Podcasts about prothrombin

*Content warning: infant loss, miscarriage, birth trauma, medical trauma, medical neglect, body image abuse, mature and stressful themes. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources Moms Advocating For MomsS23 survivors Markeda, Kristen and Amanda have created a nonprofit, Moms Advocating for Moms, in hopes to create a future where maternal well-being is prioritized, disparities are addressed, and every mother has the resources and support she needs to thrive: https://www.momsadvocatingformoms.org/take-actionhttps://linktr.ee/momsadvocatingformoms Please sign the survivors petitions below to improve midwifery education and regulation in Texashttps://www.change.org/p/improve-midwifery-education-and-regulation-in-texas?recruiter=1336781649&recruited_by_id=74bf3b50-fd98-11ee-9e3f-a55a14340b5a&utm_source=share_petition&utm_campaign=share_for_starters_page&utm_medium=copylink Malik's Law https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB4553 M.A.M.A. has helped file a Texas bill called Malik's Law, which is intended to implement requirements for midwives in Texas to report birth outcomes in hopes of improving transparency and data collection in the midwifery field in partnership with Senator Claudia Ordaz. *Sources:American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ Blood clots and pregnancyhttps://www.marchofdimes.org/find-support/topics/pregnancy/blood-clots-and-pregnancy#:~:text=Although%20birthing%20people%20with%20blood,both%20you%20and%20your%20baby.Chorioamnionitishttps://www.stanfordchildrens.org/en/topic/default?id=chorioamnionitis-90-P02441#:~:text=Chorioamnionitis%20is%20an%20infection%20of,smell%20from%20the%20amniotic%20fluid. Cross border reproductive care (CBRC): a growing global phenomenon with multidimensional implications (a systematic and critical review)https://pmc.ncbi.nlm.nih.gov/articles/PMC6063838/#:~:text=In%20vitro%20fertilization%20and%20intracytoplasmic,Belgium%20%5B37%E2%80%9344%5D. Detection of Proteinuria in Pregnancy: Comparison of Qualitative Tests for Proteins and Dipsticks with Urinary Protein Creatinine Indexhttps://pmc.ncbi.nlm.nih.gov/articles/PMC3809617/#:~:text=Background%20and%20Objectives%3A%20Excretion%20of,the%20patient%20or%20her%20pregnancy. Egg Donation and IVF in Czech Republichttps://www.eggdonationfriends.com/ivf-egg-donation-country-czech-republic/#:~:text=in%20Czech%20Republic-,IVF%20cost%20in%20Czech%20Republic,much%20from%20the%20European%20average.&text=It%20also%20needs%20to%20be,frozen%20embryo%20transfer Fundal Heighthttps://my.clevelandclinic.org/health/diagnostics/22294-fundal-height HELLP Syndromehttps://my.clevelandclinic.org/health/diseases/21637-hellp-syndrome High Blood Pressure–Understanding the Silent Killerhttps://www.fda.gov/drugs/special-features/high-blood-pressure-understanding-silent-killer#:~:text=Normal%20pressure%20is%20120/80,manage%20your%20high%20blood%20pressure? In vitro fertilization (IVF)https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716#:~:text=Research%20suggests%20that%20IVF%20slightly,or%20ovarian%20cancer%20after%20IVF%20. Magnesium - Uses, Side Effects, and Morehttps://www.webmd.com/vitamins/ai/ingredientmono-998/magnesium March of Dimeshttps://www.marchofdimes.org/peristats/about-us National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery North American Registry of Midwives (NARM)https://narm.org/ Placental Abruptionhttps://my.clevelandclinic.org/health/diseases/9435-placental-abruption Placenta and Heart Researchhttps://www.ohsu.edu/knight-cardiovascular-institute/placenta-and-heart-research#:~:text=By%20the%20end%20of%20pregnancy,area%20for%20uptake%20of%20nutrients. Postpartum Hemorrhagehttps://my.clevelandclinic.org/health/diseases/22228-postpartum-hemorrhage Preeclampsiahttps://my.clevelandclinic.org/health/diseases/17952-preeclampsia Preeclampsia - Signs & Symptoms https://www.preeclampsia.org/signs-and-symptoms#:~:text=Weight%20gain%20of%20more%20than,the%20kidneys%20to%20be%20excreted.&text=Do%20not%20try%20to%20lose%20weight%20during%20pregnancy%20by%20restricting%20your%20diet.Pregnancy weight gain: What's healthy?https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-weight-gain/art-20044360 Prothrombin Gene Mutationhttps://my.clevelandclinic.org/health/diseases/21810-prothrombin-gene-mutation Prothrombin 20210 Mutation (Factor II Mutation)https://www.ahajournals.org/doi/10.1161/01.cir.0000135582.53444.87#:~:text=There%20are%20also%20implications%20of,a%20baby%20of%20small%20size. The Risks of Prothrombin Gene Mutation in Pregnancyhttps://www.healthline.com/health/pregnancy/prothrombin-gene-mutation#What-Are-the-Risks-of-Prothrombin-Mutation-in-Pregnancy State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ Texas Health, Week by Week https://www.texashealth.org/baby-care/Week-by-Week Texas Occupations Code, Chapter 203. Midwives https://statutes.capitol.texas.gov/Docs/OC/htm/OC.203.htmWhat are high blood pressure numbers?https://www.lancastergeneralhealth.org/health-hub-home/2023/february/what-are-high-blood-pressure-numbers#:~:text=Normal:%20Less%20than%20120/80,Avoid%20secondhand%20smoke. White Coat Syndromehttps://my.clevelandclinic.org/health/diseases/23989-white-coat-syndrome Why Won't an Attorney Take My Texas Medical Malpractice Case?https://www.hastingsfirm.com/your-case-and-texas-law/ Zucker School of Medicine, Amos Grunebaum, MDhttps://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications 24-Hour Urine Collectionhttps://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/24hour-urine-collection#:~:text=A%2024%2Dhour%20urine%20collection%20is%20a%20simple%20lab%20test,is%20returned%20to%20the%20lab. 40 years later, why is IVF still not covered by insurance? Economics, ignorance and sexismhttps://www.cnn.com/2018/07/25/health/ivf-insurance-parenting-strauss/index.html *SWW S23 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookiebooSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Show notes at pharmacyjoe.com/episode1018. In this episode, I'll discuss andexanet vs. prothrombin complex concentrate for reversal of factor Xa inhibitor-related intracranial hemorrhage. The post 1018: Balancing Risk vs Benefit – Andexanet vs. Prothrombin Complex Concentrate for Reversal of Factor Xa Inhibitor-Related Intracranial Hemorrhage appeared first on Pharmacy Joe.

This week's topics include a better way to treat A-fib, managing bleeding in cardiac surgery, penicillin for strep infections, and treating pulmonary hypertension.Program notes:0:55 Ablation for afib1:51 Pulsed field ablation PFA2:55 Training physicians3:23 Prothrombin complex versus frozen plasma4:24 Noninferiority outcome5:24 Documented bleeding issue6:25 New treatment for pulmonary hypertension7:25 Improve outcomes in advanced disease8:25 Well tolerated8:40 Penicillin lowest dose to prevent pharyngitis9:40 To avoid 8.1 ng/ml steady state10:40 Get secondary prophylaxis12:10 End

Editor's Summary by Linda Brubaker, MD, MS, and Chris Muth, MD, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from March 29-April 4, 2025.

