doi: 10.1093/jalm/jfab102. PMID: 34996085.Lopez JA, Denkova M, Ramanathan S, Dale RC, Brilot F. Pathogenesis of autoimmune demyelination: from multiple sclerosis to neuromyelitis optica spectrum disorders and myelin oligodendrocyte glycoprotein antibody-associated disease. Clin Transl Immunology. 2021 Jul 26;10(7):e1316. doi: 10.1002/cti2.1316. PMID: 34336206; PMCID: PMC8312887.

  Prof. Schmidt-Erfurth is a Professor and the Past Chair of the Department of Ophthalmology at the Medical University of Vienna and the director of Vienna Reading Centre. She has been a pioneer in the application of AI in retinal image analysis. In this episode, she describes various applications of AI in retina research and the work that her group has been doing over the years. The following article is a review of the some of her work: Enzendorfer ML, Tratnig-Frankl M, Eidenberger A, Schrittwieser J, Kuchernig L, Schmidt-Erfurth U. Rethinking Clinical Trials in Age-Related Macular Degeneration: How AI-Based OCT Analysis Can Support Successful Outcomes. Pharmaceuticals (Basel). 2025 Feb 20;18(3):284. doi: 10.3390/ph18030284. PMID: 40143063; PMCID: PMC11945239.

In this Complex Care Journal Club podcast episode, Dr. Robbie Dembo and Ms. Kate Honsberger discuss a mixed methods study of oral health experiences and disparities among children with special health care needs. They describe oral health problems faced by children with medical complexity, barriers to high-quality dental care reported by family caregivers, and strategies for disseminating findings from their study. SPEAKERS Robbie Dembo, PhD Senior Research Scientist Principal Investigator National Opinion Research Center (NORC) University of Chicago Kate Honsberger, BA Director, Health Care Programs National Opinion Research Center (NORC) University of Chicago HOST Kristina Malik, MD Assistant Professor of Pediatrics, University of Colorado School of Medicine Medical Director, KidStreet Pediatrician, Special Care Clinic, Children's Hospital Colorado DATE Initial publication date: August 11, 2025. JOURNAL CLUB ARTICLE NORC at the University of Chicago. Oral Health Among Children with Special Health Care Needs. Accessed August 4, 2025. https://www.norc.org/research/projects/oral-health-children-special-health-care-needs.html OTHER ARTICLES REFERENCED Child and Adolescent Health Measurement Initiative. Shared care planning for children with special health care needs. Accessed August 4, 2025. https://www.cahmi.org/our-work-in-action/engagement-in-action/cshcn Cohen E, Kuo DZ, Agrawal R, Berry JG, Bhagat SK, Simon TD, Srivastava R. Children with medical complexity: an emerging population for clinical and research initiatives. Pediatrics. 2011 Mar;127(3):529-38. doi: 10.1542/peds.2010-0910. Epub 2011 Feb 21. PMID: 21339266; PMCID: PMC3387912. Yu JA, McKernan G, Hagerman T, Schenker Y, Houtrow A. Identifying children with medical complexity from the National Survey of Children's Health combined 2016–17 data set. Hospital Pediatrics. 2021;11(2):192- 197. doi:10.1542/hpeds.2020-0180 TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/9767nfr2rj79c2hft2cc3g8/Dembo_and_Hornsberget_final_8-7-25‌ 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 Dembo R, Honsberger K, Malik K. Brushing Up on High-Quality Oral Health Care for Children with Medical Complexity. 08/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/brushing-up-on-high-quality.

