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In this episode our team reviews the two groundbreaking RCTs which challenged the long-held dogma that a lobectomy is the only acceptable oncologic procedure for NSCLC. Listen as we compare and contrast the North American CALGB trial and Japanese JCOG trial which were both designed to investigate survival and recurrence outcomes by randomizing stage 1A patients to lobectomy versus a sublobar resection. Learning Objectives: -Compare and contrast the patient characteristics of the CALGB and JCOG trials -Understand the methodology each trial and be able to explain their nuanced differences -Analyze the results of the CALGB and JCOG trials and how they apply to patients today Hosts: Kelly Daus MD, Peter White MD, Eric Vallieres, MD and Brian Louie MD Referenced Material https://pubmed.ncbi.nlm.nih.gov/36780674/ Altorki N, et al. Lobar or Sublobar Resection for Peripheral Stage IA Non-Small-Cell Lung Cancer. N Engl J Med. 2023 Feb 9;388(6):489-498. doi: 10.1056/NEJMoa2212083. PMID: 36780674; PMCID: PMC10036605. https://pubmed.ncbi.nlm.nih.gov/35461558/' Saji H, et al. West Japan Oncology Group and Japan Clinical Oncology Group. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet. 2022 Apr 23;399(10335):1607-1617. doi: 10.1016/S0140-6736(21)02333-3. PMID: 35461558. https://pubmed.ncbi.nlm.nih.gov/37473998/ Altorki N, et al. Lobectomy, segmentectomy, or wedge resection for peripheral clinical T1aN0 non-small cell lung cancer: A post hoc analysis of CALGB 140503 (Alliance). J Thorac Cardiovasc Surg. 2023 Jul 18:S0022-5223(23)00612-8. doi: 10.1016/j.jtcvs.2023.07.008. Epub ahead of print. PMID: 37473998. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our other Cardiothoracic episodes: https://behindtheknife.org/podcast-category/cardiothoracic/
Dr. Zach Cost and Dr. Tem Bendapudi join the show to discuss the literature pertaining to tranexamic acid and thromboembolic risk. Dr. Zach Cost is an anesthesia resident at the Massachusetts General Hospital. Dr. Pavan (“Tem”) Bendapudi holds a joint faculty appointment in the Division of Hematology and Blood Transfusion Service and is assistant professor of medicine at Harvard Medical School. This podcast was recorded as part of the Depth of Anesthesia podcast elective. Thanks for listening! If you enjoy our content, leave a 5-star review on Apple Podcasts and share our content with your colleagues. — Follow us on Instagram @DepthofAnesthesia and on Twitter (X) @DepthAnesthesia for podcast and literature updates. Email us at depthofanesthesia@gmail.com with episode ideas or if you'd like to join our team. Music by Stephen Campbell, MD. — References CRASH-2 trial collaborators; Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, El-Sayed H, Gogichaishvili T, Gupta S, Herrera J, Hunt B, Iribhogbe P, Izurieta M, Khamis H, Komolafe E, Marrero MA, Mejía-Mantilla J, Miranda J, Morales C, Olaomi O, Olldashi F, Perel P, Peto R, Ramana PV, Ravi RR, Yutthakasemsunt S. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010 Jul 3;376(9734):23-32. doi: 10.1016/S0140-6736(10)60835-5. Epub 2010 Jun 14. PMID: 20554319. Henry DA, Carless PA, Moxey AJ, et al. Anti‐fibrinolytic use for minimising perioperative allogeneic blood transfusion. Cochrane Database of Systematic Reviews. 2011;(1). doi:10.1002/14651858.CD001886.pub3 Ker K, Edwards P, Perel P, Shakur H, Roberts I. Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis. BMJ. 2012;344:e3054. doi:10.1136/bmj.e3054 Myles PS, Smith JA, Forbes A, et al. Tranexamic Acid in Patients Undergoing Coronary-Artery Surgery. New England Journal of Medicine. 2017;376(2):136-148. doi:10.1056/NEJMoa1606424 Devereaux PJ, Marcucci M, Painter TW, et al. Tranexamic Acid in Patients Undergoing Noncardiac Surgery. New England Journal of Medicine. 2022;386(21):1986-1997. doi:10.1056/NEJMoa2201171 POISE 3 PeriOperative ISchemic Evaluation-3 (POISE-3) study Shakur H, Roberts I, Fawole B, et al. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum hemorrhage (WOMAN): an international, randomized, double-blind, placebo-controlled trial. The Lancet. 2017;389(10084):2105-2116. doi:10.1016/S0140-6736(17)30638-4 Roberts I, Shakur-Still H, Afolabi A, et al. Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial. The Lancet. 2020;395(10241):1927-1936. doi:10.1016/S0140-6736(20)30848-5 Taeuber I, Weibel S, Herrmann E, et al. Association of Intravenous Tranexamic Acid With Thromboembolic Events and Mortality: A Systematic Review, Meta-analysis, and Meta-regression. JAMA Surgery. 2021;156(6):e210884. doi:10.1001/jamasurg.2021.0884
We first explored the world of Telehealth back in February of 2021 in parts 1 and 2 of our telemedicine series. Telehealth has exploded since then, even after hospitals and clinics opened fully again when COVID restrictions loosened. Drs. Jenny McCormick and Kelly Owen join us to give an update on our very successful telehealth program at UC Davis, Express Care. How is it working for patients? How do physicians like it? Listen to find out! Do you have Telehealth programs where you work? Who staffs it? Let us know on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guests: Dr. Jenny McCormick, Professor of Emergency Medicine and Associate Director of Express Care at UC Davis Health Dr. Kelly Owen, Professor of Emergency, Medical Director Express Care, and Emergency Department Outpatient Operations Director at UC Davis Health Resources: UC Davis Health Express Care Epic: On-Demand Virtual Care Offers Patients Convenience and Value, by Celia Groff Thomas D, Garate D, Fu S, Bashir A, Moss N, Nair M. Telehealth reform post-public health emergency: crucial next steps. Proc (Bayl Univ Med Cent). 2022 Dec 6;36(2):269-271. doi: 10.1080/08998280.2022.2153323. PMID: 36876246; PMCID: PMC9980665.. ***** 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.
Contributor: Meghan Hurley MD Educational Pearls: Pearls about labor: Labor is split into 3 stages. Stage 1 starts when the first persistent contractions are felt and goes up until the cervix is fully dilated and the mother starts pushing. Stage 1 is split into two phases: the latent phase (cervix is dilated from 0-4 cm), and the active phase (cervix dilates from 4-10 cm). The latent phase can take between 6 and 12 hours with contractions happening every 5 to 15 minutes. The active phase usually lasts 4-8 hours with contractions occurring as close as every 3 minutes. Stage 2 is the birth itself, lasting between 20 minutes and 2 hours. Stage 3 is the delivery of the placenta and typically takes 30 minutes. 37 weeks gestational age is the cutoff for preterm. Placenta previa: Condition when the placenta overlies the cervix. Classically presents as painless vaginal bleeding in the 3rd trimester. If suspected placenta previa, avoid a speculum exam. Placenta previa can be confirmed on ultrasound. If the baby is crowning in the ER then the baby should be delivered in the ER. The ideal presentation on crowning is head first (Vertex), specifically ‘left occiput anterior'. In this position, the baby is head first and the head is facing towards the gurney at a slight angle. If the baby is coming out in a breech position then the provider should “elevate the presenting part” by maintaining pressure on the baby as the mother is wheeled to the OR for an emergency C-section. If a vertex-presenting baby is being delivered vaginally, after the head has been delivered an event called ‘restitution' must occur to align the baby's shoulders properly. During this event, the baby goes from facing down towards the gurney to facing sideways. After restitution, the anterior shoulder should be delivered, followed by the posterior. After complete delivery, the cord should be clamped (after a 1-3 minute delay), with something sterile. Gentle downward traction on the cord helps to deliver the placenta. You can place pressure above the pubic bone to prevent the uterus from involuting during this process. This is not the same as a fundal massage which happens after the delivery of the placenta to help the uterus clamp down and prevent postpartum hemorrhage. References Hutchison J, Mahdy H, Hutchison J. Stages of Labor. 2023 Jan 30. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31335010. Lavery JP. Placenta previa. Clin Obstet Gynecol. 1990 Sep;33(3):414-21. doi: 10.1097/00003081-199009000-00005. PMID: 2225572. Qian Y, Ying X, Wang P, Lu Z, Hua Y. Early versus delayed umbilical cord clamping on maternal and neonatal outcomes. Arch Gynecol Obstet. 2019 Sep;300(3):531-543. doi: 10.1007/s00404-019-05215-8. Epub 2019 Jun 15. PMID: 31203386; PMCID: PMC6694086. Summarized by Jeffrey Olson MS2 | Edited by Meg Joyce & Jorge Chalit, OMSII
Découvrez le livre NEUROSAPIENS ! Pour apprendre à créer rapidement et à moindre coût son podcast, c'est par ici ! Production, animation, réalisation et illustration : Anaïs Roux Instagram : https://www.instagram.com/neurosapiens.podcast/ Pour m'écrire : neurosapiens.podcast@gmail.com Produit et distribué en association avec LACME Production. Audio : Play-Doh meets Dora - Carmen María and Edu Espinal Good times - Patrick Patrikios. SOURCES : Franken R, Bekhuis H, Tolsma J. Running Together: How Sports Partners Keep You Running. Front Sports Act Living. 2022 Mar 16;4:643150. doi: 10.3389/fspor.2022.643150. PMID: 35368415; PMCID: PMC8966768. Fitzgerald A., Fitzgerald N., Aherne C. (2012). Do peers matter? A review of peer and/or friends' influence on physical activity among American adolescents. J. Adolesc. 35, 941–958. 10.1016/j.adolescence.2012.01.002.
