Podcasts about pmid

Taking folic acid prior to conception and during pregnancy can help protect the unborn baby from developing abnormalities. Supplements are particularly important for women who have epilepsy, as anti-seizure medication (previously known as anti-convulsants or anti-epileptic drugs) can lead to a deficiency in folic acid. Until 2023, high doses of 4-5 mg per day were recommended. However, this has changed as the data has changed. Did you know the SMFM no longer recommends “high dose” folic acid preconceptionally for patients on seizure medications? This is also highlighted in a recently released epub from Obstetrics and Gynecology (Green Journal) on October 31, 2025. Listen in for details. 1. Mokashi, Mugdha MD, MPH; Cozzi-Glaser, Gabriella MD; Kominiarek, Michelle A. MD, MS. Dietary Supplements in the Perinatal Period. Obstetrics & Gynecology ():10.1097/AOG.0000000000006098, October 31, 2025. | DOI: 10.1097/AOG.00000000000060982. Asadi-Pooya AA. High dose folic acid supplementation in women with epilepsy: are we sure it is safe? Seizure. 2015 Apr;27:51-3. doi: 10.1016/j.seizure.2015.02.030. Epub 2015 Mar 7. PMID: 25891927.3. https://aesnet.org/about/aes-press-room/press-releases/guideline-issued-for-people-with-epilepsy-who-may-become-pregnant4. Turner C, McIntosh T, Gaffney D, Germaine M, Hogan J, O'Higgins A. A 10-year review of periconceptual folic acid supplementation in women with epilepsy taking antiseizure medications. J Matern Fetal Neonatal Med. 2025 Dec;38(1):2524094. doi: 10.1080/14767058.2025.2524094. Epub 2025 Jun 30. PMID: 40588438.5. https://www.aan.com/PressRoom/Home/PressRelease/5170#:~:text=The%20guideline%20recommends%20that%20people,and%20possibly%20improve%20neurodevelopmental%20outcomes.6. https://aesnet.org/about/aes-press-room/press-releases/guideline-issued-for-people-with-epilepsy-who-may-become-pregnant

Drs. Maria Mojica, Robert Bonomo, and Ryan Shields join Dr. Erin McCreary (@erinmccreary) for a Halloween special reviewing the scariest resistance mechanisms and baddest bugs – Burkholderia spp., Achromobacter spp., and Elizabethkingia spp. Never have beta lactamase enzymes and other complexities been explained so hauntingly well. We don't want to spook you, but these environmental, opportunistic pathogens are found around the globe. While we hope you don't encounter them, take a listen to prepare in case one jumps out in your practice! This episode was sponsored by an unrestricted grant from Shionogi Inc. References: Spencer HK, Spitznogle SL, Borjan J, Aitken SL. An Overview of the Treatment of Less Common Non-Lactose-Fermenting Gram-Negative Bacteria. Pharmacotherapy. 2020 Sep;40(9):936-951. doi: 10.1002/phar.2447. Epub 2020 Aug 14. PMID: 32687670. Defining antimicrobial susceptibility testing methods and breakpoints among Achromobacter species SIDP 2025 Webinar | Mind the Gap: CLSI M100 Updates to Optimize Stewardship and Patient Care Outcomes Yasmin M, Rojas LJ, Marshall SH, Hujer AM, Cmolik A, Marshall E, Boucher HW, Vila AJ, Soldevila M, Diene SM, Rolain JM, Bonomo RA. Characterization of a Novel Pathogen in Immunocompromised Patients: Elizabethkingia anophelis-Exploring the Scope of Resistance to Contemporary Antimicrobial Agents and β-lactamase Inhibitors. Open Forum Infect Dis. 2023 Jan 31;10(2):ofad014. doi: 10.1093/ofid/ofad014. PMID: 36820316; PMCID: PMC9938519. Warner NC, Bartelt LA, Lachiewicz AM, Tompkins KM, Miller MB, Alby K, Jones MB, Carr AL, Alexander J, Gainey AB, Daniels R, Burch AK, Brown DE, Brownstein MJ, Cheema F, Linder KE, Shields RK, Longworth S, van Duin D. Cefiderocol for the Treatment of Adult and Pediatric Patients With Cystic Fibrosis and Achromobacter xylosoxidans Infections. Clin Infect Dis. 2021 Oct 5;73(7):e1754-e1757. doi: 10.1093/cid/ciaa1847. PMID: 33313656; PMCID: PMC8678443. El Chakhtoura NG, Saade E, Wilson BM, Perez F, Papp-Wallace KM, Bonomo RA. A 17-Year Nationwide Study of Burkholderia cepacia Complex Bloodstream Infections Among Patients in the United States Veterans Health Administration. Clin Infect Dis. 2017 Oct 15;65(8):1253-1259. doi: 10.1093/cid/cix559. PMID: 29017247; PMCID: PMC5848224.

Feeling knee pain on the bike (or in life)? You're not alone, and it doesn't have to be your norm. In this episode of Making Shift Happen, Jen breaks down why knees hurt (even when your bike fit is fine), why isometric strength training (like wall-sits) is a powerful tool, and how supporting hips and ankles will give your knees the backup they deserve. You'll learn: Why knee pain shows up for cyclists and what real causes are (it's not just your saddle height) How isometric wall-sits and other iso exercises reduce knee/tendon pain and build resilience (evidence included) How to structure your off-season strength and mobility plan for pain-free knees next season Why the upcoming #ShredStrong program (starts Nov 3rd - details below!) is the best way to build the strength system your knees demand Check out these other relevant episodes: This episode also includes the link for the free PDF on bike fit: 219. MTB Gains: Strength Training Secrets with a PT Who Rides  155. Combining Bike Fit and Physical Therapy with Natalie Colins, DPT Research referenced in this episode: PMID 31033611  DOI: 10.2147/OAJSM.S136653 #ShredStrong: Our Fall Cycle Starts on Monday, November 3, 2025! #ShredStrong is my year-round strength training program for mountain bikers and gravel cyclists. You can join any time you want, but we're starting the main Fall cycle in November! Learn more about the program and sign-up HERE!  Do You Want a Coach to Help Make Training & Nutrition Easier and Simpler for You? Hi, it's me.

In this episode of the Epigenetics Podcast, we talked with Vincent Pasque from KU Leuven about his work on the reprogramming of cell identity through epigenetic mechanisms, particularly during early development and cellular reprogramming. We begin by tracing Vincent's journey into biology, sparked by early childhood experiences in nature and meaningful encounters with inspiring teachers. His fascination with the complexities of biology crystallized during a pivotal moment while listening to a radio segment on epigenetics in the late '90s, which led him to pursue studies in genetics and biochemistry. This formative path brought him to leading institutions, including the prestigious lab of John Gurdon, where he explored the phenomenon of nuclear reprogramming. Vincent recounts his early experiments that led to the discovery of macro H2A as a barrier to reprogramming, emphasizing the core challenge of erasing somatic cell identity. As the conversation unfolds, Vincent introduces us to critical findings from his research. He shares how the inactive X chromosome serves as a compelling model to investigate epigenetic regulation, revealing that the dynamics of reprogramming and differentiation are far from simple reversals of development. He highlights the significant differences between male and female iPSCs and how X-linked genes influence DNA methylation and differentiation rates in these cells. The implications of these findings extend beyond developmental biology to inform our understanding of diseases, particularly cancer. Transitioning to his current work, Vincent describes pioneering advances in characterizing the chromatin-associated proteome during the differentiation of human pluripotent stem cells. The surprising discovery of elevated histone modifications in naïve cells leads to intriguing questions about the barriers to cellular plasticity and the mechanisms by which cells resist alternative fate conversions. The potential applications of this research could reshape our approach to regenerative medicine and therapeutic interventions. References Pasque V, Gillich A, Garrett N, Gurdon JB. Histone variant macroH2A confers resistance to nuclear reprogramming. The EMBO Journal. 2011 May;30(12):2373-2387. DOI: 10.1038/emboj.2011.144. PMID: 21552206; PMCID: PMC3116279. Jullien, J., Miyamoto, K., Pasque, V., Allen, G. E., Bradshaw, C. R., Garrett, N. J., Halley-Stott, R. P., Kimura, H., Ohsumi, K., & Gurdon, J. B. (2014). Hierarchical Molecular Events Driven by Oocyte-Specific Factors Lead to Rapid and Extensive Reprogramming. Molecular Cell, 55(4), 524–536. https://doi.org/10.1016/j.molcel.2014.06.024 Pasque V, Tchieu J, Karnik R, et al. X chromosome reactivation dynamics reveal stages of reprogramming to pluripotency. Cell. 2014 Dec;159(7):1681-1697. DOI: 10.1016/j.cell.2014.11.040. PMID: 25525883; PMCID: PMC4282187. Zijlmans DW, Talon I, Verhelst S, et al. Integrated multi-omics reveal polycomb repressive complex 2 restricts human trophoblast induction. Nature Cell Biology. 2022 Jun;24(6):858-871. DOI: 10.1038/s41556-022-00932-w. PMID: 35697783; PMCID: PMC9203278. Related Episodes The Discovery of Genomic Imprinting (Azim Surani) Gene Expression Control and Intricacies of X-chromosome Inactivation (Claire Rougeulle) Epigenetics and X-Inactivation (Edith Heard) 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

Elinzanetant, sold under the brand name Lynkuet, receivedapproval from the U.S. Food and Drug Administration (FDA) on October 24, 2025, for the treatment of moderate to severe hot flashes due to menopause.  How is this different than Fezolinetant, which was approved in 2023? Listen in for details. 1.   Menegaz de Almeida, Artur MS; Oliveira, Paloma MS; Lopes, Lucca MD; Leite, Marianna MS; Morbach, Victória MS; Alves Kelly, Francinny MD; Barros, Ítalo MS; Aquino de Moraes, Francisco Cezar MS; Prevedello, Alexandra MD. Fezolinetant and Elinzanetant Therapy for Menopausal Women Experiencing Vasomotor Symptoms: A Systematic Review and Meta-analysis. Obstetrics & Gynecology 145(3):p 253-261, March 2025. | DOI: 10.1097/AOG.00000000000058122.     Pinkerton JV, Simon JA, Joffe H, Maki PM, NappiRE, Panay N, Soares CN, Thurston RC, Caetano C, Haberland C, Haseli Mashhadi N, Krahn U, Mellinger U, Parke S, Seitz C, Zuurman L. Elinzanetant for the Treatment of Vasomotor Symptoms Associated With Menopause: OASIS 1 and 2 Randomized Clinical Trials. JAMA. 2024 Aug 22;332(16):1343–54. doi: 10.1001/jama.2024.14618. Epub ahead of print. PMID: 39172446; PMCID: PMC11342219.3.     Cardoso F, Parke S, Brennan DJ, Briggs P,Donders G, Panay N, Haseli-Mashhadi N, Block M, Caetano C, Francuski M, Haberland C, Laapas K, Seitz C, Zuurman L. Elinzanetant for Vasomotor Symptomsfrom Endocrine Therapy for Breast Cancer. N Engl J Med. 2025 Aug 21;393(8):753-763. doi: 10.1056/NEJMoa2415566. Epub 2025 Jun 2. PMID: 40454634.STRONG COFFEE PROMO: 20% Off Strong CoffeeCompany https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

Contributors: Preeya Prakash MD, Adam Greenhaw PharmD, Travis Barlock MD, and Jeffrey Olson MS4 In this episode, cardiologist Preeya Prakash and medical student Jeffrey Olson listen in as two cases are presented from EMM's recent event, Tox Talk 2025. Talk 1- Digoxin Overdose Dr. Adam Greenhaw presents a case of a Digoxin overdose along with many pearls. During the studio listen in, Dr. Prakash helps to answer the questions of: How does digoxin work? Why might a patient still be on digoxin in 2025? What are the EKG findings of digoxin toxicity? Is there any utility in atropine for bradycardia caused by digoxin? Should you use calcium to treat hyperkalemia in the setting of a digoxin overdose? If/when might a cardiologist get involved in a patient with a digoxin overdose? Talk 2- Propranolol Overdose Dr. Travis Barlock presents a case of a beta blocker overdose as well as many associated pearls. During our studio listen in, Dr. Prakash helps to answer the questions of: What are the different beta blockers and how do they work? If you are worried about a propranolol overdose, what medications do you want on hand? What POCUS cardiac view can give you the most information for different scenarios? Why or why not might transcutaneous or intravenous pacing be a good idea for a beta blocker overdose? If/when might you want a cardiologist to get involved in a patient with a beta blocker overdose? References Alahmed AA, Lauffenburger JC, Vaduganathan M, Aldemerdash A, Ting C, Fatani N, Fanikos J, Buckley LF. Contemporary Trends in the Use of and Expenditures on Digoxin in the United States. Am J Cardiovasc Drugs. 2022 Sep;22(5):567-575. doi: 10.1007/s40256-022-00540-x. Epub 2022 Jun 24. PMID: 35739347; PMCID: PMC10263277. Chan BS, Buckley NA. Digoxin-specific antibody fragments in the treatment of digoxin toxicity. Clin Toxicol (Phila). 2014 Sep-Oct;52(8):824-36. doi: 10.3109/15563650.2014.943907. Epub 2014 Aug 4. PMID: 25089630. Hack JB, Wingate S, Zolty R, Rich MW, Hauptman PJ. Expert Consensus on the Diagnosis and Management of Digoxin Toxicity. Am J Med. 2025 Jan;138(1):25-33.e14. doi: 10.1016/j.amjmed.2024.08.018. Epub 2024 Sep 11. PMID: 39265879. Krenz JR, Kaakeh Y. An Overview of Hyperinsulinemic-Euglycemic Therapy in Calcium Channel Blocker and β-blocker Overdose. Pharmacotherapy. 2018 Nov;38(11):1130-1142. doi: 10.1002/phar.2177. Epub 2018 Oct 4. PMID: 30141827. Patocka J, Nepovimova E, Wu W, Kuca K. Digoxin: Pharmacology and toxicology-A review. Environ Toxicol Pharmacol. 2020 Oct;79:103400. doi: 10.1016/j.etap.2020.103400. Epub 2020 May 7. PMID: 32464466. Rotella JA, Greene SL, Koutsogiannis Z, Graudins A, Hung Leang Y, Kuan K, Baxter H, Bourke E, Wong A. Treatment for beta-blocker poisoning: a systematic review. Clin Toxicol (Phila). 2020 Oct;58(10):943-983. doi: 10.1080/15563650.2020.1752918. Epub 2020 Apr 20. PMID: 32310006. Produced by Jeffrey Olson, MS4 Donate: https://emergencymedicalminute.org/donate/

