Podcasts about pmid

Short term weight loss sounds great BUT it's not all fat – it's muscle! Muscle will be much harder to regain as we age because of anabolic resistance..  Clothes might feel loose and you get weight loss compliments. But short term weight loss is just giving a “false positive” honeymoon period. This might mean you divorced muscle, the love of your life.   1. Muscle Mass Loss (Sarcopenia) Protein Deficiency Protein is essential for building and maintaining muscle tissue. Insufficient protein intake exacerbates muscle atrophy and increases the risk of falls and injuries. Excessive Cardio Prolonged cardio can lead to a breakdown of muscle tissue for energy, particularly if glycogen stores are depleted. This can worsen age-related muscle loss and counteract maintaining strength and function. 2. Bone Health (Osteoporosis) Protein Deficiency Protein is needed for bone health and bone density. Inadequate protein intake, especially after menopause, increases the risk of osteoporosis and fractures. Osteoporosis Risks After menopause, risk of osteoporosis increases due to declining estrogen levels and can weaken bones prone to fracture. Sarcopenia and Osteoporosis Link Having both increases the risk of falls and fractures. Poor nutrition leads to sarcopenic obesity and increases the risk of osteoporosis. 3. Other Negative Effects Reduced Physical Function Since inadequate protein leads to muscle loss, this reduces strength, impaired balance, and decreased ability to perform daily activities. Slow-Healing Injuries Protein repairs tissues. Deficiency can slow wound healing and recovery from injuries. Weakened Immune Function Amino acids from protein build antibodies and maintain a healthy immune system. Low protein intake can lead to frequent illnesses and infections. Potential Cardiac Issues (Excessive Cardio) Associated with potential adverse cardiac effects, such as myocardial fibrosis and an increased risk of atrial fibrillation, in some individuals. Musculoskeletal Injuries (Excessive Cardio) Increases the risk of musculoskeletal issues like osteoarthritis and stress fractures.   What Can You Do Instead of A Short Term Weight Loss Recommendations: Prioritize protein intake with 30 grams each meal. Balance cardio and strength training to build and maintain muscle mass. Listen to your body and avoid pushing yourself too hard or engaging in prolonged, strenuous exercise if it causes excessive fatigue or pain.   References:  Chucherd O, Vallibhakara O, Vallibhakara SA, Sophonsritsuk A, Chattrakulchai K, Anantaburarana M. Association of Sarcopenic Obesity and Osteoporosis in Postmenopausal Women: Risk Factors and Protective Effects of Hormonal Therapy and Nutritional Status. Arch Osteoporos. 2025 Jun 26;20(1):83. doi: 10.1007/s11657-025-01573-w. PMID: 40569474; PMCID: PMC12202630. Filip Vuletić, Berte Bøe, Considerations in the Aging Female Athlete, Operative Techniques in Sports Medicine, Volume 32, Issue 2, 2024, 151091, ISSN 1060-1872, https://doi.org/10.1016/j.otsm.2024.151091.   Other Episodes You Might Like: Previous Episode - Simple Ways to Know if You're Following Protein Rules in Menopause Next Episode - What to Do When Joints Hurt, Ache or Need Replaced? A Doctor Viewpoint More Like This - Protein for Menopause Hormone Support   Resources:  Join the Flipping50 Membership for evidence-based workout programs. Short & Easy Exercise videos in this 5 Day Flip Challenge. Get the Flipping 50 Protein & Fiber supplements for women over 50 to support muscle health, enhance recovery, and meet daily nutritional needs.  

Intrahepatic Cholestasis of Pregnancy (ICP) has dichotomous effects: Benign for the mother (although the itching it causes may be a qualify of life issue, yet potentially devasting for the child in-utero. In 2021, SMFM released Consult series 53 on the subject. This, together with the ACOG 's CO 831 (Medically Indicated Late Preterm and early term delivery) also from 2021 provide management options for ICP. However, this month- July 2025- Dr. Cynthia Gyamfi-Bannerman et al published a new proposed ICP classification and management schema that is easy to follow. Listen in for details. ​ SMFM CS #53,2021​ ACOG CO #831, 2021​ Sarker M, Ramos GA, Ferrara L, Gyamfi-Bannerman C. Simplifying Management of Cholestasis: A Proposal for a Classification System. Am J Perinatol. 2025 Jul;42(9):1229-1234. doi: 10.1055/a-2495-3553. Epub 2024 Dec 4. PMID: 39631774

What does it mean to be free? It's a question that's puzzled philosophers for millennia. But what does it mean to be metabolically free? If you've ever felt hangry, crashed after a meal, or dealt with type 2 diabetes, you've experienced the opposite — metabolic imprisonment.My guest today, Ben Azadi, knows this firsthand. In 2008, Ben was obese and unhealthy, struggling to find answers. After shedding 80 pounds and turning his health around, he dedicated his life to helping others do the same. Today, he's a functional health expert, bestselling author, and the founder of Keto Kamp, a global brand empowering people to use ancient healing tools like fasting and the ketogenic lifestyle. His new book, Metabolic Freedom: A 30-Day Guide to Restore Your Metabolism, Heal Hormones & Burn Fat, lays out the blueprint to reclaim your health.In this episode, we dive into:What metabolism really is — and why “slow” or “fast” metabolism may be a mythA groundbreaking study that disproves the idea that metabolism slows with ageWhy fasting insulin is a better marker of health than weight or glucose aloneThe surprising power of “Vitamin G” — gratitude — on your metabolic functionBen's top daily habits and biohacks to supercharge your metabolismBen's approach is all about education over medication — empowering you to take control, rather than outsourcing your health. Ben has also made a personal impact on a member of my family.Links:

[1] Does the pursuit of excellence in medicine conflict with the pursuit of well-being? This is Episode #1 which was first released on 17, 2024. Description: -  Adam invites Dr. Lisa Rosenbaum to discuss her recent publication in the NEJM titled Being Well while Doing Well — Distinguishing Necessary from Unnecessary Discomfort in Training.   This thought-provoking paper is the 3rd in a series of 4 essays in the NEJM by Dr. Rosenbaum.  It's a social commentary on recent cultural and societal changes and their impact on medical education. We discuss Lisa's critical perspectives on the important notions of wellness and professional identity in our field.   Length of Episode: 40 minutes   Article discussed: Rosenbaum L. Being Well while Doing Well - Distinguishing Necessary from Unnecessary Discomfort in Training. N Engl J Med. 2024 Feb 8;390(6):568-572. doi: 10.1056/NEJMms2308228. Epub 2024 Jan 17. PMID: 38231543. https://pubmed.ncbi.nlm.nih.gov/38231543/  Resources to check out :  Dr. Rosenbaum's recent related publications    https://www.nejm.org/doi/10.1056/NEJMms2308228 Being Well while Doing Well — Distinguishing Necessary from Unnecessary Discomfort in Training   https://pubmed.ncbi.nlm.nih.gov/38265727/ Beyond Moral Injury - Can We Reclaim Agency, Belief, and Joy in Medicine?   https://pubmed.ncbi.nlm.nih.gov/38197811/ On Calling - From Privileged Professionals to Cogs of Capitalism?   https://pubmed.ncbi.nlm.nih.gov/38170694/ What Do Trainees Want? The Rise of House Staff Unions   Podcast ‘Not Otherwise Specified' https://not-otherwise-specified-podcast.nejm.org/e/tough-love/     Contact us: keylime@royalcollege.ca   Follow: Dr. Adam Szulewski https://x.com/Adam_Szulewski    

In this Complex Care Journal Club podcast episode, Dr. Miriam Shapiro, Ms. Kate Detwiler, and Dr. Vanessa Madrigal discuss a survey of families with children with chronic conditions about ethical challenges they have experienced in their child's care and sources of support. They describe the residual distress reported by families, implications for clinical practice, and next steps from this work. SPEAKERS Miriam Shapiro, MD Associate Professor‌, Affiliate Faculty, and Pediatric Intensivist University of Minnesota Medical School University of Minnesota Center for Bioethics Masonic Children's Hospital Kathryn Detwiler, MBA Parent Advocate, Parent Researcher Program Manager, Complex Care Children's National Hospital Vanessa Madrigal, MD, MSCE, HEC-C Associate Professor, Director Pediatric Ethics Program, and Pediatric Critical Care Medicine The George Washington University Children's National Hospital HOST Kathleen Huth, MD, MMSc Pediatrician, Complex Care Service, Division of General Pediatrics Boston Children's Hospital Assistant Professor of Pediatrics Harvard Medical School DATE Initial publication date: July 7, 2025. JOURNAL CLUB ARTICLE Shapiro MC, Detwiler K, Shepard J, Bernhard T, Li X, Boss RD, Madrigal VN. Ethical Challenges in Pediatric Medical Complexity: A Survey of Parents. J Pediatr. 2025 Apr;279:114478. doi: 10.1016/j.jpeds.2025.114478. Epub 2025 Jan 27. PMID: 39864504; PMCID: PMC12013584. OTHER ARTICLES REFERENCED Cho HL, Grady C, Tarzian A, Povar G, Mangal J, Danis M. Patient and Family Descriptions of Ethical Concerns. Am J Bioeth. 2020 Jun;20(6):52-64. doi: 10.1080/15265161.2020.1754500. PMID: 32441594; PMCID: PMC7673656. Pang J, Batson L, Detwiler K, Miller ME, Thorndike D, Boss RD, Shapiro MC. Where do families turn? Ethical dilemmas in the care of chronically critically Ill children. Monash Bioeth Rev. 2024 Jul 8. doi: 10.1007/s40592-024-00201-6. Epub ahead of print. PMID: 38976209. TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/p9cpbchs45rp3xq8p747pv83/July_CCJCP_Shapiro_Madrigal_Detwiler_Transcript_7-2-25‌ 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 Shapiro MC, Detwiler K, Madrigal VN, Huth K. Families Face Ethical Challenges More Often Than They Change a G Tube: Rethinking Our Care. 7/2025. OPENPediatrics. https://soundcloud.com/openpediatrics/families-face-ethical-challenges-more-often-than-they-change-a-g-tube-rethinking-our-care.

I think I've been exercise resistant much of the time in spite of working out and eating right.   Dr. Coyle shows us that we need at least 8500 steps a day for an hour workout to have the metabolic fat-burning effects we want it to have.   Coyle EF, Burton HM, Satiroglu R. Inactivity Causes Resistance to Improvements in Metabolism After Exercise. Exerc Sport Sci Rev. 2022 Apr 1;50(2):81-88. doi: 10.1249/JES.0000000000000280. Erratum in: Exerc Sport Sci Rev. 2022 Jul 01;50(3):172. doi: 10.1249/JES.0000000000000295. PMID: 35025844.   Online Courses: https://richardhazel.podia.com (The new Unlock the Mystery of Chronic Pain: Peripheral Nerve Entrapment Course is on sale for the month of July. Use JULY100 at checkout for $100 off)  