Many women want to lose weight. To lose weight for active women over 40, they also don't want performance to deteriorate. There are a few things to consider. First, it's not the eat less, exercise more dogma that will get you what you really want. Most women want energy, tone and definition, and strength for now and later. Better blood sugar control that supports reductions in belly fat and overall insulin sensitivity. Am I right? But eating less and exercising more - if successful at all during menopause and post - will generally cause the opposite. Less energy, worse mood, poor sleep, less muscle tone, and spirals down from there with long term ramifications to health. Being active, whether sports performance level or just athletic active, requires energy. There is still a way to juggle goals of maintaining or improving performance while still dropping a few pounds of extra cushioning. Eating to Lose Weight Active Over 40 Close to the beginning and/or after completion of exercise, peri- and postmenopausal athletes should aim for a bolus of high EAA-containing (~10 g) intact protein sources or supplements to overcome anabolic resistance. Anabolic resistance is the status of muscle loss being more likely than muscle gain and it requires more intense exercise stimulus (strength training), quality protein stimulus, and recovery to overcome it. An ACSM review of literature stated 20 g protein pre-exercise (and 40 after) for older adults to boost Muscle Protein Synthesis similar to that of a 20 yr old when workout conditions were comparable. Time pre-exercise fuel for optimal digestion. Within 30 minutes of a workout the easier to digest fuel must be. It's not only a comfort factor, but also the diverted energy for digestion competing with the need for blood flow to deliver oxygen to working muscles. Both digestion and performance will suffer. A “simple shake” with protein powder and unsweetened almond milk or water may be the easy way to go. If you want carbs, add a half a banana to the shake or have half cup oatmeal with protein powder. Pre-workout, avoid fiber and fat. A mixed meal eaten pre-workout should allow at least 2 ½ - 3 hours to be fully digested. Some will feel most comfortable if this is longer than that (4 hours) if it's following recommendations for high fiber, high protein and high fat. Given recommendations range from at least 10 to 20 grams of protein pre-workout, below are some examples of protein sources. The more challenged you are with gaining lean muscle (and or are attempting to lose weight while retaining muscle) the higher end of the range you want to be. Lose Weight for Active Women: Women's Guide to Exercise Nutrition High EAA examples of 10 g protein: Small half a simple shake including protein powder and unsweetened almond milk Dairy (which does by the way include whey protein) generally pre-exercise wouldn't be recommended due to its influence in mucus production, even if you tolerate which a lot of women don't later in life (but Greek yogurt or cottage cheese are sources of protein- again I don't recommend pre-exercise). · 2 eggs equal 12 grams of protein (if you tolerate eggs) · ½ cup steel cut oats with protein stirred in · Quinoa Choices vary as to whether you want carbohydrate prior or not to avoid early fatigue during exercise sessions. Overcoming Anabolic Resistance: A study in the European Journal of Sports Science found higher protein intakes (2-3 times the protein Recommended Dietary Allowance (RDA) of 0.8 g/kg/d) during periods of energy restriction can enhance fat-free mass (FFM) preservation, particularly when combined with exercise. Athletes [and let's include, the very active] aiming to reduce fat mass and preserve FFM should consume protein intakes in the range of ∼1.8-2.7 g kg(-1) d(-1) (or ∼2.3-3.1 g kg(-1) FFM) in combination with a moderate energy deficit (-500 kcal) and the performance of some form of resistance exercise. What does that look like for you? Say you weigh 130lbs. Rounding Kgs up to 60. Based on body weight: 162 g protein Using the FFM example: Say you weigh 130lbs and are 25% body fat. Subtracting the fat weight in lbs (32.5) from bodyweight leaves 97.5 Fat Free Mass. 224 g Using the high range number for each of body weight and FFM-based protein recommendations, the daily protein recommendation then would be 162 – 224 grams of protein daily. That is with the goal of losing weight while resistance training with a moderate calorie deficit. Taking a median number of 180 g protein with each gram of protein offering 4 kcals means you'd be taking in 720 kcals/day from protein. Fat = 7 kcals, Carb = 4 kcals. Prepare to be confused. Health Organizations Weigh in (Not necessarily on losing weight) Prestigious Organizations Offer These Calculations for a 130lb active woman: American Dietetic Association (ADA): at least 59 - 106 grams/day. The Centers for Disease Control and Prevention (CDC): 48 - 169 grams/day (10-35% of daily caloric intake). World Health Organization safe lower limit: 49 grams/day. Keep in mind these recommendations vary in goal. The least amount of protein to avoid death or illness is not the same to thrive and add lean muscle, strength and energy. We have a gap. So, it is of course confusing. We also have emotional relationships to food and beliefs we've held for a long time. Those too are likely factors in your reaction to this episode. You're nodding or shaking. Even though the science is the basis of the content, we don't as humans adopt it readily. Say You Don't Want to Lose Weight You Want to Maintain Daily protein intake should fall within the mid- to upper ranges of current sport nutrition guidelines (1.4-2.2 g·kg-1·day-1) for women at all stages of menstrual function (pre-, peri-, post-menopausal, and contraceptive users) with protein doses evenly distributed, every 3-4 h, across the day. Eumenorrheic athletes in the luteal phase and peri/post-menopausal athletes, regardless of sport, should aim for the upper end of the range. Let's do the math. 130lb woman Convert to kg: 59 129 g protein 150lb woman Convert to kg: 68 149 g protein This is the equivalent of 1 g protein per lb of body weight. You can keep it easy by remembering that is your daily AND that a “dose” of protein needs to be at least 30gm at a meal. However, if you go higher as suggested for your first meal of the day, the next meal may not need to be as high if you eat within 3-4 hours to keep that muscle protein synthesis up. The alternative is muscle protein breakdown. You're in one or the other. There's really not a neutral. To Lose Weight for Active Women, Examples of a day of high protein meals: Pre-Workout: 20 gm protein in a simple shake pre-workout Or minimally, 12 gm protein in two eggs pre-workout Meal Examples: 45g protein in a post- workout smoothie 51g Salmon (35) + quinoa (6) + Greek-style yogurt (10) with berries 43g Taco Salad with ground Bison (35) + Black beans (8) 46g 6 large Sauteed Scallops (29) + Three-bean salad (8) + Black Bean Brownie (9) I'm not an advocate of calorie counting. However, a snapshot of the number of calories you take in can be helpful. Many women are too far below what they need, AND too low in protein, AND not lifting weights with adequate intensity or sleeping. Those will add up to muscle loss. You may temporarily think you're successful at the weight loss game, but unless you mitigate it, muscle loss will result in you feeling weaker, less energetic and having a slower metabolism Weight loss with an on-target activity plan means having a slight caloric deficit with an increased amount of protein from a maintenance phase. Other research I've shared suggests increasing protein by 10-15% above maintenance along with a reasonable deficit if weight loss is needed. So, let's challenge that. Do you need weight loss? Or do you need to gain lean muscle? Get very clear. You may need both but someone listening needs to hear this: you don't need weight loss; you need fat loss. That will come with an increase in lean muscle and a decrease in inflammation. Additionally, to Lose Weight While Active Over 40 Creatine supplementation of 3 to 5 g per day is recommended for the mechanistic support of creatine supplementation with regard to muscle protein kinetics, growth factors, satellite cells, myogenic transcription factors, glycogen and calcium regulation, oxidative stress, and inflammation. Postmenopausal females benefit from bone health, mental health, and skeletal muscle size and function when consuming higher (5g) doses of creatine. References: Murphy CH, Hector AJ, Phillips SM. Considerations for protein intake in managing weight loss in athletes. Eur J Sport Sci. 2015;15(1):21-8. doi: 10.1080/17461391.2014.936325. Epub 2014 Jul 11. PMID: 25014731. Hector AJ, Phillips SM. Protein Recommendations for Weight Loss in Elite Athletes: A Focus on Body Composition and Performance. Int J Sport Nutr Exerc Metab. 2018 Mar 1;28(2):170-177. doi: 10.1123/ijsnem.2017-0273. Epub 2018 Feb 19. PMID: 29182451. Sims ST, Kerksick CM, Smith-Ryan AE, Janse de Jonge XAK, Hirsch KR, Arent SM, Hewlings SJ, Kleiner SM, Bustillo E, Tartar JL, Starratt VG, Kreider RB, Greenwalt C, Rentería LI, Ormsbee MJ, VanDusseldorp TA, Campbell BI, Kalman DS, Antonio J. International society of sports nutrition position stand: nutritional concerns of the female athlete. J Int Soc Sports Nutr. 2023 Dec;20(1):2204066. doi: 10.1080/15502783.2023.2204066. Science: PMID: 37221858; PMCID: PMC10210857. Resources: 5 Day Flip: https://www.flippingfifty.com/5dayflip Flipping 50 Cafe Membership: https://www.flippingfifty.com/cafe/ Flipping 50 Protein: https://www.flippingfifty.com/store/protein-powders/paleo-protein-powder-vanilla/ Other Episodes You Might Like: How Much Collagen Counts Toward Protein Needs? https://www.flippingfifty.com/how-much-collagen/ Protein Supplements for Muscle Building: What, When & Why to Exercise for Women 40+ https://www.flippingfifty.com/protein-supplements-for-muscle-building/ Midlife Weight Loss: Burn Body Fat, Balance Your Hormones https://www.flippingfifty.com/midlife-weight-loss/
Dr Lou Halamek joins Julie Arafeh in a discussion on the use of debriefing to improve team performance, including strategies and tactics for more effective and efficient debriefings.Here are some useful references to review:Halamek LP, Cady R, Sterling MR. Using briefing, simulation and debriefing to improve human and system performance. Semin Perinatol 2019;43(8):151178. Epub 2019 Aug 10. PMID 31500845Chitkara R, Bennett M, Bohnert J, Yamada N, Fuerch J, Halamek LP, Quinn J, Padua K, Gould J, Profit J, Xu X, Lee HC. In situ simulation and clinical outcomes in infants born preterm. J Pediatr. 2023 Aug 31:113715. doi: 10.1016/j.jpeds.2023.113715. Epub ahead of print. PMID: 37659586Sawyer T, Loren D, Halamek LP. Post-event debriefings during neonatal care: Why aren't we doing them, and how can we start? J Perinatol 2016;36(6):415-419. PMID: 27031321https://cape.stanford.edu/programs/BannerPage.html
Menopausal vasomotor symptoms occur in about 80% of women and have a significant impact on quality of life. Hormone replacement therapy works well; however, it is often underused. Join host, Geoff Wall, as he evaluates Fezolinetant, a new medication to treat 'hot flashes.' The GameChangerHRT is vastly underused in menopausal women. Gabapentin and SNRIs may help with some vasomotor symptoms. Fezolinetant is effective for hot flashes and seems to be well tolerated. HostGeoff Wall, PharmD, BCPS, FCCP, BCGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint Health ReferenceLederman S, Ottery FD, Cano A, et al. Fezolinetant for treatment of moderate-to-severe vasomotor symptoms associated with menopause (SKYLIGHT 1): a phase 3 randomised controlled study. Lancet. 2023 Apr 1;401(10382):1091-1102. doi: 10.1016/S0140-6736(23)00085-5. Epub 2023 Mar 13. PMID: 36924778.https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00085-5/fulltext Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE Information Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Discuss the pros and cons of hormone replacement therapy in women with vasomotor symptoms.2. Discuss the role of fezolinetant for treatment of vasomotor symptoms. 0.05 CEU/0.5 HrUAN: 0107-0000-23-365-H01-PInitial release date: 11/27/2023Expiration date: 11/27/2024Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagramDownload the CEimpact App for Free Continuing Education + so much more!
Join @jmusgravept today on the Daily Show as he discusses how to balance infusing patient care with hope with the reality of their recovery. Take a listen or check out the full transcript with show notes on our blog (www.ptonice.com/blog) or on your favorite podcast app. Psychol Sci.2007 Feb;18(2):165-71. doi: 10.1111/j.1467-9280.2007.01867.x. Mind-set matters: exercise and the placebo effect Alia J Crum 1, Ellen J Langer Affiliations expand PMID: 17425538 DOI: 10.1111/j.1467-9280.2007.01867.x *If you want more helpful content to better serve older adults, sign up for our MMOA Digest = Free Bi-Weekly Email packed with helpful links, posts, & research relevant to your work. Link In Bio or PTonICE.com **Looking for CEU's & courses that will change your practice? Check out our MMOA Course Offerings (Online & Live) Link In Bio or PTonICE.com #physicaltherapy #geript #homehealthpt #pt #dpt #dptstudent #physiotherapy #physicaltherapist #physiotherapist #physicaltherapystudent #newgradpt #physiotherapystudent #physicaltherapyassistant #physicaltherapyassistantstudent #geript #geriot #OTs #OTA #occupationaltherapist #ottreatmentideas #otstudent #otastudent #occupationaltherapyassistant #oldnotweak #ptonice #icetrained
Speech Language Pathology: Continuing Education Courses by SLP Nerdcast Course Title: Speech Therapy Through a Psychosocial and Trauma-Informed LensGet .1 ASHA CEU and view the full course landing page: https://courses.slpnerdcast.com/courses/speech-therapy-through-a-psychosocial-and-trauma-informed-lens-abje0125Earning Speech-Language Pathology CEUs Online is Simplified with SLP Nerdcast. On SLP Nerdcast you'll find SLP Continuing Education Courses, Masterclasses and Clinical Resources. To learn more about our services visit ▶ https://bit.ly/SLPNERDCAST To learn more about our membership and save 10% on your first year of membership visit ▶ https://bit.ly/SLPNerdcastMembership use code “YouTubeNerd” to save.Learning Objectives:Describe the psychosocial & trauma informed approach to speech therapyDescribe how speech therapy fits within a bottom-up brain-based frameworkIdentify at least 3 psychosocial factors that can impact: the therapeutic relationship, communication development and learning the use of our communication skillsReferences & Resources:Goddard, A. (2021). Adverse Childhood Experiences and Trauma-Informed Care. Journal of Pediatric Health Care, 35(2), 145-155. https://doi.org/10.1016/j.pedhc.2020.09.001.LaGrange, E. P. (2022, May 23). The Relentless Hurt of Trauma. The ASHA LeaderLive Speech-Language Pathology. https://leader.pubs.asha.org/doi/10.1044/leader.SPS.27052022.18Brumfitt S. Psychosocial aspects of aphasia: speech and language therapists' views on professional practice. Disabil Rehabil. 2006 Apr 30;28(8):523-34. doi: 10.1080/09638280500219349. PMID: 16513585.McLean, S. (2016). The effect of trauma on the brain development of children: Evidence-based principles for supporting the recovery of children in care (CFCA Practitioner Resource). Melbourne: Child Family Community Australia information exchange, Australian Institute of Family Studies.Binns AV, Hutchinson LR, Cardy JO. The speech-language pathologist's role in supporting the development of self-regulation: A review and tutorial. J Commun Disord. 2019 Mar-Apr;78:1-17. doi: 10.1016/j.jcomdis.2018.12.005. Epub 2018 Dec 21. PMID: 30605734.