Are you overwhelmed by conflicting nutrition advice? In this episode, I sit down with dietitian Luca Pasquariello to unpack what a truly healthy eating pattern looks like—especially for women 40+ focused on brain health and Alzheimer's prevention. No gimmicks. Just science-backed insights that work.What to Listen For(08:20) How a dietitian thinks about food, health, and what gets him out of bed in the morning(10:50) What a healthy eating pattern really looks like—and why your grandma was probably right(12:42) Why “bad foods” might not exist, and how to think about moderation instead(14:39) The difference between fermented dairy, low-fat options, and how to modify if you're vegan(17:37) The truth about red meat, fatty fish, and ethical versus scientific arguments(19:58) What “processed food” actually means and why even tofu and oats are technically processed(22:56) Why ultra-processed food categories need a new classification system(23:49) How to avoid falling for the “silver bullet” diet myth(24:04) How to read and interpret nutrition studies—and why it's not as easy as it seems(26:30) What Luca looks for when evaluating nutrition research (sample size, methodology, bias)(28:30) The role of food fortification—especially for vegans and vegetarians—and why it's non-negotiable for nutrients like B12.(35:10) What women in perimenopause and menopause need to know about cholesterol, insulin resistance, and cognitive decline.(40:20) The truth about supplementation: When is it helpful, when is it hype, and which ones are worth it?(44:00) How to stop falling into the trap of “magical thinking” with food—and what long-term nutrition success really looks like.(47:18) Luca's thoughts on personalized nutrition vs. general guidelines—what really matters for outcomes.(50:02) Amy and Luca discuss how to shift your mindset from body shame and diet culture to long-term, brain-forward wellness.This episode cuts through the noise and gets to the heart of what truly matters when it comes to brain-supportive nutrition. With Luca's science-backed approach, you'll leave with a clearer understanding of how to build a sustainable, nourishing eating pattern.Sources:Hevia-Larraín V, Gualano B, Longobardi I, Gil S, Fernandes AL, Costa LAR, Pereira RMR, Artioli GG, Phillips SM, Roschel H. High-Protein Plant-Based Diet Versus a Protein-Matched Omnivorous Diet to Support Resistance Training Adaptations: A Comparison Between Habitual Vegans and Omnivores. Sports Med. 2021 Jun;51(6):1317-1330. doi: 10.1007/s40279-021-01434-9. Epub 2021 Feb 18. PMID: 33599941.Roberts AK, Busque V, Robinson JL, Landry MJ, Gardner CD. SWAP-MEAT Athlete (study with appetizing plant-food, meat eating alternatives trial) - investigating the impact of three different diets on recreational athletic performance: a randomized crossover trial. Nutr J. 2022 Nov 16;21(1):69. doi: 10.1186/s12937-022-00820-x. PMID: 36384651; PMCID: PMC9666956.Monteyne AJ, Coelho MOC, Murton AJ, Abdelrahman DR, Blackwell JR, Koscien CP, Knapp KM, Fulford J, Finnigan TJA, Dirks ML, Stephens FB, Wall BT. Vegan and Omnivorous High Protein Diets Support ComparaRESOURCES: Register for the FREE Masterclass: 5 Keys to Protecting Your Brain Health Book a FREE Discovery Call with Amy Lang Order Amy's book Thoughts Are Habits Too: Master Your Triggers, Free Yourself From Diet Culture, and Rediscover Joyful Eating. Follow Amy on Instagram @habitwhisperer

In this episode, we explore practical tips for caring for older adults in the clinical setting through a case-based discussion highlighting common perioperative challenges and strategies for success. We also take a deeper dive into the American College of Surgeons Geriatric Surgery Verification Program, including its goals, impact, and how clinicians can get involved in advancing surgical care for the aging patient population. Take Home Points:  The older adult population is the fastest growing patient population and it is important we focus on patient-centered care for this population, as this is a population that almost all of us will engage with.  If you or your hospital isn't prepared to get verified yet, there are still small processes that can be implemented that can make an impactful difference on your patients. Geriatric Surgery Verification is at the cutting edge of quality improvement. Like other verification programs (trauma, bariatric) patients will soon seek out these centers that can best address their personal needs. Hosts:  Agnes Premkumar, MD - General Surgery Resident at Creighton University, @agnespremkumar Nicole L. Petcka, MD – General Surgery Resident at Emory University, @npetcka2022 Guests:  Marcia M. Russell, MD - Professor of Surgery and Vice Chair for Quality and Safety at the David Geffen School of Medicine at UCLA and the VA Greater Los Angeles Healthcare System Caroline Smolkin, MD - General Surgery Resident at Northwell and American College of Surgeons Clinical Scholar Resources:  American College of Surgeons Geriatric Surgery Verification Program: https://www.facs.org/quality-programs/accreditation-and-verification/geriatric-surgery-verification/  Katlic MR, Wolf J, Demos SJ, Rosenthal RA. Making a Financial Case for the Geriatric Surgery Verification Program. Ann Surg Open. 2024 May 13;5(2):e439. doi: 10.1097/AS9.0000000000000439. PMID: 38911623; PMCID: PMC11191881. https://pubmed.ncbi.nlm.nih.gov/38911623/ Remer SL, Zhou L, Cohen ME, Russell MM, Rosenthal R, Ko CY. Discharge to Post-Acute Care as a Benchmarking Metric for Elderly Surgical Patients. J Am Coll Surg. 2025 Aug 14. doi: 10.1097/XCS.0000000000001495. Epub ahead of print. PMID: 40810404. https://pubmed.ncbi.nlm.nih.gov/40810404/ Jones TS, Jones EL, Richardson V, Finley JB, Franklin JL, Gore DL, Horney CP, Kovar A, Morin TL, Robinson TN. Preliminary data demonstrate the Geriatric Surgery Verification program reduces postoperative length of stay. J Am Geriatr Soc. 2021 Jul;69(7):1993-1999. doi: 10.1111/jgs.17154. Epub 2021 Apr 7. PMID: 33826150. https://pubmed.ncbi.nlm.nih.gov/33826150/ *** UNC Surgery is inviting you to participate in a national survey designed to understand general surgery residents' perspectives on core curriculum content, structure, & delivery. The results of this survey will inform the development of a standardized general surgery education curriculum.    SURVEY LINK: https://docs.google.com/forms/d/e/1FAIpQLSeJztQwgB1rJXpCtvboHprGB_gmHGG4UzY1HITAHRmMx9FcRQ/viewform Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Contributor: Aaron Lessen, MD Educational Pearls: Traumatic Brain Injuries are a frequent complaint in the Emergency Department and have increased in recent years. The American Association for Surgery of Trauma (AAST) has created Brain Injury Guidelines (BIG), in an attempt to categorize brain injuries and the level of treatment they require. They are… BIG 1 Normal neuro exam Not intoxicated Not on anticoagulation or antiplatelet medications Minimal findings on head CT No fracture 8 mm bleed (subdural, epidural, intraparenchymal (or more than 2 locations)) “Scattered” subarachnoid hemorrhage Intraventricular hemorrhage     Full treatment, admission to trauma center, neurosurgery evaluation References Joseph B, Friese RS, Sadoun M, Aziz H, Kulvatunyou N, Pandit V, Wynne J, Tang A, O'Keeffe T, Rhee P. The BIG (brain injury guidelines) project: defining the management of traumatic brain injury by acute care surgeons. J Trauma Acute Care Surg. 2014 Apr;76(4):965-9. doi: 10.1097/TA.0000000000000161. PMID: 24662858. Joseph B, Obaid O, Dultz L, Black G, Campbell M, Berndtson AE, Costantini T, Kerwin A, Skarupa D, Burruss S, Delgado L, Gomez M, Mederos DR, Winfield R, Cullinane D; AAST BIG Multi-institutional Study Group. Validating the Brain Injury Guidelines: Results of an American Association for the Surgery of Trauma prospective multi-institutional trial. J Trauma Acute Care Surg. 2022 Aug 1;93(2):157-165. doi: 10.1097/TA.0000000000003554. Epub 2022 Mar 28. PMID: 35343931. Summarized by Jeffrey Olson, MS4 | Edited by Jeffrey Olson and Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/

Dr. Nicole Glaser is the Chief of Pediatric Endocrinology and a professor of Pediatrics at UC Davis Children's Hospital. She is recognized as an international expert in pediatric diabetic ketoacidosis (DKA), an important complication of diabetes in children. She has led many of the key multi-center studies that guide DKA management. She has also been involved in the development of several national and international guidelines for DKA management in children that guide current practice worldwide.Learning Objectives:By the end of this podcast, listeners should be able to:Describe best practices for triaging patients with DKAExplain the pathophysiology of acute cerebral edema in DKADescribe the evidence and physiologic basis for fluid selection and rate in DKA Describe the evidence supporting insulin infusion rates in pediatric DKA List best practices for lab monitoring in DKA, and how to define when a patient is ready for transition to subcutaneous insulin References: Abramo TJ, Szlam S, Hargrave H, Harris ZL, Williams A, Meredith M, Hedrick M, Hu Z, Nick T, Gonzalez CV. Bihemispheric Cerebral Oximetry Monitoring's Functionality in Suspected Cerebral Edema Diabetic Ketoacidosis With Therapeutic 3% Hyperosmolar Therapy in a Pediatric Emergency Department. Pediatr Emerg Care. 2022 Feb 1;38(2):e511-e518. doi: 10.1097/PEC.0000000000001774. PMID: 30964851.Kuppermann N, Ghetti S, Schunk J, et al. Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis. N Engl J Med. 2018;378:2275-2287.Glaser N, Barnett P, McCaslin I, et al. Risk factors for cerebral edema in children with diabetic ketoacidosis. N Engl J Med. 2001;344:264-269.Bergmann KR, Abuzzahab MJ, Perepelista V, Udeogu J, Qiu L, Lammers S, Nickel A, Watson D, Kharbanda A. Improving Emergency Department Care for Children With Medium- and High-Risk Diabetic Ketoacidosis. Pediatrics. 2025 Oct 1;156(4):e2024068959. doi: 10.1542/peds.2024-068959. PMID: 40907982.UC-Davis-Health-Magazine-Fall-2019.pdfQuestions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

Send us a textInfant Renal Replacement Therapy Using Carpediem™: A Multicenter Observational Cohort Study from the ICONIIC Learning Network.Slagle CL, Vuong KT, Krallman KA, Casey L, Gist KM, Jetton JG, Joseph C, Luckritz K, Martin SD, Morgan J, Merrill KA, Plomaritas K, Ramirez D, Tran CL, Shin HS, Snyder AN, Van Wyk B, Yalon L, Goldstein SL, Menon S.J Pediatr. 2025 Sep 26:114838. doi: 10.1016/j.jpeds.2025.114838. Online ahead of print.PMID: 41016463 Free article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textNebulized nitroglycerin as an adjuvant drug in management of persistent pulmonary hypertension of newborns: a randomized controlled trial.Farag MM, Ghazal HAE, Abdel-Mohsen AM, Rezk MA.Eur J Pediatr. 2025 Sep 1;184(9):586. doi: 10.1007/s00431-025-06381-5.PMID: 40888971 Free PMC article. Clinical Trial.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textAzithromycin for Prevention of Bronchopulmonary Dysplasia and Other Neonatal Adverse Outcomes in Preterm Infants: An Updated Systematic Review and Meta-Analysis.Joseph M, Murali Krishna M, Karlinksi Vizentin V, Provinciatto H, Ezenna C.Neonatology. 2025 Aug 12:1-10. doi: 10.1159/000547537. Online ahead of print.PMID: 40795809 Free article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

In today's episode, Dr. Monica Gray and Dr. Pradip Kamat sit down with neurosurgeon Dr. Neal Laxpati, MD, PhD, to chat about intracranial pressure (ICP) monitoring in pediatric critical care. Using real case studies, they dive into how and when to use external ventricular drains (EVDs) and ICP bolts, walking listeners through setup, potential risks, and everyday challenges. The group discusses device complications, ways to prevent infections, how to interpret waveforms, and shares practical bedside tips. It's a must-listen for intensivists looking for hands-on advice and key insights to help optimize care for kids with brain injuries or hydrocephalus.Show Highlights:Pediatric critical care unit (PCU) case discussionsIntracranial pressure (ICP) monitoring in pediatric patientsCase studies involving a 10-year-old girl with diffuse midline glioma and a 16-year-old male with a ruptured arteriovenous malformation (AVM)Cerebrospinal fluid (CSF) physiology and its role in ICP managementTypes of ICP monitoring devices: external ventricular drains (EVDs) and intraparenchymal monitorsIndications and complications associated with ICP monitoringInterpretation of ICP waveforms and their clinical significanceManagement strategies for elevated ICP and CSF drainageRisks and challenges of ICP monitoring, including infection and device malfunctionImportance of interdisciplinary communication and meticulous bedside care in pediatric critical care settingsReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter 118. Traumatic brain injury. Kochaneck et al. Page 1375 -1400Rogers textbook:Reference 1: Forsyth RJ, Parslow RC, Tasker RC, Hawley CA, Morris KP; UK Paediatric Traumatic Brain Injury Study Group; Paediatric Intensive Care Society Study Group (PICSSG). Prediction of raised intracranial pressure complicating severe traumatic brain injury in children: implications for trial design. Pediatr Crit Care Med. 2008 Jan;9(1):8-14. doi: 10.1097/01.PCC.0000298759.78616.3A. PMID: 18477907.Reference 2: Appavu B, Burrows BT, Foldes S, Adelson PD. Approaches to Multimodality Monitoring in Pediatric Traumatic Brain Injury. Front Neurol. 2019 Nov 26;10:1261. doi: 10.3389/fneur.2019.01261. PMID: 32038449; PMCID: PMC6988791.