Prothrombin complex concentrates (PCCs) are frequently used off label for the management of factor Xa inhibitor-associated major bleeding. In 2018, accelerated approval was granted for andexanet alfa, a specific factor Xa inhibitor reversal agent, for reversal of apixaban and rivaroxaban in the setting of life-threatening or uncontrolled bleeding. Following accelerated approval, some clinical practice guidelines were updated to include recommendations for andexanet alfa preferentially over PCCs for reversal of life-threatening or uncontrolled bleeding due to rivaroxaban or apixaban. Other guidelines stated no preference of andexanet alfa over PCC. In 2020, Vizient convened an expert panel to critically appraise the literature and provide consensus-based, expert opinions on the utilization of pharmacological reversal agents for factor Xa-related major bleeding. Since then, the body of literature evaluating these agents has expanded to include a randomized controlled trial, ANNEXa-I, the results of which were submitted to the US Food and Drug Administration to convert the approval of andexanet alfa from accelerated to full approval. Dr. Lisa Baumann-Kreuziger, Associate Professor of Hematology and Oncology, Medical College of Wisconsin and medical director of the Antithrombotic Therapy Management Program at Froedtert Health discusses the current status of management of factor Xa inhibitor-associated major bleeding with Dr. Kerry Schwarz, Senior Clinical Manager of Evidence-Based Medicine and Outcomes with the Vizient Center for Pharmacy Practice Excellence, and your program host.   Guest speakers:  Liza Baumann-Kreuziger, MD, MS Investigator, Blood Research Institute, Versiti  Associate Professor of Hematology and Oncology, Medical College of Wisconsin Medical Director, Antithrombotic Therapy Management Program at Froedtert Health   Host:  Kerry Schwarz, Pharm.D, MPH Senior Clinical Manager of Evidence-Based Medicine and Outcomes  Vizient Center for Pharmacy Practice Excellence   Show Notes: [02:25-04:26] The current state of hemostatic management in the setting of factor Xa inhibitor-related major bleeding [04:27- 05:35] Limitations of available evidence making clinical practice and formulary decision making so challenging [05:35 – 10:52] Publication of the first randomized controlled trial, ANNEXa-I, comparing andexanet alfa to usual care [10:52-14:49] Meeting of the FDA advisory committee and subsequent complete response letter [14:50-16:45] How we can approach clinical management of patients and formulary decision-making in the current state   Subscribe Today! Apple Podcasts Amazon Podcasts Spotify Android RSS Feed

Contributor: Travis Barlock, MD Educational Pearls: What is Portal Vein Thrombosis? The formation of a blood clot within the portal vein, which carries blood from the gastrointestinal tract, pancreas, and spleen to the liver Not only can this cause problems downstream in the liver, but the backup of venous blood can cause ischemia in the bowels How does it present? Similar to acute mesenteric ischemia: Sudden onset of abdominal pain, nausea, vomiting, and fever How is it diagnosed? Abdominal CT or MRI with contrast What causes it? Cirrhosis Coagulopathy (Factor V Leiden mutation, Prothrombin gene mutation, Antiphospholipid syndrome, Protein C, protein S, antithrombin III deficiency, etc.) Oral Contraceptive Pills (OCPs) Cancer such as hepatocellular carcinoma How is it treated? Aggressive fluid resuscitation Antibiotics. Be sure to cover enteric gram-negative bacteria and anaerobes Heparin, same dosing as a bolus for a DVT Endovascular treatment, such as a thrombectomy with IR Surgical evaluation if there has been tissue death in the mesentery References Hilscher, M. B., Wysokinski, W. E., Andrews, J. C., Simonetto, D. A., Law, R. J., & Kamath, P. S. (2024). Portal Vein Thrombosis in the Setting of Cirrhosis: Evaluation and Management Strategies. Gastroenterology, 167(4), 664–672. https://doi.org/10.1053/j.gastro.2024.05.017 Intagliata, N. M., Caldwell, S. H., & Tripodi, A. (2019). Diagnosis, Development, and Treatment of Portal Vein Thrombosis in Patients With and Without Cirrhosis. Gastroenterology, 156(6), 1582–1599.e1. https://doi.org/10.1053/j.gastro.2019.01.265 Ju, C., Li, X., Gadani, S., Kapoor, B., & Partovi, S. (2022). Portal Vein Thrombosis: Diagnosis and Endovascular Management. Pfortaderthrombose: Diagnose und endovaskuläres Management. RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin, 194(2), 169–180. https://doi.org/10.1055/a-1642-0990 Summarized by Jeffrey Olson MS3 | Edited by Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/  

In this week's episode we'll discuss the safety and efficacy of nilotinib with or without cytarabine in Philadelphia-positive acute lymphoblastic leukemia; learn more about thrombosis risk in double heterozygous carriers of Factor V Leiden and prothrombin G20210A and discuss the utility of circulating cell-free tumor DNA in prognostic prediction in patients with relapsed/refractory multiple myeloma.Featured Articles:Nilotinib with or without cytarabine for Philadelphia positive acute lymphoblastic leukemia Thrombosis risk in double heterozygous carriers of Factor V Leiden and Prothrombin G20210A in FinnGen and the UK Biobank ctDNA improves prognostic prediction in relapsed/refractory multiple myeloma receiving ixazomib, lenalidomide, and dexamethasone 

Show notes at pharmacyjoe.com/episode900. In this episode, I’ll discuss uisng fixed-dose PCC for warfarin reversal. The post Episode 900: The Benefits of Using Fixed-Dose Prothrombin Complex Concentrate for the Emergent Reversal of Vitamin K Antagonists appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode900. In this episode, I’ll discuss uisng fixed-dose PCC for warfarin reversal. The post Episode 900: The Benefits of Using Fixed-Dose Prothrombin Complex Concentrate for the Emergent Reversal of Vitamin K Antagonists appeared first on Pharmacy Joe.

You're listening to the audio version of the PROCOAG trial presentation from the Critical Care Reviews Meeting 2023. The PROCOAG trial investigated the efficacy and safety of early administration of 4-factor prothrombin complex concentrate in trauma patients at risk of massive transfusion. The trial is presented by Pierre Bouzat from Grenoble. Susan Rowell from Chicago, delivers the editorial. The session is chaired by Chris Seymour (Pittsburgh). PROCOAG was published in JAMA in March 2023.

This week's episode will be focusing on some of the most testable thrombophilia syndromes including Antiphospholipid Syndrome, Antithrombin III deficiency, Protein C and S deficiency, Factor V Leiden, and Prothrombin mutations. We will go over important details on the presentation, diagnostic testing, and treatment.

CME credits: 1.50 Valid until: 31-03-2024 Claim your CME credit at https://reachmd.com/programs/cme/andexanet-alfa-is-associated-with-lower-in-hospital-mortality-compared-to-4-factor-prothrombin-complex-concentrate-in-patients-with-factor-xa-inhibitorrelated-major-bleeding/14863/ Patients presenting to the hospital with severe bleeding and underlying treatment with Factor Xa (FXa) or Factor IIa inhibitors represent an enormous challenge to providers and clinicians since the approvals of apixaban, edoxaban, rivaroxaban, and dabigatran within the United States. Intracranial bleeding, intra-abdominal or thoracic trauma, gastrointestinal bleeding, and bleeding from any non-compressible source represent true life-threatening emergencies. Treatment of severe bleeding in patients receiving Factor Xa and Factor IIa inhibitors currently involves using non-specific therapy such as blood factor replacement - packed red blood cells (pRBCs), fresh frozen plasma, and platelets. With the development and approval of reversal agents, treatment of severe bleeding can now be specifically directed at the source of the coagulopathy combined with appropriate blood factor replacement. Nationally recognized guidelines have provided clear direction on how best to manage these types of major bleeding events. While published guidelines are an important resource in helping direct how to appropriately intervene, the inherent clinical and system challenge is as follows: How do I justify and juxtapose the clinical rationale for using a reversal agent with the inherent cost associated with it with a lack of comparative head-to-head studies? Our assessment of learners suggests that knowledge and …