Découvrez le livre NEUROSAPIENS ! Pour apprendre à créer rapidement et à moindre coût son podcast, c'est par ici ! Bonjour et bienvenue dans la partie 2 de notre saga sur l'alimentation ! La semaine dernière, nous avons abordé le sujet de la psychonutrition, soit l'impact de l'alimentation sur la santé mentale. Cette semaine, et parce que ce podcast ne s'appelle pas Neurosapiens pour rien, on va aller voir l'impact de l'alimentation sur le cerveau, sur nos fonctions cognitives. On va aussi regarder quel impact la vision de la nourriture a sur notre cerveau, comment nos goûts alimentaires se forment et enfin pourquoi se retenir de manger n'est vraiment pas si simple que ça. Production, animation, réalisation et illustration : Anaïs Roux Instagram : https://www.instagram.com/neurosapiens.podcast/ neurosapiens.podcast@gmail.com Produit et distribué en association avec LACME Production. _________ Musique KEEP ON GOING Musique proposée par La Musique Libre Joakim Karud - Keep On Going : https://youtu.be/lOfg0jRqaA8 Joakim Karud : https://soundcloud.com/joakimkarud ONE NIGHT AWAY Musique de Patrick Patrikios _________ Sources : Baym CL, Khan NA, Monti JM, Raine LB, Drollette ES, Moore RD, Scudder MR, Kramer AF, Hillman CH, Cohen NJ. Dietary lipids are differentially associated with hippocampal-dependent relational memory in prepubescent children. Am J Clin Nutr. 2014 May;99(5):1026-32. doi: 10.3945/ajcn.113.079624. Epub 2014 Feb 12. PMID: 24522447; PMCID: PMC3985209. Cole, Joanne. The findings of the study has be presented by Dr. Cole at NUTRITION 2023, an annual event organized by the American Society for Nutrition in Boston. Schiff HC, Kogan JF, Isaac M, Czarnecki LA, Fontanini A, Maffei A. Experience-dependent plasticity of gustatory insular cortex circuits and taste preferences. Sci Adv. 2023 Jan 13;9(2):eade6561. doi: 10.1126/sciadv.ade6561. Epub 2023 Jan 11. PMID: 36630501; PMCID: PMC9833665. Andersen, T., et al. (2023) Imagined eating - An investigation of priming and sensory-specific satiety. Appetite. doi.org/10.1016/j.appet.2022.106421.
In this short episode I pick on the notion of self-compassion from the discussion with Mark Reed last week, and go back to Kristin Neff's work and other related self-compassion researcher to unpack the three components of self-compassion and some practices for cultivating self-compassion and also point to some of the research evidence base for the benefits of self-compassion. I also share my own experience in needing to apply self-compassion this week. Overview:00:29 Introduction01:27 Replaying Mark Reed on self-compassion02:26 An overview of self-compassion06:37 Examples of self-compassion practices08:24 My self-compassion experience11:25 Example research evidence base17:45 Back to Mark20:24 EndFor transcript to follow automatically with the audio: https://share.descript.com/view/JxbMM1C5ZIZ Related Links:The podcast conversation with Mark Reed Kristin Neff's Self-Compassion web page https://self-compassion.orgNeff, K., Hsieh, Y. & Dejitterat, K. Self-compassion, Achievement Goals, and Coping with Academic Failure. Self and Identity, 4, 263-287, 2005. DOI: 10.1080/13576500444000317 Zessin, U., Dickhäuser, O. & Garbade, S. The Relationship Between Self-Compassion and Well-Being: A Meta-Analysis. Health and Well-Being, 7(3), 340-364 2015Ewert, C., Vater, A. & Schröder-Abé, M. Self-Compassion and Coping: a Meta-Analysis. Mindfulness 12, 1063–1077 (2021). https://doi.org/10.1007/s12671-020-01563-8Lee, K.J., Lee, S.M. The role of self-compassion in the academic stress model. Curr Psychol41, 3195–3204 (2022).https://doi.org/10.1007/s12144-020-00843-9Dreisoerner, A., Klaic, A., van Dick, R. et al. Self-Compassion as a Means to Improve Job-Related Well-Being in Academia. J Happiness Stud 24, 409–428 (2023). https://doi.org/10.1007/s10902-022-00602-6Phillips WJ, Hine DW. Self-compassion, physical health, and health behaviour: a meta-analysis. Health Psychol Rev. 2021 Mar;15(1):113-139. Doi:10.1080/17437199.2019.1705872. Epub 2019 Dec 22. PMID: 31842689.Neff, K. Self-Compassion: Theory, Method, Research, and Intervention. Annu. Rev. Psychol. 2023. 74:193–218. Acknowledgement: Episode artwork image of person hugging themselves: Photo by Hala Al-Asadi on
In the seventh episode of this season of The Psych Review the team dig into two papers. Dave reviews recent evidence that compares ketamine and ECT in the treatment of depression, and Alanna investigates the link between prolactin elevating antipsychotics and breast cancer.The references for this episode are:Dave: Anand. A et al. Ketamine versus ECT for nonpsychotic treatment-resistant major depression. The New England Journal of Medicine. 2023 June; 388(25):2315:2324.Alanna: Hope JD, Keks NA, Copolov DL. Association between long-term use of prolactin-elevating antipsychotics in women and the risk of breast cancer: What are the clinical implications? Australas Psychiatry. 2023 Apr;31(2):205-208. doi: 10.1177/10398562231158925. Epub 2023 Mar 17. PMID: 36927059; PMCID: PMC10088343.The Psych Review was brought to you by Call to Mind, a telepsychiatry service that you can learn more about at www.calltomind.com.au. The original music in our podcast was provided by the very talented John Badgery, and our logo was designed by the creative genius of Naz.
Respiratory failure from COVID-19 should be treated as soon as possible. Join host, Geoff Wall, as he evaluates the the role of convalescent plasma in treating patients with COVID-19 and on mechanical ventilation. The GameChangerCOVID-19 is still a significant concern acutely and for long-term complications. Convalescent plasma may benefit severely ill COVID-19 patients on mechanical ventilation and with acute respiratory distress syndrome (ARDS). HostGeoff Wall, PharmD, BCPS, FCCP, BCGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint Health ReferenceMisset B, Piagnerelli M, Hoste E, Dardenne N, Grimaldi D, Michaux I, De Waele E, Dumoulin A, Jorens PG, van der Hauwaert E, Vallot F, Lamote S, Swinnen W, De Schryver N, Fraipont V, de Mey N, Dauby N, Layios N, Mesland JB, Meyfroidt G, Moutschen M, Compernolle V, Gothot A, Desmecht D, Taveira da Silva Pereira MI, Garigliany M, Najdovski T, Bertrand A, Donneau AF, Laterre PF. Convalescent Plasma for Covid-19-Induced ARDS in Mechanically Ventilated Patients. N Engl J Med. 2023 Oct 26;389(17):1590-1600. doi: 10.1056/NEJMoa2209502. Epub 2023 Oct 25. PMID: 37889107.https://www.nejm.org/doi/full/10.1056/NEJMoa2209502?query=featured_home Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE Information Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Discuss the latest NIH treatment guidelines for COVID-19 patients who are hospitalized2. Describe the use of convalescent plasma in the context of a COVID-19 treatment algorithm0.05 CEU/0.5 HrUAN: 0107-0000-23-354-H01-P Initial release date: 11/20/2023Expiration date: 11/20/2024Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagramDownload the CEimpact App for Free Continuing Education + so much more!
Contributor: Jared Scott MD Educational Pearls: Should we use opioids to treat low back and neck pain? The OPAL Trial, published in The Lancet, in June 2023, attempted to answer this very question. Objective: Investigate the efficacy and safety of a short course of opioid analgesic (oxycodone-naloxone) for acute low back pain and neck pain. Trial Design: Triple-blinded, placebo-controlled randomized trial, conducted in Emergency and Primary Care in Sydney, Australia, involving adults with 12 weeks or less of low back or neck pain. Participants: 347 recruited adults (174 in the opioid group, 173 in the placebo group) with at least moderate pain severity. Intervention: Participants were assigned to receive either an opioid or a placebo for up to 6 weeks. Primary Outcome: Pain severity at 6 weeks measured with the pain severity subscale of the Brief Pain Inventory (10-point scale). Results: No significant difference in pain severity at 6 weeks between the opioid group (mean score 2.78) and placebo group (mean score 2.25). Adverse events were reported by 35% in the opioid group and 30% in the placebo group, with more opioid-related adverse events in the opioid group (e.g., constipation). Conclusion: Opioids should not be recommended for acute non-specific low back pain or neck pain, as there was no significant difference in pain severity compared with the placebo. The study calls for a change in the frequent use of opioids for these conditions. Pharmacy Pearl: Why was naloxone mixed with oxycodone? Naloxone is an opioid receptor antagonist, meaning it can block the effects of opioids. When combined with oxycodone, naloxone's presence discourages certain forms of opioid misuse. Additionally, naloxone can bind to opioid receptors in the gut and improve symptoms of Opioid Induced Constipation (OIC). This is the same idea behind Suboxone (buprenorphine/naloxone). References Jones CMP, Day RO, Koes BW, Latimer J, Maher CG, McLachlan AJ, Billot L, Shan S, Lin CC; OPAL Investigators Coordinators. Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial. Lancet. 2023 Jul 22;402(10398):304-312. doi: 10.1016/S0140-6736(23)00404-X. Epub 2023 Jun 28. Erratum in: Lancet. 2023 Aug 19;402(10402):612. PMID: 37392748. Camilleri M, Lembo A, Katzka DA. Opioids in Gastroenterology: Treating Adverse Effects and Creating Therapeutic Benefits. Clin Gastroenterol Hepatol. 2017 Sep;15(9):1338-1349. doi: 10.1016/j.cgh.2017.05.014. Epub 2017 May 19. PMID: 28529168; PMCID: PMC5565678. Summarized by Jeffrey Olson MS2 | Edited by Jorge Chalit, OMSII