Here is a real-world clinical case with a tricky differential: Our team recently readmitted a patient 6 days postpartum/post C-section (which was done for ICP and fetal macrosomia at close to 4500 grams, with A2GDM). She had elevated blood pressures, a frontal headache, some midepigastric pain/RUQ discomfort. Pretty clear picture right: sounds like preeclampsia (PreE) with severe features based on BP elevation and symptoms. So, we started her on mag-sulfate per protocol. Well, her transaminases were in the 400-600s, which was significantly higher than they were at delivery. They then peaked the next day at 900! OK, it still meets criteria for PreE with severe features. But could this also be postpartum Acute fatty Liver of Pregnancy (AFLP)? The clinical picture of these 2 conditions may overlap but there are distinct differences here. AFLP is potentially fatal, so we have to get that diagnosis correct. How can we distinguish AFLP from PreE with severe features or HELLP? Listen in for details.1. https://www.preeclampsia.org/the-news/health-information/acute-fatty-liver-of-pregnancy-can-be-confused-with-preeclampsia-and-hellp-syndrome2. Yemde A Jr, Kawathalkar A, Bhalerao A. Acute Fatty Liver of Pregnancy: A Diagnostic Challenge. Cureus. 2023 Mar 26;15(3):e36708. doi: 10.7759/cureus.36708. PMID: 37113350; PMCID: PMC10129069.3. Maalbi O, Elachhab N, Elkabbaj A, Arfaoui M, Hindi S, Lahbabi S, Oudghiri N, Tachinante R. Management of Acute Fatty Liver of Pregnancy: A Retrospective Study of 12 Cases Compared With Data in the Literature. Cureus. 2025 Jun 11;17(6):e85753. doi: 10.7759/cureus.85753. PMID: 40656400; PMCID: PMC12247011.4. Siwatch S, De A, Kaur B, et al. Safety and Efficacy of Plasmapheresis in Treatment of Acute Fatty Liver of Pregnancy-a Systematic Review and Meta-Analysis.Frontiers in Medicine. 2024;11:1433324. doi:10.3389/fmed.2024.1433324.5. Sarkar M, Brady CW, Fleckenstein J, et al.6. Reproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases.Hepatology (Baltimore, Md.). 2021;73(1):318-365. doi:10.1002/hep.31559.STRONG COFFEE PROMO: 20% Off Strong Coffee Company https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

Episode DescriptionWhat if detox wasn't about deprivation, but about bringing your body back into flow?In this episode, Shelley Swapp blends Traditional Chinese Medicine philosophy with cutting-edge nutrigenomics to reveal how your body's natural detox pathways influence hormones, metabolism, and energy. You'll learn why restoring gentle flow—rather than forcing a cleanse—is the key to long-term balance.Shelley explains how genes like NRF2, GSTM1, GSTT1, GCLM, and COMT shape your ability to clear hormones and toxins, and how everyday foods, herbs, and joyful practices can switch those genes on again. From the “savings-account” power of glutathione to the hormone-balancing effects of sulforaphane from broccoli sprouts, this episode turns complex biochemistry into everyday wisdom.“Your genes may show where the river narrows, but your lifestyle is the water itself—bringing life back into those channels, one small, consistent ripple at a time.”

Pisa syndrome is rare, but identifiable in urgent care and associated with drugs we will commonly see.  It is a reversible condition.  It highlights the importance of a full drug history and to consider medications as causes of strange symptoms.     Check out the Prescriber Update, Vol 46, No 3, September 2025 Check out the paper mentioned - Link Pitton Rissardo J, Murtaza Vora N, Danaf N, Ramesh S, Shariff S, Fornari Caprara AL. Pisa Syndrome Secondary to Drugs: A Scope Review. Geriatrics (Basel). 2024 Jul 30;9(4):100. doi: 10.3390/geriatrics9040100. PMID: 39195130; PMCID: PMC11353465.   www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice, always consult your usual doctor 

How has our understanding of menopause evolved over time? Even going back 200 years? In this episode, Adele explains how menopause was first brought to the public eye and how the research into it has sped up over the years, hopefully speeding up even further in the future. References: Appiah D, Nwabuo CC, Ebong IA, Wellons MF, Winters SJ. Trends in Age at Natural Menopause and Reproductive Life Span Among US Women, 1959-2018. JAMA. 2021 Apr 6;325(13):1328-1330. doi: 10.1001/jama.2021.0278. PMID: 33821908; PMCID: PMC8025101. Hawkes K, O'Connell JF, Jones NG, Alvarez H, Charnov EL. Grandmothering, menopause, and the evolution of human life histories. Proc Natl Acad Sci U S A. 1998 Feb 3;95(3):1336-9. doi: 10.1073/pnas.95.3.1336. PMID: 9448332; PMCID: PMC18762. Singh A, Kaur S, Walia I. A historical perspective on menopause and menopausal age. Bull Indian Inst Hist Med Hyderabad. 2002 Jul-Dec;32(2):121-35. PMID: 15981376. Check Out Love Mushrooms: https://lovemushrooms.co.uk/ About Love Mushrooms Co-founded in the Scottish Highlands by mushroom expert Smith Feeney, Love Mushrooms specialises in high-potency supplements that blend traditional mycology with modern biotechnology. All products are manufactured in the UK, vegan-friendly and non-GMO. Reflecting a wider generational shift, the Empower range responds to the increasing number of women seeking natural, science-led solutions to navigate menopause with clarity and confidence. Additionally, the range is certified with the M-Tick, the world's first universal menopause-friendly symbol, helping improve shelf transparency and trust with consumers. ____________ Check out Adele's FREE symptom assessment here: https://adelejohnstoncoaching.com/free-copy-of-our-symptom-assessment/ 12 Minute Breathwork Method: https://adelejohnstoncoaching.com/breathwork/ The Menopause Cheat Sheet: https://docs.google.com/document/d/1ka-fN6J5DJW2J3IE0Qa80zFCKFXmTs4srlnlXYBf-gA/edit?usp=sharing If you want a chat for your future success, fuel yourself here: https://calendly.com/adelejohnston/successchat Download Adele's Journey Journal here : https://adelejohnstoncoaching.com/my-journey-journal/ Enquire about 121 coaching here : https://docs.google.com/forms/d/e/1FAIpQLSfw6vrmKPE7A1eYDKQJiR9No7ZDdpfq-grBdKYjZSR-vl0Qag/viewform For extra support: Support@adelejohnstoncoaching.com ____________ From your host : Adele Johnston I'm Adele Johnston, a certified nutritionist and positive psychology coach, passionate about helping women improve their menopause health and reclaim who you are without menopause taking over. This is a time in your life where you get to feel vibrant, sexy and reclaim you again! I'm proud to work with women like you and have created a very successful proven Reclaiming You 3 STEP PROCESS to help you take back control of your body during your menopause. For more details : https://adelejohnstoncoaching.com/ To get Adele's FREE 3-step Menopause Weight Loss Guide: https://adelejohnstoncoaching.com/menopause-weight-loss-guide/

ASOPRS Website: Click Here Have you ever wanted to know more about aesthetic lasers, but don't know where to start?  Confused by the lingo? Join Dr. Nicole Langelier as she takes Dr. Christina Choe and Dr. Sandy Zhang-Nunes through a whirlwind tour of laser physics, laser terminology, and laser-tissue interactions. We'll explain how lasers work, discuss selective photothermolysis, cover basic skin anatomy, and define workhorse terms like chromophore, wavelength, joules, watts, fluence, thermal relaxation time, and pulse width. Consider this the prequel to upcoming episodes on the clinical uses of ablative laser resurfacing, non-ablative laser resurfacing, light and energy based devices.  By understanding the language and core scientific concepts of lasers, we hope to make you a safer and more educated laser provider!   Corrections/Clarifications: - Blood vessels are lined by endothelium (not epithelium) - The skin registers pain from heat at 45C, but may occur between 43-44C with variability based on the time of exposure and area of exposure (I stated it occurs at 42C) https://www.cardinalhealth.com/content/dam/corp/web/documents/whitepaper/cardinal-health-localized-temperature-therapy%20White%20Paper.pdf - The exact number varies by source, but waters absorbs the erbium 2940nm wavelength 10-20 times more efficiently than it absorbs the CO2 10,600nm wavelength (I said 30 times) - Clarification:  Eyelid skin is thinner closer to the lashes and on the medial aspect of the eyelid as compared to skin further from the lashes and the lateral aspect of the eyelid.  A study in Korean skin by Hwang et al found the thickest part of the eyelid to be just below the eyebrow (1.127 +/- 238um) with the thinnest skin near the ciliary margin 320 +/- 49um).  Jeong et al found that epidermal thickness is similar between genders while men had thicker reticular dermis than women and skin thickness was not correlated with BMI. - The UV wavelengths range from 100nm - 400nm.  UVC: 100nm - 280nm; UVB: 280nm-315nm; UVA: 315-400.  (I used single wavelength numbers rather than a range for ease of explanation).   Citations for skin thickness: Full thickness punch biopsies from cadaver heads processed with paraffin-embedded slides: Karan Chopra, Daniel Calva, Michael Sosin, Kashyap Komarraju Tadisina, Abhishake Banda, Carla De La Cruz, Muhammad R. Chaudhry, Teklu Legesse, Cinithia B. Drachenberg, Paul N. Manson, Michael R. Christy, A Comprehensive Examination of Topographic Thickness of Skin in the Human Face, Aesthetic Surgery Journal, Volume 35, Issue 8, November/December 2015, Pages 1007–1013, https://doi.org/10.1093/asj/sjv079   Ultrasonographic measurements in live participants: Jeong KM, Seo JY, Kim A, Kim YC, Baek YS, Oh CH, Jeon J. Ultrasonographic analysis of facial skin thickness in relation to age, site, sex, and body mass index. Skin Res Technol. 2023 Aug;29(8):e13426. doi: 10.1111/srt.13426. PMID: 37632182; PMCID: PMC10370326.   Cut and trichrome stained specimens from fresh cadavers Hwang, Kun MD, PhD*; Kim, Dae Joong PhD†; Hwang, Se Ho†. Thickness of Korean Upper Eyelid Skin at Different Levels. Journal of Craniofacial Surgery 17(1):p 54-56, January 2006. | DOI: 10.1097/01.scs.0000188347.06365.a0  

I was recently asked to OPINE on the labor management for a patient who was receiving IV Pitocin for augmentation, who experienced a placental abruption. One physician stated that in "his opinion", Pitocin increased the risk of placental abruption intrapartum, a point which the original treating physician refuted. So, I was asked to be the "referee" on the play. IV Pitocin can result in some maternal-fetal complications but is abruption one of them as a stand-alone complication. Was the first reviewer's opinion correct? Listen in for details.1. Ben-Aroya Z, Yochai D, Silberstein T, Friger M, Hallak M, Katz M, Mazor M. Oxytocin use in grand-multiparous patients: safety and complications. J Matern Fetal Med. 2001 Oct;10(5):328-31. doi: 10.1080/714904358. PMID: 11730496.2. Morikawa M, Cho K, Yamada T, et al. Do Uterotonic Drugs Increase Risk of Abruptio Placentae and Eclampsia? Archives of Gynecology and Obstetrics. 2014;289(5):987-91. doi:10.1007/s00404-013-3101-8.3. ACOG: First and Second Stage Labor Management: ACOG Clinical Practice Guideline No. 8. Obstetrics and Gynecology. 2024;143(1):144-162. doi:10.1097/AOG.0000000000005447.4. Pitocin. FDA Drug Label. Food and Drug Administration Updated date: 2024-08-125. Litorp H, Sunny AK, Kc A. Augmentation of Labor With Oxytocin and Its Association With Delivery Outcomes: A Large-Scale Cohort Study in 12 Public Hospitals in Nepal.Acta Obstetricia Et Gynecologica Scandinavica. 2021;100(4):684-693. doi:10.1111/aogs.13919.

This episode continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn and his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. In this session, the group discusses Principles of Psychodynamic Treatment for Patients with Narcissistic Personality Disorder by Holly Crisp, M.D., and Glen Gabbard, M.D. The conversation explores how psychodynamic clinicians conceptualize and treat narcissistic personality disorder, emphasizing the disorder's pleomorphic nature - its capacity to take many forms depending on context, stress, and level of personality organization. Themes include the oscillation between grandiose and vulnerable self-states, the role of shame as a central organizing affect, and the therapist's challenge of moving flexibly along a supportive–interpretive continuum. The group also examines common transference and countertransference dynamics, the integration of Kohut's and Kernberg's models, and the transformative role of rupture and repair in the therapeutic process. Through candid discussion, clinical reflection, and moments of humor, the seminar illustrates how empathic attunement, flexibility, and authentic connection form the heart of effective treatment for pathological narcissism. This series is designed for clinicians, students, and anyone interested in a deeper and more nuanced understanding of narcissism, personality, and the process of psychological healing. To learn more about our work, visit www.HealNPD.org. Citation for the article discussed: Crisp H, Gabbard GO. Principles of psychodynamic treatment for patients with narcissistic personality disorder. Journal of Personality Disorders. 2020 Mar;34(Suppl):143-158. doi: 10.1521/pedi.2020.34.supp.143. PMID: 32186987.