Dr. Harish Kinni, a triple-board-certified emergency medicine and critical care physician and assistant professor at the Mayo Clinic, provides an overview of the fundamentals of ventilator care for emergency department professionals. We will review key modes that we should know, the variables to set, how to adjust them for your patient's needs, and provide troubleshooting tips and tricks for when things suddenly go awry. This is sure to be one of the most helpful chapters of Always on EM, but don't let it take your breath away! CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS Swart P, Nijbroek SGLH, Paulus F, Neto AS, Schultz MJ. Sex Differences in Use of Low Tidal Volume Ventilation in COVID-19-Insights From the PRoVENT-COVID Study. Front Med (Lausanne). 2022 Jan 3;8:780005. doi: 10.3389/fmed.2021.780005. PMID: 35300177; PMCID: PMC8923734. McNicholas BA, Madotto F, Pham T, Rezoagli E, Masterson CH, Horie S, Bellani G, Brochard L, Laffey JG; LUNG SAFE Investigators and the ESICM Trials Group. Demographics, management and outcome of females and males with acute respiratory distress syndrome in the LUNG SAFE prospective cohort study. Eur Respir J. 2019 Oct 17;54(4):1900609. doi: 10.1183/13993003.00609-2019. PMID: 31346004. Swart P, Deliberato RO, Johnson AEW, Pollard TJ, Bulgarelli L, Pelosi P, de Abreu MG, Schultz MJ, Neto AS. Impact of sex on use of low tidal volume ventilation in invasively ventilated ICU patients-A mediation analysis using two observational cohorts. PLoS One. 2021 Jul 14;16(7):e0253933. doi: 10.1371/journal.pone.0253933. PMID: 34260619; PMCID: PMC8279424. Evans, Laura1; Rhodes, Andrew2; Alhazzani, Waleed3; Antonelli, Massimo4; Coopersmith, Craig M.5; French, Craig6; Machado, Flávia R.7; Mcintyre, Lauralyn8; Ostermann, Marlies9; Prescott, Hallie C.10; Schorr, Christa11; Simpson, Steven12; Wiersinga, W. Joost13; Alshamsi, Fayez14; Angus, Derek C.15; Arabi, Yaseen16; Azevedo, Luciano17; Beale, Richard18; Beilman, Gregory19; Belley-Cote, Emilie20; Burry, Lisa21; Cecconi, Maurizio22; Centofanti, John23; Coz Yataco, Angel24; De Waele, Jan25; Dellinger, R. Phillip26; Doi, Kent27; Du, Bin28; Estenssoro, Elisa29; Ferrer, Ricard30; Gomersall, Charles31; Hodgson, Carol32; Hylander Møller, Morten33; Iwashyna, Theodore34; Jacob, Shevin35; Kleinpell, Ruth36; Klompas, Michael37; Koh, Younsuck38; Kumar, Anand39; Kwizera, Arthur40; Lobo, Suzana41; Masur, Henry42; McGloughlin, Steven43; Mehta, Sangeeta44; Mehta, Yatin45; Mer, Mervyn46; Nunnally, Mark47; Oczkowski, Simon48; Osborn, Tiffany49; Papathanassoglou, Elizabeth50; Perner, Anders51; Puskarich, Michael52; Roberts, Jason53; Schweickert, William54; Seckel, Maureen55; Sevransky, Jonathan56; Sprung, Charles L.57; Welte, Tobias58; Zimmerman, Janice59; Levy, Mitchell60. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Critical Care Medicine 49(11):p e1063-e1143, November 2021. | DOI: 10.1097/CCM.0000000000005337  Fan E, Del Sorbo L, Goligher EC, Hodgson CL, Munshi L, Walkey AJ, Adhikari NKJ, Amato MBP, Branson R, Brower RG, Ferguson ND, Gajic O, Gattinoni L, Hess D, Mancebo J, Meade MO, McAuley DF, Pesenti A, Ranieri VM, Rubenfeld GD, Rubin E, Seckel M, Slutsky AS, Talmor D, Thompson BT, Wunsch H, Uleryk E, Brozek J, Brochard LJ; American Thoracic Society, European Society of Intensive Care Medicine, and Society of Critical Care Medicine. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med. 2017 May 1;195(9):1253-1263. doi: 10.1164/rccm.201703-0548ST. Erratum in: Am J Respir Crit Care Med. 2017 Jun 1;195(11):1540. doi: 10.1164/rccm.19511erratum. PMID: 28459336. Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, Oczkowski S, Levy MM, Derde L, Dzierba A, Du B, Aboodi M, Wunsch H, Cecconi M, Koh Y, Chertow DS, Maitland K, Alshamsi F, Belley-Cote E, Greco M, Laundy M, Morgan JS, Kesecioglu J, McGeer A, Mermel L, Mammen MJ, Alexander PE, Arrington A, Centofanti JE, Citerio G, Baw B, Memish ZA, Hammond N, Hayden FG, Evans L, Rhodes A. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Crit Care Med. 2020 Jun;48(6):e440-e469. doi: 10.1097/CCM.0000000000004363. PMID: 32224769; PMCID: PMC7176264. Wang W, Scharfstein D, Wang C, Daniels C, Needham D, Brower R, NHLBI ARDS Clinical Network. Estimating the Causal Effect of Low Tidal Volume Ventilation on Survival in Patients with Acute Lung Injury. J R Stat Soc Ser C Appl Stat. 2011. PMC: PMC3197806 Brower RG, Thompson BT, NIH/NHLBI/ARDSNetwork. Tidal volumes in acute respiratory distress syndrome--one size does not fit all. Crit Care Med. 2006. Hager DN, Krishman JA, Hayden D, Brower RG, ARDSNet NIH / NHLBI. Tidal Volume Reduction in Patients with acute Lung Injury When Plateau Pressures Are Not High. Am J Resp Crit Care Med. 2005. Rubenfeld GD, Cooper C, Carter G, Thompson BT, Hudson LD. Barriers to providing lung protective ventilation to patients with acute lung injury. Crit Care Med. 2004. Chatburn RL, El-Khatib M, Mireles-Cabodevila E. A taxonomy for mechanical ventilation: 10 fundamental maxims. Respir Care. 2014 Nov;59(11):1747-63. doi: 10.4187/respcare.03057. Epub 2014 Aug 12. PMID: 25118309. Guo L, Wang W, Zhao N, Guo L, Chi C, Hou W, Wu A, Tong H, Wang Y, Wang C, Li E. Mechanical ventilation strategies for intensive care unit patients without acute lung injury or acute respiratory distress syndrome: a systematic review and network meta-analysis. Crit Care. 2016 Jul 22;20(1):226. doi: 10.1186/s13054-016-1396-0. PMID: 27448995; PMCID: PMC4957383. Rice TW, Wheeler AP, Bernard GR, Hayden DL, Schoenfeld DA, Ware LB, NIH NHLBI ARDS Network. Comparison of the Sp02/FI02 Ratio and the PaO 2/FI02 in Patients with Acute Lung Injury or ARDS. Chest. 2007. Zhang G, Burla MJ, Caesar BB, Falank CR, Kyros P, Zucco VC, Strumilowska A, Cullinane DC, Sheppard FR. Emergency Department SpO2/FiO2 Ratios Correlate with Mechanical Ventilation and Intensive Care Unit Requirements in COVID-19 Patients. West J Emerg Med. 2024 May;25(3):325-331. doi: 10.5811/westjem.17975. PMID: 38801037; PMCID: PMC11112664.   WANT TO WORK AT MAYO? EM Physicians: https://jobs.mayoclinic.org/emergencymedicine EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs   Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs

In this episode of the Saving Lives Podcast, we break down a 2025 study from Intensive Care Medicine that emulates a target trial on the use of sodium bicarbonate in ICU patients with metabolic acidosis. With over 6,000 patients across 12 Australian ICUs, the study reveals a small but significant reduction in mortality and RRT use with bicarbonate therapy. Tune in to learn how this could transform our clinical approach to acidemia in the critically ill patients.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: Blank SP, Blank RM, Laupland KB, Tabah A, Gill D, Kumar A, White K, Attokaran A, Luke S, Whebell S, Garrett P, McCullough J, McIlroy P, Ramanan M; Queensland Critical Care Research Network (QCCRN). Sodium bicarbonate administration for metabolic acidosis in the intensive care unit: a target trial emulation. Intensive Care Med. 2025 Jun;51(6):1-9. doi: 10.1007/s00134-025-07979-x. Epub 2025 Jun 10. PMID: 40493225; PMCID: PMC12208957.

If you've heard that you'll get doughy trying to build muscle on beans, or indeed anything else that's made you doubt pulses even for a second, then this nugget's for you. Daisy and Clare discuss the nutrition of a range of legumes, as well as health benefits and environmental impacts, and how best to cook and eat them.Didinger, C.; Thompson, H.J. Defining Nutritional andFunctional Niches of Legumes: A Call for Clarity to Distinguish a Future Role for Pulses in the Dietary Guidelines for Americans. Nutrients 2021, 13,1100. https://doi.org/10.3390/nu13041100Mullins AP, Arjmandi BH. Health Benefits of Plant-BasedNutrition: Focus on Beans in Cardiometabolic Diseases. Nutrients. 2021 Feb5;13(2):519. doi: 10.3390/nu13020519. PMID: 33562498; PMCID: PMC7915747.

In this episode of the Saving Lives Podcast, we review a comprehensive 2025 meta-analysis on mortality risk factors in pulmonary embolism. Learn which clinical signs, biomarkers, and imaging findings most strongly predict outcomes — and how they can guide triage and therapy decisions in acute PE cases. A must-listen for anyone managing thromboembolic disease in the critically ill patients.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: You W, Fan XY, Chen Y, Wang XL, Song J, Nie CC, Dong Q. Risk Factors for Mortality in Patients with Pulmonary Embolism-A Meta-Analysis. J Intensive Care Med. 2025 May 5:8850666251326539. doi: 10.1177/08850666251326539. Epub ahead of print. PMID: 40320917.

Ben and Dr. Ralph Moss take a deep dive into newly published research on extra virgin olive oil and its potential role in supporting cancer patients. The discussion covers reduced hand-foot syndrome during chemotherapy, specifically Xeloda (capecitabine), lowered all-cause mortality, and the reasons EVOO topped Dr. Moss's list of anti-cancer foods. The episode also examines how to understand real quality in olive oil—from taste to polyphenol content—and what to look for in a product that offers more than just flavor. “Fill up that self-help space with scientifically documented ways to reduce your cancer risk.” – Dr. Ralph W. Moss

Ever feel like your brain just works differently - like how you need more space, more quiet, or more time to think? In this solo episode of The Ambitious Introvert®, I'm diving into some fascinating (and science-backed) reasons why that's not just in your head - it's actually how your brain is wired.We'll explore three key ways introverts process, respond, and recharge that set us apart - not in a “fix yourself” kind of way, but in a “ohhhh, that's why I do that!” kind of way. If you've ever second-guessed the way you work or wondered why other people seem to thrive on things that drain you, this one's for you.Here's what we cover:Why dopamine floods can feel overwhelming, and which neurotransmitter is the introvert's secret weapon for calm focus.The surprising way introverts use more brain energy, and what it means for your fatigue levels and social battery.What really happens when you pause before speaking, and why your slower processing is actually a strength.How your brain's default mode influences decision-making, reflection, and creativity by taking the long roadWhether you're an introvert wanting to better understand your own patterns or someone who leads or lives with one, this episode will help you reframe how you think about energy, focus, and expression.MENTIONED STUDIES:◾️ Laney, M. O. (2002). The Introvert Advantage – explains dopamine sensitivity and acetylcholine rewards◾️Johnson, D. L., & Wiebe, J. S. et al. (1999). Cerebral Blood Flow and Personality: A PET Study. Am J Psychiatry, 156(2), 252–257. (PMID 9989562)CONNECT WITH EMMA-LOUISE:Website: https://theambitiousintrovert.com/ LinkedIn: https://www.linkedin.com/in/emmalouparkes/Instagram: https://www.instagram.com/emmalouparkesSign up to receive my monthly Introverts Only digest, delivering all the best introvert-friendly resources straight to your inbox, minus the scroll here.PREMIUM SUPPORT: Interested in working with me 1:1? Learn more and apply here.