What is the best surgical treatment for a vasculopathy with critical limb threatening ischemia? In this episode of Behind the Knife the vascular surgery subspecialty team discusses two pivotal trials (BEST-CLI and BASIL-2) and how the findings of these trials can help answer this question. In this episode, we will discuss the age old question: open bypass versus best endovascular treatment. Hosts: Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan Dr. Frank Davis is an Assistant Professor of Vascular Surgery at the University of Michigan Dr. David Schechtman is a Vascular Surgery Fellow at the University of Michigan Dr. Drew Braet is a PGY-4 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives Review the definition, prevalence, and prognosis of critical limb threatening ischemia Review basic treatment options for patients with critical limb threatening ischemia Understand the methodology, findings, limitations, and clinical applications of the BEST-CLI trial Understand the methodology, findings, limitations, and clinical applications of the BASIL-2 trial Compare open bypass and best endovascular therapy for patients with critical limb threatening ischemia References Farber A, Menard MT, Conte MS, Kaufman JA, Powell RJ, Choudhry NK, Hamza TH, Assmann SF, Creager MA, Cziraky MJ, Dake MD, Jaff MR, Reid D, Siami FS, Sopko G, White CJ, van Over M, Strong MB, Villarreal MF, McKean M, Azene E, Azarbal A, Barleben A, Chew DK, Clavijo LC, Douville Y, Findeiss L, Garg N, Gasper W, Giles KA, Goodney PP, Hawkins BM, Herman CR, Kalish JA, Koopmann MC, Laskowski IA, Mena-Hurtado C, Motaganahalli R, Rowe VL, Schanzer A, Schneider PA, Siracuse JJ, Venermo M, Rosenfield K; BEST-CLI Investigators. Surgery or Endovascular Therapy for Chronic Limb-Threatening Ischemia. N Engl J Med. 2022 Dec 22;387(25):2305-2316. doi: 10.1056/NEJMoa2207899. Epub 2022 Nov 7. PMID: 36342173. https://pubmed.ncbi.nlm.nih.gov/36342173/ Bradbury AW, Moakes CA, Popplewell M, Meecham L, Bate GR, Kelly L, et al. A vein bypass first versus a best endovascular treatment first revascularisation strategy for patients with chronic limb threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal revascularisation procedure to restore limb perfusion (BASIL-2): an open-label, randomised, multicentre, phase 3 trial. The Lancet. 2023. 401(10390), 1798-1809. https://doi.org/10.1016/S0140-6736(23)00462-2 Conte MS Bradbury AW Kolh P et al. Global vascular guidelines on the management of chronic limb-threatening ischemia. Eur J Vasc Endovasc Surg. 2019; 58 (109.e33.): S1-109 https://pubmed.ncbi.nlm.nih.gov/31182334/ Bradbury AW Adam DJ Bell J et al. Multicentre randomised controlled trial of the clinical and cost-effectiveness of a bypass-surgery-first versus a balloon-angioplasty-first revascularisation strategy for severe limb ischaemia due to infrainguinal disease. The bypass versus angioplasty in severe ischaemia of the leg (BASIL) trial. Health Technol Assess. 2010; 14: 1-210 https://pubmed.ncbi.nlm.nih.gov/20307380/ Adam DJ Beard JD Cleveland T et al. Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trial. Lancet. 2005; 366: 1925-1934 https://pubmed.ncbi.nlm.nih.gov/16325694/ Bradbury AW Adam DJ Bell J et al. Bypass versus angioplasty in severe ischaemia of the leg (BASIL) trial: an intention-to-treat analysis of amputation-free and overall survival in patients randomized to a bypass surgery-first or a balloon angioplasty-first revascularization strategy. J Vasc Surg. 2010; 51: 5S-17 https://pubmed.ncbi.nlm.nih.gov/20435258/ Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH; GVG Writing Group. Global vascular guidelines on the management of chronic limb-threatening ischemia. J Vasc Surg. 2019 Jun;69(6S):3S-125S.e40. doi: 10.1016/j.jvs.2019.02.016. Epub 2019 May 28. Erratum in: J Vasc Surg. 2019 Aug;70(2):662. PMID: 31159978; PMCID: PMC8365864. https://pubmed.ncbi.nlm.nih.gov/31159978/ Menard MT, Rosenfield K, Farber A. The BEST-CLI Trial: Implications of the Primary Results. Eur J Vasc Endovasc Surg. 2023 Mar;65(3):317-319. doi: 10.1016/j.ejvs.2022.12.032. Epub 2023 Jan 6. PMID: 36621707. https://pubmed.ncbi.nlm.nih.gov/36621707/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other vascular surgery episodes: https://behindtheknife.org/podcast-category/vascular/
This is the next episode of our Push Dose Pearls miniseries with ED Pharmacist, Chris Adams. In this ongoing series we'll dig into some of the questions we all have about medications we commonly see and use in the ED. This episode again focuses on common antibiotics we use in the ED. What has changed and what are the latest recommendations? We'll answer these questions and more! Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guests: Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and Assistant Professor at UC Davis Resources: CDC STI Treatment Guidelines Metlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST. PMID: 31573350; PMCID: PMC6812437. ACEP EMRA Antibiotic Guide. *** 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.
João e Fred discutem sobre tratamento de pneumonia, incluindo as diferenças de tratmento do paciente internado e o paciente ambulatorial, quando usar terapia dupla e uso de corticoide. Referências: 1. Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, Cooley LA, Dean NC, Fine MJ, Flanders SA, Griffin MR, Metersky ML, Musher DM, Restrepo MI, Whitney CG. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST. PMID: 31573350; PMCID: PMC6812437. 2. Martin-Loeches I, Torres A, Nagavci B, Aliberti S, Antonelli M, Bassetti M, Bos LD, Chalmers JD, Derde L, de Waele J, Garnacho-Montero J, Kollef M, Luna CM, Menendez R, Niederman MS, Ponomarev D, Restrepo MI, Rigau D, Schultz MJ, Weiss E, Welte T, Wunderink R. ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia. Intensive Care Med. 2023 Jun;49(6):615-632. doi: 10.1007/s00134-023-07033-8. Epub 2023 Apr 4. Erratum in: Intensive Care Med. 2023 May 17;: PMID: 37012484; PMCID: PMC10069946. 3. Corrêa RA, Costa AN, Lundgren F, Michelin L, Figueiredo MR, Holanda M, Gomes M, Teixeira PJZ, Martins R, Silva R, Athanazio RA, Silva RMD, Pereira MC. 2018 recommendations for the management of community acquired pneumonia. J Bras Pneumol. 2018 Sep-Oct;44(5):405-423. doi: 10.1590/S1806-37562018000000130. Erratum in: J Bras Pneumol. 2018 Nov-Dec;44(6):532. Erratum in: J Bras Pneumol. 2019 May 13;45(2):e20180130. PMID: 30517341; PMCID: PMC6467584. 4. Dequin PF, Meziani F, Quenot JP, Kamel T, Ricard JD, Badie J, Reignier J, Heming N, Plantefève G, Souweine B, Voiriot G, Colin G, Frat JP, Mira JP, Barbarot N, François B, Louis G, Gibot S, Guitton C, Giacardi C, Hraiech S, Vimeux S, L'Her E, Faure H, Herbrecht JE, Bouisse C, Joret A, Terzi N, Gacouin A, Quentin C, Jourdain M, Leclerc M, Coffre C, Bourgoin H, Lengellé C, Caille-Fénérol C, Giraudeau B, Le Gouge A; CRICS-TriGGERSep Network. Hydrocortisone in Severe Community-Acquired Pneumonia. N Engl J Med. 2023 May 25;388(21):1931-1941. doi: 10.1056/NEJMoa2215145. Epub 2023 Mar 21. PMID: 36942789.
Se ha viralizado un vídeo que dice que el salmón es tóxico. Una vez más dedico el podcast a desmentir estos bulos y falsas creencias que personajes como el autor del vídeo se dedican a divulgar. No tengáis miedo al salmón y mucho menos, dejéis de comerlo. El autor del vídeo cita 3 fuentes con 3 conclusiones, que son las siguientes:Estudio → PMID: 11999769 → “Los consumidores frecuentes de salmón de piscifactoría excedan los límites para la salud de muchos contaminantes como dioxinas, PCBs, plaguicidas… Relacionados con el daño al sistema inmunológico, neurológico, fetal, cáncer...".Estudio → PMID: 14716013 → “Un estudio que analizó 700 muestras de salmón de todo el mundo, reveló que el salmón de piscifactoría tenía 8 veces más concentraciones de PCB que el pescado salvaje”.Estudio → PMID: 15866762 → “el consumo de salmón de piscifactoría a frecuencias relativamente bajas da como resultado una exposición elevada a dioxinas y compuestos similares con una elevación proporcional en las estimaciones de riesgo para la salud”.Los 3 están desactualizados y tienes un método de estudio de baja fiabilidad. Sin embargo hay otros estudios más actuales que desmienten todo esto: PMID: 28189073 → El presente estudio determinó dioxinas, PCB, PBDE, OCP, metales y ácidos grasos en salmón del Atlántico salvaje y de piscifactoría. Los niveles contaminantes de dioxinas, PCB, OCP (DDT, dieldrín, lindano, clordano, Mirex y toxafeno) y mercurio fueron mayores en el salmón salvaje que en el salmón de piscifactoría, al igual que las concentraciones de los elementos esenciales selenio, cobre, zinc y hierro. y el ácido graso marino omega-3 ácido docosahexaenoico (DHA). [...]. El contenido total de grasa fue significativamente mayor en el salmón de piscifactoría que en el salvaje debido a un mayor contenido de ácidos grasos saturados y monoinsaturados, así como a un mayor contenido de ácidos grasos omega-6. Las concentraciones de contaminantes en el salmón del Atlántico estaban muy por debajo de los niveles máximos aplicables en la Unión Europea. El salmón del Atlántico, tanto de piscifactoría como salvaje, es una buena fuente de EPA y DHA, con una porción de 200 g por semana que aporta 3,2 g o 2,8 g respectivamente, siendo casi el doble de la ingesta considerada adecuada para adultos por la Autoridad Europea de Seguridad Alimentaria (es decir, 250 mg/día). o 1,75 g/semana).PMID: 33352671 → Las concentraciones de dioxinas, PCB, mercurio y arsénico eran tres veces mayores en el salmón salvaje que en el salmón de piscifactoría, pero todos muy por debajo de los niveles máximos uniformes de la UE para contaminantes en los alimentos. El contenido de proteínas fue ligeramente mayor en el salmón salvaje (16%) en comparación con el pescado de piscifactoría (15%), y la cantidad de aminoácidos esenciales fue similar. El contenido de grasa del salmón de piscifactoría (18%) era tres veces mayor que el del pescado salvaje, y la proporción de ácidos grasos marinos omega-3 de cadena larga era sustancialmente menor (8,9 frente a 24,1%). La proporción de ácidos grasos omega-6 y omega-3 fue mayor en el salmón de piscifactoría que en el salvaje (0,7 frente a 0,05). Tanto el salmón del Atlántico cultivado como el salvaje siguen siendo fuentes valiosas de ácido eicosapentaenoico y ácido docosahexaenoico. Una ración de 150 g por semana aportará más (2,1 gy 1,8 g) de la ingesta semanal recomendada para adultos.En conclusión, el salmón no es tóxico, se debe consumir pescado azul (como el salmón) entre 1 y 2 veces por semana. Que alguien cite fuentes bibliográficas no convierte lo que dice en verdad.Una vez más, personas no cualificadas dando mensajes erróneos a la población y metiendo miedo a las personas.