CME credits: 1.50 Valid until: 31-03-2024 Claim your CME credit at https://reachmd.com/programs/cme/comparing-in-hospital-mortality-with-andexanet-alfa-versus-4-factor-prothrombin-complex-concentrate/14862/ Patients presenting to the hospital with severe bleeding and underlying treatment with Factor Xa (FXa) or Factor IIa inhibitors represent an enormous challenge to providers and clinicians since the approvals of apixaban, edoxaban, rivaroxaban, and dabigatran within the United States. Intracranial bleeding, intra-abdominal or thoracic trauma, gastrointestinal bleeding, and bleeding from any non-compressible source represent true life-threatening emergencies. Treatment of severe bleeding in patients receiving Factor Xa and Factor IIa inhibitors currently involves using non-specific therapy such as blood factor replacement - packed red blood cells (pRBCs), fresh frozen plasma, and platelets. With the development and approval of reversal agents, treatment of severe bleeding can now be specifically directed at the source of the coagulopathy combined with appropriate blood factor replacement. Nationally recognized guidelines have provided clear direction on how best to manage these types of major bleeding events. While published guidelines are an important resource in helping direct how to appropriately intervene, the inherent clinical and system challenge is as follows: How do I justify and juxtapose the clinical rationale for using a reversal agent with the inherent cost associated with it with a lack of comparative head-to-head studies? Our assessment of learners suggests that knowledge and …

DrBeen#58 MTHFR Gene Mutation and the Risk of Clotting In the United States, 20-40% of whites and hispanics have MTHFR gene mutation (C677T). This mutation leads to reduced function of MTHFR enzyme to 65% of normal. The second most common mutation leads to reduced function of MTHFR enzyme, to 30% of normal. The result of these performance issues is reduced methyl groups' availability for methylation functions. The likelihood of clotting in the cardiovascular system increases because of the endothelial impaired function, clotting factor abnormalities, and increased levels of reactive oxygen species (ROS). DrBeen: Medical Education Onlinehttps://www.drbeen.com/ FLCCC | Front Line COVID-19 Critical Care Alliancehttps://covid19criticalcare.com/ URL list from Tuesday, June 6, 2023 Homocysteine and MTHFR Mutations | Circulationhttps://www.ahajournals.org/doi/10.1161/circulationaha.114.013311 preprints202303.0418.v2.pdffile:///C:/Users/s_mob/Downloads/preprints202303.0418.v2.pdf Folate, MTHFR Gene and Heart Healthhttps://www.gbhealthwatch.com/GND-Cardiovascular-Diseases-MTHFR.php Folate Insufficiency Due to MTHFR Deficiency Is Bypassed by 5-Methyltetrahydrofolate - PMChttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564482/ Frontiers | Prognostic Genetic Markers for Thrombosis in COVID-19 Patients: A Focused Analysis on D-Dimer, Homocysteine and Thromboembolismhttps://www.frontiersin.org/articles/10.3389/fphar.2020.587451/full Methylenetetrahydrofolate Reductase Deficiency - Medical Genetics Summaries - NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK66131/ Contribution of genotypes in Prothrombin and Factor V Leiden to COVID‐19 and disease severity in patients at high risk for hereditary thrombophilia - Kiraz - 2023 - Journal of Medical Virology - Wiley Online Libraryhttps://onlinelibrary.wiley.com/doi/abs/10.1002/jmv.28457 Do MTHFR polymorphisms make you more susceptible to COVID-19? - MTHFR Support Australiahttps://mthfrsupport.com.au/2021/08/do-mthfr-polymorphisms-make-you-more-susceptible-to-covid-19/ Acute Macular Neuroretinopathy Associated With COVID-19 Infection: Is Double Heterozygous Methylenetetrahydrofolate Reductase (MTHFR) Mutation an Underlying Risk Factor? - PMChttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968507/ Methylenetetrahydrofolate reductase - Wikipediahttps://en.wikipedia.org/wiki/Methylenetetrahydrofolate_reductase Disclaimer:This video is not intended to provide assessment, diagnosis, treatment, or medical advice; it also does not constitute provision of healthcare services. The content provided in this video is for informational and educational purposes only. Please consult with a physician or healthcare professional regarding any medical or mental health related diagnosis or treatment. No information in this video should ever be considered as a substitute for advice from a healthcare professional.

Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief of JAMA, the Journal of the American Medical Association, for the April 25, 2023, issue. Related Content: Audio Highlights

In this episode we will be covering Facebook Live Questions 10/11/10/16/22. For the latest updates visit my blog and be sure to join the free Facebook Group Registered Dietitian Exam Study Group with Dana RD! Don't forget to check out my recorded courses here, including the MNT Part 1 class I mentioned in the class! Need extra support? November Group Tutoring is now open and you can apply here!Grab the free RD Exam Prep Class here.  Looking for additional tutoring service? Visit my website!

Join us after hours at Dr. Bryan A. Cotton's pop-up bourbon bar at the AAST 2022 Meeting in Chicago. In this FANTASTIC & FUN episode, we talk amongst friends about cutting edge research at this year's meeting. To no one's surprise, coagulopathy, damage control resuscitation, whole blood, and factor replacement therapy just happen to be but a few of the topics discussed on Rounds.Time Stamps:00:12 AAST 2022 - Intro00:42 Sex diamoprhisms in coagulation01:52 Hemostatic profiles of female donors02:48 Pediatric whole blood (WB) is safe03:10 WB for TBI03:31 Leukoreduction is unnecessary05:30 TXA, TEG  and trauma06:44 STAAMP trial07:21 TXA: go early, big or go home07:52 Calcium...early!09:33 Canadian perspective on TXA and TEG – Neil Perry from London, ON11:25 Nori Bradley from Edmonton, AB13:53 Jordan Weinberg, not Canadian – Phoenix, AZ16:12 Issues with WB – COMBAT vs PAMPer17:31 Cold stored platelets18:22 Rapid transfusers and whole blood: Only the strong survive!!19:42 How are we doing with our resuscitation? 1:1:1 is just the beginning, not the end!21:44 Timing is everything!23:38 Plasma first resuscitation: “…God damn good!” -BAC24:37 Dr. Joshua B. Brown - Pittsburgh, PA25:31 More Canadian perspectives with Perry and Bradley29:48 Less is best!31:27 Prothrombin complex concentrate: Yay or nay?32:18 More on the endotheliopathy of trauma33:38 Just messing around and having a blast34:22 What was the best bourbon tonight?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.Gruen DS, Guyette FX, Brown JB, Okonkwo DO, Puccio AM, Campwala IK, Tessmer MT, Daley BJ, Miller RS, Harbrecht BG, Claridge JA, Phelan HA, Neal MD, Zuckerbraun BS, Yazer MH, Billiar TR, Sperry JL. Association of Prehospital Plasma With Survival in Patients With Traumatic Brain Injury: A Secondary Analysis of the PAMPer Cluster Randomized Clinical Trial. JAMA Netw Open. 2020 Oct 1;3(10):e2016869. doi: 10.1001/jamanetworkopen.2020.16869. PMID: 33057642; PMCID: PMC7563075.Guyette FX, Brown JB, Zenati MS, Early-Young BJ, Adams PW, Eastridge BJ, Nirula R, Vercruysse GA, O'Keeffe T, Joseph B, Alarcon LH, Callaway CW, Zuckerbraun BS, Neal MD, Forsythe RM, Rosengart MR, Billiar TR, Yealy DM, Peitzman AB, Sperry JL; STAAMP Study Group. Tranexamic Acid During Prehospital Transport in Patients at Risk for Hemorrhage After Injury: A Double-blind, Placebo-Controlled, Randomized Clinical Trial. JAMA Surg. 2020 Oct 5;156(1):11–20. doi: 10.1001/jamasurg.2020.4350. Epub ahead of print. Erratum in: JAMA Surg. 2021 Jan 1;156(1):105. PMID: 33016996; PMCID: PMC7536625.Moore HB, Moore EE, Chapman MP, McVaney K, Bryskiewicz G, Blechar R, Chin T, Burlew CC, Pieracci F, West FB, Fleming CD, Ghasabyan A, Chandler J, Silliman CC, Banerjee A, Sauaia A. Plasma-first resuscitation to treat haemorrhagic shock during emergency ground transportation in an urban area: a randomised trial. Lancet. 2018 Jul 28;392(10144):283-291. doi: 10.1016/S0140-6736(18)31553-8. Epub 2018 Jul 20. PMID: 30032977; PMCID: PMC6284829.Pusateri AE, Moore EE, Moore HB, Le TD, Guyette FX, Chapman MP, Sauaia A, Ghasabyan A, Chandler J, McVaney K, Brown JB, Daley BJ, MSupport the show