In this high-yield two part episode, we dive into the evolving world of resuscitation with Dr. David Leon, Assistant Professor of Emergency Medicine and Anesthesia at UC Davis. From the shift in priorities from ABC (Airway-Breathing-Circulation) to CAB (Circulation first) to the practical use of peripheral vasopressors and rapid infusion catheters, this episode breaks down how frontline ED care is adapting to sicker patients, longer ICU boarding times, and limited resources. Tune in for insights on advanced access strategies, pre-hospital blood products, and why old tools, like whole blood and vasopressin, are making a powerful comeback. What do you think of Dr. Leon's tips? Are you using these tools in your practice? We'd love to hear from you. Share them 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 Emergency Medicine at UC Davis Guest: Dr. David Leon, Assistant Professor of Emergency Medicine and Anesthesia at UC Davis Resources: American Heart Association (AHA) Algorithms Perman SM, Elmer J, Maciel CB, Uzendu A, May T, Mumma BE, Bartos JA, Rodriguez AJ, Kurz MC, Panchal AR, Rittenberger JC; American Heart Association. 2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2024 Jan 30;149(5):e254-e273. doi: 10.1161/CIR.0000000000001194. Epub 2023 Dec 18. PMID: 38108133. **** 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.

EMDR (Eye Movement Desensitization and Reprocessing) therapy is a recognized and effective treatment for postpartum PTSD, particularly when related to a traumatic birth experience. EMDR helps individuals process traumatic memories and reduce the associated distress, allowing for a more adaptive way of remembering the event. On Aug 4, 2025, a new publication was released in AJOG pertaining to this therapy. What's this latest randomized controlled trial data saying? Listen in for details.     1. Hendrix YMGA, van Dongen KSM, de Jongh A, vanPampus MG. Postpartum Early EMDR therapy Intervention (PERCEIVE) study forwomen after a traumatic birth experience: study protocol for a randomizedcontrolled trial. Trials. 2021 Sep 6;22(1):599. doi: 10.1186/s13063-021-05545-6.PMID: 344888472.     Sajedi, S.S., Navvabi-Rigi, SD. & Navidian,A. Midwifery-led brief counseling on the severity of posttraumatic stresssymptoms of postpartum hemorrhage: quasi-experimental study. BMC PregnancyChildbirth 24, 729 (2024).3.     8/4/25: Treatment of Traumatic Birth Experiencewith Postpartum Early Eye Movement Desensitization and Reprocessing Therapy:Hendrix, Yvette M.G. A. et al.4.     A Randomized Clinical Trial. American Journal ofObstetrics & Gynecology, Volume 0, Issue 0

[2] Listening to podcasts while you exercise is an exercise in futility: fact or fiction? This episode was first released on October 1, 2024. Description : - Adam and guest resident co-host, Dr. Victoria Turnbull, interview Dr. Michael Gottlieb about a recent paper of his that should be relevant to anyone who listens to podcasts for learning. The paper looked at immediate and delayed recall of podcast content of residents listening to podcasts during aerobic exercise and at rest. We also discuss multitasking, cognitive load, and the way our brains make decisions.   Length of Episode: 38 minutes   Resources to check out :  Gottlieb M, Cooney R, Haas MRC, King A, Fung CC, Riddell J. A Randomized Trial Assessing the Effect of Exercise on Residents' Podcast Knowledge Acquisition and Retention. Acad Med. 2024 May 1;99(5):575-581. doi: 10.1097/ACM.0000000000005592. Epub 2023 Dec 18. PMID: 38109353. https://pubmed.ncbi.nlm.nih.gov/38109353/  Perham, N., & Currie, H. (2014). Does listening to preferred music improve reading comprehension performance? Applied Cognitive Psychology, 28(2), 279–284. https://doi.org/10.1002/acp.2994 https://psycnet.apa.org/record/2014-08687-016  Contact us: keylime@royalcollege.ca   Follow: Dr. Adam Szulewski https://x.com/Adam_Szulewski 