Every iconic scientist has a quote emphasising the importance of uncertainty and doubt that underpins the scientific attitude. This holds true as much for fundamental physics and biological science as it does for health science, probably far more so in the case of health science. For we are complex, non-linear creatures, each with different stories, backgrounds, contexts and circumstances. Because of this, clinical uncertainty is ubiquitous, it's everywhere, but this should not paralyse us according to my guest on this episode, Nathalia Costa, PhD. Enjoy. Key Papers: Costa N, Olson R, Mescouto K, Hodges PW, Dillon M, Evans K, Walsh K, Jensen N, Setchell J. Uncertainty in low back pain care - insights from an ethnographic study. Disabil Rehabil. 2023 Mar;45(5):784-795. doi: 10.1080/09638288.2022.2040615. Epub 2022 Feb 21. PMID: 35188845. Costa N, Mescouto K, Dillon M, Olson R, Butler P, Forbes R, Setchell J. The ubiquity of uncertainty in low back pain care. Soc Sci Med. 2022 Nov;313:115422. doi: 10.1016/j.socscimed.2022.115422. Epub 2022 Oct 3. PMID: 36215924. Costa N, Butler P, Dillon M, Mescouto K, Olson R, Forbes R, Setchell J. "I felt uncertain about my whole future"-a qualitative investigation of people's experiences of navigating uncertainty when seeking care for their low back pain. Pain. 2023 Jul 20. doi: 10.1097/j.pain.0000000000002975. Epub ahead of print. PMID: 37478013. Gibson, B. E. (2016). Rehabilitation : a post critical approach. CRC Press. Paul Christiaan Beenen, Dario Filiputti, Erna Rosenlund Meyer, Lidia Carballo-Costa, Patricia Maria Duarte de Almeida, Antonio Alves Lopes, Joost Egbertus Jacobus Lidwina van Wijchen & Alexandre Castro Caldas (2018) Epistemic beliefs as a determinant in evidence-based practice in physiotherapy – a Multi-Country (Europe) Cross-Sectional Online Survey Study, European Journal of Physiotherapy, 20:2, 85-91, DOI: 10.1080/21679169.2017.1374454 Rocca, E., Anjum, R.L. (2020). Complexity, Reductionism and the Biomedical Model. In: Anjum, R.L., Copeland, S., Rocca, E. (eds) Rethinking Causality, Complexity and Evidence for the Unique Patient. Springer, Cham. https://doi.org/10.1007/978-3-030-41239-5_5 Connect with Jared and guests: Jared on Instagram: @shoulder_physio Jared on Twitter: @jaredpowell12 Nathalia on Twitter: @nathaliaccosta1 Cliniko free trial, click here! See our Disclaimer here: The Shoulder Physio - Disclaimer
In this episode, Dr. Brooke Stubbs, explores the advantages of substituting animal protein with plant protein and the profound benefits of a diversified plant-based diet. Listen in to learn more about how and why to incorporate more plant-protein into your diets, without completely disregarding animal proteins, and prioritizing overall wellness. Follow Dr. Stubbs on Instagram, Threads, and Tiktok at @brookiestubbsmd Book an appointment at rootedfemme.com No medical advice given. Please consult a medical professional. PMID: 27479196
Thyroid Talk with Dr. Angela Mazza, DORecorded: November 10, 2023SHOW NOTES EPISODE 24Food Categories and InflammationHost: Dr. Angela Mazza, DOCo-host: Dawn SheffieldI'm Dr. Angela Mazza, D.O., a thyroid, endocrine, and metabolism specialist with a private practice in Central Florida. My goal for this podcast is to define and demystify the thyroid gland, and thyroid-related medical conditions. By providing information in an easy-to-understand format, we hope to help patients better understandthe ways in which their bodies work, and to help them thrive. My goal is to help us live more fulfilling lives by taking control of our health, to feel our best. I do this podcast to provide life-saving education and encourage patients to see a doctor in time to prevent or minimize damage. That's deeply fulfilling. I enjoy helping folks understand how all aspects of their lives are tied to both thyroid and overall health. That's why I went into endocrinology. It's a medical art that combines science with the study of our lives—and all that they encompass.To recap just some of what we covered in this episode, not necessarily in this order:Unprocessed, processed, and ULTRA-processed foods, defined;Making healthy food decisions;The NOVA food classification system;The dreaded Leaky Gut connection;Metabolism, weight, and health effects of food choices;And best of all, we learned that we CAN impact our thyroid health!Dr. Mazza's book, Thyroid Talk: An Integrative Endocrinologist's Guide to Optimal Thyroid Health is now available on Amazon. For information on the related Webinar and an online master course, go to birthabook.com/drmazza. Regarding supplements mentioned in various episodes of this podcast, please visit the Wellness Store at metaboliccenterforwellness.com. Send your comments, show ideas, and questions for future episodes to thyroidtalk.mazza@gmail.com We may disclose your general location on air (the city or town, for example), but we will NOT read your name NOR your address on the show. We reserve the right to edit your input as necessary. Please stay in touch! Check us out on YouTube, the website at metaboliccenterforwellness.com, as well as Facebook, Instagram, and TikTok. Our next episode—number 25—will cover both local and international listeners' questions, comments, and suggestions! PS: Part 3 on Leaky Gut coming soon, too! Listeners can't get enough!Citations, references, additional information for SHOW NOTES: Montiero CA, Cannon G, Levy RB et al. NOVA. The star shines bright. World Nutrition 2016;7, 1-3, 28-38.Hall KD, et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab. 2019 Jul 2;30(1):67-77.e3.Healthline.com “What's the Difference Between Processed and Ultra-Processed Food?” Medically reviewed by Sade Meeks, MS, RD Nutrition -- By Sarah Garone -- Updated on May 8, 2023.Mazza A. Thyroid Talk: An Integrative Endocrinologist's Guide to Optimal Thyroid Health. Now available; please look for it on Amazon.Shi Z. Gut Microbiota: An Important Link between Western Diet and Chronic Diseases. Nutrients. 2019 Sep 24;11(10):2287. doi: 10.3390/nu11102287. PMID: 31554269; PMCID: PMC6835660.Zhang J, et al. Ultra-processed food consumptionCheck out our YouTube channel - Dr. Angela Mazza, our website at Metabolic Center for Wellness, our FaceBook and our Instagram page.
Hydroxyapatite Deposition Disease Dr. Rosenblum discusses shoulder pain, and the pathophysiology of Hydroxyapatite Deposition Disease. He discusses personal experience with infraspinatous tendon tear, and treatments such as NSAIDs, Lidocaine patch and steroid injections of the infraspinatous tendon. Dr. Rosenblum discusses his experience with a failed suprascapular nerve block as well as evidence to support PRP injections and ethical safe care. Dr. Rosenbum also is the NRAP Academy Course director for Ultrasound, Regenerative Pain Medicine and Regional Anesthesia CME Workshops and developed online PainExam, AnesthesiaExam and PMRExam Board Reviews Pain Management Board Review Upcoming Workshops and Events NYC Regional Anesthesia and Pain Ultrasound CME Workshop Saturday, December 16, 2023 7:30 AM NYC Regional Anesthesia and Pain Ultrasound CME Workshop Saturday, January 6, 2024 7:30 AM For up to date Calendar, Click Here! References Valerio Sansone, Emanuele Maiorano, Alessandro Galluzzo & Valerio Pascale (2018) Calcific tendinopathy of the shoulder: clinical perspectives into the mechanisms, pathogenesis, and treatment, Orthopedic Research and Reviews, 10:, 63-72, DOI: 10.2147/ORR.S138225 Seijas R, Ares O, Alvarez P, Cusco X, Garcia-Balletbo M, Cugat R. Platelet-Rich Plasma for Calcific Tendinitis of the Shoulder: A Case Report. Journal of Orthopaedic Surgery. 2012;20(1):126-130. doi:10.1177/230949901202000128 Hegazi T. Hydroxyapatite Deposition Disease: A Comprehensive Review of Pathogenesis, Radiological Findings, and Treatment Strategies. Diagnostics (Basel). 2023 Aug 15;13(16):2678. doi: 10.3390/diagnostics13162678. PMID: 37627938; PMCID: PMC10453434.
Hydroxyapatite Deposition Disease Dr. Rosenblum discusses shoulder pain, and the pathophysiology of Hydroxyapatite Deposition Disease. He discusses personal experience with infraspinatous tendon tear, and treatments such as NSAIDs, Lidocaine patch and steroid injections of the infraspinatous tendon. Dr. Rosenblum discusses his experience with a failed suprascapular nerve block as well as evidence to support PRP injections and ethical safe care. Dr. Rosenbum also is the NRAP Academy Course director for Ultrasound, Regenerative Pain Medicine and Regional Anesthesia CME Workshops and developed online PainExam, AnesthesiaExam and PMRExam Board Reviews Pain Management Board Review Upcoming Workshops and Events NYC Regional Anesthesia and Pain Ultrasound CME Workshop Saturday, December 16, 2023 7:30 AM NYC Regional Anesthesia and Pain Ultrasound CME Workshop Saturday, January 6, 2024 7:30 AM For up to date Calendar, Click Here! References Valerio Sansone, Emanuele Maiorano, Alessandro Galluzzo & Valerio Pascale (2018) Calcific tendinopathy of the shoulder: clinical perspectives into the mechanisms, pathogenesis, and treatment, Orthopedic Research and Reviews, 10:, 63-72, DOI: 10.2147/ORR.S138225 Seijas R, Ares O, Alvarez P, Cusco X, Garcia-Balletbo M, Cugat R. Platelet-Rich Plasma for Calcific Tendinitis of the Shoulder: A Case Report. Journal of Orthopaedic Surgery. 2012;20(1):126-130. doi:10.1177/230949901202000128 Hegazi T. Hydroxyapatite Deposition Disease: A Comprehensive Review of Pathogenesis, Radiological Findings, and Treatment Strategies. Diagnostics (Basel). 2023 Aug 15;13(16):2678. doi: 10.3390/diagnostics13162678. PMID: 37627938; PMCID: PMC10453434.
Editor-in-Chief, Robert Amdur, MD, explains how radiation oncologists are using ChatGPT and other Large Language Model programs in clinical practice. The discussion is based on a paper published in the November/December 2023 issue of PRO titled “Unlocking the Power of ChatGPT, Artificial Intelligence, and Large Language Models: Practical Suggestions for Radiation Oncologists” (2023, Issue 6, November/December, PMID: 37598727).
Editor-in-Chief, Robert Amdur, MD, explains how radiation oncologists are using ChatGPT and other Large Language Model programs in clinical practice. The discussion is based on a paper published in the November/December 2023 issue of PRO titled "Unlocking the Power of ChatGPT, Artificial Intelligence, and Large Language Models: Practical Suggestions for Radiation Oncologists" (2023, Issue 6, November/December, PMID: 37598727).
One of the benefits of the use of online platforms for meetings is the ability to record and disseminate talks more widely. This is an edited version of a talk given by Dr Andy Curry, Consultant Cardiothoracic Intensive Care Consultant at University Hospital Southampton, covering the origins of Extra Corporeal Membrane Oxygenation (ECMO) right up to the present day. Throughout the talk, he gives real world experience, coupled with a knowledge of the literature to communicate all you could ever want to know about this fascinating and potentially very exciting therapy. References Peek GJ, Clemens F, Elbourne D, Firmin R, Hardy P, Hibbert C, Killer H, Mugford M, Thalanany M, Tiruvoipati R, Truesdale A, Wilson A. CESAR: conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure. BMC Health Serv Res. 2006 Dec 23;6:163. doi: 10.1186/1472-6963-6-163. PMID: 17187683; PMCID: PMC1766357. Stub D, Bernard S, Pellegrino V, Smith K, Walker T, Sheldrake J, Hockings L, Shaw J, Duffy SJ, Burrell A, Cameron P, Smit de V, Kaye DM. Refractory cardiac arrest treated with mechanical CPR, hypothermia, ECMO and early reperfusion (the CHEER trial). Resuscitation. 2015 Jan;86:88-94. doi: 10.1016/j.resuscitation.2014.09.010. Epub 2014 Oct 2. PMID: 25281189. Belohlavek J, Smalcova J, Rob D, et al. Effect of Intra-arrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Immediate Invasive Assessment and Treatment on Functional Neurologic Outcome in Refractory Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2022;327(8):737–747. doi:10.1001/jama.2022.1025 Martje M. Suverein, M.D., Thijs S.R. Delnoij, M.D., et al. Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest. The INCEPTION trial. N Engl J Med 2023; 388:299-309. DOI: 10.1056/NEJMoa2204511 The Alfred ECPR Role Cards The Bottom Line ECMO Reviews
Découvrez le livre NEUROSAPIENS ! Pour apprendre à créer rapidement et à moindre coût son podcast, c'est par ici ! Bonjour et bienvenue dans ce tout premier épisode de la saison 7 ! Dans ce premier épisode nous reverrons comment fonctionne la dynamique ventre-cerveau, puis nous verrons les liens particuliers qu'entretient la nutrition avec la santé mentale. Production, animation, réalisation et illustration : Anaïs Roux Instagram : https://www.instagram.com/neurosapiens.podcast/ neurosapiens.podcast@gmail.com Produit et distribué en association avec LACME Production. _________ Musique KEEP ON GOING Musique proposée par La Musique Libre Joakim Karud - Keep On Going : https://youtu.be/lOfg0jRqaA8 Joakim Karud : https://soundcloud.com/joakimkarud ONE NIGHT AWAY Musique de Patrick Patrikios _________ Sources : Arotcarena ML, Dovero S, Prigent A, Bourdenx M, Camus S, Porras G, Thiolat ML, Tasselli M, Aubert P, Kruse N, Mollenhauer B, Trigo Damas I, Estrada C, Garcia-Carrillo N, Vaikath NN, El-Agnaf OMA, Herrero MT, Vila M, Obeso JA, Derkinderen P, Dehay B, Bezard E. Bidirectional gut-to-brain and brain-to-gut propagation of synucleinopathy in non-human primates. Brain. 2020 May 1;143(5):1462-1475. doi: 10.1093/brain/awaa096. PMID: 32380543. Molendijk M, Molero P, Ortuño Sánchez-Pedreño F, Van der Does W, Angel Martínez-González M. Diet quality and depression risk: A systematic review and dose-response meta-analysis of prospective studies. J Affect Disord. 2018 Jan 15;226:346-354. doi: 10.1016/j.jad.2017.09.022. Epub 2017 Sep 23. PMID: 29031185. Goh KK, Liu YW, Kuo PH, Chung YE, Lu ML, Chen CH. Effect of probiotics on depressive symptoms: A meta-analysis of human studies. Psychiatry Res. 2019 Dec;282:112568. doi: 10.1016/j.psychres.2019.112568. Epub 2019 Sep 17. PMID: 31563280. Valles-Colomer, M., Falony, G., Darzi, Y. et al. The neuroactive potential of the human gut microbiota in quality of life and depression. Nat Microbiol 4, 623–632 (2019).