Contributor: Taylor Lynch, MD Educational Pearls: A recent study published in a pediatric journal in April 2025 compared temporal and oral thermometers Paired temperature measurements (temporal and oral temperature within 30 minutes) were obtained from 1,412 pediatric patients 26% of patients had statistically different temporal and oral temperatures The temporal reading was always lower than the oral reading Children less than 12 years old were 2-3x more likely to actually have that statistical difference in temperatures The study also evaluated 1,000 adult patients 36% had a temporal temperature that was 0.5 degrees Celsius lower than the oral temperature Reasons for the statistical difference between the two types of thermometers: Environment: temporal thermometers are affected by ambient room temperature, diaphoresis, and inaccuracy in measuring temperature at the site of the temporal artery Physiologic: a patient with inadequate perfusion will not have an accurate temporal reading Impact: Obtaining an accurate temperature is crucial in patient care For example, in the setting of sepsis, temperature is a necessary component to identifying when a patient meets SIRS criteria References Salhi RA, Meeker MA, Williams C, Iwashyna TJ, Samuels-Kalow ME. Inaccuracy of Temporal Thermometer Measurement by Age and Race. Acad Pediatr. 2025 Apr;25(3):102620. doi: 10.1016/j.acap.2024.102620. Epub 2024 Dec 15. PMID: 39681266. Summarized by Meg Joyce, MS2 | Edited by Meg Joyce & Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/

In this episode, we dive into the charged world of Morbidity and Mortality conferences—where good intentions can collide with fear, shame, and silence. We've all felt that jolt of adrenaline sitting in the audience—or worse, standing at the podium. Our guest expert, Dr. Jaymin Patel, helps us unpack why the traditional M&M model no longer works and how we can rebuild it into something better: a space that turns mistakes into meaningful learning, supports both patient and provider healing, and helps us face our ghosts without fear. How do you think we can improve M&M? Share your ideas with us on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guest: Dr. Jaymin Patel, Assistant Professor of Emergency Medicine and Assistant Residency Program Director at UC Davis Resources: ALiEM: The M&M Shame Game; Case by Dr. Tamara McColl   Nussenbaum B, Chole RA. Rethinking Morbidity and Mortality Conference. Otolaryngol Clin North Am. 2019 Feb;52(1):47-53. doi: 10.1016/j.otc.2018.08.007. Epub 2018 Oct 5. PMID: 30297182. Wittels K, Aaronson E, Dwyer R, Nadel E, Gallahue F, Fee C, Tubbs R, Schuur J; EM M&M Culture of Safety Research Team. Emergency Medicine Morbidity and Mortality Conference and Culture of Safety: The Resident Perspective. AEM Educ Train. 2017 May 4;1(3):191-199. doi: 10.1002/aet2.10033. PMID: 30051034; PMCID: PMC6001737. *** 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.

Hello and welcome to my book on: Habit Stacking, Synaptic Pruning, and Diabetes Naturally. I hope you enjoy and find this book useful.Our life is what our thoughts make it. Do every act of your life as if it were your last. In a word, your life is short. You must make the most of the present with the aid of reason and justice. Since it is possible that you may be quitting life at this very moment, govern every act and thought accordingly.Marcus Aurelius Emperor of Rome, 121 AD -180 ADIs your glass half-empty or half-full? How you answer this age-old question about positive thinking may reflect your outlook on life, your attitude toward yourself, and whether you are optimistic or pessimistic—and it may even affect your health. [1]In 2007, Researchers at Oxford University compared the number of neurons in new born babies with that of adults and found the new born babies had a significantly higher number of neurons than adults.[2] As we mature, synapses or connections between neurons in the brain are pruned if they are not used, and the energy is redirected to maintaining synapses that are used.You likely have strong habits and connections that you take for granted each day. There are many thousands of daily habits our brain is good at repeating over and over. When developing new habits, you can leverage the interconnectedness of behaviour to your advantage. One of the most effective methods for establishing a new habit is to identify a current habit and then stack your new behaviour on top of it. This technique is known as habit stacking. I have consciously developed habits that help me avoid consuming foods containing highly refined carbohydrates, sugar, and sugar alcohols. You can learn to turn negative thinking into positive thinking. The process is simple, but it does take time and practice because you are creating a new habit, after all. It is important to learn the value of positive thinking and to focus on having a positive outlook.Habit Stacking is the foundation of Lifestyle Changes to Prevet and Reverse Type 2 Diabetes NaturallyMark Ashfordinformation@markaashford.com[1] Mayo Clinic, "Stress Management,"  (2025).[2] Nielsen RD Abitz M, Jones EG, Laursen H, Graem N, Pakkenberg B. Excess of neurons in the human newborn mediodorsal thalamus compared with that of the adult. Cereb Cortex. 2007 Nov;17(11):2573-8. doi: 10.1093/cercor/bhl163. Epub 2007 Jan 11. PMID: 17218480., "Excess of Neurons in the Human Newborn Mediodorsal Thalamus Compared with That of the Adult," (2007).

Current guidelines recommend universal collection of a vaginal-rectal swab for GBS colonization at 36-37 weeks and 6 days for the identification of patients who require intrapartum IV antibiotic coverage to prevent early onset neonatal GBS infection/sepsis. Recently, we had a patient in clinic whose GBS culture at 36 weeks was negative. Good right? Well, the patient was on amoxicillin at the time for pharyngitis. Did that course of oral PCN based therapy affect the GBS culture result? Should we believe that culture or could it be a false negative, demanding rescreen after therapy completion? There is currently a GAP here in the guidance. In this episode we will cover this controversial scenario, look at the data, and provide a real-world implementable approach to this case.1. Kim DD, Page SM, McKenna DS, Kim CM. Neonatal Group B Streptococcus Sepsis After Negative Screen in a Patient Taking Oral Antibiotics. Obstetrics and Gynecology. 2005;105(5 Pt 2):1259-61. doi:10.1097/01.AOG.0000159040.51773.bf.2. ACOG CO Number 797 (Replaces Committee Opinion No. 782, June 2019.); 20203. Mackay G, House MD, Bloch E, Wolfberg AJ. A GBS culture collected shortly after GBS prophylaxis may be inaccurate. J Matern Fetal Neonatal Med. 2012 Jun;25(6):736-8. doi: 10.3109/14767058.2011.596961. Epub 2011 Aug 1. PMID: 21801141.STRONG COFFEE PROMO: 20% Off Strong Coffee Company https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

Sleeve, bypass, or something new – which surgery really dominates the day?  This Bariatric Surgery Journal Club dives into the debate over which bariatric operation is best. We compare the outcomes of the gastric bypass, sleeve gastrectomy, and the newer Sadie procedure, exploring how bypass may have an edge in long-term diabetes remission and weight loss.  We also discuss revisional options for failed sleeves and the importance of matching the patient to the right operation for their specific needs. Hosts: - Matthew Martin, trauma and bariatric surgeon at the University of Southern California/Los Angeles General Medical Center (Los Angeles, California)  - Adrian Dan, bariatric and MIS surgeon, program director for the advanced MIS bariatric and foregut fellowship at Summa Health System (Akron, Ohio) - Crystal Johnson Mann, bariatric and foregut surgeon at the University of Florida (Gainesville, Florida) - Katherine Cironi, general surgery resident at the University of Southern California/Los Angeles General Medical Center (Los Angeles, California) Learning objectives: - Contrast the outcomes of Roux-en-Y gastric bypass, sleeve gastrectomy, and revisional options such as the single-anastomosis duodeno-ileal bypass (SADI) - Article #1: Hauge 2025, Effect of gastric bypass versus sleeve gastrectomy on the remission of type 2 diabetes, weight loss, and cardiovascular risk factors at 5 years (Oseberg): secondary outcomes of a single-centre, triple blind, randomized controlled trial https://pubmed.ncbi.nlm.nih.gov/40185112/ - Describe the design and unique triple-blind methodology of a single-center randomized trial comparing bypass and sleeve in patients with obesity and type 2 diabetes.  - Interpret the clinical relevance of the 5-year outcomes, including 63% diabetes remission with bypass vs 30% with sleeve.  - Examine secondary outcomes such as weight loss and cholesterol reduction, which favored bypass over the sleeve - Formulate patient-centered strategies for selecting bypass versus sleeve in populations with advanced metabolic disease, balancing efficacy with patient preference  - Article #2: The By-Band-Sleeve Collaborative Group 2025, Roux-en-Y gastric bypass, adjustable gastric banding, or sleeve gastrectomy for severe obesity (By-Band-Sleeve): a multicenter, open-label, three-group, randomized controlled trial https://pubmed.ncbi.nlm.nih.gov/40179925/ - Summarize the findings of this multi-center, open-label randomized controlled trial of over 1,300 patients comparing bypass, sleeve, and gastric banding at 5 years - Discuss the relative weight loss outcomes: 67% excess weight loss for bypass, 63% for sleeve, and 28% for adjustable gastric band - Evaluate the improvements in diabetes remission, hypertension control, and lipid management with bypass and sleeve compared to banding. - Analyze the declining role of gastric banding in modern bariatric surgery, while acknowledging its benefits compared to no weight loss treatment - Article #3: Thomopoulos 2024, Long-term results of Roux-en-Y gastric bypass (RYGB) versus single anastomosis duodeno-ileal bypass (SADI) as revisional procedures after failed sleeve gastrectomy: a systematic literature review and pooled analysis https://pubmed.ncbi.nlm.nih.gov/39579238/ - Compare long-term outcomes of bypass versus SADI after failed sleeve gastrectomy, based on pooled analysis of over 1,000 patients  - Interpret the trade-offs: SADI provides greater weight loss and metabolic improvements, but carries a higher risk for malnutrition and fat-soluble vitamin deficiencies  -  Develop strategies for preoperative counseling, nutritional supplementation, and close long-term monitoring, particularly for patients undergoing SADI - Individualize decision-making for revisional surgery, considering factors such as patient goals, comorbidity burden, prior anatomy, BMI, and reliability with follow-up - Evolving revisional strategies will influence the next decade of bariatric surgical innovation   - Overall, bariatric surgery consistently improves weight, diabetes control, and cardiovascular risk. - The procedure of choice should be tailored to the patient through detailed discussion between surgeon and patient, aligning clinical evidence with patient goals and risks.   References 1.     Wågen Hauge J, Borgeraas H, Birkeland KI, Johnson LK, Hertel JK, Hagen M, Gulseth HL, Lindberg M, Lorentzen J, Seip B, Kolotkin RL, Svanevik M, Valderhaug TG, Sandbu R, Hjelmesæth J, Hofsø D. Effect of gastric bypass versus sleeve gastrectomy on the remission of type 2 diabetes, weight loss, and cardiovascular risk factors at 5 years (Oseberg): secondary outcomes of a single-centre, triple-blind, randomised controlled trial. Lancet Diabetes Endocrinol. 2025 May;13(5):397-409. doi: 10.1016/S2213-8587(24)00396-6. Epub 2025 Apr 1. PMID: 40185112. https://pubmed.ncbi.nlm.nih.gov/40185112/ 2.     By-Band-Sleeve Collaborative Group. Roux-en-Y gastric bypass, adjustable gastric banding, or sleeve gastrectomy for severe obesity (By-Band-Sleeve): a multicentre, open label, three-group, randomised controlled trial. Lancet Diabetes Endocrinol. 2025 May;13(5):410-426. doi: 10.1016/S2213-8587(25)00025-7. Epub 2025 Mar 31. PMID: 40179925. https://pubmed.ncbi.nlm.nih.gov/40179925/ 3.     Thomopoulos T, Mantziari S, Joliat GR. Long-term results of Roux-en-Y gastric bypass (RYGB) versus single anastomosis duodeno-ileal bypass (SADI) as revisional procedures after failed sleeve gastrectomy: a systematic literature review and pooled analysis. Langenbecks Arch Surg. 2024 Nov 23;409(1):354. doi: 10.1007/s00423-024-03557-9. PMID: 39579238; PMCID: PMC11585492. https://pubmed.ncbi.nlm.nih.gov/39579238/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Pain Exam Podcast  Recent Conference Activities London Conference Weekend: Successfully attended and spoke at ISPN and SOMOS care conferences Somos Care Conference: Delivered presentation on pain management for primary care physicians Presentation consisted of 50+ slides with only one slide dedicated to opiates Emphasized shift away from opiate-based treatments in interventional pain management Recommended primary care physicians refer patients to pain specialists for comprehensive treatment options ISPN Conference: Participated in international pain management conference Met with doctors from London, Iraq, and various other countries Observed different international approaches to pain treatment including increased phenol use and varying regenerative medicine restrictions Upcoming Events and Workshops New York-New Jersey Pain Conference: November (NRAP Academy booth presence) IV Ultrasound Placement Workshops: Monthly sessions in New York Regional Anesthesia and Ultrasound-Guided Interventional Pain Medicine Workshops: New York: December 13th, January 10th Florida (Fort Lauderdale/Hollywood): November 8th Detroit: January 18th, February 15th Alternative Options: Online ultrasound courses and shadowing opportunities available Board Prep and NRAP Community at PainExam.com or NRAPpain.org ABA ABPM ABIPP FIPP Pain Management Board prep, Question Banks, and Virtual Pain Fellowship Educational Offerings and Events Training and Courses: Research Review: ACL Treatment Study Study Focus: Non-surgical treatment of ACL tears using bone marrow concentrate (BMAC) and platelet products versus exercise therapy Key Findings: BMAC group showed significantly greater improvement in Lower Extremity Function Scale (LEFS) and Single Assessment Numeric Evaluation (SANE) scores at three months Sustained improvement in function and decreased pain maintained through two-year follow-up Patients reported median subjective improvement of 90% at final follow-up No significant improvements observed in exercise-only group during initial three months Treatment Protocol: Bone marrow harvest from posterior superior iliac crest (60-90ml from 6-8 sites) PRP preparation from 60ml whole blood Fluoroscopy-guided injection directly into ACL ligament Comprehensive 52-week rehabilitation protocol with activity restrictions Clinical Practice Implications Current ACL Treatment Landscape: Over 400,000 ACL reconstruction surgeries performed annually in the US Surgical Limitations: Risk of graft failure, persistent instability, cartilage injury, and increased arthritis risk Return to Sport Statistics: Post-surgical rates vary significantly (33-92% return to sport, 65% return to pre-injury level) Practice Integration Considerations: Potential incorporation of BMAC/PRP protocols for ACL tears, though insurance coverage remains limited   David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.    Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 References Centeno CJ, Berger DR, Pitts J, Markle J, Pelle AJ, Murphy M, Dodson E. Non-surgical treatment of anterior cruciate ligament tears with percutaneous bone marrow concentrate and platelet products versus exercise therapy: a randomized-controlled, crossover trial with 2-year follow-up. BMC Musculoskelet Disord. 2025 Sep 30;26(1):882. doi: 10.1186/s12891-025-09153-2. PMID: 41029301; PMCID: PMC12486544.   #pccwindsor #paincareclinicswindsor #painwindsorontario #paindocwindsorontarior #paincareclinics #prpwindsorontario #prp #aabppain 