Los artículos que se tratan en el episodio de hoy están listados aquí: Associations of Bronchopulmonary Dysplasia and Infection with School-Age Brain Development in Children Born Preterm.Kim C, Ufkes S, Guo T, Chau V, Synnes A, Grunau RE, Miller SP.J Pediatr. 2025 Jun;281:114524. doi: 10.1016/j.jpeds.2025.114524. Epub 2025 Feb 27. PMID: 40023219.Active Treatment vs Expectant Management of Patent Ductus Arteriosus in Preterm Infants: A Meta-Analysis.Buvaneswarran S, Wong YL, Liang S, Quek SC, Lee J.JAMA Pediatr. 2025 May 27:e251025. doi: 10.1001/jamapediatrics.2025.1025. Online ahead of print.PMID: 40423988 Occurrence and Time of Onset of Intraventricular Hemorrhage in Preterm Neonates: A Systematic Review and Meta-Analysis of Individual Patient Data.Nagy Z, Obeidat M, Máté V, Nagy R, Szántó E, Veres DS, Kói T, Hegyi P, Major GS, Garami M, Gasparics Á, Te Pas AB, Szabó M.JAMA Pediatr. 2025 Feb 1;179(2):145-154. doi: 10.1001/jamapediatrics.2024.5998.PMID: 39786414  Bienvenidos a La Incubadora: una conversación sobre neonatología y medicina basada en evidencia. Nuestros episodios ofrecen la dosis ideal (en mg/kg) de los más recientes avances para el neonato y para las increíbles personas que forman parte de la medicina neonatal. Soy tu host, Maria Flores Cordova, MD. Este podcast está presentado por los médicos neonatólogos Dani de Luis Rosell, Elena Itriago, Carolina Michel y Juliana Castellanos. No dudes en enviarnos preguntas, comentarios o sugerencias a nuestro correo electrónico: nicupodcast@gmail.comSíguenos en nuestras redes:Twitter: @incubadorapodInstagram: @laincubadorapodcast Creado originalmente por Ben Courchia MD y Daphna Yasova Barbeau MD http://www.the-incubator.org

This week we're traveling back to 1970s Britain with Joy! Join us as we learn about the real people who invented IVF, including Patrick Steptoe, Jean Purdy, and Matron Muriel, as well as how papers like the Daily Mirror covered the whole thing.  Sources https://www.theguardian.com/film/2024/nov/10/screenwriter-jack-thorne-ivf-joy-film-netflix https://deadline.com/2024/10/joy-movie-thomasin-mckenzie-shines-as-test-tube-baby-pioneer-in-joy-1236115393/ https://time.com/7178799/joy-true-story-jean-purdy-netflix/ https://en.wikipedia.org/wiki/Joy_(2024_film) Litynski GS. Patrick C. Steptoe: laparoscopy, sterilization, the test-tube baby, and mass media. JSLS. 1998 Jan-Mar;2(1):99-101. PMID: 9876723; PMCID: PMC3015256. Edwards Robert Geoffrey 1996Patrick Christopher Steptoe, C. B. E., 9 June 1913 - 22 March 1988Biogr. Mems Fell. R. Soc.42433–452 Daily Mirror articles from 21 January 1960 to 14 December 1979, accessed through the British Newspaper Archive Bourn Hall Fertility Clinic: https://www.bournhall.co.uk/fertilityblog/international-nurses-day-12-may-recognising-the-dedication-of-fertility-nurses/ John Webster, "Muriel Harris: Nursing IVF to Success," Science Museum Blog, available at https://blog.sciencemuseum.org.uk/muriel-harris-nursing-ivf-to-success/ https://www.scopus.com/authid/detail.uri?authorId=7101718324  Web of Science Josh Halliday, "Female nurse who played crucial role in IVF ignored on plaque," The Guardian (2019), https://www.theguardian.com/society/2019/jun/10/jean-purdy-female-nurse-who-played-crucial-role-in-ivf-ignored-on-plaque  Johnson, Martin H. "Edwards, Sir Robert Geoffrey (Bob) (1925–2013), physiologist." Oxford Dictionary of National Biography.

Listener discretion is advised. References: Cook AM, Morgan Jones G, Hawryluk GWJ, Mailloux P, McLaughlin D, Papangelou A, Samuel S, Tokumaru S, Venkatasubramanian C, Zacko C, Zimmermann LL, Hirsch K, Shutter L. Guidelines for the Acute Treatment of Cerebral Edema in Neurocritical Care Patients. Neurocrit Care. 2020 Jun;32(3):647-666. doi: 10.1007/s12028-020-00959-7. PMID: 32227294; PMCID: PMC7272487. Desai A, Damani R. Hyperosmolar therapy: A century of treating cerebral edema. Clin Neurol Neurosurg. 2021 Jul;206:106704. doi: 10.1016/j.clineuro.2021.106704. Epub 2021 May 20. PMID: 34045110. Mount CA, Das JM. Cerebral Perfusion Pressure. [Updated 2023 Apr 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537271/ Susanto M, Riantri I. Optimal Dose and Concentration of Hypertonic Saline in Traumatic Brain Injury: A Systematic Review. Medeni Med J. 2022 Jun 23;37(2):203-211. doi: 10.4274/MMJ.galenos.2022.75725. PMID: 35735001; PMCID: PMC9234368.