Show notes at pharmacyjoe.com/episode707. In this episode, I'll discuss the effects of giving both andexanet alfa AND 4-factor prothrombin complex concentrate. The post 707: What are the effects of giving both andexanet alfa AND 4-factor prothrombin complex concentrate? appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode707. In this episode, I ll discuss the effects of giving both andexanet alfa AND 4-factor prothrombin complex concentrate. The post 707: What are the effects of giving both andexanet alfa AND 4-factor prothrombin complex concentrate? appeared first on Pharmacy Joe.

In this week's episode of Red Pill Revolution, we discuss the recently released Watch the Water documentary which claims that we have all been secretly poisoned with king cobra snake venom disguised as a virus through our water supply; We also discuss Twitter going broke because they went woke, Musk still attempting to save the free world and buy Twitter and the difficulties he is running into and also the federal travel mask mandate being dropped! All of that and more on this week's episode! On this week's Patreon-only bonus content, we discuss Wiki-leaks releasing Hunter Bidens full laptop contents, Julian Assange being extradited, BP gaslighting the entire world, and more! You can add the bonus RSS feed right to your favorite podcast player! The Patreon begins at only $5 and includes weekly bonus topics, full video episodes, and more! Sign up now at: https://Patreon.com/redpillrevolt ----more---- For all the articles, videos, and documents discussed on this week's podcast join our substack!  Podcast Companion Substack: https://redpillrevolution.substack.com ----more---- Please consider leaving a donation for all of the hard work that goes into this ad-free podcast. I love doing what I do and can only continue through your generosity and support!  Donate https://givesendgo.com/redpillrevolution  ----more----   Full Transcription:   Welcome to red pill revolution. My name is Austin Adams. Red pill revolution started out with me realizing everything that I knew, everything that I believed, everything I interpreted about my life is through the lens of the information I was spoonfed as a child, religion, politics, history, conspiracies, Hollywood medicine, money, food, all of it, everything we know was tactfully written to influence your decisions and your view on reality by those in power. Now I'm on a mission, a mission to retrain and reeducate myself to find the true reality of what is behind that curtain. And I'm taking your ass with me. Welcome to the rebel. Hello, and welcome to red pill revolution. My name is Austin Adams, and thank you so much for joining me today. This is episode number 25 of the red pill revolution podcast, and we have some very interesting stuff to get into today. The things that we're going to touch today are going to range anything from Joe Biden being directly. By the Easter bunny himself. Yeah. You heard that, right. And then we're going to talk about the dropped recently dropped federal mandate surrounding masks, which is a big, big win for freedom. Now that our oppressors have allowed us not to have to have our face covered all of the time. If we want to have the privilege of going somewhere across this great nation, we're also going to touch on where the is at currently with Elon Musk and Twitter. We're going to talk about the four, the per cent increase in overall death in the ages of 19 to 40 years old. I really can't begin to fathom the implications of that. But I'm sure we all can conclude maybe potentially why there's been a 40% increase in overall deaths in the ages of 19. Just in the last two years, and this is a life insurance study we're also going to discuss briefly the watch the water documentary, which was also quite deep and concerning. And I have some questions. I have some reservations. I have some observations that we will talk about during that as well. And then we're also going to discuss briefly the Netflix situation with Netflix dropping basically 30% overnight, which a lot of people are attributing to the woke agenda by Netflix, themselves. So all of that more today, but the first thing I need you to do is go ahead and hit that subscribe button. It takes just a second of your day, and that means the world to. Every day, every day, we try and think of ways that we can give back to the world and give good karma, you know, get, get good karma back. And in one way you can do that is by doing good things for others. And you can do something great for me right now that will come back around to you. I know it by just hitting that subscribe button for me. I would appreciate it so much. I worked very hard. And it means the world to me that you're even listening, let alone considering subscribing. So go ahead and click that button right now. It takes two seconds out of your day. Makes a huge difference in your universal karma. Press that button right now. And if you could also leave a five-star review, I would appreciate it a lot that helps us basically get higher on the ratings pages. It also tells me that what I'm doing is valuable to you. If you can take it just a minute to click that five-star button and even better, go ahead and read a review or write a review up there for me. Tell me what I'm doing. Great. Tell me the most ridiculous thing that you've ever learned from this podcast. One of the maybe crazier things that you've learned by going through these episodes, I would love to hear about it. Go ahead and leave a review right now. Apple podcasts, Spotify, YouTube, wherever the hell you're at. Go ahead and do that for me. Now let's go ahead and jump into this first topic, which is going to be the Easter bunny himself now being in a better position to manage our country than our own president. It was Easter weekend. And on on Sunday, Joe Biden went and spoke in front of a group of people and was basically ushered around by what seemed to be a, possibly like a secret service agent or I don't know who it was, but, but there's some, some funny, some funny thoughts on that. So let's go ahead and I'll walk you through the video here, if you're listening. And we'll, we'll talk about it after. What you're going to see here is going to be Joe Biden on this fence, talking to some nice people and beginning to answer questions while the, the Easter bunny basically runs in front of him, waves his arms in front of the president of the United States. Like he's a toddler who is about to jump off of a cliff so that he doesn't answer this individual's questions. Then I want to see that again. Let's see if we can get that back. So it was really funny to me. I think, I think my favorite viewpoint on this was the idea that it was not the Easter bunny that was doing this. It was actually Barack Obama hidden in the Easter bunny costume. You know how there's all these conspiracies around how Barack Obama is in his third term. Just like you said, that he would do by the way, which is kind of eerie and weird that he mentioned that he would, you know, if I could have my way, he said, I don't have a very good Barack Obama impression. If I could have my way, I would have a third. And do my third term. I would just have somebody else that pretended to be there for me, I'll have to find the clip to get the exact, to the exact information that he said there and maybe improve my Barack Obama voiceover. But it it's a hilarious, hilarious idea that Barack Obama himself dressed up as the Easter bunny to usher the president of the United States around and eliminate him from actually as answering questions from the general population that he should answer to technically. Um, but who am I? Just a guy, right? So the next thing that we're going to touch on. It's going to be the mass mandate and this is pretty, I mean, it's pretty awesome and it's pretty sad that it's awesome. I think is the best way to put it. When, when your oppressor loosens the handcuffs, right. I think is the best analogy for this. I'm sure there's a better one, but I think that's the best one I have on the, off the cuff right now. Oh, off the cuff. Good, good one. There I'm. So off the cuff, the best one I have is based on handcuffs and but, but I think it is, it's like they they, they, they backed us into this position where you literally were masking toddlers, who were, you were forced forcing Todd three year olds, three year olds to, to wear masks and, and have to be put in a situation where they're uncomfortable for hours on end with no scientific backing for the reason why at all, at all, not a single reason, not a single reason that a toddler should be wearing a mask and you force them to do there's many people like my family, I have children. Who we just didn't travel on the plane. We weren't going to do that. I would never put my, my three, two, whatever year old in a position where they have to wear a mask like that because I just think it's wrong. I think that it, it positions you in a place where you're going to end up in some, well, at least for me, I know I would end up in some sort of conflict if somebody tried to force that upon my child. And it, it's just unbelievable to me that we have such Stockholm syndrome that when they loosened our cuffs and allowed us to not have to wear a piece of cloth over our face that we know did literally nothing all of a sudden it's a big party. Right? You see all the videos of the pilots coming on over the loudspeakers. If you're, if you know the pilots that this was coming though, it's like a pilot's personality is, is a little interesting. I was air traffic control in the air force. So similar, similar site type of atmosphere there. But but the, the pilots that were coming on were just like kind of excited to go over the loudspeaker and excuse me just to let you guys know, the TSA has now told us that you no