Pain Exam Podcast  Recent Conference Activities London Conference Weekend: Successfully attended and spoke at ISPN and SOMOS care conferences Somos Care Conference: Delivered presentation on pain management for primary care physicians Presentation consisted of 50+ slides with only one slide dedicated to opiates Emphasized shift away from opiate-based treatments in interventional pain management Recommended primary care physicians refer patients to pain specialists for comprehensive treatment options ISPN Conference: Participated in international pain management conference Met with doctors from London, Iraq, and various other countries Observed different international approaches to pain treatment including increased phenol use and varying regenerative medicine restrictions Upcoming Events and Workshops New York-New Jersey Pain Conference: November (NRAP Academy booth presence) IV Ultrasound Placement Workshops: Monthly sessions in New York Regional Anesthesia and Ultrasound-Guided Interventional Pain Medicine Workshops: New York: December 13th, January 10th Florida (Fort Lauderdale/Hollywood): November 8th Detroit: January 18th, February 15th Alternative Options: Online ultrasound courses and shadowing opportunities available Board Prep and NRAP Community at PainExam.com or NRAPpain.org ABA ABPM ABIPP FIPP Pain Management Board prep, Question Banks, and Virtual Pain Fellowship Educational Offerings and Events Training and Courses: Research Review: ACL Treatment Study Study Focus: Non-surgical treatment of ACL tears using bone marrow concentrate (BMAC) and platelet products versus exercise therapy Key Findings: BMAC group showed significantly greater improvement in Lower Extremity Function Scale (LEFS) and Single Assessment Numeric Evaluation (SANE) scores at three months Sustained improvement in function and decreased pain maintained through two-year follow-up Patients reported median subjective improvement of 90% at final follow-up No significant improvements observed in exercise-only group during initial three months Treatment Protocol: Bone marrow harvest from posterior superior iliac crest (60-90ml from 6-8 sites) PRP preparation from 60ml whole blood Fluoroscopy-guided injection directly into ACL ligament Comprehensive 52-week rehabilitation protocol with activity restrictions Clinical Practice Implications Current ACL Treatment Landscape: Over 400,000 ACL reconstruction surgeries performed annually in the US Surgical Limitations: Risk of graft failure, persistent instability, cartilage injury, and increased arthritis risk Return to Sport Statistics: Post-surgical rates vary significantly (33-92% return to sport, 65% return to pre-injury level) Practice Integration Considerations: Potential incorporation of BMAC/PRP protocols for ACL tears, though insurance coverage remains limited   David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.    Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 References Centeno CJ, Berger DR, Pitts J, Markle J, Pelle AJ, Murphy M, Dodson E. Non-surgical treatment of anterior cruciate ligament tears with percutaneous bone marrow concentrate and platelet products versus exercise therapy: a randomized-controlled, crossover trial with 2-year follow-up. BMC Musculoskelet Disord. 2025 Sep 30;26(1):882. doi: 10.1186/s12891-025-09153-2. PMID: 41029301; PMCID: PMC12486544.   #pccwindsor #paincareclinicswindsor #painwindsorontario #paindocwindsorontarior #paincareclinics #prpwindsorontario #prp #aabppain 

Pain Exam Podcast  Recent Conference Activities London Conference Weekend: Successfully attended and spoke at ISPN and SOMOS care conferences Somos Care Conference: Delivered presentation on pain management for primary care physicians Presentation consisted of 50+ slides with only one slide dedicated to opiates Emphasized shift away from opiate-based treatments in interventional pain management Recommended primary care physicians refer patients to pain specialists for comprehensive treatment options ISPN Conference: Participated in international pain management conference Met with doctors from London, Iraq, and various other countries Observed different international approaches to pain treatment including increased phenol use and varying regenerative medicine restrictions Upcoming Events and Workshops New York-New Jersey Pain Conference: November (NRAP Academy booth presence) IV Ultrasound Placement Workshops: Monthly sessions in New York Regional Anesthesia and Ultrasound-Guided Interventional Pain Medicine Workshops: New York: December 13th, January 10th Florida (Fort Lauderdale/Hollywood): November 8th Detroit: January 18th, February 15th Alternative Options: Online ultrasound courses and shadowing opportunities available Board Prep and NRAP Community at PainExam.com or NRAPpain.org ABA ABPM ABIPP FIPP Pain Management Board prep, Question Banks, and Virtual Pain Fellowship Educational Offerings and Events Training and Courses: Research Review: ACL Treatment Study Study Focus: Non-surgical treatment of ACL tears using bone marrow concentrate (BMAC) and platelet products versus exercise therapy Key Findings: BMAC group showed significantly greater improvement in Lower Extremity Function Scale (LEFS) and Single Assessment Numeric Evaluation (SANE) scores at three months Sustained improvement in function and decreased pain maintained through two-year follow-up Patients reported median subjective improvement of 90% at final follow-up No significant improvements observed in exercise-only group during initial three months Treatment Protocol: Bone marrow harvest from posterior superior iliac crest (60-90ml from 6-8 sites) PRP preparation from 60ml whole blood Fluoroscopy-guided injection directly into ACL ligament Comprehensive 52-week rehabilitation protocol with activity restrictions Clinical Practice Implications Current ACL Treatment Landscape: Over 400,000 ACL reconstruction surgeries performed annually in the US Surgical Limitations: Risk of graft failure, persistent instability, cartilage injury, and increased arthritis risk Return to Sport Statistics: Post-surgical rates vary significantly (33-92% return to sport, 65% return to pre-injury level) Practice Integration Considerations: Potential incorporation of BMAC/PRP protocols for ACL tears, though insurance coverage remains limited   David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.    Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 References Centeno CJ, Berger DR, Pitts J, Markle J, Pelle AJ, Murphy M, Dodson E. Non-surgical treatment of anterior cruciate ligament tears with percutaneous bone marrow concentrate and platelet products versus exercise therapy: a randomized-controlled, crossover trial with 2-year follow-up. BMC Musculoskelet Disord. 2025 Sep 30;26(1):882. doi: 10.1186/s12891-025-09153-2. PMID: 41029301; PMCID: PMC12486544.   #pccwindsor #paincareclinicswindsor #painwindsorontario #paindocwindsorontarior #paincareclinics #prpwindsorontario #prp #aabppain 

In the 09/1/2018 Society for Academic Specialists in General Obstetrics and Gynecology's (SASGOG's) Pearls of Exxcellence publication, “Management of Preeclampsia at Term”, it states: “If hypertension management requires acute IV treatment, it is often prudent to initiate oral labetalol or EXTENDED-release nifedipine to maintain blood pressures below the severe range. Intrapartum blood pressure management and consultation should not delay progress towards delivery. Fetal monitoring should be continuous.” In the original ACOG CO 692 from 2017, oral nifedipine was first referenced as an alternative to IV meds GIVEN INTRAPARTUM, stating, “Although relatively less information currently exists for the use of calcium channel blockers for this clinical indication, the available evidence suggests that immediate release oral nifedipine also may be considered as a first-line therapy, particularly when intravenous access is not available.” This may be given orally as 10mg, 20mg, and 20 mg separated in time by 20 minutes per dose. Notice it says “immediate release oral nifedipine”. But what about EXTENDED release nifedipine intrapartum as stated by the SASGOG? Is that an option after immediate attentive and therapy has been given with IV anti-hypertensives? Listen in for details.1. Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period: Committee Opinion, Number 692. Obstetrics & Gynecology 129(4):p e90-e95, April 2017. | DOI: 10.1097/AOG.00000000000020192. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020 Jun;135(6):e237-e260. doi: 10.1097/AOG.0000000000003891. PMID: 32443079.3. Cleary EM, Racchi NW, Patton KG, Kudrimoti M, Costantine MM, Rood KM. Trial of Intrapartum Extended-Release Nifedipine to Prevent Severe Hypertension Among Pregnant Individuals With Preeclampsia With Severe Features. Hypertension. 2023 Feb;80(2):335-342. doi: 10.1161/HYPERTENSIONAHA.122.19751. Epub 2022 Oct 3. PMID: 36189646.STRONG COFFEE PROMO: 20% Off Strong Coffee Company ⁠https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

With Rodrigo off caring for sick children, James Nurse joins Silvia Radenkovic to speak with Dr Judith Jans and Dr Devin Oglesbee about the emerging field of untargeted metabolomics. Authors' opinions are their own and do not represent their institutions. Referenced papers include: Miller MJ, et al The emerging role of metabolomics analysis in genetic and genomic testing: A points to consider statement of the American College of Medical Genetics and Genomics (ACMG). Genet Med. 2025 Jul 17:101493. doi: 10.1016/j.gim.2025.101493. Epub ahead of print. Evans AM, et al Dissemination and analysis of the quality assurance (QA) and quality control (QC) practices of LC-MS based untargeted metabolomics practitioners. Metabolomics. 2020 Oct 12;16(10):113. doi: 10.1007/s11306-020-01728-5. Wurth R, et al. An evaluation of untargeted metabolomics methods to characterize inborn errors of metabolism. Mol Genet Metab. 2024 Jan;141(1):108115. doi: 10.1016/j.ymgme.2023.108115. Epub 2023 Dec 15. Haijes HA, et al. Direct Infusion Based Metabolomics Identifies Metabolic Disease in Patients' Dried Blood Spots and Plasma. Metabolites. 2019 Jan 11;9(1):12. doi: 10.3390/metabo9010012. Willems AP, et al A one-year pilot study comparing direct-infusion high resolution mass spectrometry based untargeted metabolomics to targeted diagnostic screening for inherited metabolic diseases. Front Mol Biosci. 2023 Nov 2;10:1283083. doi: 10.3389/fmolb.2023.1283083. Haijes HA, et al. Aspartylglycosamine is a biomarker for NGLY1-CDDG, a congenital disorder of deglycosylation. Mol Genet Metab. 2019 Aug;127(4):368-372. doi: 10.1016/j.ymgme.2019.07.001. Epub 2019 Jul 9. PMID: 31311714. Hoegen B, et al Application of metabolite set enrichment analysis on untargeted metabolomics data prioritises relevant pathways and detects novel biomarkers for inherited metabolic disorders. J Inherit Metab Dis. 2022 Jul;45(4):682-695. doi: 10.1002/jimd.12522. Epub 2022 May 22. PMID: 35546254; PMCID: PMC9544878. Gao Q, et al A diagnostic algorithm for inherited metabolic disorders using untargeted metabolomics. Metabolomics. 2025 Jul 27;21(4):101. doi: 10.1007/s11306-025-02302-7. PMID: 40715884; PMCID: PMC12301266. Kerkhofs MHPM, et al. Cross-Omics: Integrating Genomics with Metabolomics in Clinical Diagnostics. Metabolites. 2020 May 18;10(5):206. doi: 10.3390/metabo10050206. Ashenden AJ, et al. The Multi-Omic Approach to Newborn Screening: Opportunities and Challenges. Int J Neonatal Screen. 2024 Jun 21;10(3):42. doi: 10.3390/ijns10030042. Liu N, et al. Comparison of Untargeted Metabolomic Profiling vs Traditional Metabolic Screening to Identify Inborn Errors of Metabolism. JAMA Netw Open. 2021 Jul 1;4(7):e2114155. doi: 10.1001/jamanetworkopen.2021.14155.