This episode of Bioethics in the Margins features a panel of bioethicists: Danielle Pacia of The Hastings Center, Sana Baban of UMass Chan Medical School, J. Wesley Boyd of Harvard Medical School, and Ryan Dougherty of Kaiser Permanente. They are the co-authors of a national survey exploring the role of social justice in their field, published in the American Journal of Bioethics: Empirical Bioethics. In this conversation, the authors discuss their key findings on what social justice obligations bioethicists feel they have, the concept of "social bioethics," and the duty of the field to address systemic injustice. We start by defining the term "social justice" and discussing how it relates to the four principles of bioethics. We spend some time unpacking the methods of the study including strengths and limitations. The main finding - that >80% of bioethicists surveyed believe that social justice should be part of their work - is contextualized by exploring how social justice can add information and objectivity to our work. The episode ends with some reflections by the authors on how we can move forward in the field with these important tools.Work cited in this episode: Pacia DM, Baban SS, Fletcher FE, Mithani Aziz Z, Cooper JF, Boyd JW, Dougherty RJ. A Survey of Attitudes Toward Social Justice Obligations in the Field of Bioethics. AJOB Empir Bioeth. 2025 Apr 17:1-12. doi: 10.1080/23294515.2025.2474915. https://pubmed.ncbi.nlm.nih.gov/40244571/Fletcher, F. E., Ray, K. S., Brown, V. A., & Smith, P. T. (Eds.). (2022). A critical moment in bioethics: Reckoning with anti-black racism through intergenerational dialogue. Hastings Center Report, 52(S2), S1-S68. https://doi.org/10.1002/hast.1363 Pierson, L., Gibert, S., Orszag, L., Sullivan, H. K., Fei, R. Y., Persad, G., & Largent, E. A. (2024). Bioethicists today: Results of the views in bioethics survey. The American Journal of Bioethics, 24(5), 4-22. https://doi.org/10.1080/15265161.2024.2323869Dougherty RJ, Fins JJ. Toward a Social Bioethics Through Interpretivism: A Framework for Healthcare Ethics. Camb Q Healthc Ethics. 2024 Jan;33(1):6-16. doi: 10.1017/S0963180123000452. Epub 2023 Aug 25. PMID: 37622652. https://pubmed.ncbi.nlm.nih.gov/37622652/

Pour accéder à l'intégralité de ce podcast et écouter chaque semaine un nouvel épisode du Quart d'Heure Véto, c'est très simple, il vous suffit de voushttps://m.audiomeans.fr/s/S-yUNSBZSR Notes et référencesArticle : Pluim M, Frippiat T. Survey of veterinarians' usage and satisfaction with intra-articular polyacrylamide gel in horses. J Equine Vet Sci. 2025 Jul;150:105610. doi: 10.1016/j.jevs.2025.105610. Epub 2025 May 19. PMID: 40398597.Retrouvez toute la synthèse sur la fiche podcast juste ici : https://audmns.com/QCkxXfAPour nous suivre :1. Abonnez-vous à notre chaine pour profiter de l'intégralité des épisodes : Le Quart d'Heure Véto : décrypte et résume en moins de 15 min un article de biblio véto - Sur abonnement uniquementLe Véto du Mois : Partagez le temps d'une interview l'expérience de vétérinaires emblématiques de notre milieu, des rencontres conviviales, comme si nous étions dans votre salon au coin du feu. Podcasts bonus au fil des inspirations... 2. Le ScopeNous partageons avec vous nos dernières découvertes, inspirations, pistes de réflexion, nouveautés… À découvrir et utiliser dès maintenant, TOUT DE SUITE, dans votre quotidien de vétérinaire, de manager, de vie personnelle, de chef d'entreprise… Et tout cela en moins de 5 minutes top chrono un à 2 mardis par mois ! Je souhaite recevoir mon Scope : https://vetmasterclass.com/lescope/ 3. Contactez-nous, suivez-nous et donnez nous votre avis ! Des sujets que vous souhaiteriez approfondir, des références à partager, ou nous faire part de vos feed-backs :Abonnez-vous à notre chaine, donnez nous des étoiles, un commentaire et partagez autour de vous !Sur notre site : https://vetmasterclass.com/Sur Facebook : https://www.facebook.com/VmHorseSur Instagram : https://www.instagram.com/vetmasterclass/Sur YouTube : https://www.youtube.com/channel/UC18ovcWk9e-mFiTL34OQ03gSur Linkedin : https://www.linkedin.com/company/vetmasterclass-horse/about/Belle journée à tous, Et continuez à vivre votre métier avec Passion ! Distribué par Audiomeans. Visitez audiomeans.fr/politique-de-confidentialite pour plus d'informations.

Send us a textProphylactic hydrocortisone and the risk of sepsis in neonates born extremely preterm.Baud O, Lehert P; PREMILOC study group.Eur J Pediatr. 2025 Jun 14;184(7):419. doi: 10.1007/s00431-025-06248-9.PMID: 40515786 Clinical Trial.As 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 textFrom Warm to Cold: Feeding Cold Milk to Preterm Infants with Uncoordinated Oral Feeding Patterns.Ferrara-Gonzalez L, Kamity R, Htun Z, Dumpa V, Islam S, Hanna N.Nutrients. 2025 Apr 26;17(9):1457. doi: 10.3390/nu17091457.PMID: 40362766 Free PMC article. Clinical Trial.As 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 textNorepinephrine versus Dopamine for Septic Shock in Neonates: A Randomized Controlled Trial.Mazhari MYA, Priyadarshi M, Singh P, Chaurasia S, Basu S.J Pediatr. 2025 Jul;282:114599. doi: 10.1016/j.jpeds.2025.114599. Epub 2025 Apr 17.PMID: 40252959 Clinical Trial.As 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 textAll-cause mortality and infection-related outcomes of hospital-initiated kangaroo care versus conventional neonatal care for low-birthweight infants: a systematic review and meta-analysis.Minotti C, Jost K, Aghlmandi S, Schlaeppi C, Sieswerda E, van Werkhoven CH, Schulzke SM, Bielicki JA.Lancet Child Adolesc Health. 2025 Jul;9(7):470-483. doi: 10.1016/S2352-4642(25)00130-0. Epub 2025 May 26.PMID: 40441171 Free article.As 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!

A simple daily practice to have happier, more productive days: gratitude journalling for students.*Hosted by William Wadsworth, memory psychologist, independent researcher and study skills coach. I help ambitious students to study smarter, not harder, so they can ace their exams with less work and less stress.BOOK 1:1 COACHING to supercharge your exam success: https://examstudyexpert.com/workwithme/Get a copy of Outsmart Your Exams, my award-winning exam technique book, at https://geni.us/exams*Today's references:Jeliseh, M.T., Valizadeh, M., Zohrabi, M. and Xodabande, I. (2025), Enhancing Language Teachers' Well-Being Through Positive Psychology Interventions: A Mixed-Methods Study Focusing on Gratitude Journaling. Psychology in the Schools. https://doi.org/10.1002/pits.70005Tolcher, K., Cauble, M., & Downs, A. (2022). Evaluating the effects of gratitude interventions on college student well-being. Journal of American College Health, 72(5), 1321–1325. https://doi.org/10.1080/07448481.2022.2076096Redwine LS, Henry BL, Pung MA, Wilson K, Chinh K, Knight B, Jain S, Rutledge T, Greenberg B, Maisel A, Mills PJ. Pilot Randomized Study of a Gratitude Journaling Intervention on Heart Rate Variability and Inflammatory Biomarkers in Patients With Stage B Heart Failure. Psychosom Med. 2016 Jul-Aug;78(6):667-76. doi: 10.1097/PSY.0000000000000316. PMID: 27187845; PMCID: PMC4927423.**As an Amazon Associate, I earn from qualifying purchases on suggested books.Questions? Comments? Requests? Or just want to say "thanks" - send me a text message (I read them all!).

Top Episode Replay:Designing HIIT workouts isn't just about the session you put down on paper.You need to first know the important basics of WHY you are doing them, and this relates critically to the CONTEXT! The impact of TIME ⏱️, INTENSITY

In this episode of the Saving Lives Podcast, we review a 2025 NEJM-Evidence study analyzing over 21,000 cases of severe hyponatremia to determine the safest and most effective correction rates. Learn why moderate correction (8–10 mmol/L/day) may actually reduce mortality, and how central pontine myelinolysis (CPM) remains rare even with faster correction. The Vasopressor & Inotrope HandbookI have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy. Amazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/47qJZe1⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Affiliate Link)My Store: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Use "podcast" to save 10%)Citation: Seethapathy H, Zhao S, Ouyang T, Passos C, Sarang A, Cheung PW, Waikar SS, Steele DJR, Kalim S, Allegretti AS, Ayus JC, Nigwekar SU. Severe Hyponatremia Correction, Mortality, and Central Pontine Myelinolysis. NEJM Evid. 2023 Oct;2(10):EVIDoa2300107. doi: 10.1056/EVIDoa2300107. Epub 2023 Sep 26. PMID: 38320180.

In this episode, we analyze a June 2025 study from the Journal of Intensive Care, which shows that lower hemoglobin levels at admission are strongly associated with worse outcomes in cardiogenic shock. We dive into the data from the FRENSHOCK registry, uncover key subgroup findings, and discuss implications for transfusion strategies. Could this shift how we manage anemia in shock? Tune in and find out.The Vasopressor & Inotrope HandbookI have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy. Amazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/47qJZe1⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Affiliate Link)My Store: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Use "podcast" to save 10%)Citation: Cherbi M, Levy B, Merdji H, Puymirat E, Bonnefoy E, Vardon F, Elbaz M, Morel O, Leurent G, Lamblin N, Gerbaud E, Gautier P, Roubille F, Delmas C. Hemoglobin in cardiogenic shock: the lower, the poorer survival. J Intensive Care. 2025 Jun 23;13(1):36. doi: 10.1186/s40560-025-00805-y. PMID: 40551259.

Hypoglycemia can be subtle—or dangerously obvious—and knowing when and how to treat it is critical. In her first episode as our new Push Dose Pearls expert, Emergency Medicine Clinical Pharmacist, Haley Burhans, joins us to break it down. We discuss glucose thresholds by age, when to draw critical labs, and how to choose the right treatment—whether it's oral glucose, IV dextrose, or IM or intranasal glucagon. From neonates to older adults, Haley delivers practical, evidence-based pearls to help you manage low blood sugar safely and effectively in the ED. Was this episode helpful? What other medications would you like to learn more about? Hit us up on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis Resources: Gandhi K. Approach to hypoglycemia in infants and children. Transl Pediatr. 2017 Oct;6(4):408-420. doi: 10.21037/tp.2017.10.05. PMID: 29184821; PMCID: PMC5682370. Rickels MR, Ruedy KJ, Foster NC, Piché CA, Dulude H, Sherr JL, Tamborlane WV, Bethin KE, DiMeglio LA, Wadwa RP, Ahmann AJ, Haller MJ, Nathan BM, Marcovina SM, Rampakakis E, Meng L, Beck RW; T1D Exchange Intranasal Glucagon Investigators. Intranasal Glucagon for Treatment of Insulin-Induced Hypoglycemia in Adults With Type 1 Diabetes: A Randomized Crossover Noninferiority Study. Diabetes Care. 2016 Feb;39(2):264-70. doi: 10.2337/dc15-1498. Epub 2015 Dec 17. PMID: 26681725; PMCID: PMC4722945.. MD Calc GIR (Glucose Infusion Rate) Calculator **** 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.