longer have to wear masks and yeah. Enjoy your flight wins one 70. It's a, it's a, it's pretty cool to see that everybody is celebrating this. I haven't really seen very many negative videos surrounding this, which. You saw like flight attendants, walking down and dancing and singing music and like trying to get people to throw their masks. So it's, it's pretty, it's, it's cool. But like I said, it's almost concerning that it's cool because it should have never been so in the first place, right. There's no reason I should have ever showed about implemented. It was unlawful. And hopefully I had somebody comment about kind of like what w where could we go legally from here? I think that's an interesting conversation that we kind of have to have is because if there was a, if there is some sort of legal recourse if you were kicked off of a plane or put on a no fly list or forced to wear a mask while you had that's one thing that bothered me is like, even the medical exemptions, right? Like now there's people who are going to take advantage of that, but there's always going to be people who take advantage of things, just because there's people who take advantage of things does not mean that you don't have to submit to them based on the Americas American disability act. Right. Like, just, just because there's going to be a Small few who take advantage of that. Maybe it sound small for you, but fuck you. I don't have to wear a mask anyways. Right. Like, and, and how do you know, how can PIPA laws don't even allow you to know my medical history? Right? So there was people who were being shut out, people who are being not allowed on flights because they wouldn't wear a mask because they wouldn't violate HIPAA laws and tell a stewardess about their anxiety disorder or about their breather CLPD and all of these things that would affect them negatively to have to wear a mask. There's literally no reason that we should have been in this situation to begin with. And it's so frustrating being a parent, knowing that for three years, almost we weren't able to travel that way because of some unlawful mandate given out by the, the, the powers that be the CDC and the TSA and the the whatever bullshit acronym you want to give. Some, some power to it's just so frustrating. So I, I think it's cool. I think it's awesome. Let's go ahead and watch this video about the mass mandate so we can get a little bit more details on it, then we'll discuss it again. Real real briefly. Here, here it is out of Florida where a federal judge has just overturned the CDCs national mask mandate for planes and other forms of public transportation. Joining me now is NBC news, justice correspondent, Pete Williams. So Pete will this, does this mean that everyone can take their mask off inside a plane or is there another step? Well, that's what the judge says. We're waiting to hear what the centers for disease control TSA and the FAA S. I doubt that planes in flight for example, know about this or that most airlines are even quite aware of what they're supposed to do now. No comment yet from the justice department about what it will do, although I suspect that the government will seek a stay of this judge's order. So this is a federal judge in Tampa, Florida, who has ruled in a lawsuit, brought by a group called the health freedom defense fund, and two women who said that they didn't like wearing masks on a plane. One of them said that her anxiety was aggravated by having to wear a face mask. And the other said the mask constricted breathing and provoked or exacerbated her panic attacks. And the judge has said two things here that the centers for disease control did not have the authority to issue this mask under the law that set up the CDC. And secondly, but the federal government failed to go through all the necessary. In making a rule like this in seeking public comment. Now, the judge said, normally speaking, in a case like this, she would issue a ruling in favor only of the parties to the lawsuit. In other words, would not apply only to them, but the judge who is Katherine Kimball, Mizelle of Tampa said that's not possible that it would be hard to distinguish them from others. And then she says if, if she were to try to limit it, how is the ride sharing driver, the flight attendant or the bus driver to know that somebody was a plaintiff to this lawsuit with permission to enter mass free, that just wouldn't work. So she has declared the mask mandate illegal. She has struck it down now as I said, I don't know what the government's going to do about this. I would see, I would think they'd seek a stay of her ruling. This was the mass mandate. Of course, as you mentioned, applied to airplanes, trains buses, other kinds of mass transit. And in the case of airplanes, it's been extended several times because the government has said that it's been effective in helping to prevent the spread of COVID, but we just don't know what the federal government is going to do here. I would certainly guess they'll try to put a stop to this and get, and get a stay while this is appealed. Pete, two years into the pandemic, though, with this mass mandate that has been in place for so long. Why the lawsuit now? Why would it get overturned now? Well, the lawsuit was actually filed last year. It was filed last July. So it's been going through grinding its way through the court in the, in, in this before this judge who, by the way, issued this a decision without a trial on summary judgment based only on the arguments that were made in the written briefs. I think that may be another cause of concern here. This this is going to be a very controversial ruling. It's going to be a victory for people who have hated the mass mandates, but the government seems to believe that they are effective. All right. So that's enough of that guy. So, the, the point of it is it was struck down by a federal judge. They've gotten some heat for it. And what's even more interesting is that the white house is now coming back and saying that they're going to fight this. Like, Biden's now saying that he's going to push for this to be appealed and in, see if he can get this changed back. Right. So what it was is they came out and said, we're gonna, we need two more weeks. Right. They extended us two more weeks. And then within those two weeks that they were extending it from the white house's perspective. This federal judge struck this down as a response to a group, the freedom, something you heard of in that video, who basically put in a lawsuit was saying that this is an unlawful mandate and is not constitutional. And the judge agreed with. So now where we're at is basically that the Biden administration is now saying that they're even going to go back and fight this. Now, even on the, especially one thing people have pointed out is that sound in the election year, right? We're where his approval rating is so low already. And now he's going to go against what majority of people believe should, should be the case and make a big push against people's right to their own body. So it's going to be interesting to see how that plays out. I think if anything else, it's good for the Republicans that this is even a conversation again, because it's gonna look really bad on Biden if he makes this push to eliminate or make mass mandated again, beyond what the federal government or judge ruled which is seemingly it shouldn't be his place, right? I mean, if they make a ruling that's based off of the constitution not based off of the opinion of the woke mob which I think is an important distinction. However, one that. Don't seem to have our politicians make very often. Now the next conversation we're going to have us running, Elon Musk and Twitter. So it's, it's been a tough week for Elon Musk. I mean, never, probably I wonder if I bet you every week's actually tough for him it seems like it wouldn't be with how rich he is, but I'm sure he has more responsibility and more weight on their shoulders than any of us can even imagine. I digress. What I think it is going on here is, is basically the Twitter did something where they basically purged their shares, where they put out a big pump of, or going to, I don't know the exact case of it, but they're going to put out a bunch of new shares to dilute the overall value, which again, is, is leading them into a position where they could be given a lawsuit by their shareholders because they're not accomplishing their fiduciary responsibility, which basically means that they have a responsibility to their shareholders to do what's in the best interest of the company and to them. And, and they're obviously not doing that when somebody offers far above what it was worth two weeks ago to buy the entirety of the company. And, and for the purpose, specifically of the reason of not wanting to give the anything Alonzo, like as Eve on the Elon, even the right, has he ever come out and said, he's a Republican? Like, why is this, why is this so crazy that, that a billionaire wants to buy a social media outlet, right? Like like people were showing that. I think it was Bloomberg came out with articles, like raving raving, about how about how Jeff Bezos bought the Washington post and how it was great for democracy and how mark for the entrepreneurs of the world that they get a say in the political sphere and this whole thing. Right. And, and, and now the second that Elon Musk another. It says that he wants to jump into the conversation around social media, because he feels like the freedom of speech hindrance is being taken too far right between these companies. Which again, I agree with fully as I sit here completely shadow banned on Instagram. It will be one month to the day where I lost my entire Instagram platform tomorrow. So we'll see if the 30 day mark allows that shadow ban to fall off. And I hope it does. Cause