This week we're traveling back to 1987 Oakland with Freaky Tales! Join us as we learn about punk v. skinhead battles, Sleepy Floyd, Operation Ivy, and more! Sources: Southern Poverty Law Center, Timeline of the Racist Skinhead Movement: https://www.splcenter.org/resources/reports/timeline-racist-skinhead-movement/ Christopher Phelps, "Skinheads: The New Nazism," Marxists.org: https://www.marxists.org/history/etol/newspape/atc/10048.html Steve Knopper, "Nazi Punks Fuck Off: How Black Flag, Bad Brains, and More Took Back Their Scene from White Supremacists," https://www.gq.com/story/punks-and-nazis-oral-history Gabe Meline, "The Realy Life Freaky Tales Behind Freaky Tales," available at https://www.kqed.org/arts/13973907/freaky-tales-true-stories-pedro-pascal-too-short-924-gilman-oakland Singh SP. Sakshi and Dhyana: the origin of mindfulness-based therapies. BJPsych Bull. 2023 Apr;47(2):94-97. doi: 10.1192/bjb.2022.39. PMID: 35796539; PMCID: PMC10063990. Ngram: https://books.google.com/ngrams/graph?content=mindfulness&year_start=1800&year_end=2022&corpus=en&smoothing=3 Jessie Sun, "Mindfulness in Context: A Historical Discourse Analysis," available at https://jessiesun.me/publication/sun-2014/sun-2014.pdf Aaron Carnes, In Defense of Ska, https://www.rollingstone.com/music/music-features/operation-ivy-energy-in-defense-of-ska-book-aaron-carnes-1162048/  https://cmagazine.org/2018/03/22/924-gilman/ https://www.concertarchives.org/concerts/rancid-rice-the-rudiments-bumblescrump-the-aborted?photo=392323  https://www.924gilman.org/about   https://eastbayexpress.com/twenty-five-years-of-924-gilman-1/  https://eastbaypunk.com/about/ https://www.kqed.org/arts/11333286/green-day-dookie-924-gilman Liam O'Donoghue, https://www.sfgate.com/sf-culture/article/berkeley-nazi-brawl-bay-area-movie-freaky-tales-20250563.php  RT: https://www.rottentomatoes.com/m/freaky_tales  Christy Lemire, https://www.rogerebert.com/reviews/freaky-tales-pedro-pascal-movie-review-2025 The Hollywood Reporter, https://youtu.be/DhgFbs2QPbo?si=sLuHMtMzF3xh_Ket  CBS Mornings, https://youtu.be/BRYTyYOLQEk?si=9k8aWh0GNErBWvJg  https://www.kqed.org/arts/13973907/freaky-tales-true-stories-pedro-pascal-too-short-924-gilman-oakland https://www.espn.com/nba/player/stats/_/id/3703/sleepy-floyd  https://www.espn.com/nba/player/stats/_/id/3703/type/nba/seasontype/3 

What if menopause wasn't something to “get through,” but a time to reconnect with your body in an entirely new way? In this solo episode for Menopause Month, I'm diving deep into what's really happening beneath the surface during perimenopause and menopause - and how you can support your body through every change with nourishment and care.We'll explore how nutrition can protect your bone and heart health, help you maintain muscle mass, and even support brain health during this transition. We'll also unpack the link between hormones and cognitive function, including what we know about Alzheimer's risk and how lifestyle can make a difference.What we cover in this episode:Perimenopause + menopause — what's really happening underneathNourishing your body through this phase: bone, heart, and muscle healthThe brain connection: Alzheimer's risk + supporting cognitive resilienceWhat to focus on next to feel your best in midlife and beyondWhether you're just starting to notice changes or already in the thick of it, this episode is here to help you feel informed, empowered, and deeply connected to your body's evolution. Enjoyed the podcast? Please leave us a rating and review, we'd love to hear it! Links:1-on-1 nutrition programs for menopause: ThegoodlifedietitianServices — Trista Chan RD, MHScMenopause IG series   ReferencesAtaei Kachouei A, Singar S, Wood A, Flatt JD, Rosenkranz SK, Rosenkranz RR, Akhavan NS. Cardiovascular Risk Factors, Alzheimer's Disease, and the MIND Diet: A Narrative Review from Molecular Mechanisms to Clinical Outcomes. Nutrients. 2025 Jul 16;17(14):2328. doi: 10.3390/nu17142328. PMID: 40732953; PMCID: PMC12299063. Glenn AJ, Guasch-Ferré M, Malik VS, Kendall CWC, Manson JE, Rimm EB, Willett WC, Sun Q, Jenkins DJA, Hu FB, Sievenpiper JL. Portfolio Diet Score and Risk of Cardiovascular Disease: Findings From 3 Prospective Cohort Studies. Circulation. 2023 Nov 28;148(22):1750-1763. doi: 10.1161/CIRCULATIONAHA.123.065551. Epub 2023 Oct 25. PMID: 37877288; PMCID: PMC10841173. Inaraja V, Thuissard I, Andreu-Vazquez C, Jodar E. Lipid profile changes during the menopausal transition. Menopause. 2020 Jul;27(7):780-787. doi: 10.1097/GME.0000000000001532. PMID: 32187130. Kodete, C. S., Thuraka, B., Pasupuleti, V., & Malisetty, S. (2024). Hormonal Influences on Skeletal Muscle Function in Women across Life Stages: A Systematic Review. Muscles, 3(3), 271-286. Ryczkowska K, Adach W, Janikowski K, Banach M, Bielecka-Dabrowa A. Menopause and women's cardiovascular health: is it really an obvious relationship? Arch Med Sci. 2022 Dec 10;19(2):458-466. doi: 10.5114/aoms/157308. PMID: 37034510; PMCID: PMC10074318.

Fetal gastroschisis is a congenital defect of the abdominal wall, typically located to the right of a normally inserted umbilical cord, through which the fetal intestines and sometimes other abdominal organs herniate directly into the amniotic cavity. This condition is usually isolated, not associated with other major anomalies, and is reliably diagnosed prenatally by ultrasound. Does this require antenatal fetal surveillance? In this episode, we will cover the prevalence, diagnosis, classification, and management of this congenital anomaly. 1. Ferreira RG, Mendonça CR, Gonçalves Ramos LL, de Abreu Tacon FS, Naves do Amaral W, Ruano R. Gastroschisis: a systematic review of diagnosis, prognosis and treatment. J Matern Fetal Neonatal Med. 2022 Dec;35(25):6199-6212. doi: 10.1080/14767058.2021.1909563. Epub 2021 Apr 25. PMID: 33899664.2. Pontes KFM, Muniz TD, Caldas JVJ, Acácio GL, Lapa DA, Rolo LC, Araujo Júnior E. Fetal Gastroschisis: Review From Diagnosis to Delivery. J Clin Ultrasound. 2025 Jun;53(5):1122-1130. doi: 10.1002/jcu.23976. Epub 2025 Mar 28. PMID: 40152061.3. Muniz TD, Rolo LC, Araujo Júnior E. Gastroschisis: embriology, pathogenesis, risk factors, prognosis, and ultrasonographic markers for adverse neonatal outcomes. J Ultrasound. 2024 Jun;27(2):241-250. doi: 10.1007/s40477-024-00887-8. Epub 2024 Mar 29. PMID: 38553588; PMCID: PMC11178761.STRONG COFFEE PROMO: 20% Off Strong Coffee Company ⁠https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

Listener discretion is advised. References: Christine Witten. Airway Jedi Blog. Available: https://airwayjedi.com/2019/01/24/etco2-valuable-vital-sign-perfusion/ Dubin A, Murias G, Estenssoro E, Canales H, Sottile P, Badie J, Barán M, Rossi S, Laporte M, Pálizas F, Giampieri J, Mediavilla D, Vacca E, Botta D. End-tidal CO2 pressure determinants during hemorrhagic shock. Intensive Care Med. 2000 Nov;26(11):1619-23. doi: 10.1007/s001340000669. PMID: 11193267. Öztürk Örmeci G, Yiğit Ö, Eray O. Utility of ETCO2 to predict hemorrhagic shock in multiple trauma patients. Turk J Med Sci. 2022 Feb;52(1):206-215. doi: 10.3906/sag-2103-206. Epub 2022 Feb 22. PMID: 36161601; PMCID: PMC10734833. Wahba RW, Tessler MJ, Béïque F, Kleiman SJ. Changes in PCO2 with acute changes in cardiac index. Can J Anaesth. 1996 Mar;43(3):243-5. doi: 10.1007/BF03011742. PMID: 8829863 Warner KJ, Cuschieri J, Garland B, Carlbom D, Baker D, Copass MK, Jurkovich GJ, Bulger EM. The utility of early end-tidal capnography in monitoring ventilation status after severe injury. J Trauma. 2009 Jan;66(1):26-3

Drs. Erin Barreto (@erin_barreto) and Jeffrey Lipman join Dr. Whitney Buckel for a conversation on ideal dosing of cefepime. Hear from the experts on the differences between package insert and “high-dose” regimens, adjustments for renal impairment/augmented renal clearance, and the role of cefepime therapeutic drug monitoring. References: Barreto EF, et al. Setting the Beta-Lactam Therapeutic Range for Critically Ill Patients: Is There a Floor or Even a Ceiling? Crit Care Explor. 2021 Jun 11;3(6):e0446.PMID: https://pubmed.ncbi.nlm.nih.gov/34136822/ Barreto EF, et al. Adequacy of cefepime concentrations in the early phase of critical illness: A case for precision pharmacotherapy. Pharmacotherapy. 2023 Nov;43(11):1112-1120. https://pubmed.ncbi.nlm.nih.gov/36648390/ ** **Udy AA, et al. Augmented renal clearance: implications for antibacterial dosing in the critically ill. Clin Pharmacokinet. 2010;49(1):1-16. https://pubmed.ncbi.nlm.nih.gov/20000886/ Lipman J, Wallis SC, Boots RJ. Cefepime versus cefpirome: the importance of creatinine clearance.   Anesth Analg. 2003 Oct;97(4):1149-1154. doi: 10.1213/01.ANE.0000077077.54084.B0.PMID: 14500173 Roberts JA, Ulldemolins M, Roberts MS, McWhinney B, Ungerer J, Paterson DL, Lipman J. Therapeutic drug monitoring of beta-lactams in critically ill patients: proof of concept.  Int J Antimicrob Agents. 2010 Oct;36(4):332-9. doi: 10.1016/j.ijantimicag.2010.06.008. Epub 2010 Aug 3.PMID: 20685085

Contributor: Aaron Lessen, MD Educational Pearls: The cause of Alzheimer's disease is multifactorial, but the most widely suspected mechanism is the amyloid cascade hypothesis: Beta-amyloid proteins accumulate in the central nervous system, forming plaques that impair neuronal function. In recent years, advances have led to the development of targeted therapies with monoclonal antibodies. These drugs: Work by degrading amyloid plaques Slow the rate of cognitive decline and disease progression Have major side effects, most notably the development of amyloid-related imaging abnormalities (ARIA) ARIA may present as edema, effusion, or microhemorrhages, which are only detectable on MRI Symptoms can include headache, vertigo, or focal neurologic deficits that mimic stroke For patients presenting to the emergency department with stroke-like symptoms, it is important to consider whether they have a history of Alzheimer's disease and whether they are taking these medications. This guides decisions about imaging and treatment: The work-up may require MRI, which can delay thrombolytic or endovascular therapy in patients with true strokeConversely, treating a patient with ARIA using thrombolytics increases the risk of bleeding and other complications References Ebell MH, Barry HC, Baduni K, Grasso G. Clinically Important Benefits and Harms of Monoclonal Antibodies Targeting Amyloid for the Treatment of Alzheimer Disease: A Systematic Review and Meta-Analysis. Ann Fam Med. 2024 Jan-Feb;22(1):50-62. doi: 10.1370/afm.3050. PMID: 38253509; PMCID: PMC11233076. Ma C, Hong F, Yang S. Amyloidosis in Alzheimer's Disease: Pathogeny, Etiology, and Related Therapeutic Directions. Molecules. 2022 Feb 11;27(4):1210. doi: 10.3390/molecules27041210. PMID: 35209007; PMCID: PMC8876037. Perneczky R, Dom G, Chan A, Falkai P, Bassetti C. Anti-amyloid antibody treatments for Alzheimer's disease. Eur J Neurol. 2024 Feb;31(2):e16049. doi: 10.1111/ene.16049. Epub 2023 Sep 11. PMID: 37697714; PMCID: PMC11235913. Summarized by Ashley Lyons, OMS3 | Edited by Ashley Lyons and Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/

What happens when a febrile infant presents at 61 days old? Are they suddenly low risk for invasive bacterial infections? In this episode, we explore the gray zone of managing febrile infants aged 61–90 days with the help of two new clinical prediction rules from PECARN. Joining us are two powerhouses in pediatric emergency medicine: Dr. Nate Kuppermann and Dr. Paul Aronson, who walk us through their recent study published in Pediatrics. We discuss why prior research has traditionally stopped at 60 days, what the new data shows about risk in this slightly older age group, and how these rules might help guide clinical decision-making. This study fills a long-standing gap—but should we start using the rules now? Tune in for a nuanced discussion on sensitivity, missed cases, practical application, and the future of risk stratification in young infants with fever. What is your practice in terms of work-up of 2-3 month old febrile infants? Will this change what you do? Hit us up social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Dr. Nate Kuppermann, Executive Vice President and Chief Academic Officer; Director, Children's National Research Institute; Department Chair, Pediatrics, George Washington University School of Medicine and Health Sciences Dr. Paul Aronson, Professor of Pediatrics (Emergency Medicine); Deputy Director, Pediatric Residency Program at Yale University School of Medicine Resources: “Hot” Off the Press: Infant Fever Rule Do I really need to LP a febrile infant with a UTI? Aronson PL, Mahajan P, Meeks HD, Nielsen B, Olsen CS, Casper TC, Grundmeier RW, Kuppermann N; PECARN Registry Working Group. Prediction Rule to Identify Febrile Infants 61-90 Days at Low Risk for Invasive Bacterial Infections. Pediatrics. 2025 Sep 1;156(3):e2025071666. doi: 10.1542/peds.2025-071666. PMID: 40854562; PMCID: PMC12432541. Kuppermann N, Dayan PS, Levine DA, Vitale M, Tzimenatos L, Tunik MG, Saunders M, Ruddy RM, Roosevelt G, Rogers AJ, Powell EC, Nigrovic LE, Muenzer J, Linakis JG, Grisanti K, Jaffe DM, Hoyle JD Jr, Greenberg R, Gattu R, Cruz AT, Crain EF, Cohen DM, Brayer A, Borgialli D, Bonsu B, Browne L, Blumberg S, Bennett JE, Atabaki SM, Anders J, Alpern ER, Miller B, Casper TC, Dean JM, Ramilo O, Mahajan P; Febrile Infant Working Group of the Pediatric Emergency Care Applied Research Network (PECARN). A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. JAMA Pediatr. 2019 Apr 1;173(4):342-351. doi: 10.1001/jamapediatrics.2018.5501. PMID: 30776077; PMCID: PMC6450281. Pantell RH, Roberts KB, Adams WG, Dreyer BP, Kuppermann N, O'Leary ST, Okechukwu K, Woods CR Jr; SUBCOMMITTEE ON FEBRILE INFANTS. Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old. Pediatrics. 2021 Aug;148(2):e2021052228. doi: 10.1542/peds.2021-052228. Epub 2021 Jul 19. Erratum in: Pediatrics. 2021 Nov;148(5):e2021054063. doi: 10.1542/peds.2021-054063. PMID: 34281996. **** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

In this episode of Herb of the Month, I dive into the world of Angelica archangelica—a tall, majestic herb celebrated for both its medicinal and magical qualities. I'll share its physical traits, how it grows best, and the many ways it has been used throughout history. From protecting against plague to soothing anxiety, Angelica has long been considered one of the great protectors in the herbal tradition.I also weave in some of my own experiences working with this plant, particularly in supporting family health and children's well-being. Together, we'll explore its role as both a healing ally and a spiritual guardian.