What is sarcopenia and why is this such an important topic for every woman over 40?  That is the topic of conversation today.  What is Sarcopoenia? Sarcopenia is to muscle what osteoporosis is to bone.  Significant loss of skeletal muscle mass and or muscle strength. Sarcopenia is tied to anabolic resistance in midlife women, making it harder to gain lean muscle growth or maintenance after 40. Older adults - both men and women - have to work harder to gain lean muscle mass.  Women have less overall body mass and muscle to begin with and more dramatic reductions in estrogen at menopause, than men experience loss of testosterone.  The key stimulus for muscle protein synthesis, will suffer more from loss of strength and mass if they aren't carefully offsetting it with planned and progressive resistance training.  For women, estrogen protects muscle and bone. We need and use testosterone which is the most abundant hormone in the female body - but it's the decline in estrogen that makes the difference in muscle preservation. What Contributes to Sarcopenia?  Malnutrition. Combined with sarcopenia, it's a predictor of all-cause mortality than sarcopenia alone.  The United States is one of the most overfed and undernourished countries in the world. We're not eating well enough to sustain health.  Sarcopenia is 100% avoidable.  How Do You Measure Sarcopenia? Strength Fat free mass and height Online calculators  There are physical tests or measures that include grip strength or calf circumference.  Women didn't measure or track their skeletal muscle mass decades ago to know where it was at peak. It's harder to say how much mass or strength you've lost.  The Surprising Statistics on What is Sarcopenia On average, muscle loss occurs 3-8% each decade starting at 30. That CAN accelerate during menopause transition. It isn't associated with loss of estrogen driving skeletal muscle protein synthesis down. It's the side effects of the decline of estrogen.  Not sleeping. Struggle exercising as hard or as long  Less support for your muscle from testosterone and growth hormone  Have cortisol, ghrelin and leptin hormone dysregulation that interferes with muscle and fat. We do have the ability to regain lean muscle.  It's proven (and shared in prior episodes) that 85+ individuals can gain both mass and strength.  Available Sarcopenia Assessments: SARC-F  A simple questionnaire that is a good point of reference but an easy assessment if you're active.  How it works: Includes 5 components with scale scores range from 0 to 10: Strength: How much difficulty do you have in lifting and carrying 10 pounds? Assistance in walking: How much difficulty do you have walking across a room, whether you use aids or need help to do this? Rise from a chair: How much difficulty do you have transferring from a chair or bed, whether you use aids or need help to do this? Climb stairs: How much difficulty do you have climbing a flight of 10 stairs? Falls: How many times have you fallen in the past year? Flipping 50 Fitness Scorecard  Helps not only measure strength and muscle mass but to see how you rank according to others in your age group.  Most important is progress, comparing you to you. Start where you are by benchmarking it and learn how to improve it. How is Sarcopenia Diagnosed? Fat-Free Mass Index: FFMI ≤ 15 kg/m2 Visit this URL to calculate (turn on metric to see result): https://ffmicalculator.org/ A strength test. What is Sarcopenia: The New Glossary Osteosarcopenia - low bone mass and low muscle mass Sarcobesity - low muscle mass and high fat mass Osteosarcobesity - low bone mass, low muscle mass and high fat mass  Osteobesity - low bone mass and high fat mass    The biggest risk of sarcopenia is falling due to instability and inability to “right” yourself when slips and falls occur. I promised we'd visit what's possible so here that is: A 1.9-3.3% increase in global muscle mass in humans is associated with a 4.1% to 5.8% lower fat mass and reduced A1c and fasting glucose in studies lasting 2 weeks to 3 years.   How to Avoid Sarcopenia? Resistance train 2x per week minimum, for some that's maximum. Know your recovery needs. Consume high protein foods and micronutrient dense foods at each meal.   Wouldn't it be wonderful if in 30 or 40 years, “What is sarcopenia?” is a question like “What is scurvy or rickets?” now which is never heard of. That starts with us.    References:  Nutrients. 2023, PMID: 38201856. Sports Medicine, 2025, PMID: 40576707. Advances in Nutrition 2025, PMID: 40222723. Scientific Reports, 2025, PMID: 39833326. Front Med (Lausanne), 2025, PMID: 40636391.   Other Episodes You Might Like: Previous Episode - Stronger Muscles, Longer Life: The Untold Value of this Accessible to All Anatomy Next Episode - How Mold Toxicity Affects Hormonal Balance During Menopause And Effective Detox Strategies More Like This: 5 Reasons You're Not Losing Weight or Gaining Muscle After 50 Protein for Menopause Hormone Support Where Protein Recommendations for Women Come From?   Resources:  Don't know where to start? Book your Discovery Call with Debra. Use Flipping 50 Scorecard & Guide to measure what matters with easy at-home self-assessment test you can do in minutes. Opening in August!! Join the Hot, Not Bothered! Challenge to learn why timing matters and why what works for others is not working for you.  