Polymyalgia rheumatica is a common rheumatic disorder. Steroids are the mainstay of therapy despite significant adverse reactions. Join host, Geoff Wall, as he evaluates a new treatment for PMR.The GameChangerSarilumab is now FDA-approved for relapsing polymyalgia rheumatica. Sarilumab can be an alternative to long-term steroid therapy or methotrexate. HostGeoff Wall, PharmD, BCPS, FCCP, BCGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint Health ReferenceSpiera RF, Unizony S, Warrington KJ, Sloane J, Giannelou A, Nivens MC, Akinlade B, Wong W, Bhore R, Lin Y, Buttgereit F, Devauchelle-Pensec V, Rubbert-Roth A, Yancopoulos GD, Marrache F, Patel N, Dasgupta B; SAPHYR Investigators. Sarilumab for Relapse of Polymyalgia Rheumatica during Glucocorticoid Taper. N Engl J Med. 2023 Oct 5;389(14):1263-1272. doi: 10.1056/NEJMoa2303452. PMID: 37792612.https://www.nejm.org/doi/full/10.1056/NEJMoa2303452 Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE Information Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Describe the diagnosis and treatment of polymyalgia rheumatica 2. Assess the SAPHYR study and the role of sarilumab for treatment of polymyalgia rheumatica 0.05 CEU/0.5 HrUAN: 0107-0000-23-352-H01-P Initial release date: 11/6/2023Expiration date: 11/6/2024Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagramDownload the CEimpact App for Free Continuing Education + so much more!
Contributor: Travis Barlock MD Educational Pearls: Common sedatives used in the Emergency Department and a few pearls for each. Propofol Type: Non-barbiturate sedative hypnotic agonizing GABA receptors. Benefit: Quick on and quick off (duration of action is approximately 2-7 minutes), helpful for suspected neurologic injury so the patient can wake up and be re-evaluated. Also has the benefit of reducing intracranial pressure (ICP). Downsides: Hypotension, bradycardia, respiratory depression. What should you do if a patient is getting hypotensive on propofol? Do not stop the propofol. Start pressors. May have to reduce the propofol dose if delay in pressors. Dexmedetomidine (Precedex) Type: Alpha 2 agonist - causes central sedation Uses: Patients are more alert and responsive and therefore can be on BiPAP instead of being intubated. Does not cause respiratory depression. Downsides: Hypotension and Bradycardia. Caution in using this for head injuries, its side effects can mask the Cushing reflex and make it more difficult to spot acute elevations in ICP and uncal herniation. Ketamine Type: NMDA antagonist and dissociative anesthetic, among other mechanisms. Benefits: Quick Onset (but slower than propofol). Does not cause hypotension, but can even increase HR and BP (Thought to potentially cause hypotension if patient is catecholamine-depleted (ie. sepsis, delayed trauma)). Dosing ketamine can be challenging. Typically low doses (0.1-0.3mg/kg (max ~30mg)) can give good pain relief. Higher doses (for intubation/procedural sedation) are generally thought to have a higher risk of dissociation. Downsides: Emergence reactions which include hallucinations, vivid dreams, and agitation. Increased secretions. Benzos Type: GABA agonists. Benefits: Seizure, alcohol withdrawal, agitation due to toxic overdoses. Push doses are useful because doses can stack. Longer half-life than propofol. Downsides: Respiratory depression. Longer half-life can make neuro assessments difficult to complete. Etomidate MOA: Displaces endogenous GABA inhibitors. Useful as a one-time dose for quick procedures (cardioversion, intubation). Often drug of choice for intubation since it is thought to have no hemodynamic effects. Downsides; If used without paralytic - myoclonus. Though to have some adrenal suppression. Fentanyl Type: Opioid analgesic. Not traditional sedative. Benefits: There are many instances in emergency medicine in which sedation can be avoided by prioritizing proper analgesia. Fentanyl can even be used to maintain intubated patients without needing to keep them constantly sedated. Downsides: Respiratory depression. Patients may have tolerance. References Chawla N, Boateng A, Deshpande R. Procedural sedation in the ICU and emergency department. Curr Opin Anaesthesiol. 2017 Aug;30(4):507-512. doi: 10.1097/ACO.0000000000000487. PMID: 28562388. Keating GM. Dexmedetomidine: A Review of Its Use for Sedation in the Intensive Care Setting. Drugs. 2015 Jul;75(10):1119-30. doi: 10.1007/s40265-015-0419-5. PMID: 26063213. Lundström S, Twycross R, Mihalyo M, Wilcock A. Propofol. J Pain Symptom Manage. 2010 Sep;40(3):466-70. doi: 10.1016/j.jpainsymman.2010.07.001. PMID: 20816571. Matchett G, Gasanova I, Riccio CA, Nasir D, Sunna MC, Bravenec BJ, Azizad O, Farrell B, Minhajuddin A, Stewart JW, Liang LW, Moon TS, Fox PE, Ebeling CG, Smith MN, Trousdale D, Ogunnaike BO; EvK Clinical Trial Collaborators. Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. Intensive Care Med. 2022 Jan;48(1):78-91. doi: 10.1007/s00134-021-06577-x. Epub 2021 Dec 14. PMID: 34904190. Mihaljević S, Pavlović M, Reiner K, Ćaćić M. Therapeutic Mechanisms of Ketamine. Psychiatr Danub. 2020 Autumn-Winter;32(3-4):325-333. doi: 10.24869/psyd.2020.325. PMID: 33370729. Nakauchi C, Miyata M, Kamino S, Funato Y, Manabe M, Kojima A, Kawai Y, Uchida H, Fujino M, Boda H. Dexmedetomidine versus fentanyl for sedation in extremely preterm infants. Pediatr Int. 2023 Jan-Dec;65(1):e15581. doi: 10.1111/ped.15581. PMID: 37428855. Summarized by Jeffrey Olson MS2 | Edited by Jorge Chalit, OMSII
In this Complex Care Journal Club podcast episode, Dr. Catherine Diskin and Ms. Kate Robinson discuss their team's approach to co-developing a continuing education seminar series. They describe the value of family partnership in complex care education and research, important considerations for effectively engaging families, and next steps from this work. SPEAKERS Catherine Diskin, MB, BCh, BAO Assistant Professor of Pediatrics, University of Toronto Co-Educational Lead, Complex Care Program, Department of Paediatrics, The Hospital for Sick Children Kate Robinson, MFA Founder and Artistic Director, Foxservingpie.org Mother of a child with medical complexity HOST Emily Goodwin, MD Clinical Associate Professor of Pediatrics, University of Missouri Kansas City School of Medicine Pediatrician, General Academic Pediatrics Beacon Program, Children's Mercy Kansas City DATES Initial Publication: November 6, 2023. CITATION Diskin C, Robinson K, Goodwin EJ. Partnering in Pedagogy: Reflections of a Family Leader and Clinician-Educator. 11/2023. OPENPediatrics. Online Podcast. Links: https://youtu.be/o7qTC7WsAKg, https://soundcloud.com/openpediatrics/partnering-in-pedagogy-reflections-of-a-family-leader-and-clinician-educator. JOURNAL ARTICLE REFERENCED Diskin C, Robinson K, Agrawal R, Masterson D, Coleman C, Cohen E. Family Partnership in Continuing Medical Education: A Collaborative Experience. Pediatrics. 2023;151(5):e2022060280. doi:10.1542/peds.2022-060280 ADDITIONAL ARTICLES CITED Diskin C, Malik K, Gill PJ, Rashid N, Chan CY, Nelson KE, Thomson J, Berry J, Agrawal R, Orkin J, Cohen E. Research priorities for children with neurological impairment and medical complexity in high-income countries. Dev Med Child Neurol. 2022 Feb;64(2):200-208. doi: 10.1111/dmcn.15037. Epub 2021 Aug 30. PMID: 34462917; PMCID: PMC9291325. TRANSCRIPT https://op-docebo-images.s3.amazonaws.com/Transcripts/Partnering+in+Pedagogy+Reflections+of+a+Family+Leader+and+Clinician-Educator.pdf Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6 Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu
In this episode I bust the myth that women shouldn't carb load & dive into the research on this topic along with my clinical experience working with hundreds of female runners. Sources referenced: PMID- 26920240, 10846030, 11408434, 12716874, 29444266 Thank you BetterHelp for sponsoring this episode! For 10% off your first month of therapy with BetterHelp, visit https://www.betterhelp.com/holleyfueled Check out my Online Learning Academy here for more nutrition education & support: https://holleyfuelednutrition.thinkific.com/ --- Support this podcast: https://podcasters.spotify.com/pod/show/holleyfuelednutrition/support
Why is Ketamine being used to treat depression and anhedonia? In this science-y episode I'm going through the neuroscience of Ketamine and the brain, the chemical makeup of the drug, and why it's being used in many trials to treat people with treatment resistant depression and anhedonia. BRAIN FACT:ECT therapy – what is It, how does it work, what type of mental disorders is it used as a treatment for. Read more about ECT from the Mayo Clinic https://mayocl.in/3sfPN9W . EXTRA READING Read Understanding Anhedonia https://bit.ly/anhedonia-explained . Mandal S, Sinha VK, Goyal N. Efficacy of ketamine therapy in the treatment of depression. Indian J Psychiatry. 2019 Sep-Oct;61(5):480-485. doi: 10.4103/psychiatry.IndianJPsychiatry_484_18. PMID: 31579184; PMCID: PMC6767816. LISTENER QUESTION:rr I'm doing my PHD and have realised I don't think I want a career in the thing I'm studying. After listening to your episode on the Sunk Cost Fallacy (https://bit.ly/46TyOJs ) I'm looking for advice on whether or not I should finish the PHD or not. LINKS: Send your Listener question to info@dyfmpod.com Join DYFM + https://bit.ly/dyfm-membership . Subscribe to the DYFM 6 week course https://bit.ly/dyfm-course . Follow @dyfmpodcast on Instagram Follow @alexispredez on Instagram Join the DYFM Facebook Group https://bit.ly/dyfm-group . Follow @listnrentertainment on Instagram CREDITS Host: Alexis Fernandez Executive Producer & Editor: Elise CooperDigital Producer: Zoe Panaretos DYFM Social Producer: Shania MaguaManaging Producer: Sam Cavanagh Find more great podcasts like this at www.listnr.com/ See omnystudio.com/listener for privacy information.