I found some new, awesome ways to do some videos and do a lot more content for you guys. So look out for that. If you don't follow our Instagram, it's at red pill revolt on Instagram you can also check our new website. I made it, I made a website over the last A couple of weeks trying to get off of these platforms a little bit and have a place for you guys to go. That's not specifically based on somebody allowing me to be there. So I built a website it's red pill, revolution dot C O M red pill, revolution dot C O. And eventually I'll probably get the.com. I'm waiting on some response rooms. So anyways, I digress again. I'm digressing a lot. Yeah, go check out the website, red pill, revolution dot C O, which is kind of cool. Yeah. Anyways, let's move on. Elon Musk is trying to buy Twitter. They are diluting the shares and they're trying to stop him from doing so. So here's a video on that. I believe it's from the hill. And we'll go ahead and watch that right now. And then again, we'll discuss it. Robbie, what's on your radar. Well, Elon Musk offer to buy the entirety of Twitter, turn it into a private company and correct what he feels is a waning commitment to the principles of free and open source. Has drawn both praise and criticism. So many people who share Elan's to satisfaction with the platform, including Republicans and conservatives who think it discriminates against oops, Robbie, what's on your radar. So here it goes again. Let me, let me go hide. And Twitter turned it into a private company and correct what he feels is a waning commitment to the principles, order free and open. Every indication that it sides with the traditional gatekeepers of information is inclined to fend off must bid. So the company adopted a poison pill approach late last week. This is a well-known corporate tactic intended to thwart a potential buyer. So in this specific case, Twitter would flood the market with additional shares available for sale. If must stake in the company reaches 15% effectively Twitter plans to dilute his stake, making it much harder for him to reach the 51% threshold. Now, Twitter is ultimately interested in muscles. Well, this gives them more time to consider it and time as well to look for other potential buyers. So we have a pretty good idea of what the board of Twitter wants. It wants to hold onto its power. They're offered to make musky member of the board was probably one board of a desire to control and quiet him as a board member. He would have an obligation to the company not to disparage it publicly and thus, he would no longer be able to tweet his thoughts about ways in which Twitter should be different, but that brings him to the real subject of this radar. What exactly does Elon Musk want to change about Twitter? If we know that then we don't have to get into the thornier questions of which group of people do you like better, which governance structure do you think is preferable. Instead we can just quite literally evaluate the individual ideas for improving the platform. Now, fortunately it must cause. And interview late last week, let's watch. Well, I think it's very important for that'd be an inclusive arena for free speech where, so yeah, Twitter has become kind of the de facto town square. It's just really important that people have the, both the the reality and the perception that they are able to speak freely within the bounds of the law. And know, so one of the things that I believe Twitter should do is open-source the algorithm and make any changes to people's tweets. If they're emphasized or deemphasized that action should be. It made apparent. So anyone can see that that action has been taken. So there's, there's no sort of behind the scenes manipulation, either algorithmically or manually later on in that interview, Musk articulated support for a feature of many people have demanded a Twitter edit button. So you could alter a tweet after you send it book has this function. So it's workable in some sense, there's a little note that appears showing that you edited. It must also talked about removing ads for premium subscribers, providing other perks for those willing to pay more. He also wants to eliminate spam and scam bots, and he's even given some indication. He thinks some tweets should be longer, should not be bound by the character count. Now, in my view, many of these ideas, they have merit more transparency. It would be a massive improvement. It's critical for the people to know why and how the platform decides to reward and punish them. So the ultimate goal should be to devolve content, moderation to users, instead of Twitter, deciding for you what it thinks you ought to see what it thinks is dangerous or what it thinks is. So one thing that I think is interesting about that is, is the approach that Elan's talked about, where, where he basically says that he believes that it is absolutely necessary to the survival of humanity, that there is freedom of speech and the survival of democracy. Right? That's a very fair statement to make. I think that Elon Musk is like literally the, the, the, if there was like a legitimate, real world, iron man. I think, I think it's Elon Musk it's, it's, it's great to see that there is somebody who represents the general public, somebody who is, is in our corner at least feels like they are. And maybe that's a reason to question that I I've seen some people say that Elon Musk is like a shill or whatever. And I, I do think that it is a an interesting conversation to be had around anytime. There is somebody, but I also think it's like to the conditioning of, of where we're at as a society where we just can't trust anybody, even when they're willing to spend $41 billion in the pursuit of the freedom of speech and truth. I think that's a fair buy-in of your trust. Like if he's willing to spend a fair amount of, of the entire world's forge. And ensuring that you have the right to talk shit on Twitter, about everything that you want to. I think that's a fair buy-in of my trust. To me, I, I don't have very many suspicions of Elon Musk. I think that he's shown fairly clearly that he has at least in most cases, the general populations best interest in mind, maybe not when it comes to neuro link or putting microchips in people's brains. If we were going to have somebody who does it, I would rather it be him than bill gates. So there's that. So I hope that this goes through. I really do. And, and, and if not, it's going to be a really sad day for the freedom of speech and another, another blocking of, of, of the ability for us to speak out. And if you recall what happened with parlor, right? I think that we need to revisit that we need to look back on what our oppressors did to us. Just a year or two, two years ago, year and a half ago now where they completely de platformed parlor at every stage, along the way from. The de platforming of them not allowing the, basically Amazon, their servers even pulled away from them. The app store made it so you couldn't get on there after a certain amount of time after a certain amount of users signed on, because they were so afraid of what was going to come, if you were able to speak out against their hypocrisy and, and, and their deceitful ways. Right. So it's, it's, we're seeing it again, right. Twitter and the powers that be BlackRock, Vanguard, whoever it is. I think it's, I think it's Vanguard maybe BlackRock that owns or owns a very large percentage of Twitter that just bought more shares in order to be the primary stakeholder. I don't know if that's led to a bid war of any type recently with the Elon Musk. But we have seen that LMS said that he would be coming out with a counter response to what is going on here within like 10 days Time will tell, we'll see, is Elon Musk going to be able to take over Twitter? I hope so now I'm not a big Twitter. I don't even have a Twitter. I, if Elon Musk gets on there and owns it, I think I would just have to, because you kind of have to support that. I, I'm not a huge fan of like the short form, text content. Just think it's boring and I like shooting videos and maybe I'll find a use case for that on Twitter. But as of right now, I do not have a Twitter, but if Elon Musk owns Twitter, I'm definitely going to go get on Twitter. I think it's just, just to show my support there. So I, I really do hope that Elon Musk is able to take over Twitter. I think that it would be not only a good day for democracy, but also it would check the check. Those who believe they're so protected in their positions. The ministry of truth like the 1984 or Wesleyan belief system that they have their best, your best interest in mind. And you're too stupid to think for yourself. And there's no way, freedom of speech of all these heathens out there who disagree with me on these topics should be able to actually express their opinions, right? Like the, the Justin Trudeau there's a small fringe minority who has opposing opinions and they are expressing them. Uh they're they're so scared. Right? And, and again, as I said, last, last time, it just shows you how weak their arguments are and how, how S how weak they are and how scared they are of just words. Right? And, and they're scared of you having a platform to talk about them truthfully and not be able to silence you as a result. And so it will be a great day if that follows through. And now, now here's one that I think. It is going to be a, an interesting side of it. So it's like the w the other reason that Twitter wants this platform is because then they can point the laser pointer, right? Like, if it's like the we went from the, the, I got jabbed Facebook overlay on your picture to the Ukrainian flag next to it. Like when, when Instagram or Twitter or whoever it is just points a laser pointer at the next woke idea that the, the, the liberal infestation, licks their