What if IVF didn't have to mean so many shots? Could a new protocol allow for fewer shots, less office visits, AND be less expensive?  In this episode of Brave & Curious, Dr. Lora Shahine is joined by Dr. Linnea Goodman to answer these questions and more. They review Dr. Goodman's research into a protocol, not new to the fertility field around the world, but new to most listeners in the United States that has many benefits to IVF patients. Dr. Linnea Goodman is a board-certified reproductive endocrinologist and infertility specialist. Throughout her career, Dr. Goodman has been dedicated to advancing the field of reproductive medicine through both clinical excellence and innovative research. Currently, Dr. Goodman practices at Virginia Fertility & IVF, where she specializes in minimally invasive office procedures aimed at optimizing fertility outcomes. In this episode you'll hear: [1:16] Meet Dr. Linnea Goodman: reproductive endocrinologist and researcher [2:24] IVF shots & their necessity [4:45] Provera Protocol is a game-changer [14:35] Research & evidence for the Provera Protocol  [22:19] A patient-centered approach [25:00] Research Outcomes [27:07] Innovations in IVF: Progestins [29:32 The patient experience: benefits and side effects of progestins [32:36 What does the future hold?  Resources mentioned:  http://vafertility.com Massin N, et al. New stimulation regimens: endogenous and exogenous progesterone use to block the LH surge during ovarian stimulation for IVF. Hum Reprod Update. 2017 Mar 1;23(2):211-220. doi: 10.1093/humupd/dmw047.PMID: 28062551  R Beguería, et al. Medroxyprogesterone acetate versus ganirelix in oocyte donation: a randomized controlled trial. Hum Reprod. 2019 May 1;34(5):872-880 doi:10.1093/humrep/dez034. PMID: 30927417 Giles J, et al. Medroxyprogeseterone acetate is a useful alternative to a gonadotropin-releasing hormone antagonist in ooxyte-donation: a randomized controlled trial. Fert Stert 2021;116: 404-412. PMID: 33814126. DOI: 10.1016/j.fertnstert.2021.02.036 Welp A, et al. Oral medroxyprogesterone acetate for the use of ovulation suppression in in vitro fertilization: a cohort trial. Fertil Steril 2024 May;121(5):806-813. PMID: 38253117 DOI: 10.1016/j.fertnstert.2024.01.026   Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Join the Behind the Knife Surgical Oncology Team as we discuss the two key studies investigating optimal management strategies of neuroendocrine tumors of the small bowel. Hosts: - Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center - Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist/HPB surgeon at Kaiser LAMC in Los Angeles. - Connor Chick, MD (@connor_chick) is a 2nd Year Surgical Oncology fellow at Ohio State University. - Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a 1st Year Surgical Oncology fellow at MD Anderson. - Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a PGY-6 General Surgery resident at Brooke Army Medical Center Learning Objectives: In this episode we review two important papers that discuss optimal management strategies of neuroendocrine tumors (NET) of the small bowel.  The first paper by Singh and colleagues discusses the NETTER-2 trial investigating the role of radioligand therapy for NET as a first-line treatment.  The second article by Maxwell et all challenges surgical dogma regarding optimal debulking cutoffs for debulking of NET. Links to Papers Referenced in this Episode: 1.     Singh S, Halperin D, Myrehaug S, Herrmann K, Pavel M, Kunz PL, Chasen B, Tafuto S, Lastoria S, Capdevila J, García-Burillo A, Oh DY, Yoo C, Halfdanarson TR, Falk S, Folitar I, Zhang Y, Aimone P, de Herder WW, Ferone D; all the NETTER-2 Trial Investigators. [177Lu]Lu-DOTA-TATE plus long-acting octreotide versus high‑dose long-acting octreotide for the treatment of newly diagnosed, advanced grade 2-3, well-differentiated, gastroenteropancreatic neuroendocrine tumours (NETTER-2): an open-label, randomised, phase 3 study. Lancet. 2024 Jun 29;403(10446):2807-2817. doi: 10.1016/S0140-6736(24)00701-3. Epub 2024 Jun 5. PMID: 38851203. https://pubmed.ncbi.nlm.nih.gov/38851203/ 2.     Maxwell JE, Sherman SK, O'Dorisio TM, Bellizzi AM, Howe JR. Liver-directed surgery of neuroendocrine metastases: What is the optimal strategy? Surgery. 2016 Jan;159(1):320-33. doi: 10.1016/j.surg.2015.05.040. Epub 2015 Oct 9. PMID: 26454679; PMCID: PMC4688152. https://pubmed.ncbi.nlm.nih.gov/26454679/ 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

Contributor: Taylor Lynch, MD Educational Pearls: How do we risk-stratify chest-pain patients? One option is the HEART score This score predicts a patient's 6-week risk of a major adverse cardiac event. Ex. Cath procedure, CABG, PCI, death H stands for History Ask 1) Was the patient diaphoretic? 2) Did they have nausea and/or vomiting? 3) Did the pain radiate down the right or left arm? 4) Was it exertional? Yes to one = one point. Two or more = two points. E stands for EKG One point for left ventricular hypertrophy, t-wave inversions, new bundle-branch blocks. No points for first degree AV block, benign early repolarization, or QT-prolongation Two points for ST-depression A stands for Age >65 gets two points 45-64 gets one point R stands for Risk factors Hypertension, hyperlipidemia, diabetes, obesity, family history, smoking, previous MI, previous CABG, stroke, peripheral arterial disease 1-2 risk factors get 1 point More than two risk factors gets two points T stands for Troponin 1-3x upper limit of normal gets one point >3x upper limit of normal gets two points This gives you a score between zero and ten 0-3 points, patients have a ~2% chance of an adverse event These patients likely go home 4-6 points, patients have a ~20% chance of an adverse event These patients get admitted or expedited outpatient stress test/echo 7-10 points, patients have a ~60% chance of an adverse event Admit and call cardiology. These patients likely get catheterized References Backus BE, Six AJ, Kelder JC, Bosschaert MA, Mast EG, Mosterd A, Veldkamp RF, Wardeh AJ, Tio R, Braam R, Monnink SH, van Tooren R, Mast TP, van den Akker F, Cramer MJ, Poldervaart JM, Hoes AW, Doevendans PA. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013 Oct 3;168(3):2153-8. doi: 10.1016/j.ijcard.2013.01.255. Epub 2013 Mar 7. PMID: 23465250. Laureano-Phillips J, Robinson RD, Aryal S, Blair S, Wilson D, Boyd K, Schrader CD, Zenarosa NR, Wang H. HEART Score Risk Stratification of Low-Risk Chest Pain Patients in the Emergency Department: A Systematic Review and Meta-Analysis. Ann Emerg Med. 2019 Aug;74(2):187-203. doi: 10.1016/j.annemergmed.2018.12.010. Epub 2019 Feb 2. PMID: 30718010. https://www.mdcalc.com/calc/1752/heart-score-major-cardiac-events Summarized by Jeffrey Olson, MS4 | Edited by Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/

In this episode of the Saving Lives Podcast, we reviews a 2024 multicenter study on valproic acid for hyperactive delirium and agitation in ICU patients. The findings show that VPA may help reduce sedation needs, improve ventilator synchrony, and resolve delirium without major adverse effects. Tune in for practical insights into this emerging option for complex critical care cases.The Vasopressor & Inotrope HandbookI have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy. Amazon: ⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/47qJZe1⁠⁠⁠⁠⁠⁠⁠⁠ (Affiliate Link)My Store: ⁠⁠⁠⁠⁠⁠⁠⁠https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook⁠⁠⁠⁠⁠⁠⁠⁠ (Use "podcast" to save 10%)Citation: Nuti O, Merchan C, Ahuja T, Arnouk S, Papadopoulos J, Katz A. Valproic Acid for Hyperactive Delirium and Agitation in Critically Ill Patients. J Intensive Care Med. 2025 May;40(5):519-527. doi: 10.1177/08850666241302760. Epub 2024 Dec 8. PMID: 39648603.

Was passiert im Körper, wenn wir altern? Wird es irgendwann eine Wunderpille geben, die uns alle 120 Jahre alt - oder sogar unsterblich werden lässt? Sehr alt zu werden, das ist zwar der Wunsch von vielen Menschen, aber bei allen gehören auch - mal mehr, mal weniger - Alterserscheinungen dazu. Die Sehkraft nimmt ab, die Haut ist nicht mehr so straff wie mit Anfang 20, die Haare werden grau, aber häufig kommen auch verschiedene Krankheiten wie Diabetes Typ 2, Herzprobleme oder Krebs dazu. Unsere Autorin Daniela Remus hat mit Forschenden über den Prozess des Alterns gesprochen: Was passiert überhaupt im Körper, wenn Falten entstehen und lässt sich dieser Prozess aufhalten? Im Gespräch mit Host Beke Schulmann erklärt sie, worum es der Forschung in diesem Bereich geht: Kann ein besseres und gesünderes Leben im Alter gelingen? Oder können wir sogar in Richtung Unsterblichkeit blinzeln? HINTERGRUNDINFORMATIONEN Forschung von Prof. Björn Schumacher, zur DNA Schädigung: Schumacher B, Pothof J, Vijg J, Hoeijmakers JHJ. The central role of DNA damage in the ageing process. Nature. 2021 Apr;592(7856):695-703. doi: 10.1038/s41586-021-03307-7 https://www.nature.com/articles/s41586-021-03307-7 Soltanmohammadi N, Wang S, Schumacher B. Somatic PMK-1/p38 signaling links environmental stress to germ cell apoptosis and heritable euploidy. Nat Commun. 2022 Feb 4;13(1):701. doi: 10.1038/s41467-022-28225-8 https://www.nature.com/articles/s41467-022-28225-8 Literaturtipps: Björn Schumacher: Das Geheimnis des menschlichen Alterns. Die überraschenden Erkenntnisse der noch jungen Alternsforschung. Blessing Verlag, 2015 Forschung von Prof. Hartmut Geiger, zur Alterung der Blutstammzellen: Amanda Amoah 1, Anja Keller 1, Ramiz Emini 2, Markus Hoenicka 2, Andreas Liebold 2, Angelika Vollmer 1, Karina Eiwen 1, Karin Soller 1, Vadim Sakk 1, Yi Zheng 3, Maria Carolina Florian 1, Hartmut Geiger 4 Aging of human hematopoietic stem cells is linked to changes in Cdc42 activity. PMID: 33440922 PMCID: PMC8804569//DOI: 10.3324/haematol.2020.269670 https://haematologica.org/article/view/haematol.2020.269670 Hartmut Geiger 1, Gerald de Haan, M Carolina Florian The ageing haematopoietic stem cell compartment PMID: 23584423// DOI: 10.1038/nri3433 https://pubmed.ncbi.nlm.nih.gov/23584423/ Homepage Prof. Björn Schumacher https://www.cecad.uni-koeln.de/de/research/principal-investigators/full-members/bjoern-schumacher Homepage Dr. Inas Huppertz https://www.age.mpg.de/person/129208/227915 Homepage Prof. Christoph Englert https://www.leibniz-fli.de/de/forschung/forschungsgruppen/englert Homepage Prof. Hartmut Geiger https://www.geigerlab.com Hier geht's zu ARD Gesund: https://www.ndr.de/ratgeber/gesundheit Habt ihr Feedback oder einen Lifehack aus der Welt der Wissenschaft? Schreibt uns gerne an synapsen@ndr.de.

Was passiert im Körper, wenn wir altern? Wird es irgendwann eine Wunderpille geben, die uns alle 120 Jahre alt - oder sogar unsterblich werden lässt? Sehr alt zu werden, das ist zwar der Wunsch von vielen Menschen, aber bei allen gehören auch - mal mehr, mal weniger - Alterserscheinungen dazu. Die Sehkraft nimmt ab, die Haut ist nicht mehr so straff wie mit Anfang 20, die Haare werden grau, aber häufig kommen auch verschiedene Krankheiten wie Diabetes Typ 2, Herzprobleme oder Krebs dazu. Unsere Autorin Daniela Remus hat mit Forschenden über den Prozess des Alterns gesprochen: Was passiert überhaupt im Körper, wenn Falten entstehen und lässt sich dieser Prozess aufhalten? Im Gespräch mit Host Beke Schulmann erklärt sie, worum es der Forschung in diesem Bereich geht: Kann ein besseres und gesünderes Leben im Alter gelingen? Oder können wir sogar in Richtung Unsterblichkeit blinzeln? HINTERGRUNDINFORMATIONEN Forschung von Prof. Björn Schumacher, zur DNA Schädigung: Schumacher B, Pothof J, Vijg J, Hoeijmakers JHJ. The central role of DNA damage in the ageing process. Nature. 2021 Apr;592(7856):695-703. doi: 10.1038/s41586-021-03307-7 https://www.nature.com/articles/s41586-021-03307-7 Soltanmohammadi N, Wang S, Schumacher B. Somatic PMK-1/p38 signaling links environmental stress to germ cell apoptosis and heritable euploidy. Nat Commun. 2022 Feb 4;13(1):701. doi: 10.1038/s41467-022-28225-8 https://www.nature.com/articles/s41467-022-28225-8 Literaturtipps: Björn Schumacher: Das Geheimnis des menschlichen Alterns. Die überraschenden Erkenntnisse der noch jungen Alternsforschung. Blessing Verlag, 2015 Forschung von Prof. Hartmut Geiger, zur Alterung der Blutstammzellen: Amanda Amoah 1, Anja Keller 1, Ramiz Emini 2, Markus Hoenicka 2, Andreas Liebold 2, Angelika Vollmer 1, Karina Eiwen 1, Karin Soller 1, Vadim Sakk 1, Yi Zheng 3, Maria Carolina Florian 1, Hartmut Geiger 4 Aging of human hematopoietic stem cells is linked to changes in Cdc42 activity. PMID: 33440922 PMCID: PMC8804569//DOI: 10.3324/haematol.2020.269670 https://haematologica.org/article/view/haematol.2020.269670 Hartmut Geiger 1, Gerald de Haan, M Carolina Florian The ageing haematopoietic stem cell compartment PMID: 23584423// DOI: 10.1038/nri3433 https://pubmed.ncbi.nlm.nih.gov/23584423/ Homepage Prof. Björn Schumacher https://www.cecad.uni-koeln.de/de/research/principal-investigators/full-members/bjoern-schumacher Homepage Dr. Inas Huppertz https://www.age.mpg.de/person/129208/227915 Homepage Prof. Christoph Englert https://www.leibniz-fli.de/de/forschung/forschungsgruppen/englert Homepage Prof. Hartmut Geiger https://www.geigerlab.com Hier geht's zu ARD Gesund: https://www.ndr.de/ratgeber/gesundheit Habt ihr Feedback oder einen Lifehack aus der Welt der Wissenschaft? Schreibt uns gerne an synapsen@ndr.de.