➡ CLICK HERE to send me a text, I'd love to hear what you thought about this episode! Leave your name in the text so I know who it's from! This week's episode is chock FULL of tips on how to set boundaries if and when we decide to return to social media after this summer detox. If you've been following along on your own detox, but fear the dip back into the socials like I do, this is the episode you don't want to miss. Thekla and I talk all about protecting ourselves and being mindfully aware of our intentions upon return. And if you want to dive more into some of the research we talk about in today's episode, here are the links you'll want (h/t Thekla!) Self-Compassion in the Age of Social Media ResourcesScholarly ArticlesCastelo, N., Kushlev, K., Ward, A.F., Esterman, M., & Reiner, P.B. (2025). Blocking mobile internet on smartphones improves sustained attention, mental health, and subjective well-being. PNAS Nexus, 4(2): pgaf017. https://doi.org/10.1093/pnasnexus/pgaf017. PMID: 39967678; PMCID: PMC11834938.Kuchar AL, Neff KD, Mosewich AD. Resilience and Enhancement in Sport, Exercise, & Training (RESET): A brief self-compassion intervention with NCAA student-athletes. Psychol Sport Exerc. 2023 Jul;67:102426. doi: 10.1016/j.psychsport.2023.102426. Epub 2023 Mar 28. PMID: 37665879.Wadsley M, Ihssen N. A Systematic Review of Structural and Functional MRI Studies Investigating Social Networking Site Use. Brain Sci. 2023 May 11;13(5):787. doi: 10.3390/brainsci13050787. Erratum in: Brain Sci. 2023 Jul 17;13(7):1079. doi: 10.3390/brainsci13071079. PMID: 37239257; PMCID: PMC10216498.Websites/OrganizationsCenter for Humane Technology. humanetech.comDigital Wellness Lab at Boston Children's Hospital. digitalwellnesslab.orgAfter Babel by Jonathan Haidt. (Substack)Scales/MeasuresThe Bergen Social Media Addiction Scale (BSMAS)Support the show