Send us a textCritical Congenital Heart Disease and Infant Cancer.Chin S, Lupo PJ, Baer R, Hobbs CA, Chambers CD, Bandoli G.Pediatrics. 2025 Sep 25:e2025072934. doi: 10.1542/peds.2025-072934. Online ahead of print.PMID: 40992753 No abstract available.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

VO2max is trendy right now - but is training for VO2max legit or grift? We dive into the science of VO2max, how to improve it, and if it actually matters for long-distance runners. Thank you to our sponsors:✨ Upstep: Custom orthotics, molded from the comfort of your home. Use code RUNTOTHEFINISH at https://www.upstep.com/?ref=cajmuang for $20 off your purchase. ✨ FlipBelt: Sleek storage options, including no-bounce running belts and shorts. Use code TLF20 at flipbelt.com for 20% off your purchase. In this episode, you will learn:✅ What is your VO2max?✅ What do VO2max numbers actually mean? ✅ How is VO2max calculated?✅ Is your Garmin's VO2max estimate accurate?✅ How much does VO2max matter for performance?✅ How to improve your VO2max✅ Can you improve your performance without changing your VO2max?✅ Is VO2max a health indicator?Field Tests for VO2max:Cooper test: After a 10-20 min warm-up, run as far as you can in 12 minutes. Record distance and enter into this calculator. 1.5-mile run test: After a 10-20 min warm-up, run as fast as you can for 1.5 miles. Record distance and enter into this calculator.Lactate threshold test. After a 10-20 min warm-up, run 30 minutes as fast as you can (self-paced, even effort). Your average pace over the final 20 minutes is your velocity at second LT (60-min race pace) and your average HR over the final 20 min is your LTHR. References:

A breakthrough discovery in the 1970s was the determination of alpha-fetoprotein levels in the serum of pregnant women to detect fetuses with neural tube defects. In the case of high AFP values in maternal serum, amniocentesis was performed to determine the levels of AFP and acetylcholinesterase (AChE) in the amniotic fluid to confirm the diagnosis. Currently, the ACOG states that high-quality, second-trimester fetal anatomy ultrasonography is an appropriate screening test for NTDs where routinely performed for fetal anatomic survey at 18 to 22 weeks. If optimal images of the fetal spine, intracranial anatomy, or anterior abdominal wall are not obtained (eg, fetal position or maternal obesity), MSAFP should be performed to improve detection of NTDs (ACOG Practice Bulletin No. 187: Neural Tube Defects. Committee on Practice Bulletins Obstet Gynecol. 2017). Some clinicians (as we do in our practice) order both fetal anatomy ultrasound and msAFP concurrently. What are the implications when the msAFP is elevated with a normal fetal anatomical survey? Where is this msAFP coming from? Listen in for details.1. ACOG Practice Bulletin No. 187: Neural Tube Defects. Committee on Practice Bulletins Obstet Gynecol. 20172. Pregnancy Outcomes Regarding Maternal Serum AFP Value in Second Trimester Screening. Bartkute K, Balsyte D, Wisser J, Kurmanavicius J. Journal of Perinatal Medicine. 2017;45(7):817-820. doi:10.1515/jpm-2016-0101.3. Głowska-Ciemny J, Szmyt K, Kuszerska A, Rzepka R, von Kaisenberg C, Kocyłowski R. Fetal and Placental Causes of Elevated Serum Alpha-Fetoprotein Levels in Pregnant Women. J Clin Med. 2024 Jan 14;13(2):466. doi: 10.3390/jcm13020466. PMID: 38256600; PMCID: PMC10816536.STRONG COFFEE PROMO: 20% Off Strong Coffee Company https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

Join the Behind the Knife Surgical Oncology Team as we discuss the nuances in the work up and management of patients with pheochromocytomas. 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. Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a 2ndYear Surgical Oncology fellow at MD Anderson. Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a General Surgery physician in the United States Air Force station at RAF Lakenheath. Joe (Joseph) Broderick, MD, MA (@joebrod5) is a General Surgery research resident between his second and third year at Brooke Army Medical Center. Galen Gist, MD (@gistgalen) is a General Surgery research resident between his second and third year at Brooke Army Medical Center. Learning Objectives: 1)    Review the presentation of patients with pheochromocytomas.  2)    Review the work up of patients with pheochromocytomas.  3)    Review the treatment of patients with pheochromocytomas.  4)    Review the surveillance of patients with pheochromocytomas.  References used in the making of this episode: Patel D. Surgical approach to patients with pheochromocytoma. Gland Surg. 2020;9(1):32-42. doi:10.21037/gs.2019.10.20. PMID: 32206597; PMCID:PMC7082266.   Eisenhofer G, Lenders JW, Siegert G, et al. Plasma methoxytyramine: a novel biomarker of metastatic pheochromocytoma and paraganglioma in relation to established risk factors of tumour size, location and SDHB mutation status. Eur J Cancer. 2012;48(11):1739-1749. doi:10.1016/j.ejca.2011.07.016. PMID:22036874; PMCID: PMC3372624.   Lenders JWM, Eisenhofer G, Mannelli M, Pacak K. Phaeochromocytoma. Lancet. 2005;366(9486):665-675. doi:10.1016/S0140-6736(05)67139-5.   Vicha A, Musil Z, Pacak K. Genetics of pheochromocytoma and paraganglioma syndromes: new advances and future treatment options. Curr Opin Endocrinol Diabetes Obes. 2013;20(3):186-191. doi:10.1097/MED.0b013e32835fcc45. PMID: 23481210; PMCID: PMC4711348. https://pubmed.ncbi.nlm.nih.gov/23481210/ Dickson PV, Alex GC, Grubbs EG, et al. Posterior retroperitoneoscopic adrenalectomy is a safe and effective alternative to transabdominal laparoscopic adrenalectomy for pheochromocytoma. Surgery. 2011;150(3):452-458. doi:10.1016/j.surg.2011.07.004. https://pubmed.ncbi.nlm.nih.gov/21878230/ Lei K, Wang X, Yang Z, et al. Comparison of the retroperitoneal laparoscopic adrenalectomy versus transperitoneal laparoscopic adrenalectomy for large (≥6 cm) pheochromocytomas: a single-centre retrospective study. Front Oncol. 2023;13:1043753. doi:10.3389/fonc.2023.1043753. PMID: 36910608; PMCID: PMC9992891. https://pubmed.ncbi.nlm.nih.gov/36910608/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

The only structure of fetal gastrointestinal tract (GIT) which is seen on routine second trimester anomaly scan is the fetal stomach. Under normal conditions, the fetal stomach "bubble" is seen on the left side of the fetal abdomen. This is a normal finding on an ultrasound and indicates the stomach's normal position. There are two functions of the fetal GIT: 1. Propulsive action by peristalsis which takes the swallowed amniotic fluid up to the small bowel; 2. Absorption – the amniotic fluid is absorbed through the fetal small bowel. When the stomach is found prenatally to be located on the right side, it is called dextrogastria. Today in our high-risk prenatal clinic, we encountered a patient whose fetus was found to have this rare condition dextrogastria. Is this an isolated issue? What does this mean for clinical outcomes. Listen in for details.1. Versteegh HP, Adams SD, Boxall S, Burge DM, Stanton MP. Antenatally diagnosed right-sided stomach (dextrogastria): A rare rotational anomaly. J Pediatr Surg. 2016 Feb;51(2):236-9. doi: 10.1016/j.jpedsurg.2015.10.060. Epub 2015 Nov 4. PMID: 26655213.2. A Case Report Of An Isolated Dextrogastria Diagnosed In First Trimester Ultrasound Screening: https://hjog.org/?p=35403. Docx MKF, Steylemans A, Govaert PIsolated dextrogastria in a newbornArchives of Disease in Childhood - Fetal and Neonatal Edition 2015;100:F513.4. https://www.researchgate.net/publication/43349867_Isolated_dextrogastria_A_case_report5. Aziz, S., König, S., Noor, H. et al. Isolated dextrogastria with eventration of right hemidiaphragm and hiatal hernia in an adult male. BMC Gastroenterol 22, 56 (2022). https://doi.org/10.1186/s12876-022-02127-x

All about gymnastics! We interview Dr. Elspeth Hart from Boston Children's on her latest article on Gymnastics Medicine and what to look out for when treating gymnasts in the orthopedic setting. We also highlight recent articles on the urgency of stable SCFE, a lesser-known method for pinning supracondylar humerus fractures, and short versus long leg casting for distal tibia physeal fractures. Your hosts are Tyler McDonald (University of South Alabama), and Stephanie Logterman (Arnold Palmer Hospital for Children), Josh Holt (University of Iowa), and Carter Clement (Manning Family Children's in New Orleans). Music by A. A. Aalto. Gymnastics Upper Extremity Article mentioned: Hart E, Bauer AS, Bae DS. Common upper extremity gymnastics injuries and gymnastic specific return to play protocols. J Pediatr Soc North Am. 2024 Feb 28;6:100016. doi: 10.1016/j.jposna.2024.100016. PMID: 40433250; PMCID: PMC12088353. Link to the non profit Gymnastics Medicine: Education and Research: GymnasticsMedicine.org Link to learn more about the 7th annual Gymnastics Medicine Symposium (use code "Gym15" to save 15% if interested in signing up!): Symposium 2025 - Gymnastics Medicine   References: 1. Hart E, Bair K, Broz J, Griffith K, Herrera-Set A, Lattimore D, Melvin E, Sweeney E. Gymnastics Medicine: A New Subspecialty in Sports Medicine. Curr Sports Med Rep. 2025 May 1;24(5):126-134. doi: 10.1249/JSR.0000000000001249. PMID: 40323057. 2. White AB, Keil LG, Bardsley H, Selberg C, Mansour A, Brooks AC, Manickam R, Mayassi HA, Zhao L, Uchtman M, Whitlock P, Stone J. How Urgent Are Stable SCFEs? A Multisite Retrospective Study of Surgical Timing and Complications Among Patients With Stable Slipped Capital Femoral Epiphysis. J Pediatr Orthop. 2025 Sep 1;45(8):485-491. doi: 10.1097/BPO.0000000000002997. Epub 2025 May 1. PMID: 40314216. 3. Grewal RS, Kitchen BT, Bomar JD, Cidambi EO, Dexter MJ, Edmonds EW, Pring ME, Upasani VV, Wallace CD, Pennock A. Displaced Distal Tibia Physeal Fractures: Short Leg Versus Long Leg Casting-A Prospective Study. J Pediatr Orthop. 2025 Aug 1;45(7):e614-e617. doi: 10.1097/BPO.0000000000002961. Epub 2025 Apr 7. PMID: 40191914. 4. Muto S, Niwa S, Fujihara Y, Ota H, Kumagai H. Comparative Analysis of Postoperative Rotational Malalignment in Pediatric Supracondylar Humerus Fractures: Cross Pinning Versus Lateral Para-olecranon Pinning. J Pediatr Orthop. 2025 Sep 1;45(8):458-465. doi: 10.1097/BPO.0000000000003000. Epub 2025 May 5. PMID: 40323798.