You have a patient with complicated diverticulitis s/p IR drain with colo-cutaneous fistula and colo-vaginal fistula. They are scheduled for surgery. How will you do it? What is the role for hand assist? How can hand assist help? Tune in to find out! Join Drs. Peter Marcello, Jonathan Abelson, and Tess Aulet as they discuss high yield papers discussing hand assist laparoscopy in Colon and Rectal surgery.  Learning Objectives 1. Describe the technical considerations and how to do hand assist laparoscopic surgery (HALS) 2. Discuss the indications for use of HALS 3. Review literature supporting use of HALS   References: Marcello PW, Fleshman JW, Milsom JW, Read TE, Arnell TD, Birnbaum EH, Feingold DL, Lee SW, Mutch MG, Sonoda T, Yan Y, Whelan RL. Hand-assisted laparoscopic vs. laparoscopic colorectal surgery: a multicenter, prospective, randomized trial. Dis Colon Rectum. 2008 Jun;51(6):818-26; discussion 826-8. doi: 10.1007/s10350-008-9269-5. Epub 2008 Apr 17. PMID: 18418653. https://pubmed.ncbi.nlm.nih.gov/18418653/ Jacobs C, Read TE. "Peek port": avoiding conversion during laparoscopic colectomy-an update. Surg Endosc. 2020 Sep;34(9):3944-3948. doi: 10.1007/s00464-019-07165-3. Epub 2019 Oct 4. PMID: 31586252. https://pubmed.ncbi.nlm.nih.gov/31586252/ Heneghan HM, Martin ST, Kiran RP, Khoury W, Stocchi L, Remzi FH, Vogel JD. Laparoscopic colorectal surgery for obese patients: decreased conversions with the hand-assisted technique. J Gastrointest Surg. 2013 Mar;17(3):548-54. doi: 10.1007/s11605-012-2089-x. Epub 2012 Nov 27. PMID: 23188222. https://pubmed.ncbi.nlm.nih.gov/23188222/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

In this episode, Professor Asim Surani, shares how his extensive research has significantly advanced the understanding of how the mammalian germline is specified, the mechanisms governing epigenetic reprogramming, and the critical conditions that maintain genomic integrity during early development. The discussion, led by Dr. Stefan Dillinger, provides an overview of Surani's journey into biology, the evolution of his research interests, and the pivotal discoveries that have shaped the field of epigenetics. Dr. Surani discusses the groundbreaking experiment he co-conducted in 1984 that led to the discovery of genomic imprinting. Initially a student involved in in vitro fertilization at Cambridge, he became intrigued by the implications of parthenogenesis in mammals. Challenging the prevailing cytoplasmic theory of development, Surani and his collaborators demonstrated that normal mammalian development requires contributions from both parental genomes, leading to the introduction of the concept of genomic imprinting—a term Surani defended to describe the phenomenon that he and his team observed. Surani's research then evolved toward understanding the mechanisms of genomic imprinting, particularly the role of DNA methylation. Throughout the interview, he details specific experiments that elucidated how genes could exhibit imprinted expression depending on the parental lineage, highlighting the importance of epigenetic factors in gene regulation. The revelation that DNA methylation marks were responsible for imprinting solidified the connection between genetic information and epigenetic influence in development. The conversation dives deeper into the mechanisms involved in germline specification and epigenetic reprogramming. Surani explains his transition into studying mammalian germline development and the intricacies of primordial germ cell specification. Working with his team, he utilized single-cell approaches to investigate gene expression profiles specific to germ cells, identifying critical factors like PRDM1 and PRDM14 that repress somatic gene programs while initiating germline-specific pathways. This work underscored the complex interplay of genetic and epigenetic factors that govern the development of germ cells. Another focus of the interview is the comparison of epigenetic resetting between mouse and human germlines. Surani addresses key differences in the timing and mechanisms of epigenetic reprogramming in humans, particularly the involvement of specific factors such as SOX17, which emerged as a crucial player in human germline specification, contrary to his earlier expectations. The discussion also highlights the technical challenges researchers face when studying human embryos due to ethical constraints, driving innovation in model systems such as stem cells to explore germline development.   References Surani MA, Barton SC, Norris ML. Development of reconstituted mouse eggs suggests imprinting of the genome during gametogenesis. Nature. 1984 Apr 5-11;308(5959):548-50. doi: 10.1038/308548a0. PMID: 6709062. Surani MA, Barton SC, Norris ML. Nuclear transplantation in the mouse: heritable differences between parental genomes after activation of the embryonic genome. Cell. 1986 Apr 11;45(1):127-36. doi: 10.1016/0092-8674(86)90544-1. PMID: 3955655. Ohinata Y, Payer B, O'Carroll D, Ancelin K, Ono Y, Sano M, Barton SC, Obukhanych T, Nussenzweig M, Tarakhovsky A, Saitou M, Surani MA. Blimp1 is a critical determinant of the germ cell lineage in mice. Nature. 2005 Jul 14;436(7048):207-13. doi: 10.1038/nature03813. Epub 2005 Jun 5. PMID: 15937476. Hajkova P, Ancelin K, Waldmann T, Lacoste N, Lange UC, Cesari F, Lee C, Almouzni G, Schneider R, Surani MA. Chromatin dynamics during epigenetic reprogramming in the mouse germ line. Nature. 2008 Apr 17;452(7189):877-81. doi: 10.1038/nature06714. Epub 2008 Mar 19. PMID: 18354397; PMCID: PMC3847605.   Related Episodes Epigenetic Reprogramming During Mammalian Development (Wolf Reik) Epigenetic and Metabolic Regulation of Early Development (Jan Żylicz) Epigenetic Mechanisms in Genome Regulation and Developmental Programming (James Hackett) Epigenetic Mechanisms of Mammalian Germ Cell Development (Mitinori Saitou) Exploring DNA Methylation and TET Enzymes in Early Development (Petra Hajkova)   Contact Epigenetics Podcast on Mastodon Epigenetics Podcast on Bluesky Dr. Stefan Dillinger on LinkedIn Active Motif on LinkedIn Active Motif on Bluesky Email: podcast@activemotif.com

Welcome to the podcast with Dr. Brendan McCarthy!   In this deeply personal episode, he shares why lab work—especially testing FSH (Follicle Stimulating Hormone)—is non-negotiable in hormone replacement therapy.   This is not about gatekeeping. It's about understanding. It's about caring. Dr. McCarthy recounts a formative memory of meeting a woman who underwent surgical menopause and was never told what would happen to her body afterward. That moment shaped his lifelong mission to treat women with comprehensive, individualized care—not cookie-cutter patches or “blind firing” estrogen without context. In this episode, he explains:

Contributor: Aaron Lessen, MD Educational Pearls: A prospective study at the Mayo Clinic Rochester was conducted to examine whether patients actively using their phones on initial assessment in the ED was associated with higher discharge rates The study included 292 patients, and only about 15% of patients were on their phone The patients on their phone tended to be a younger demographic Scribes were trained to record the data during their shifts The results did show that patients on their phone have a higher rate of discharge 94% chance of discharge if the patient is on their phone 64% chance of discharge if the patient is not on their phone This concept can potentially contribute to improving triage decisions References Garcia SI, Jacobson A, Moore GP, Frank J, Gifford W, Johnson S, Lazaro-Paulina D, Mullan A, Finch AS. Airway, breathing, cellphone: a new vital sign? Int J Emerg Med. 2024 Nov 22;17(1):177. doi: 10.1186/s12245-024-00769-0. PMID: 39578750; PMCID: PMC11583604. Summarized by Meg Joyce, MS2 | Edited by Meg Joyce & Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/

Today, Dr. Rahul Damania, Dr. Pradip Kamat, and Dr. Monica Gray, pediatric intensivists, sit down to chat about the diagnosis and management of acute myocarditis in children. They focus on a real-life case involving a one-month-old infant who presented with poor feeding, respiratory distress, and fever. Together, they break down the possible causes, key clinical signs, diagnostic approaches, and treatment options for pediatric myocarditis. Throughout the discussion, they highlight the importance of early recognition, a multidisciplinary team approach, and supportive care in improving outcomes for these critically ill infants. This episode is packed with practical insights and is designed to help pediatric intensivists tackle this challenging and potentially life-threatening condition. Tune in to hear more!Show Highlights:Definition and etiology of acute myocarditis in pediatric patientsClinical case presentation of a one-month-old infant with acute myocarditisSymptoms and clinical manifestations of acute myocarditis in childrenDiagnostic approaches for identifying acute myocarditis, including echocardiography and laboratory testsManagement strategies for acute myocarditis, including intensive care and medicationImportance of recognizing atypical presentations in infantsPrognosis and risk factors associated with acute myocarditisRole of multidisciplinary collaboration in managing acute myocarditisImpact of viral infections on the development and severity of myocarditisOutcomes and potential complications related to acute myocarditis in pediatric patientsReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter 108. Life-threatening viral diseases and their treatment. Vora S et al. Pages 1273-1278Rogers' textbook of Pediatric Intensive Care. Chapter 74: cardiomyopathy, myocarditis, and mechanical circulatory support. Harmon WG et al. Pages 1247-1255Robinson J, Hartling L, Vandermeer B, Sebastianski M, Klassen TP. Intravenous immunoglobulin for presumed viral myocarditis in children and adults. Cochrane Database Syst Rev. 2020 Aug 19;8(8): CD004370. Doi: 10.1002/14651858.CD004370.pub4. PMID: 32835416

This is a capstone presentation from Chief Resident of Mayo Clinic Emergency Medicine, Dr. Taylor Christian.   Teaser: Can we fulfill our oath to “do no harm” if we ignore the harm of racial injustice in medicine? Understanding the historical roots and persistent impact of medical racism isn't just informative; it is a call to action. This presentation is an opportunity to learn, reflect, and act to become better advocates.   CONTACTS X - @AlwaysOnEM; @VenkBellamkonda; @TayMChristian YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch; @drtaylormonet Email - AlwaysOnEM@gmail.com   REFERENCES & LINKS Meisel ZF, Shofer FS, Dolan AR, Goldberg E, Cannuscio CC, Rhodes KV, Perrone J, Hess EP, Rogers M, Bellamkonda V, Bell J, Zyla M, Becker L, McCollum S, Schapira M. Comparing Three Ways to Help Patients with Acute Pain Learn about Opioid Risks — The Life STORRIED Study [Internet]. Washington (DC): Patient-Centered Outcomes Research Institute (PCORI); 2021 Oct. PMID: 39383261. Engel-Rebitzer E, Dolan AR, Aronowitz SV, Shofer FS, Nguemeni Tiako MJ, Schapira MM, Perrone J, Hess EP, Rhodes KV, Bellamkonda VR, Cannuscio CC, Goldberg E, Bell J, Rodgers MA, Zyla M, Becker LB, McCollum S, Meisel ZF. Patient Preference and Risk Assessment in Opioid Prescribing Disparities: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2021 Jul 1;4(7):e2118801. doi: 10.1001/jamanetworkopen.2021.18801. PMID: 34323984; PMCID: PMC8322998. Racic M, Roche-Miranda MI, Fatahi G. Twelve tips for implementing and teaching anti-racism curriculum in medical education. Med Teach. 2023 Aug;45(8):816-821. doi: 10.1080/0142159X.2023.2206534. Epub 2023 May 3. PMID: 37134226. Sahai A, Corley AMS, Lipps L, Lawton R, DeBlasio D, Klein M. A Locally-Focused Structural Racism Curriculum for Pediatric Primary Care Residents. Acad Pediatr. 2023 Nov-Dec;23(8):1510-1512. doi: 10.1016/j.acap.2023.06.012. Epub 2023 Jun 9. PMID: 37302703. Carrera D, Tejeda C, Kakani P, Napolitano J. Addressing Racism in Medical Education: A Longitudinal Antiracism Discussion Curriculum for Medical Students. Med Sci Educ. 2023 Apr 28;33(3):639-643. doi: 10.1007/s40670-023-01788-x. PMID: 37501797; PMCID: PMC10368613. Seegmiller Renner AM, Gross JR, Laughlin-Tommaso SK. Paving a Path to Inclusion, Diversity, Anti-Racism, and Equity: A Curriculum Roadmap. Mayo Clin Proc. 2023 Dec;98(12):1755-1762. doi: 10.1016/j.mayocp.2023.08.026. PMID: 38043992.