their, their paws, and then just scurries after the next thing that they can identify with and feel like they're better than everybody else. And so it's not just silencing opinions. It's, it's directing a thought from their party and eliminating thoughts from your. And assuming that you're on the side of not the side of the woke mob of Twitter, or maybe you are. And if you're listening to this kudos to you for listening to an alternate opinion than what you normally would. But I highly doubt it, but if you are thanks, I appreciate it. I'm always happy to have, here are the other side of things and we would always be open for a conversation. But anyways, I, I do think it's important and I do think it's important that not only do we allow the human, the human brain, the human organism as a whole to, I, I just think that when, when left be the human organism, the human mind, the human hive generally moves towards goodness, right? There is a small fringe minority, and those that small fringe minority is the ones that are directing our consciousness towards these negative environments and these negative conversations and these terrible things for our children and, and these the, the, the, it, it, it just, there's, there's a small group that. Trying to effect effectively taint the water of human consciousness. And, and they're so scared of you taking away their ability to do that and into allow the human hive mind to, to point it's, it's almost like a religious conversation. I had somebody comment that because I asked a question I posed it in one of my, the last episode, which is like, what, what is that right? Like what, what is the human need for truth, right? What, what is inside of us that makes us want to, to speak out when we hear things that are being said that are not true, that we see these deceitful individuals in positions of power, trying to control the masses. What is that drive like? It has to, it's not a PR, it's not an animalistic drive, right? It's not, there's not monkeys who are like shouting from the mountaintops that the other monkeys are lying to the masses. Like it's, it's a consciousness, it's a second layer, it's a prefrontal cortex issue. And we, we have to explore it from the sense that There, there is humans when left to themselves are generally good, but when directed by, by those who are, who are insistent upon tainting the water. And, and that's an interesting analogy to you is with what we're going to watch here in a few minutes with the watch the water documentary. But it w when you take away their ability to taint the water, they're so afraid of that human hive mind going towards goodness, right? Going towards positivity and, and, and realizing that we're all just literally a sliver of the same divinity, like to take the words of Marcus a really us, like we are all cut from the same cloth. We are there, there's so many different analogies that you can use, but we are all that same sliver of divinity. And we have just been thrust into different bodies and then different family situations and in different households with different parents and different upbringings. And, and, but, but at the end of the day, we are the same. Right. We are the same. We are human. We are, we are a part of this individualistic, like a perception of a greater high of mind of consciousness. And if you look at life from that perspective, you start to view the people who are on the other side is just like you, right? Like, like, yeah. The way that I view, like when people are so like involved in the mask stuff and so involved in, like everybody should get vaccinate. It's like they are the victims more than you were. I, they were, they've been taken advantage of, they are. They're the ones who are naive enough to believe these these lines. And so you shouldn't demonize the individual. They are just you in a different position, but they're just more agreeable potentially, or they're just more naive or they're just more willing to be manipulated by these people. Or they gave them more credit than they should have. And now they've been deceived into a point where they believe they have your best interest in mind. And that's maybe not everybody, there's definitely some assholes who were out there just being decks because they think they're better than everybody. But even those people, like there's a reason that they're there in that position, acting like that. And it's generally not because they want to do what the, the, the the, a ruling. Class is hoping for, which is push us towards totalitarianism and giving them more power. They're just trying to go through life and, and just so happened to be thrust into the river of propaganda that eventually led them to believe that you were killing people with your breath. It's like, how paranoid do you have to believe it, to be it to believe that that's a reality. Right. And in a high too, like at the beginning of the pandemic, right? Let's, let's take it. The backstop, like the beginning of the pandemic. I literally wanted my wife to go to the grocery store with gloves on, like I was taking this seriously. I wasn't just like laughing at this stuff frivolously and. Giving it no merit, what, before we knew what we knew before we knew the PCR tests were being manipulated before we knew that the, the numbers are being inflated with comorbidities before we knew that they were throwing people with COVID into nursing facilities in hopes of leading to a higher death rate. Before we knew CNN came out with the bar on the side of it and admitted the literally the only reason they had the death count up on the CNN newscast was to instill fear in you because it drove more views. How gross, how disgusting. Right before all of that, before we knew those things, I was scared to. And if you were following what was going on, you probably should have been also like if you, I remember watching like world counter.org or something like that. And it just, it had its own death count. And I remember watching it before CNN and before everybody else really jumped onto it before it was this like big mass hysteria. I remember following it pretty closely and pretty seriously. And to a point where, when it was at its peak, you know, to where we, none of this information came out, I was scared for my family and, and, and would have went to seemingly to somebody else, irrational lengths to ensure that my family was safe from these things. And so it, I could have very well been in that position too. And, and so to realize that it's not the individuals that are on the other side, it's not the general population and it's not the civilians that are out there. It's not the, it's the it's those who are working the proverbial Puppet whatever. I wonder if there's a word for that. It's probably a good analogy to know that the thing you hold when you have a puppet, right? The puppet masters, right. We know that those are the people who have ill intentions. Those are the people that we should be concerned about. Those are the people, the masses should be talking about that the same people who stifled the antiwar movement in the seventies, because it's a machine it's because it's all about money. And so when you realize that you should not be looking at the, your neighbor with a Ukraine flag, which was pretty stupid, right? To be honest, although I wonder how crazy it would be. If I put up a Russia flag, can you imagine how quickly your house would get AGD? If you had a Russia flag up? I kind of do want to do that low. Like literally just go in the middle of a city and have a sign that goes Russian lives matter and like, see how many people get mad and yell at you without any reasoning as to why. It would be, it would be an interesting interview and conversation to, to get into with some people, because I think you get very many people who are mad at you, none of which actually have a legitimate reason as to why. And of course, Russian lives do matter. Right? You want to use that slogan. They do. Right. And so it would, it would cause mass hysteria though, if you had a Russia flag on your house or you, you went to the middle of the town square with a Russian lives matter poster it would be a really interesting thought experiment to see people's reactions. Anyways so, the point of all that is that. Don't don't demonize the individual, right? Realize that that individual could just have very well been you and they just haven't had the same access to information or the same personality that you had to drive your search for the truth and took everything the oppressor told them at face value without questioning it or without really following up on it. And now there are some assholes for sure. There's absolutely some assholes who think that they're better than you, who generally put their I'm vaccinated flex picture on Facebook or whatever it is. But there's definitely some assholes out there, but majority of people who are on the other side of you just want to keep safe and, and, and just are following the information of the individuals that they believe are worthy of them following. And didn't have the. Mind to second, guess them and to question them and to look up the information that opposes them and to ask the right questions and look for the right information that may lead to you, finding out what the real truth is. I think that a lot of people just go straight to demonizing somebody and you shouldn't do that. You should, you should always be open to having a conversation. You should always be willing to look at the other side and put your hand across the fence and shake a hand and maybe ask them a little bit why, because that's the only way that we get to a point where things are positive again. And obviously we've seen that the point of all of this from their perspective is the diverse or the divisiveness that has come from these