Did you know that C-Section birth is referenced in Shakespeare's Macbeth? Cesarean Section is the most common laparotomy in the world, and yest we are still learning surprising facts about it. This episode we will summarize 2publications which have recently been released. One is from the American Journal of Perinatology (September 2025 ) and the other is from the AJOG (August 2025 ). Does a primary C-section on a laboring uterus have a different risk of PAS in the subsequent pregnancy compared to a non-labored uterus? And what is the percentage of patients who experience “pain” at time of C-section? Listen in for the surprising data.1. Kashani Ligumsky L, Lopian M, Jeong A, Desmond A, Elmalech A, Many A, Martinez G, Krakow D, Afshar Y. Impact of Labor in Primary Cesarean Delivery on Subsequent Risk of Placenta Accreta. Am J Perinatol. 2025 Sep 16. doi: 10.1055/a-2693-8599. Epub ahead of print. PMID: 40957594.2. Somerstein, Rachel. I feel pain, not pressure: a personal and methodological reflection on pain during cesarean delivery. American Journal of Obstetrics & Gynecology, Volume 0, Issue 0 (EPub Ahead of Print)

In our first episode released in both English and Spanish, Drs. Laila Woc-Colburn and Nicholás Ignacio Valdebenito Farías join Dr. José Pablo Díaz Madriz to discuss the role of the pharmacist in antimicrobial stewardship in Latin America. They discuss the need for growth of antimicrobial stewardship programs across Latin America, how pharmacists can expand their roles to support multidisciplinary antimicrobial stewardship teams, and much more!   Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/. Visit our website! https://breakpoints-sidp.org/ References: Ciapponi A, Bardach A, Sandoval MM, Palermo MC, Navarro E, Espinal C, Quirós R. Systematic review and meta-analysis of deaths attributable to antimicrobial resistance, Latin America. Emerg Infect Dis. 2023 Nov;29(11):2335-44. doi:10.3201/eid2911.230753. PMID:37877573; PMCID:PMC10617342. Antimicrobial Resistance Collaborators. The burden of antimicrobial resistance in the Americas in 2019: a cross-country systematic analysis. Lancet Reg Health Am. 2023 Aug 8;25:100561. doi:10.1016/j.lana.2023.100561. Erratum in: Lancet Reg Health Am. 2023 Nov 10;28:100632. doi:10.1016/j.lana.2023.100632. PMID:37727594; PMCID:PMC10505822. Fabre V, Secaira C, Cosgrove SE, Lessa FC, Patel TS, Alvarez AA, Anchiraico LM, Del Carmen Bangher M, Barberis MF, Burokas MS, Castañeda X, Colque AM, De Ascencao G, Esquivel C, Ezcurra C, Falleroni LA, Frassone N, Garzón MI, Gomez C, Gonzalez JA, Hernandez D, Laplume D, Lemir CG, Maldonado Briones H, Melgar M, Mesplet F, Martinez G, Pertuz CM, Moreno C, Nemirovsky C, Nuccetelli Y, Palacio B, Sandoval N, Vergara H, Videla H, Villamandos S, Villareal O, Viteri A, Quiros R. Deep dive into gaps and barriers to implementation of antimicrobial stewardship programs in hospitals in Latin America. Clin Infect Dis. 2023 Jul 5;77(Suppl 1):S53-S61. doi:10.1093/cid/ciad184. PMID:37406044; PMCID:PMC10321692. Charani E, Smith I, Skodvin B, Perozziello A, Lucet JC, Lescure FX, Birgand G, Poda A, Ahmad R, Singh S, Holmes AH. Investigating the cultural and contextual determinants of antimicrobial stewardship programmes across low-, middle- and high-income countries: a qualitative study. PLoS One. 2019 Jan 16;14(1):e0209847. doi:10.1371/journal.pone.0209847. PMID:30650099; PMCID:PMC6335060. Bavestrello L, Cabello Á, Casanova D. Impact of regulatory measures on antibiotic sales in Chile. Rev Med Chil. 2002 Nov;130(11):1265-72. doi:10.4067/S0034-98872002001100009. ISSN 0034-9887. Díaz-Madriz JP, et al. Impact of a pharmacist-driven antimicrobial stewardship program in a private hospital in Costa Rica. Rev Panam Salud Publica. 2020;44:e57. doi:10.26633/RPSP.2020.57. Díaz-Madriz JP, et al. Impact of a pharmacist-driven antimicrobial stewardship program on the prescription of antibiotics by intensive care physicians in a Latin American hospital: a retrospective study. J Am Coll Clin Pharm. 2022;5(11):1148-55. doi:10.1002/jac5.1708. Domínguez I, et al. Evaluación del consumo de antimicrobianos en 15 hospitales chilenos: resultados de un trabajo colaborativo, 2013. Rev Chil Infectol. 2016 Jun;33(3):307-12. doi:10.4067/S0716-10182016000300010. ISSN 0716-1018. Ministerio de Salud de Chile. Norma general técnica N°210 para la racionalización del uso de antimicrobianos en la atención clínica. Resolución Exenta N°1146, 2020. Disponible en: https://diprece.minsal.cl/wp-content/uploads/2021/01/RES.-EXENTA-N%C2%B01146-Aprueba-Norma-Gral.-Te%CC%81cnica-N%C2%B00210-para-la-racionalizacio%CC%81n-del-uso-de-antimicrobianos-en-la-Atencio%CC%81n-Cli%CC%81nica_v2.pdf

En nuestro primer episodio publicado tanto en inglés como en español, la Dra. Laila Woc-Colburn y el QF. Nicolás Ignacio Valdebenito Farías se unen al Dr. José Pablo Díaz Madriz para hablar sobre el papel del farmacéutico en los PROA en América Latina. Ellos discuten la necesidad de expandir los PROA en toda la región, cómo los farmacéuticos pueden ampliar sus funciones para apoyar equipos multidisciplinarios dedicados a esta labor, ¡y mucho más! Ciapponi A, Bardach A, Sandoval MM, Palermo MC, Navarro E, Espinal C, Quirós R. Systematic review and meta-analysis of deaths attributable to antimicrobial resistance, Latin America. Emerg Infect Dis. 2023 Nov;29(11):2335-44. doi:10.3201/eid2911.230753. PMID:37877573; PMCID:PMC10617342. Antimicrobial Resistance Collaborators. The burden of antimicrobial resistance in the Americas in 2019: a cross-country systematic analysis. Lancet Reg Health Am. 2023 Aug 8;25:100561. doi:10.1016/j.lana.2023.100561. Erratum in: Lancet Reg Health Am. 2023 Nov 10;28:100632. doi:10.1016/j.lana.2023.100632. PMID:37727594; PMCID:PMC10505822. Fabre V, Secaira C, Cosgrove SE, Lessa FC, Patel TS, Alvarez AA, Anchiraico LM, Del Carmen Bangher M, Barberis MF, Burokas MS, Castañeda X, Colque AM, De Ascencao G, Esquivel C, Ezcurra C, Falleroni LA, Frassone N, Garzón MI, Gomez C, Gonzalez JA, Hernandez D, Laplume D, Lemir CG, Maldonado Briones H, Melgar M, Mesplet F, Martinez G, Pertuz CM, Moreno C, Nemirovsky C, Nuccetelli Y, Palacio B, Sandoval N, Vergara H, Videla H, Villamandos S, Villareal O, Viteri A, Quiros R. Deep dive into gaps and barriers to implementation of antimicrobial stewardship programs in hospitals in Latin America. Clin Infect Dis. 2023 Jul 5;77(Suppl 1):S53-S61. doi:10.1093/cid/ciad184. PMID:37406044; PMCID:PMC10321692. Charani E, Smith I, Skodvin B, Perozziello A, Lucet JC, Lescure FX, Birgand G, Poda A, Ahmad R, Singh S, Holmes AH. Investigating the cultural and contextual determinants of antimicrobial stewardship programmes across low-, middle- and high-income countries: a qualitative study. PLoS One. 2019 Jan 16;14(1):e0209847. doi:10.1371/journal.pone.0209847. PMID:30650099; PMCID:PMC6335060. Bavestrello L, Cabello Á, Casanova D. Impact of regulatory measures on antibiotic sales in Chile. Rev Med Chil. 2002 Nov;130(11):1265-72. doi:10.4067/S0034-98872002001100009. ISSN 0034-9887. Díaz-Madriz JP, et al. Impact of a pharmacist-driven antimicrobial stewardship program in a private hospital in Costa Rica. Rev Panam Salud Publica. 2020;44:e57. doi:10.26633/RPSP.2020.57. Díaz-Madriz JP, et al. Impact of a pharmacist-driven antimicrobial stewardship program on the prescription of antibiotics by intensive care physicians in a Latin American hospital: a retrospective study. J Am Coll Clin Pharm. 2022;5(11):1148-55. doi:10.1002/jac5.1708. Domínguez I, et al. Evaluación del consumo de antimicrobianos en 15 hospitales chilenos: resultados de un trabajo colaborativo, 2013. Rev Chil Infectol. 2016 Jun;33(3):307-12. doi:10.4067/S0716-10182016000300010. ISSN 0716-1018. Ministerio de Salud de Chile. Norma general técnica N°210 para la racionalización del uso de antimicrobianos en la atención clínica. Resolución Exenta N°1146, 2020. Disponible en: https://diprece.minsal.cl/wp-content/uploads/2021/01/RES.-EXENTA-N%C2%B01146-Aprueba-Norma-Gral.-Te%CC%81cnica-N%C2%B00210-para-la-racionalizacio%CC%81n-del-uso-de-antimicrobianos-en-la-Atencio%CC%81n-Cli%CC%81nica_v2.pdf

Husband-and-wife team William Firth Wells and Mildred Weeks Wells conducted research that had the potential to make a big difference in the safety of indoor air. But it didn’t really have a significant impact on public health. Research: Associated Press. “Super-Oyster Is On its Way to Dinner Table Bigger and Better Bivalve Sports Pedigree.” 3/13/1927. https://www.loc.gov/resource/sn84020064/1927-03-13/ed-1/?sp=14 “Brought Back to Texas.” The Houston Semi-Weekly Post. 12/26/1889. https://www.newspapers.com/image/1196039760/ Decatur Daily Review. “Scientists Fight Flu Germs with Violet Ray.” 7/30/1936. https://www.newspapers.com/image/94335504/ Evening Star. “Scientific Trap-shooter.” 6/26/1937. https://www.loc.gov/resource/sn83045462/1937-06-26/ed-1/?sp=7&q=William+Firth+Wells&r=0.668,0.557,0.438,0.158,0 Fair, Gordon M. and William Weeks Wells. “Method and Apparatus for Preventing Infection.” U.S. Patent 2,198,867. https://ppubs.uspto.gov/api/pdf/downloadPdf/2198867 Hall, Dominic. “New Center for the History of Medicine Artifact - Wells Air Centrifuge.” Harvard Countway Library. https://countway.harvard.edu/news/new-center-history-medicine-artifact-wells-air-centrifuge “Incubator Is Now Oyster Nurse.” Washington Times. 10/1/1925. https://www.loc.gov/resource/sn84026749/1925-10-01/ed-1/?sp=12 Lewis, Carol Sutton. “Mildred Weeks Wells’s Work on Airborne Transmission Could Have Saved Many Lives—If the Scientific Establishment Listened.” Lost Women of Science Podcast. Scientific American. 5/22/2025. https://www.scientificamerican.com/article/a-public-health-researcher-and-her-engineer-husband-found-how-diseases-can/ Library and Archives Team. “William Firth Wells and Mildred Weeks Wells.” Washington College. https://www.washcoll.edu/people_departments/offices/miller-library/archives-special-collections/archives-blog/Wells%20papers.php Molenti, Megan. “The 60-Year-Old Scientific Screwup That Helped Covid Kill.” Wired. 5/13/2021. https://www.wired.com/story/the-teeny-tiny-scientific-screwup-that-helped-covid-kill/ Perkins JE, Bahlke AM, Silverman HF. Effect of Ultra-violet Irradiation of Classrooms on Spread of Measles in Large Rural Central Schools Preliminary Report. Am J Public Health Nations Health. 1947 May;37(5):529-37. PMID: 18016521; PMCID: PMC1623610. Randall, Katherine and Ewing, E. Thomas and Marr, Linsey and Jimenez, Jose and Bourouiba, Lydia, How Did We Get Here: What Are Droplets and Aerosols and How Far Do They Go? A Historical Perspective on the Transmission of Respiratory Infectious Diseases (April 15, 2021). Available at SSRN: https://ssrn.com/abstract=3829873 Riley, Richard L. “What Nobody Needs to Know About Airborne Infection.” American Journal of Respiratory and Critical Care Medicine. Volume 163, Issue 1. https://www.atsjournals.org/doi/10.1164/ajrccm.163.1.hh11-00 Simon, Clea. “Did a socially awkward scientist set back airborne disease control?” The Harvard Gazette. 3/7/2025. https://news.harvard.edu/gazette/story/2025/03/did-a-socially-awkward-scientist-set-back-airborne-disease-control/ “Texas State News.” McKinney Weekly Democrat-Gazette. 4/17/1890. https://www.newspapers.com/image/65385350/ WELLS MW, HOLLA WA. VENTILATION IN THE FLOW OF MEASLES AND CHICKENPOX THROUGH A COMMUNITY: Progress Report, Jan. 1, 1946 to June 15, 1949, Airborne Infection Study, Westchester County Department of Health. JAMA. 1950;142(17):1337–1344. doi:10.1001/jama.1950.02910350007004 WELLS MW. VENTILATION IN THE SPREAD OF CHICKENPOX AND MEASLES WITHIN SCHOOL ROOMS. JAMA. 1945;129(3):197–200. doi:10.1001/jama.1945.02860370019006 WELLS WF, WELLS MW. AIR-BORNE INFECTION. JAMA. 1936;107(21):1698–1703. doi:10.1001/jama.1936.02770470016004 WELLS WF, WELLS MW. AIR-BORNE INFECTION: SANITARY CONTROL. JAMA. 1936;107(22):1805–1809. doi:10.1001/jama.1936.02770480037010 Wells, W F, and M W Wells. “Measurement of Sanitary Ventilation.” American journal of public health and the nation's health vol. 28,3 (1938): 343-50. doi:10.2105/ajph.28.3.343 Wells, William Firth and Gordon Maskew Fair. Viability of B. coli Exposed to Ultra-Violet Radiation in Air.Science82,280-281(1935).DOI:10.1126/science.82.2125.280.b Wells, William Firth and Mildred Weeks Wells. Measurement of Sanitary Ventilation American Journal of Public Health and the Nations Health 28, 343_350, https://doi.org/10.2105/AJPH.28.3.343 Zimmer, Carl. “Air-Borne: The Hidden History of the Life We Breathe.” Dutton. 2025. See omnystudio.com/listener for privacy information.