As many runners know, a run takes more time than just the miles themselves. You have a pre-run warm-up and recovery nutrition - and so you may wonder if you really need a cooldown after your run, or if you can save some time there. In this episode, we answer a common listener question about what a cooldown after runs actually does - and if you need to do them. We break this discussion into a physiological explanation of what a cooldown does (and what a cooldown won't achieve) and a practical explanation of how to apply effective cooldowns in your training. You will learn:✅ What a cooldown after a run achieves - and what it doesn't ✅ If you need to cool down after an easy run ✅ Why you don't need to worry about flushing out “lactic acid”✅ How cool down miles can improve your running performance✅ Do you need to stretch for your cool down?✅ How to cool down after an interval or tempo run✅ Should you use an ice bath for a post-run cooldown?Thank you to our sponsors:➡️ BodyBio: Research-backed, practitioner-trusted supplements. Use code AMANDA25 for 25% off at https://runtothefinish.com/bodybio/➡️ Tifosi: Follow link https://tifosiopticsinc.pxf.io/c/2475256/2888012/29284 for durable, budget-friendly, no-slip sunglasses!  ➡️ Skratch: Follow the link Skratch Sample Pack and use code TREADLIGHTLY for 20% off your first purchase. Let's stay connected:➡️ Join our community at patreon.com/treadlightlyrunning➡️ Tread Lightly Running Podcast on Instagram: https://www.instagram.com/treadlightlyrunning/➡️ Laura Norris Running on Instagram: https://www.instagram.com/lauranorrisrunning/➡️ Hundreds of evidence-based training tips on Laura's website: https://lauranorrisrunning.com/➡️ Run to the Finish on Instagram: https://www.instagram.com/runtothefinish/?hl=en➡️ Thousands of running gear reviews and training guides: https://runtothefinish.com/References:

Phytoremediation. A fun word to say, but what does it mean? Turns out it's quite simple: using the superpower many plants naturally have to heal our wonderful Earth from terrible soil contaminants. Allan pulls us off the dark abyss edge that is our current world to deliver a wonderful tale of plants. Primary Sources: Gerhardt KE, Gerwing PD, Greenberg BM. Opinion: Taking phytoremediation from proven technology to accepted practice. Plant Sci. 2017 Mar;256:170-185. Epub 2016 Dec 5. PMID: 28167031. Lee, Jae. (2013). An overview of phytoremediation as a potentially promising technology for environmental pollution control. Biotechnology and Bioprocess Engineering. 18. +++ More of Our Work +++ Website Facebook TikTok Twitch Bluesky +++ Contact Us +++ Text/Call: (316)-512-8933 info@grasslandgroupies.org +++ Support Us +++ Bonfire Merch Store CashApp: $GrasslandGroupies Or... donate directly to our org.

In this Complex Care Journal Club podcast episode, Drs. Tamara Simon and Patrick Brady discuss the role of the journal Hospital Pediatrics in disseminating emerging evidence in complex care. They describe the evolution of complex care research throughout the journal's history, alignment with the journal's mission, and opportunities for clinicians to contribute to the literature in partnership with families. SPEAKERS Tamara Simon, MD, MSPH, FAAP Professor of Pediatrics (Clinical Scholar) University of Southern California Keck School of Medicine and Children's Hospital Los Angeles CHLA Site Principal Investigator and Director, Workforce Development, SC CTSI‌‌ Patrick Brady, MD, MSc Professor, Division Director, Division of Hospital Medicine Cincinnati Children's Hospital University of Cincinnati College of Medicine 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: June 9, 2025. ARTICLE REFERENCED Simon TD; THE EDITORIAL BOARD OF HOSPITAL PEDIATRICS. Complex Care Has Arrived. Hosp Pediatr. 2020 Aug;10(8):631-632. doi: 10.1542/hpeds.2020-001057. Epub 2020 Jul 2. PMID: 32616601. TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/q4sxvz3kvrpbvk7wqw7vms5z/Simon_and_Brady_Final_Transcript_6-4-25‌‌ 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: 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 Simon T, Brady P, Malik K. Elevating the Evidence: Complex Care Research in the Journal Hospital Pediatrics. 6/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/elevating-the-evidence-complex-care-research-in-the-journal-hospital-pediatrics.

Send us a textPatent Ductus Arteriosus in Preterm Infants.Ambalavanan N, Aucott SW, Salavitabar A, Levy VY; Committee on Fetus and Newborn; Section on Cardiology and Cardiac Surgery.Pediatrics. 2025 May 1;155(5):e2025071425. doi: 10.1542/peds.2025-071425.PMID: 40288780 Review.As 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 textActive 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 Free PMC As 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 textConsensus Approach for Standardization of the Timing of Brain Magnetic Resonance Imaging and Classification of Brain Injury in Neonates With Neonatal Encephalopathy/Hypoxic-Ischemic Encephalopathy: A Canadian Perspective.Mohammad K, Reddy Gurram Venkata SK, Wintermark P, Farooqui M, Beltempo M, Hicks M, Zein H, Shah PS, Garfinkle J, Sandesh S, Cizmeci MN, Fajardo C, Guillot M, de Vries LS, Pinchefsky E, Shroff M, Scott JN; Newborn Brain Health Working Group of the Canadian Neonatal Network.Pediatr Neurol. 2025 May;166:16-31. doi: 10.1016/j.pediatrneurol.2025.01.021. Epub 2025 Feb 12.PMID: 40048833 Free article.As 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 textShifting outlooks after neonatal encephalopathy in the era of therapeutic hypothermia.Christoffel K, Mulkey SB.Pediatr Res. 2025 Jun 4. doi: 10.1038/s41390-025-04156-0. Online ahead of print.PMID: 40467976 Review.As 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!

Content warning:  arson, assault, fetal abduction, kidnapping, attempted murder, murder, substance use, and substance use disorder. As shared in part one, Angelique Robledo is an incredible mother and survivor living in Arizona. She was born in Southern California, but after a pivotal move nearly four hundred miles east in her middle school years, she found herself having trouble fitting in. Several years later, and not long after finding out she was pregnant, Angelique was introduced (by a mutual friend) to a Maricopa newcomer who she seemed to have a lot in common with. Over the next several months she would get to know the also-18-year-old via text and social media; they would discuss their pregnancies and build what Angelique considered a friendship. But everything changed on February 16, 2011, when their burgeoning relationship became nearly lethal. The Broken Cycle Media team is deeply honored and grateful that Angelique was willing to so rawly share about her experiences and all that came next for her after courageously surviving an alleged attempted fetal abduction and attempted arson. Angelique's Instagram: https://www.instagram.com/angelique.robledo92/ Angelique's TikTok: https://www.tiktok.com/@angeliquemonet0 Sources: Dr. Phil Fanatic. (2025, March 12). Dr. Phil - s11 e97: Baby Snatcher: Barely escaping a fetal abduction? [Video]. YouTube. https://www.youtube.com/watch?v=AbDdw19NLgI Welner M, Burgess A, O'Malley KY. Fetal abduction by maternal evisceration: A planned homicide. Forensic Sci Int. 2021 Dec;329:111057. doi: 10.1016/j.forsciint.2021.111057. Epub 2021 Oct 17. PMID: 34739916. https://pubmed.ncbi.nlm.nih.gov/34739916/ For a list of related resources and non-profit organizations that can help, please visit http://www.somethingwaswrong.com/resources