Today, we have a bilingual podcast to connect Spanish speaking listeners to a Spanish special edition of Exceptional Needs Today magazine.www.exceptionalneedstoday.comHoy, la Dra. Stephanie y sus invitados Erica y Luis les cuentan acerca de una revista de edición especial que estará disponible en español.A continuación se muestra una carta de la editora de Exceptional Needs Today, Amy Tobik.¡Es gratis! ¡Visite www.excepcionalneedstoday.com!Desde el escritorio del editorCuando publiqué la revista Exceptional Needs Today hace un par de años, mi objetivo era unir a una comunidad de defensores, familias, educadores, médicos y terapistas. Presenciar el cambio tan significativo que ocurre cuando gente dinámica trabaja junta ha sido un honor. Durante mi tiempo trabajando con niños de distintas habilidades, participando en conferencias en relaciones a las necesidades especiales, y conversado con terapistas y educadores, se ha vuelto evidente que los niños de la comunidad hispanohablante con el Trastorno de Espectro Autista (TEA) y otras necesidades especiales han sido pasadas por alto. Muy a menudo, estos niños no reciben diagnósticos ni el apoyo que necesitan. Estas situaciones pueden afectar individuos y sus familias de por vida. Esta disparidad no es aceptable.De acuerdo con el estudio Disparidades en el diagnóstico y tratamiento de Autismo en las comunidades Latinas y no Latinas, competencia en el inglés tiene un impacto en el acceso al diagnóstico y tratamiento del TEAdiagnóstico y tratamiento pueden ser reducidas mediante una mejoría en el conocimiento del TEA y confianza en su proveedor médico o doctor a cargo de su hijo. Cuando los niños son diagnosticados de manera errónea, su acceso a servicios se ve afectado de manera negativa. Esperamos dar el consejo y el apoyo necesario en español para llegar a reducir esta brecha entre el tratamiento recibido por niños hispanos y no hispanos.Esta edición especial de Exceptional Needs Today provee 15 artículos en español escrito porextraordinarios profesionales involucrados en la comunidad hispana. Dra. Joscelyn Ramos-Campell, una ganadora del premio nacional al mejor portavoz y consultora de discapacidades bilingües se encuentra en la portado junto con su hijo de ocho años, Joshua, quien fue diagnosticado con TEA. Estamos muy emocionados por publicar su artículo exclusivo, Guía de intervención temprana y cómo encontrar servicios en los 50 estados de Los Estados Unidos. dirección justo al alcance de sus manos.Esta versión también presenta un excelente artículo de la Dra. Mary Jones, pediatra que se mudó recientemente a la Republica Dominicana proveniente de los Estados Unidos con su familia de siete personas en busca de una vida más sencilla. No se pierdan de su artículo, Nuestro viaje con necesidades excepcionales: Cómo el traslado a otro país creó una vida más tranquila, donde discute como este cambio afectó de manera positiva a sus hijos con TEA y las modificaciones que pueden hacer en su vida diaria para fomentar la paz. Adicionalmente, estamos emocionados por compartir Entendiendo la disparidad de apoyo para las familias hispanas y cómo superarla, escrito por la Dra. Stephanie C. Holmes, BBCC, quien es una consejera profesional, educadora, autora y especialista certificada para tratar TEA.Una colección de artículos escritos por defensores como Temple Gradin, PhD. y Debra Moore, PhD, Siena Castellon, Noah Seback, J. Edwards Holt, Nicole Dauz, están orgullosamente incluidos en esta edición especial de Exceptional Needs Today. Cada uno de estos artículos ha sido traducido al español por estudiantes universitarios pertenecientes a una clase de nivel superior de traducción en Lee University, Tennessee.Nos gustaría agradecer a nuestro fantástico equipo de traductores, Erica Holmes, Cameron Hatcher, Julia Gambill, Kierstin Havens, Sarah Leab, y nuestros correctores Erica Holmes y Luis Eduardo De Paz Capobianco. También estamos muy agradecidos con nuestros contribuidores, anunciantes y subscriptores quienes continúan apoyándonos y son una parte integral de nuestra revista ganadora de premios.Nos encantaría pedirles que alienten a sus amigos y familiares a subscribirse a Exceptional Needs Today.Saludos cordials,AmySigamos promoviendo la conciencia, aceptación e inclusión de las comunidades con necesidades especiales mientras trabajamos por hacer un cambio significativo para el futuro – JUNTOS!1 Zuckerman KE, Lindly OJ, Reyes NM, Chavez AE, Macias K, Smith KN, Reynolds A. Disparities in Diagnosis and Treatment of Autism in Latinx and Non-Latinx White Families. Pediatrics.2017 May;139(5):e20163010. doi: 10.1542/peds.2016-3010. PMID: 2855https://pubmed.ncbi.nlm.nih.gov/28557734/7734; PMCID: PMC5404727
While the hospital is a place of science and medicine, this does not keep our human tendency to be superstitious at bay. In today's episode we will be exploring a few of the most common hospital superstitions, their origins, and if there is any scientific evidence to support them. If you are enjoying Don't Look Under the Med, please help us out and leave a five-star review! And make sure you follow the podcast on your favorite platform so you never miss an episode. Articles: ABC: Friday the 13th and Emergency Departments, by Oliva Willis for Sum of All Parts Fusion Medical Staffing: Top 5 ER Superstitions, by Megan Bebout Healthline: How Does a Full Moon Affect Our Physical and Mental Well-Being?, by Rebecca Joy Stanborough, MFA The Washington Post: Friday the 13th: Things You Should Know, by Valerie Strauss CNN: Why is Friday the 13th Unlucky? The Cultural Origins of An Enduring Superstition, by Christobel Hastings Academic Articles: Wu YW, Lai WS, Chen YC. [Superstitious Beliefs Among Healthcare Providers: A Concept Analysis]. Hu Li Za Zhi. 2023 Jun;70(3):85-93. Chinese. doi: 10.6224/JN.202306_70(3).11. PMID: 37259654. Johnson G. The Q**** Study – basic randomised evaluation of attendance at a children's emergency department. Emergency Medicine Journal 2010;27:A11. Zargar M, Khaji A, Kaviani A, Karbakhsh M, Yunesian M, Abdollahi M. The full moon and admission to emergency rooms. Indian J Med Sci. 2004 May;58(5):191-5. PMID: 15166467. Lo BM, Visintainer CM, Best HA, Beydoun HA. Answering the myth: use of emergency services on Friday the 13th. Am J Emerg Med. 2012 Jul;30(6):886-9. doi: 10.1016/j.ajem.2011.06.008. Epub 2011 Aug 19. PMID: 21855260.Podcast Art By: Irit Mogilevsky --- Support this podcast: https://podcasters.spotify.com/pod/show/dontlookunderthemed/support
Do you know if you are setting the bar too low for yourself, your relationships and your career / abilities? In this episode, I cover what happens when you do that, and why it is important to turn that around so you can start expecting and receiving more out of life. Brain Fact: Explaining Urbach-Wiethe disease. of people who don't experience the physiological aspects of the fear response. Urbach-Wiethe disease on Wikipedia https://bit.ly/urbachwiethe . Koen N, Fourie J, Terburg D, Stoop R, Morgan B, Stein DJ, van Honk J. Translational neuroscience of basolateral amygdala lesions: Studies of Urbach-Wiethe disease. J Neurosci Res. 2016 Jun;94(6):504-12. doi: 10.1002/jnr.23731. PMID: 27091312. LINKS Send your Listener question to info@dyfmpod.com Join DYFM + https://bit.ly/dyfm-membership . Subscribe to the DYFM 6 week course https://bit.ly/dyfm-course . Follow @dyfmpodcast on Instagram Follow @alexispredez on Instagram Join the DYFM Facebook Group https://bit.ly/dyfm-group . Follow @listnrentertainment on Instagram CREDITS Host: Alexis Fernandez Executive Producer & Editor: Elise CooperDigital Producer: Zoe Panaretos Social Producer: Shania MaguaManaging Producer: Sam Cavanagh Find more great podcasts like this at www.listnr.com/ See omnystudio.com/listener for privacy information.
Disparities in Care and Barriers to Access for Patients with Advanced Prostate Cancer At the conclusion of these activities, participants will be able to: 1. Recognize current patterns of use for systemic therapies in patients with advanced prostate cancer. 2. Identify disparities in access to care with respect to advanced prostate cancer treatment (ie. race, geography, socioeconomics). 3. Understand opportunities to improve quality and compliance with ADT treatment across different treatment populations. 4. Appreciate financial challenges that may be associated with current therapy options for advanced prostate cancer. 5. Apply treatment approaches that improve patient adherence to ADT including use of oral and parenteral therapies. ACKNOWLEDGEMENTS: This series is supported by independent educational grants from: Myovant Sciences LTD Pfizer, Inc. REFERENCES: Benjamin, D.J., Shrestha, A., Fellman, D. et al. Hormonal treatment for newly diagnosed metastatic prostate cancer: a population-based study from the California cancer registry. Prostate Cancer Prostatic Dis (2023). https://doi.org/10.1038/s41391-023-00732-9 Cortese BD, Dusetzina SB, Al Hussein Al Awamlh B, Penson DF, Chang SS, Barocas DA, Luckenbaugh AN, Scarpato KR, Moses KA, Talwar R. Estimating the Impact of the Inflation Reduction Act on the Out-of-Pocket Costs for Medicare Beneficiaries With Advanced Prostate Cancer. Urol Pract. 2023 Sep;10(5):476-483. doi: 10.1097/UPJ.0000000000000425. Epub 2023 Jul 3. PMID: 37409930.
How much volume is too much volume? People always ask me how many sets per week. Lets break down a new study and i'll share my thoughts on it!Topics Discussed: (00:08) - Welcome (01:20) - What the study looked at (09:11) - Results after 12 weeks (14:29) - How am I applying this? (18:03) - Some things to be careful about (21:32) - What have we changed out minds on in recent years? New Training program for glutes and delts beginning October 30th. This will be a mid volume that ends high volume by the end of the 8 week program.Need a quality training program? Sign up HERE for the LiftingLindsay app where you can train smart! There are home alternatives in the groups, OR choose the @home - 12 week Full Bodyrecomp plan under the ‘plans' section! Train Smart! New training October 30th !I have 4 and 5 day program options, including glute/delt specialized programs too! Come train with me!Training Programs based off of your Fat Loss or Muscle and Strength goals? Sign up here.Announcement!!! - From Macros to Mindful Eating course will be launching NOVEMBER!! Join the waitlist to get a discount - Sign up HEREThe point of the course is to help empower women to be able to be more mindful about foods and not have to track everythingSubscribe to my Youtube Channel HERE.Studies cited• PMID: 37796222
Welcome to the Olink® Proteomics in Proximity podcast! Below are some useful resources from this episode: Published study of primary focusKoprulu M, Carrasco-Zanini J, Wheeler E, Lockhart S, Kerrison ND, Wareham NJ, Pietzner M, Langenberg C. Proteogenomic links to human metabolic diseases. Nat Metab. 2023 Mar;5(3):516-528. doi: 10.1038/s42255-023-00753-7. Epub 2023 Feb 23. Erratum in: Nat Metab. 2023 Mar 19;: PMID: 36823471; PMCID: PMC7614946. https://pubmed.ncbi.nlm.nih.gov/36823471/ Laboratory, first author, and corresponding author of the study· Public Health University Research Institute (PHURI), a multidisciplinary research center to drive personalized healthcare: https://www.qmul.ac.uk/phuri/about/· Mine Koprulu (first author), PhD student, University of Cambridge: https://www.linkedin.com/in/mine-koprulu-497659b9/ · Dr. Claudia Langenberg (corresponding author); Director of PHURI, Queen Mary, University of London; Professor of Computational Medicine, Berlin Institute of Health at Charité: https://www.qmul.ac.uk/phuri/our-people/professor-claudia-langenberg/ Olink tools and software· Olink® Explore 3072, the platform that measured proteins in this study with a next-generation sequencing (NGS) readout: https://olink.com/products-services/explore/ UK Biobank Pharma Proteomics Project (UKB-PPP), one of the world's largest scientific studies of blood protein biomarkers conducted to date, https://www.ukbiobank.ac.uk/learn-more-about-uk-biobank/news/uk-biobank-launches-one-of-the-largest-scientific-studies Genotype-Tissue Expression (GTEx) project, a biobank and open-access database to study tissue-specific gene expression and regulation: https://www.gtexportal.org/home/ European Prospective Investigation into Cancer (EPIC)-Norfolk study, a prospective cohort of middle-aged individuals from Eastern England: https://www.epic-norfolk.org.uk/ Genome Aggregation Database (gnomAD), the largest publicly available collection of population variation from harmonized exome and genome sequencing data: https://gnomad.broadinstitute.org/ Would you like to subscribe to the podcast on your favorite player or app? You can do so here: Apple Podcasts: https://apple.co/3T0YbSm Spotify Podcasts: https://open.spotify.com/show/2sZ2wxO... Google Podcasts: https://podcasts.google.com/feed/aHR0... Amazon Music: https://music.amazon.com/podcasts/d97... Podcast Addict: https://podcastaddict.com/podcast/409... Deezer: https://www.deezer.com/show/5178787 Player FM: https://player.fm/series/series-3396598 In case you were wondering, Proteomics in Proximity refers to the principle underlying Olink technology called the Proximity Extension Assay (PEA). More information about the assay and how it works can be found here: https://bit.ly/3Rt7YiY For any questions regarding information Olink Proteomics, please email us at info@olink.com or visit our website: https://www.olink.com/ WHAT IS PROTEOMICS IN PROXIMITY?Proteomics in Proximity discusses the intersection of proteomics with genomics for drug target discovery, the application of proteomics to reveal disease biomarkers, and current trends in using proteomics to unlock biological mechanisms. Co-hosted by Olink's Cindy Lawley and Sarantis Chlamydas.