Aligning Person and Profession: The Work of Identity Formation in Medical Education—and Beyond (EP:43) With Joke Fleer What if the future of medicine depends not just on what learners know—but on who they are becoming? In this thought-provoking episode we sit down with psychologist and medical education expert Joke Fleer to explore the invisible but powerful process of professional identity formation. From the unspoken cultural norms that shape future physicians, to the risks of unchecked assumptions, Fleer unpacks how reflection, self-awareness, and safe learning spaces can help learners stay true to themselves while stepping into demanding professional roles. Whether you're in healthcare, education, or any high-pressure field, this conversation offers insights that go far beyond the clinic. Discover why reflection isn't just a soft skill, and why grading it might be missing the point entirely. Questions? Feedback? Ideas? Contact us at edufi@mayo.edu Audio Editing: Celina Bertoncini Additional Resources Vaa Stelling BE, Andersen CA, Suarez DA, Nordhues HC, Hafferty FW, Beckman TJ, Sawatsky AP. Fitting In While Standing Out: Professional Identity Formation, Imposter Syndrome, and Burnout in Early-Career Faculty Physicians. Acad Med. 2023 Apr 1;98(4):514-520. doi: 10.1097/ACM.0000000000005049. Epub 2022 Nov 1. PMID: 36512808. Fleer, J., Smit, M. J., Boer, H. J., Knevel, M., Velthuis, F., Trippenzee, M., de Carvalho Filho, M. A., & Scholtens, S. (2025). An evidence-informed pedagogical approach to support professional identity formation in medical students: AMEE Guide No. 171. Medical Teacher, 47(4), 580-588. https://doi.org/10.1080/0142159X.2024.2387809 Scholtens, S., Barnhoorn, P. C., & Fleer, J. (2023). Education to support professional identity formation in medical students: guiding implicit social learning. International journal of medical education, 14, 19-22. https://doi.org/10.5116/ijme.63f3.ddcb SCOPE | SCOPE - Expertise centre for personal development | University of Groningen  SCOPE's Substack | Substack  

Today, we're diving into a condition that's as fascinating as it is complex: Achalasia—where the esophagus stops playing nice, and swallowing becomes a daily challenge. We're breaking down the latest evidence, comparing POEM, pneumatic dilation, and Heller myotomy, and digging into what actually matters when deciding how to treat each achalasia subtype. Join show hosts Drs. Jake Greenberg, Dana Portenier, Zach Weitzner, and Joey Lew as they discuss the past, present, and future of Achalasia management. Whether you're a medical student or a seasoned attending, this episode will arm you with the tools to think critically about diagnosis, tailor your treatment strategy, and stay ahead of the curve on the future of achalasia care. Hosts:  ·      Jacob Greenberg, MD, EdM, MIS Division Chief and Vice Chair for Education, Duke University ·      Dana Portenier, MD, MIS Fellowship Director, 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__actually Learning Goals:  By the end of this episode, listeners will be able to: ·      Describe the pathophysiology and key diagnostic criteria for achalasia, including the role of manometry, EGD, and esophagram. ·      Differentiate between the three subtypes of achalasia based on the Chicago Classification and understand the clinical significance of each. ·      Compare treatment options for achalasia—pneumatic dilation, Lap Heller myotomy, and POEM—including indications, efficacy, and long-term outcomes. ·      Interpret landmark studies (e.g., European Achalasia Trial, JAMA POEM trial) and their impact on treatment decision-making. ·      Recognize patient-specific factors (age, comorbidities, achalasia subtype) that influence the choice of therapy. ·      Discuss evolving technologies and future directions in achalasia management, including endoluminal robotics, ARMS, and combined anti-reflux strategies. ·      Outline a basic treatment algorithm for newly diagnosed achalasia, incorporating diagnostic steps and tailored interventions. ·      Appreciate the multidisciplinary approach to achalasia care, including the roles of MIS surgeons, gastroenterologists, and emerging procedural skillsets. References: ·      Boeckxstaens G, Elsen S, Belmans A, Annese V, Bredenoord AJ, Busch OR, Costantini M, Fumagalli U, Smout AJPM, Tack J, Vanuytsel T, Zaninotto G, Salvador R; European Achalasia Trial Investigators. 10‑year follow-up results of the European Achalasia Trial: a multicentre randomised controlled trial comparing pneumatic dilation with laparoscopic Heller myotomy. Gut. 2024 Mar;73(4):582‑589. doi: 10.1136/gutjnl‑2023‑331374. PMID: 38050085 https://pubmed.ncbi.nlm.nih.gov/38050085/ ·      He J, Yin Y, Tang W, Jiang J, Gu L, Yi J, Yan L, Chen S, Wu Y, Liu X. Objective Outcomes of an Extended Anti‑reflux Mucosectomy in the Treatment of PPI‑Dependent Gastroesophageal Reflux Disease (with Video). J Gastrointest Surg. 2022 Aug;26(8):1566–1574. doi:10.1007/s11605‑022‑05396‑9. PMID: 35776296 https://pubmed.ncbi.nlm.nih.gov/35776296/ ·      Modayil RJ, Zhang X, Rothberg B, et al. Peroral endoscopic myotomy: 10-year outcomes from a large, single-center U.S. series with high follow-up completion and comprehensive analysis of long-term efficacy, safety, objective GERD, and endoscopic functional luminal assessment. Gastrointest Endosc. 2021;94(5):930-942. doi:10.1016/j.gie.2021.05.014. PMID: 33989646. https://pubmed.ncbi.nlm.nih.gov/33989646/ ·      Ponds FA, Fockens P, Lei A, Neuhaus H, Beyna T, Kandler J, Frieling T, Chiu PWY, Wu JCY, Wong VWY, Costamagna G, Familiari P, Kahrilas PJ, Pandolfino JE, Smout AJPM, Bredenoord AJ. Effect of peroral endoscopic myotomy vs pneumatic dilation on symptom severity and treatment outcomes among treatment-naive patients with achalasia: a randomized clinical trial. JAMA. 2019 Jul 9;322(2):134–144. doi:10.1001/jama.2019.8859. PMID: 31287522. https://pubmed.ncbi.nlm.nih.gov/31287522/ ·      Vaezi MF, Pandolfino JE, Yadlapati RH, Greer KB, Kavitt RT; ACG Clinical Guidelines Committee. ACG clinical guidelines: Diagnosis and management of achalasia. Am J Gastroenterol. 2020 Sep;115(9):1393–1411. doi:10.14309/ajg.0000000000000731. PMID: 32773454; PMCID: PMC9896940 https://pubmed.ncbi.nlm.nih.gov/32773454/ ·      West RL, Hirsch DP, Bartelsman JF, de Borst J, Ferwerda G, Tytgat GN, Boeckxstaens GE. Long term results of pneumatic dilation in achalasia followed for more than 5 years. Am J Gastroenterol. 2002;97(6):1346-1351. doi:10.1111/j.1572-0241.2002.05771.x. PMID:12094848. https://pubmed.ncbi.nlm.nih.gov/12094848/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