Episode 193: Gestational Diabetes IntroJesica Mendoza (OMSIII) describes the pathophysiology of gestational diabetes and the right timing and method of screening for it. Dr. Arreaza adds insight into the need for culturally-appropriate foods, such as vegetables in Mexican cuisine.    Written by Jesica Mendoza, OMSIII, Western University of Health Sciences, College of Osteopathic Medicine of the Pacific. Editing 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.DefinitionGestational diabetes mellitus (GDM) is a condition that occurs to previously non-diabetic pregnant women, caused by glucose intolerance at around the 24th week of gestation. PathophysiologyGDM arises due to an underlying pancreatic beta cell dysfunction in the mother which leads to a decrease in the amount of insulin produced and thus leads to higher blood sugar levels during pregnancy. The placenta of the fetus will produce hPL (human placental lactogen) to ensure a steady supply of sugars to the fetus, creating an anti-insulin effect. However, hPL readily crosses the placental barrier causing the mothers insulin requirement to increase, when the mother's pancreas cannot increase production of insulin to that level needed to counter the effect of hPL they become diabetic, and this leads to gestational diabetes. So, basically the placenta is asking for more glucose for the baby and the mother's pancreas struggles to keep the glucose level within normal limits in the body of the mother. If left untreated, high levels of glucose in the mother can cause glucotoxicity in the mother.“Glucotoxicity” refers to the toxic effect of glucose. Glucose is the main fuel for cell functions, but when it is high in the bloodstream, it causes toxicity to organs. Prevalence of GDM.The CDC reports mean prevenance of GDM is 6.9%. In U.S. mothers the prevenance increased from 6.0% in 2016 to 8.3% in 2021. Many different factors have played a role in increasing gestational diabetes in American mothers, some of those being the ongoing obesity epidemic with excess body weight being a known risk factor for insulin resistance. Another being advanced maternal age (AMA) as more American women have children later in life their body becomes less sensitive to insulin and requires a higher insulin output on top of the insulin that is required for the fetus. The “American diet” is also something that has a big effect in diabetes development. With the increase of high-carb foods that are readily available, the diet of Americans has declined and is affecting the metabolic health of mothers as they carry and deliver their children. Despite ongoing awareness of GDM, 6% to 9% of pregnant women in the United States are diagnosed with gestational diabetes, and the prevalence continues to increase worldwide. It is estimated that in 2017 18.4 million pregnancies were affected by GDM in the world, which then continued to increase to 1 in 6 births to women with GDM in 2019. It was also found that women living in low-income communities were disproportionately affected due to limited healthcare access. Additionally, women with GDM had a 1.4-fold increase in likelihood of undergoing a c-section, with 15% increase in risk of requiring blood transfusion. Screening for GDMGestational diabetes is screened between the 24th to 28th week of gestation in all women without known pregestational diabetes. In women who have high-risk for GDM the screening occurs during the first trimester, these women usually have at least one of the following: BMI > 30, prior history of GDM, known impaired glucose metabolism, and/or a strong family history of diabetes. The screening during the first trimester is to detect “pregestational diabetes” because we have to keep a good glycemic control to improve outcomes of pregnancy. So, if it's positive, you start treatment immediately. If these women are found to have a normal glucose, they repeat the testing again as done normally, at 24-28 weeks of gestation. How do we screen?The screening itself consists of two types of approaches. The two-step approach includes a 50-gram oral glucose tolerance test (OGTT), where blood glucose is measured in an hour and if it is below 140 they are considered to not have GDM, however if the reading is greater than 140 they must then do a 3-hour, 100g oral glucose tolerance test. The 3-hour OGTT includes measuring the blood sugars at Fasting which should be less than 95, at 1 hour at less than 180, at 2 hours at less than 155, and at 3 hours at less than 140. If 2 or more of these values exceed the threshold the patient is diagnosed with gestational diabetes mellitus. The one-step approach includes 75g after an overnight fast. Blood glucose is measured while fasting which should be less than 92, at 1 hour less than 180 and at 2 hours less than 153. If any one of these values is exceeded, the patient is diagnosed with GDM.If the mother is found to be GDM positive during pregnancy she will also need continued screening post-partum to monitor for any development of overt diabetes. The testing is usually 75g 2-hour OGTT at 6-12 weeks postpartum. If this testing is normal, then they are tested using HbA1c every 3 years. If the post-partum testing shows pre-diabetes, annual testing is recommended using HbA1c measurements. Maternal complications Women with GDM are at an increased risk for future cardiovascular disease, T2DM, and chronic kidney disease. GDM is also associated with increased likelihood of developing pre-eclampsia following delivery. Pre-eclampsia is a complication seen in pregnancy characterized by high blood pressure, proteinuria, vision changes, and liver involvement (high LFTs). Pre-eclampsia can then progress to eclampsia or HELLP syndrome, both of which can include end organ damage. Additionally, she can develop polyhydramnios which leads to overstretching of the uterus and can induce pre-term labor, placental abruption, and or uterine atony, all of which additionally put the mother at increased risk for c-section. All of these maternal complications that stem from GDM lead to complications and extended hospitalization. Child's complications Although there is an increased set of risks for the mother, the neonate can also develop a variety of risks due to the increased glucose while in utero. While the fetus is growing, the placenta is the source of nutrition for the fetus. As the levels of glucose in the mother increase so does the amount of glucose filtered through the placenta and into the fetal circulation. Over time the glucose leads to oxidative stress and inflammation with activation of TGF-b which leads to fibroblast activation and fibrosis of the placenta. This fibrosis decreases the nutrient and oxygen exchange for the fetus. As the fetus attempts to grow in this restrictive environment its development is affected. The fetus can develop IUGR (intrauterine growth restriction) leading to a small for gestation age newborn which can then lead to another set of complications. The low oxygen environment can lead to increased EPO production and polycythemia at birth which can then lead to increased clotting that can travel to the newborn brain. Newborns can also be born with fetal acidosis due to the anerobic metabolism and lactic acid buildup in fetal tissues which can cause fetal encephalopathy leading to cerebral palsy and developmental delay. And the most severe of newborn complications to gestational diabetes can lead to fetal demise. Furthermore, the increase of glucose can also lead to macrosomia in the infant which can often lead to a traumatic delivery and delivery complications such as shoulder dystocia and brachial plexus injury. Brachial plexus injury sometimes resolves without sequela, but other times can lead to permanent weakness or paralysis of the affected arm. The baby can be born too small or too big.Additionally, once the fetus is born the cutting of the umbilical cord leads to a rapid deceleration in blood glucose in the fetal circulation and hypoglycemic episodes can occur, that often lead to NICU admission. The insulin that is created by the fetus in utero to accommodate the large quantities of glucose is known to affect lung maturation as well. The insulin produced inhibits surfactant production in the fetus. Upon birth some of the newborns also have to be placed on PEEP for ventilation and some children require treatment with surfactant to prevent alveolar collapse and/or progression to NRDS created by the low surfactant levels. Additionally, neonates who are macrosomic, which is usually seen in GDM mothers, are larger and stronger and when put on PEEP to help increase ventilation the newborn's stronger respiratory effort can lead to higher pulmonary pressures and barotrauma such as neonatal pneumothorax.Long term complications to the child of a mother with GDM also occur. As the child grows, they are also at an increased risk for developing early onset obesity because of the increased adipose storage triggered by the increase in insulin in response to the high glucose in utero. This then can lead to a higher chance of developing type 2 diabetes mellitus in the child. With diabetes, also comes an increase in cardiovascular risk as the child ages and becomes an adult. The effects of GDM go beyond the fetal life but continue through adulthood.What can be done?Gestational Diabetes Mellitus has many severe and lifelong consequences for both the mother and the child and prevention of GDM would help enhance the quality of life of both. Many of the ways to prevent GDM complications include patient education and dietary modifications with a diet rich in whole grains, fruits, vegetables and lean proteins. Benefits of some vegetables in the Mexican cuisine that may be beneficial: Nopales, Chayote, and Jicama. Those are good alternatives for highly processed carbs.Mothers are usually offered nutritional counseling to help them develop a tailored eating plan. This and 30 minutes of moderate exercise daily is recommended to increase insulin sensitivity and lower the post-prandial glucose levels. If within 2 weeks of implementing lifestyle changes alone the glucose measurements remain high, then medications like insulin can be put onboard to manage the GDM. If they require insulin, I think it is time to refer to a higher level of care, if available, high risk OB clinic.Conclusion: Now we conclude episode number ###, “[TITLE].” [summary here]. _____________________References:Eades CE, Burrows KA, Andreeva R, Stansfield DR, Evans JM. Prevalence of gestational diabetes in the United States and Canada: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2024 Mar 15;24(1):204. doi: 10.1186/s12884-024-06378-2. PMID: 38491497; PMCID: PMC10941381. https://pubmed.ncbi.nlm.nih.gov/38491497/QuickStats: Percentage of Mothers with Gestational Diabetes,* by Maternal Age — National Vital Statistics System, United States, 2016 and 2021. Weekly / January 6, 2023 / 72(1);16. https://www.cdc.gov/mmwr/volumes/72/wr/mm7201a4.htm?utmAkinyemi OA, Weldeslase TA, Odusanya E, Akueme NT, Omokhodion OV, Fasokun ME, Makanjuola D, Fakorede M, Ogundipe T. Profiles and Outcomes of Women with Gestational Diabetes Mellitus in the United States. Cureus. 2023 Jul 4;15(7):e41360. doi: 10.7759/cureus.41360. PMID: 37546039; PMCID: PMC10399637. https://pmc.ncbi.nlm.nih.gov/articles/PMC10399637/?utmPerlman, J. M. (2006). Summary proceedings from the neurology group on hypoxic-ischemic encephalopathy. Pediatrics, 117(3), S28–S33.DOI: 10.1542/peds.2005-0620C.Low, J. A. (1997). Intrapartum fetal asphyxia: definition, diagnosis, and classification. American Journal of Obstetrics and Gynecology, 176(5), 957–959.DOI: 10.1016/S0002-9378(97)70609-0.Hallman, M., Gluck, L., & Liggins, G. (1985). Role of insulin in delaying surfactant production in the fetal lung. Journal of Pediatrics, 106(5), 786–790.DOI: 10.1016/S0022-3476(85)80227-0.Sweet, D. G., Carnielli, V., Greisen, G., et al. (2019). European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update. Neonatology, 115(4), 432–450.DOI: 10.1159/000499361.Raju, T. N. K., et al. (1999). Respiratory distress in term infants: when to suspect surfactant deficiency. Pediatrics, 103(5), 903–909.DOI: 10.1542/peds.103.5.903.Burns, C. M., Rutherford, M. A., Boardman, J. P., & Cowan, F. M. (2008). Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycemia. Pediatrics, 122(1), 65–74.DOI: 10.1542/peds.2007-2822.Dabelea, D., et al. (2000). Long-term impact of maternal diabetes on obesity in childhood. Diabetes Care, 23(10), 1534–1540.DOI: 10.2337/diacare.23.10.1534.Dashe, J. S., et al. (2002). "Hydramnios: Etiology and outcome." Obstetrics & Gynecology, 100(5 Pt 1), 957–962.DOI: 10.1016/S0029-7844(02)02279-6.Long-term cost-effectiveness of implementing a lifestyle intervention during pregnancy to prevent gestational diabetes mellitus: a decision-analytic modelling study. Diabetologia.American College of Obstetricians and Gynecologists. (2018). Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstetrics & Gynecology, 131(2), e49–e64. https://doi.org/10.1097/AOG.0000000000002501Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. 

In this episode of the Epigenetics Podcast, we talked with Petra Hajkova from the MRC Laboratory of Medical Sciences about her work on epigenetics research on mammalian development, highlighting DNA methylation, histone modifications, and TET enzymes, along with her journey in molecular genetics and future research on epigenetic maintenance. Dr. Hajkova's early work focused on DNA methylation and resulted in innovative collaboration that allowed her to develop bisulfide sequencing techniques. We discuss her transition to the UK, where she began working in Azim Surani's lab at the University of Cambridge. Dr. Hajkova describes the excitement of researching chromatin dynamics in the mouse germline, leading to significant findings published in Nature. Her story highlights the intense yet rewarding nature of postdoctoral research as she navigated the complexities of working with embryos for the first time. As her research progressed, Dr. Hajkova established her own lab at the MRC London Institute of Medical Sciences, where she became a professor in 2017. We delve into her investigations on the differences between embryonic stem cells and embryonic germ cells regarding their distinct developmental origins. Dr. Hajkova outlines the challenges she faced in understanding the mechanisms behind global DNA demethylation in germline cells and the role of hydroxymethylation during early development. The discussion further covers her exciting findings regarding the specific functions of TET enzymes and their regulatory roles in maintaining epigenetic states. We explore her recent research published in Nature, which provides insights into the transition from primordial germ cells to gonocytes, emphasizing the significance of various epigenetic mechanisms in germline development.   References Hajkova P, Ancelin K, Waldmann T, Lacoste N, Lange UC, Cesari F, Lee C, Almouzni G, Schneider R, Surani MA. Chromatin dynamics during epigenetic reprogramming in the mouse germ line. Nature. 2008 Apr 17;452(7189):877-81. doi: 10.1038/nature06714. Epub 2008 Mar 19. PMID: 18354397; PMCID: PMC3847605. Hajkova P, Jeffries SJ, Lee C, Miller N, Jackson SP, Surani MA. Genome-wide reprogramming in the mouse germ line entails the base excision repair pathway. Science. 2010 Jul 2;329(5987):78-82. doi: 10.1126/science.1187945. PMID: 20595612; PMCID: PMC3863715. Hill PWS, Leitch HG, Requena CE, Sun Z, Amouroux R, Roman-Trufero M, Borkowska M, Terragni J, Vaisvila R, Linnett S, Bagci H, Dharmalingham G, Haberle V, Lenhard B, Zheng Y, Pradhan S, Hajkova P. Epigenetic reprogramming enables the transition from primordial germ cell to gonocyte. Nature. 2018 Mar 15;555(7696):392-396. doi: 10.1038/nature25964. Epub 2018 Mar 7. PMID: 29513657; PMCID: PMC5856367. Huang TC, Wang YF, Vazquez-Ferrer E, Theofel I, Requena CE, Hanna CW, Kelsey G, Hajkova P. Sex-specific chromatin remodelling safeguards transcription in germ cells. Nature. 2021 Dec;600(7890):737-742. doi: 10.1038/s41586-021-04208-5. Epub 2021 Dec 8. PMID: 34880491.   Related Episodes Epigenetic Mechanisms of Mammalian Germ Cell Development (Mitinori Saitou) Epigenetic Reprogramming During Mammalian Development (Wolf Reik) DNA Methylation and Mammalian Development (Déborah Bourc'his)   Contact Epigenetics Podcast on Mastodon Epigenetics Podcast on Bluesky Dr. Stefan Dillinger on LinkedIn Active Motif on LinkedIn Active Motif on Bluesky Email: podcast@activemotif.com