Join Professor Michael Solomon, Dr Kilian Brown and Dr Jacob Waller from Royal Prince Alfred Hospital in Sydney, Australia, for this special four part series on pelvic exenteration surgery for locally advanced and recurrent rectal cancer. Learn about these ultra-radical procedures which go beyond the traditional TME planes that we learn during surgical training, and into all compartments of the pelvis. Episode 2 outlines the radical technical approaches to anteriorly invasive tumours, including en bloc cystectomy, perineal urethrectomy, inter-labial vaginectomy and radical pubic bone resections. Each episode in this series features a different international guest surgeon. In episode 2, the RPA team are joined by Dr Paul Sutton from The Christie Hospital, Manchester, UK. Technical videos: Solomon MJ, Däster S, Loizides S, Sutton P, Brown KGM, Austin KKS, Lee PJ. Access to the anterior pelvic compartment in pelvic exenteration in women-the interlabial approach: video vignette. Br J Surg. 2021 Aug 19;108(8):e268-e269. doi: 10.1093/bjs/znab127. Solomon MJ, Alahmadi R, Lee PJ, Austin KKS. En bloc partial pubic bone excision with complete soft tissue pelvic exenteration. Br J Surg. 2022 Jun 14;109(7):640-641. doi: 10.1093/bjs/znac122. PMID: 35485605. References: Solomon MJ, Austin KK, Masya L, Lee P. Pubic Bone Excision and Perineal Urethrectomy for Radical Anterior Compartment Excision During Pelvic Exenteration. Dis Colon Rectum. 2015 Nov;58(11):1114-9. doi: 10.1097/DCR.0000000000000479. Check our more high-yield colorectal surgery content from Behind the Knife.
Welcome back to "From Our Neurons to Yours," a podcast where we criss-cross scientific disciplines to take you to the frontiers of brain science. This week, we explore the science of dizziness with Stanford Medicine neurologist Kristen Steenerson, MD, who treats patients experiencing vertigo and balance disorders.In our conversation, we'll see that dizziness is not a singular experience but rather a broad term encompassing a variety of different sensations of disorientation. We learn about the vestibular system, a set of biological "accelerometers" located deep within the inner ear that detect linear and angular acceleration, helping us perceive motion, orientation, and our connection to the world around us. We also discuss a wearable medical device Dr. Steenerson and colleagues at the Wu Tsai Neurosciences Institute are developing a wearable device to measure the activity of the vestibular system by tracking a patient's eye movements. With the ability to study this mysterious system in unprecedented detail, we're on the verge of learning more than ever about this misunderstood "sixth sense."Learn MoreDr. Steenerson's Stanford academic profileDr. Steenerson's Stanford Healthcare profile (Neurology and Neurological Sciences, Otolaryngology)The wearable ENG, a dizzy attack event monitor (DizzyDx)ReferencesPopkirov, Stoyan, Jeffrey P. Staab, and Jon Stone. "Persistent postural-perceptual dizziness (PPPD): a common, characteristic and treatable cause of chronic dizziness." Practical neurology 18.1 (2018): 5-13.Harun, Aisha, et al. "Vestibular impairment in dementia." Otology & Neurotology: Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 37.8 (2016): 1137.Brandt T, Dieterich M. The dizzy patient: don't forget disorders of the central vestibular system. Nat Rev Neurol. 2017 Jun;13(6):352-362. doi: 10.1038/nrneurol.2017.58. Epub 2017 Apr 21. PMID: 28429801.Allison S. Young, Corinna Lechner, Andrew P. Bradshaw, Hamish G. MacDougall, Deborah A. Black, G. Michael Halmagyi, Miriam S. Welgampola Neurology Jun 2019, 92 (24) e2743-e2753; DOI: 10.1212/WNL.0000000000007644Episode CreditsThis episode was produced by Michael Osborne, with production assistance by Morgan Honaker, and hosted by Nicholas Weiler. Cover art by Aimee Garza.Thanks for listening! Learn more about the Wu Tsai Neurosciences Institute at Stanford and follow us on Twitter, Facebook, and LinkedIn.
This week on BackTable Urology, Dr. Manoj Monga (UC San Diego) invites Dr. Margaret Pearle (UT Southwestern) to discuss kidney stone prevention with lifestyle changes and medical therapy. --- SHOW NOTES First, the doctors reflect on Dr. Pearle and Dr. Yair Lotan's paper from 2008 that predicted the impact of climate change on kidney stones. Dr Pearle then shares her recommendations for lifestyle changes to prevent kidney stones, such as increasing fluid intake and reducing sodium and animal protein intake. She also advises on reducing oxalate intake in diets and maintaining adequate calcium intake to ensure bone health. Next, the doctors discuss strategies for treating and preventing stones with medical therapy. They explore the use of thiazides and potassium citrate for both calcium oxalate and calcium phosphate stones, as well as the importance of evaluating PTH levels and serum uric acid levels in these patients. They also discuss the role of dietary oxalate and bowel disease in determining when to order genetic testing. Additionally, they explore the nuances of treating hypercalciuria with thiazide holidays and the use of potassium citrate as a second line therapy. Potassium citrate is beneficial for alkalinization and citrate supplementation. There are different benefits when comparing the liquid formulation to the tablets. Finally, they discuss the use of urinary pH and xanthine oxidase inhibitors, the importance of genetic testing, and the importance of fluid intake and potassium citrate for cystine stones. --- RESOURCES Brikowski TH, Lotan Y, Pearle MS. Climate-related increase in the prevalence of urolithiasis in the United States. Proc Natl Acad Sci U S A. 2008 Jul 15;105(28):9841-6. doi: 10.1073/pnas.0709652105. Epub 2008 Jul 14. PMID: 18626008; PMCID: PMC2474527.
Have you ever questioned your ambition? Have you ever thought to yourself "I'm just not that ambitious anymore"? Did this usually happen during a time when your career was at a stand still? Or perhaps you weren't interested in growing in your chosen career? On this episode, I am busting the belief that ambition is restricted to the 9-5 and breaking down how:The definition of ambition has shifted over the last 60 yearsOur ambition takes different shapes throughout our careerThe absence of ambition may signal something deeprIf you are a high achieving, driven individual who has ever questioned your ambition you won't want to miss today's episode.Show Notes:Dark Horse: Achieving Success Through the Pursuit of FulfillmentPsychological Context PrincipleBurunda Prince: Paving a Path For ChangePopulaceThink Again by Adam GrantEnd of History Illusion - Quoidbach, J., Gilbert, D. T., & Wilson, T. D. (2013). The end of history illusion. Science, 339(6115), 96–98.92 Studies - Roberts BW, Walton KE, Viechtbauer W. Patterns of mean-level change in personality traits across the life course: a meta-analysis of longitudinal studies. Psychol Bull. 2006 Jan;132(1):1-25. doi: 10.1037/0033-2909.132.1.1. PMID: 16435954.Join the waitlist for Unstuck Yourself: The Process To Meaningful Career Change
Contributor: Dylan Luyten MD Educational Pearls: What is a Bradyarrhythmia? Also known as a bradyarrhythmia, it is an irregular heart rate that is also slow (below 60 beats per minute). What can cause it? Complete heart block AKA third-degree AV block; identified on ECG by a wide QRS, and complete dissociation between the atrial and ventricular rhythms with the ventricular being much slower. Treat with a pacemaker. Medication overdose, especially beta blockers. Many other drugs can slow the heart as well including: opioids, clonidine, digitalis, amiodarone, diltiazem, and verapamil to name a few. Electrolyte abnormalities, specifically hyperkalemia. Hypokalemia, hypocalcemia, and hypomagnesemia can also cause bradyarrhythmias. Myocardial infarction. Either by damaging the AV node or the conduction system itself or by triggering a process called Reperfusion Bradycardia. Hypothermia. Bradycardia is generally a sign of severe or advanced hypothermia. References Jurkovicová O, Cagán S. Reperfúzne arytmie [Reperfusion arrhythmias]. Bratisl Lek Listy. 1998 Mar-Apr;99(3-4):162-71. Slovak. PMID: 9919746. Simmons T, Blazar E. Synergistic Bradycardia from Beta Blockers, Hyperkalemia, and Renal Failure. J Emerg Med. 2019 Aug;57(2):e41-e44. doi: 10.1016/j.jemermed.2019.03.039. Epub 2019 May 30. PMID: 31155316. Wung SF. Bradyarrhythmias: Clinical Presentation, Diagnosis, and Management. Crit Care Nurs Clin North Am. 2016 Sep;28(3):297-308. doi: 10.1016/j.cnc.2016.04.003. Epub 2016 Jun 22. PMID: 27484658. Summarized by Jeffrey Olson MS2 | Edited by Meg Joyce & Jorge Chalit, OMSII
Priya Bhaskar, M.D. is an Associate Professor of Pediatrics at UT Southwestern and an attending in the Cardiac ICU at Children's Medical Center Dallas. She completed her pediatric residency at Inova Children's Hospital in Virginia and critical care fellowship at UTSW prior to completing a 1 year CICU fellowship at Laurie Children's in Chicago. Prior to her current position here at UTSW she was a cardiac intensivist at Arkansas Children's Hospital. Her professional interests include extracorporeal support and education. She serves on the ECMO team as a core staff physician, and she has co-authored a review on this topic that we will use to guide our conversation. Learning Objectives:By the end of this podcast, listeners should be able to discuss:The general indications for VA-ECMO in pediatrics.The anatomic and physiologic rationale supporting various VA-ECMO cannulation strategies.Physiologic targets to ensure adequate oxygen delivery for patients on VA-ECMO.Hemodynamic complications of VA-ECMO such as left atrial hypertension and harlequin syndrome and general strategies in their management. Liberation strategies for VA-ECMO either to decannulation or conversion to ventricular assist device.How to support PedsCrit:Please 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.References:Bhaskar, P., Davila, S., Hoskote, A., & Thiagarajan, R. (2021). Use of ECMO for Cardiogenic Shock in Pediatric Population. Journal of clinical medicine, 10(8), 1573. https://doi.org/10.3390/jcm10081573Brown G, Moynihan KM, Deatrick KB, Hoskote A, Sandhu HS, Aganga D, Deshpande SR, Menon AP, Rozen T, Raman L, Alexander PMA. Extracorporeal Life Support Organization (ELSO): Guidelines for Pediatric Cardiac Failure. ASAIO J. 2021 May 1;67(5):463-475. doi: 10.1097/MAT.0000000000001431. Erratum in: ASAIO J. 2022 Jul 1;68(7):e129. PMID: 33788796.Xie A, Forrest P, Loforte A. Left ventricular decompression in veno-arterial extracorporeal membrane oxygenation. Ann Cardiothorac Surg. 2019 Jan;8(1):9-18. doi: 10.21037/acs.2018.11.07. PMID: 30854308; PMCID: PMC6379183. https://www.elso.org/ecmo-resources/elso-ecmo-guidelines.aspx https://www.congenitalheartacademy.com/home Support the show