“Green spaces and trees are not an amenity—they're a necessity,” explains Marc Berman, Ph.D.  Marc Berman, Ph.D., environmental neuroscientist, professor and chair of psychology at the University of Chicago, and the founding director of the Environmental Neuroscience Lab, joins us today to dive deep into the powerful benefits of nature on our mental and physical health.  - What is environmental neuroscience? (~2:50) - The Nature Walk study (~6:20) - Green vs. blue spaces (~12:00) - How much nature do you need? (~18:10) - The case for more green spaces (~19:10) - Mental health benefits of being in nature (~22:55) - How different types of trees impact the benefits (~27:25) - The impact of natural disasters (~28:25) - Redesigning our  environments, schools, & workplaces (~31:00) - Nature for depression (~34:30)  - Why you should be ‘nature rising' (~36:15) - Berman's favorite places (~38:05) - Upcoming research (~40:30) - Start doing this today (~42:50) Referenced in the episode:  - Learn more about Berman & his lab (https://voices.uchicago.edu/bermanlab/berman/)  - Pick up his book, Nature and the Mind (https://www.amazon.com/Nature-Mind-Improves-Cognitive-Well-being/dp/1668058774)  - Check out his research (https://scholar.google.com/citations?user=zCT_0OQAAAAJ&hl=en)  - Research on green spaces and schoolchildren (PMID: 25204008)  - Research on crime and vegetation (https://doi.org/10.1177/001391601219731)  - Research on hospital recovery and nature views (PMID: 6143402)  We hope you enjoy this episode, and feel free to watch the full video on YouTube! Whether it's an article or podcast, we want to know what we can do to help here at mindbodygreen. Let us know at: podcast@mindbodygreen.com. Learn more about your ad choices. Visit megaphone.fm/adchoices