Jody responds to the American College of Physicians' Annals On Call Podcast episode released on May 19th, 2025.Links:Advanced Practice Clinicians Cannot Replace Primary Care Physicians. Annals On Call Podcast, 5-29-25Physician Assistant and Former PA-Turned-Physician Discuss the State of the Profession. Patients At Risk Podcast, 7-25-21 (Spotify)New Workforce Model Suggests Continued Physician Shortages In Nonprimary Care Specialties (AAMC Article)Christin Giordano McAuliffe. There Is No Substitute for Primary Care Physicians: A Response to the Association of American Medical Colleges' Workforce Model. Ann Intern Med.2025;178:590-591. [Epub 4 March 2025]. doi:10.7326/ANNALS-24-03806University of South Alabama Dual Role NP CurriculumRazavi, Moaven PhD*; O'Reilly-Jacob, Monica RN, PhD, FNP-BC†; Perloff, Jennifer PhD*; Buerhaus, Peter RN, PhD, FAAN, FAANP(h)‡. Drivers of Cost Differences Between Nurse Practitioner and Physician Attributed Medicare Beneficiaries. Medical Care 59(2):p 177-184, February 2021. | DOI: 10.1097/MLR.0000000000001477 McMenamin A, Turi E, Schlak A, Poghosyan L. A Systematic Review of Outcomes Related to Nurse Practitioner-Delivered Primary Care for Multiple Chronic Conditions. Medical Care Research and Review. 2023;80(6):563-581. doi:10.1177/10775587231186720Kippenbrock T, Emory J, Lee P, Odell E, Buron B, Morrison B. A national survey of nurse practitioners' patient satisfaction outcomes. Nurs Outlook. 2019 Nov-Dec;67(6):707-712. doi: 10.1016/j.outlook.2019.04.010. Epub 2019 May 4. PMID: 31607371.Haas, D., Pozehl, B., Alonso, W. W., & Diederich, T. (2023). Patient Satisfaction With a Nurse Practitioner–Led Heart Failure Clinic. Journal for Nurse Practitioners, 19(4), Article 104496. https://doi.org/10.1016/j.nurpra.2022.11.006https://www.techtarget.com/patientengagement/news/366584669/Nurse-Practitioners-Boost-Patient-Satisfaction-Quality-Outcomeshttps://www.aanp.org/advocacy/advocacy-resource/position-statements/quality-of-nurse-practitioner-practicehttps://www.aacnnursing.org/news-data/all-news/rounds-with-leadership-focusing-on-the-outcomes-of-np-practiceStanik-Hutt, J., Newhouse, R. P., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., Wilson, R., Fountain, L., Steinwachs, D. M., Heindel, L., & Weiner, J. P. (2013). The quality and effectiveness of care provided by nurse practitioners. Journal for Nurse Practitioners, 9(8), 492-500.e13. https://doi.org/10.1016/j.nurpra.2013.07.004Savard I, Al Hakim G, Kilpatrick K. The added value of the nurse practitioner: An evolutionary concept analysis. Nurs Open. 2023 Apr;10(4):2540-2551. doi: 10.1002/nop2.1512. Epub 2022 Dec 17. PMID: 36527435; PMCID: PMC10006655.

In this episode, we dive into the rapidly evolving world of ambient listening AI in healthcare. From outpatient clinics to inpatient wards and operating rooms, this technology is reshaping how care is delivered, documented, and experienced. We explore how ambient listening AI is improving clinic flow by streamlining documentation and reducing interruptions, allowing clinicians to stay more present with their patients. The technology is increasingly adaptive to individual provider styles, learning preferences and workflows to deliver more personalized support. Plus, we share practical tips for new users to get the most out of their ambient listening AI systems from day one. Join us as we hear from experts on the front lines and debate the future of ambient listening AI in medicine—where the walls really do have ears, but for all the right reasons. Host:  - Nicole Petcka, MD – General Surgery Resident, Emory University, @npetcka2022 Guests:  - Samuel R. Torres Landa Fernández, MD – Minimally Invasive Surgery Fellow, Emory University  - Anastasios Nikolaos (Nick​) Panagopoulos, MD – Internal Medicine Resident, Emory University  - Joe Sharma, MD - McGarity Chair in Endocrine Surgery and Professor of Surgery, Vice-chair for Patient Safety, Quality and Innovation, Emory University  Resources:  Enhancing Accuracy of Operative Reports with Automated Artificial Intelligence Analysis of Surgical Video Khanna A, Wolf T, Frank I, Krueger A, Shah P, Sharma V, Gettman MT, Boorjian SA, Asselmann D, Tollefson MK. Enhancing Accuracy of Operative Reports with Automated Artificial Intelligence Analysis of Surgical Video. J Am Coll Surg. 2025 May 1;240(5):739-746. doi: 10.1097/XCS.0000000000001352. Epub 2025 Apr 16. PMID: 39918224. https://pubmed.ncbi.nlm.nih.gov/39918224/ 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

Contributor: Aaron Lessen, MD Educational Pearls: How do we take care of kids in severe pain? There are many non-pharmacologic options for pain (i.e. ice, elevation) as well as more conventional medication options (i.e. acetaminophen, NSAIDS) but in severe pain stronger medications might be indicated. These stronger medications include options such as IV morphine, a subdissociative dose of ketamine, as well as intranasal fentanyl. Intranasal fentanyl has many advantages: Studies have shown it might be more effective early on in controlling pain, as in the first 15-20 minutes after administration, and then becomes equivalent to other pain control options Total adverse effects were also lower with IN fentanyl, including low rates of nausea and vomiting To administer, use the IV formulation with an atomizer and spray into the nose; therefore, you do not need an IV line Dose is 1-2 micrograms per kilogram, can be redosed once at 10 minutes.  Don't forget about gabapentinoids for neuropathic pain, muscle relaxants for muscle spasms, and nerve blocks when appropriate. (Disclaimer: muscle relaxers have not been well studied in children) References Alsabri M, Hafez AH, Singer E, Elhady MM, Waqar M, Gill P. Efficacy and Safety of Intranasal Fentanyl in Pediatric Emergencies: A Systematic Review and Meta-analysis. Pediatr Emerg Care. 2024 Oct 1;40(10):748-752. doi: 10.1097/PEC.0000000000003187. Epub 2024 Apr 11. PMID: 38713846. Bailey B, Trottier ED. Managing Pediatric Pain in the Emergency Department. Paediatr Drugs. 2016 Aug;18(4):287-301. doi: 10.1007/s40272-016-0181-5. PMID: 27260499. Hadland SE, Agarwal R, Raman SR, Smith MJ, Bryl A, Michel J, Kelley-Quon LI, Raval MV, Renny MH, Larson-Steckler B, Wexelblatt S, Wilder RT, Flinn SK. Opioid Prescribing for Acute Pain Management in Children and Adolescents in Outpatient Settings: Clinical Practice Guideline. Pediatrics. 2024 Sep 30:e2024068752. doi: 10.1542/peds.2024-068752. Epub ahead of print. PMID: 39344439. Summarized by Jeffrey Olson, MS4 | Edited by Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/

Send us a textNeonatologists' perceptions of uncertainty: a national survey.Rholl E, Krick JA, Leuthner SR, Pan AY, Challa SA, Kukora S.J Perinatol. 2025 Apr 19. doi: 10.1038/s41372-025-02292-3. Online ahead of print.PMID: 40253559 No abstract available.As 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!

Drs. Amy Crockett (@amyhcrockett), Ben Ereshefsky (@brainofbpharm), and Pamela Bailey (@pamipenem) join Dr. Julie Ann Justo (@julie_justo) to discuss new treatment strategies for management of intraamniotic infections, also known as chorioamnionitis. They discuss whether it is time to move away from the combination of ampicillin, gentamicin, and/or clindamycin, alternative antibiotic regimens to consider, and stewardship strategies to approach this practice change at a local level. References: Basic stats/epi on chorioamnionitis: Romero R, et al. Clinical chorioamnionitis at term I: microbiology of the amniotic cavity using cultivation and molecular techniques. J Perinat Med. 2015 Jan;43(1):19-36. doi: 10.1515/jpm-2014-0249. PMID: 25720095. ACOG 2017 Guideline for IAI: Committee Opinion No. 712: Intrapartum Management of Intraamniotic Infection. Obstet Gynecol. 2017 Aug;130(2):e95-e101. doi: 10.1097/AOG.0000000000002236. PMID: 28742677. ACOG 2024 Update on clinical criteria for IAI: ACOG Clinical Practice Update: Update on Criteria for Suspected Diagnosis of Intraamniotic Infection. Obstetrics & Gynecology 144(1):p e17-e19, July 2024. doi: 10.1097/AOG.0000000000005593 Helpful review with more recent microorganisms : Jung E, et al. Clinical chorioamnionitis at term: definition, pathogenesis, microbiology, diagnosis, and treatment. Am J Obstet Gynecol. 2024 Mar;230(3S):S807-S840. doi: 10.1016/j.ajog.2023.02.002. PMID: 38233317. Cochrane Review: Chapman E, et al. Antibiotic regimens for management of intra-amniotic infection. Cochrane Database Syst Rev. 2014 Dec 19;2014(12):CD010976. doi: 10.1002/14651858.CD010976.pub2. PMID: 25526426. Helpful recent review on intrapartum infections: Bailey, P, et al_._ Out with the Old, In with the New: A Review of the Treatment of Intrapartum Infections. Curr Infect Dis Rep. 2024;26:107–113 doi: 10.1007/s11908-024-00838-8. Role of genital mycoplasmas in IAI: Romero R, et al. Evidence that intra-amniotic infections are often the result of an ascending invasion - a molecular microbiological study. J Perinat Med. 2019 Nov 26;47(9):915-931. doi: 10.1515/jpm-2019-0297. PMID: 31693497. Regimens without enterococcal coverage with similar clinical outcomes: Blanco JD, et al. Randomized comparison of ceftazidime versus clindamycin-tobramycin in the treatment of obstetrical and gynecological infections. Antimicrob Agents Chemother. 1983 Oct;24(4):500-4. doi: 10.1128/AAC.24.4.500. PMID: 6360038. Bookstaver PB, et al. A review of antibiotic use in pregnancy. Pharmacotherapy. 2015 Nov;35(11):1052-62. doi: 10.1002/phar.1649. PMID: 26598097. Updated review in pregnancy, includes data on frequency of antibiotic use in pregnancy: Nguyen J, et al. A review of antibiotic safety in pregnancy-2025 update. Pharmacotherapy. 2025 Apr;45(4):227-237. doi: 10.1002/phar.70010. Epub 2025 Mar 19. PMID: 40105039. Locksmith GJ, et al. High compared with standard gentamicin dosing for chorioamnionitis: a comparison of maternal and fetal serum drug levels. Obstet Gynecol. 2005 Mar;105(3):473-9. doi: 10.1097/01.AOG.0000151106.87930.1a. PMID: 15738010. Clindamycin CDI Risk: Miller AC, et al. Comparison of Different Antibiotics and the Risk for Community-Associated Clostridioides difficile Infection: A Case-Control Study. Open Forum Infect Dis. 2023 Aug 5;10(8):ofad413. doi: 10.1093/ofid/ofad413. PMID: 37622034. Impact of penicillin allergy on clindamycin use & cites 47% clindamycin resistance per CDC among GBS: Snider JB, et al. Antibiotic choice for Group B Streptococcus prophylaxis in mothers with reported penicillin allergy and associated newborn outcomes. BMC Pregnancy Childbirth. 2023 May 30;23(1):400. doi: 10.1186/s12884-023-05697-0. PMID: 37254067. Clindamycin anaerobic coverage data: Hastey CJ, et al. Changes in the antibiotic susceptibility of anaerobic bacteria from 2007-2009 to 2010-2012 based on the CLSI methodology. Anaerobe. 2016 Dec;42:27-30. doi: 10.1016/j.anaerobe.2016.07.003. PMID: 27427465. Older PK study of ampicillin & gentamicin for chorioamnionitis: Gilstrap LC 3rd, Bawdon RE, Burris J. Antibiotic concentration in maternal blood, cord blood, and placental membranes in chorioamnionitis. Obstet Gynecol. 1988 Jul;72(1):124-5. PMID: 3380500. Paper putting out the call for modernization of OB/Gyn antibiotic regimens: Pek Z, Heil E, Wilson E. Getting With the Times: A Review of Peripartum Infections and Proposed Modernized Treatment Regimens. Open Forum Infect Dis. 2022 Sep 5;9(9):ofac460. doi: 10.1093/ofid/ofac460. PMID: 36168554. Vanderbilt University Medical Center experience with modernizing OB/Gyn infection regimens: Smiley C, et al. Implementing Updated Intraamniotic Infection Guidelines at a Large Academic Medical Center. Open Forum Infect Dis. 2024 Sep 5;11(9):ofae475. doi: 10.1093/ofid/ofae475. PMID: 39252868. Prisma Health/University of South Carolina experience with modernizing OB/Gyn infection regimens: Bailey P, et al. Cefoxitin for Intra-amniotic Infections and Endometritis: A Retrospective Comparison to Traditional Antimicrobial Therapy Regimens Within a Healthcare System. Clin Infect Dis. 2024 Jul 19;79(1):247-254. doi: 10.1093/cid/ciae042. PMID: 38297884.