last few years. That is the point. That is the goal of all of this is divisiveness and at least a portion of it. And if he realized that we're literally giving them what they want by demonizing people. So, quick. Without question or without without putting yourself in a position to actually engage in a real conversation with that person that may turn out to be very positive and makes you question your, your narrative too, because you should be open and willing to change your opinions too. Right? If you, if you would expect that of somebody else, you should be on the same, the same side of that to, to allow that for yourself too. So on the backs of that, here is a video where we will watch about this talking about people, posting their vaccine on Facebook flexing with their bandaid, from the, the McDonald's they went to, to get injected with an experimental drug. Here is an individual from Canada who I believe it's from Canada, who said that there was an overall 40% increase in death rates in people from the ages of 19 to 40, specifically in the last year. And that is. Very terrifying statistic, and one that we can't fake because they had to make life insurance payout. So the, accurate, the information on this is completely accurate and can not be fudged and, and, and will not allow the mainstream narrative to position them the position, the, the information in a way to where it's not showing the truth, because these companies are being costs millions of dollars, millions, and millions of hundreds, of millions, of dollars on the backs of these deaths of these young and healthy individuals who have died over the last several years. So they have the data and this is what the data says. No one is saying with any certainty, Jason, what is causing this, but we certainly would be remiss as scientists. If we didn't look at that and say, there is something going on, what happened in 2021 that was so different from the previous five-year average, that would cause this massive increase in certain medical conditions. So the, the, the, the source of the information is several us life insurance companies that have been reporting this correct. And these three career physicians. Yes, there are separate groups of data. Jason, the previous study from the U S life insurance companies. Many of them were reporting a 40% increase in deaths from all causes in the 18 to 49 year old group. They know that because these are life insurance companies that provide group life insurance policies to employers. So these are working age individuals with a 40% increase in all costs. That was a different report from this bombshell that came out last week from, as I said, three career military physicians and the question is what, what has changed in calendar year 2021 that is causing number one, an increase in all cause deaths as reported by the life insurance companies and an increase in certain medical conditions, such as heart attacks, what clots to the lungs congenital malformations of children born that year, female infertility and those sorts of things. Did these three career military physicians offer any type of speculate? They did not. And they, but they did not do this anonymously. They signed an affidavit on this. I have not seen the raw data. I'm not a military physician. I don't have access to that database, but I don't have any reason to believe at this juncture that the data is in question. These are again, based on ICD codes and it should, I should make it clear because it's very easy to make statistics of these sorts. Deceptive. So what I say that there's a 300% increase, for example, in cancers is what they found. This wasn't an increase from one case to four cases. In the case of cancer, for example, it was an increase from an average, a five-year average of 38,000 cases per year to almost 120,000 cases in calendar year 2021. And. Wow. So that's, that's pretty crazy and pretty alarming too, is, is the idea that, that it's not just a small margin, right? It's not, like she said, it's not one person dying from cancer going to a hundred people dying or even 50 or 30 or 10 it's, 38,000 or whatever. The number was going to a hundred thousand, like, oh, crazy, unbelievable. Drastic difference in the last year for cancer deaths of the age of 19 to 40, like how, what are the odds of that? Right? What are the odds of that? And what changed since 2020 that made it like, what is a medical large medical big rollout push of the medical industrial complex that has come out and basically invited every single person, not even just invited, manipulated and, and pressured and bullied. Young healthy individuals to get a vaccine that they didn't need to get a experimental MRI and a drug put into their body that we know none of the effects of what would absolutely. That's a causation they're like, I guess you can't exactly say causation until it's proven, but is a very, very interesting correlation that F F like 40% overall deaths, 19 to 40. And when you think about the most deaths from 19 to 40, like, I wonder what the actual statistics are on that. Like, what is the average what are the most common deaths for younger individuals, like most common reasons for death in, in 19 to 40 years old? I think it would be interesting to see, and I bet you they're pretty closely associated with car accidents or drug overdoses or suicide or things like that. Like, especially in 19 to 40, that's a generally speaking, a very healthy individual with no medical issues, right? No, no ongoing issues at all, for them like statistically speaking in that age bracket commonly, and you have a 40% overall increase in death, that's terrifying, terrifying. And, and, and how can anybody try to diminish that? And, and they all. Right. The that there's going to be a big push for these life insurance companies to keep their mouth shut. And I wouldn't be surprised if there was a payout to these life insurance companies, where the government has to come to them. And behind the closed doors say that we know you had to pay hundreds because the, the life insurance industry is 100%. The one that will take the brunt of these large scale deaths of young, healthy individuals, because they didn't take into consideration when they were doing their underwriting. The fact that everybody was going to get bullied into taking an experimental drug that we knew, none of the side effects, I'm surprised the life insurance companies weren't shouting from the rooftops in, in, in funding, anti campaigns over this stuff, because they are the ones who are going to have to monetarily deal with the outcome of, of this pandemic. From the perspective of. Of the vaccinations and the 40% increase in overall deaths of 19 to 40 year olds. Right. They are the ones who are going to have to deal with this. I I'm surprised they haven't spoken out before this and, and, and made people second guess whether or not they may want to put, put these things in their bodies. Right. And so I don't know how anybody is willing to, to take to, like, they're still pushing this, right? Like, I think they've kind of accepted now that if you're not getting, or you haven't gotten it to this point that you're probably not going to get it. Like if McDonald's free burgers and a a hundred dollar gift card to. I don't know burger king didn't do it for you. I guess nothing will cause they've really given up on the vaccine push. I haven't been told to get a vaccine from the radio in at least a few weeks. But, but it has to make you wonder why, why, why are these individuals at such a young, healthy age dying at such high alarming rates and why is nobody sounding the alarm on this? Like, I, I really have to go back and I want to look at these statistics for myself and see, because that just seems so terrifying. If there was like, if there is a pandemic, it's the 40% of whatever is causing 40% more people to die in the ages of 19 to 40. And there is one, right. There is a reason for this. And now we're seeing the result of that being from not the like if you didn't know this, John McAfee, the antivirus guy that was mysteriously died in the last two years in his apartment in Miami He basically admitted to the fact that it, the beginning of the computer age, they would basically make viruses and then come out with the antivirus software. So they would infect a bunch of people's computers because they were a bunch of nerds in garages and they would infect your computer and they would have ransomware and viruses and all of this crazy stuff. And then they would come up with a solution and then they'd charge you for it. Right. And then, and so they could exactly target the people that they knew had it, it was like this crazy money making scheme that he made billions off of. And John McAfee's are crazy. Do it. He's like really interesting conversations. He did a a podcast I believe with gosh, who was it? It wasn't Joe Rogan. Was it? John McAfee podcast. I'm sure you'll find it. If you, if you look it on your end too, but he, he did a big podcast and talked about his crazy. Crazy life. There's a documentary called gringo the dangerous life of John McAfee. But I am fairly positive. He did a very big podcast. I, I don't know if it was Joe Rogan, but but it was something like that where he spoke out on. Yeah, he did the episode two 90 John McAfee on Joe Rogan. And that sounds Spotify right now. And, and it allows John McAfee just to go into some crazy detail on some of these things in his life. And you hear that he's like a, he's just a wild dude, but he would basically create these viruses and then profit off of coming out with a solution. Right. And, and so, now. You see the effects of that. And we see that, that what is actually going to come of that. And we're seeing that very quickly. If we're seeing a 40% increase in deaths in ages of 19 to 40 now, what are we going to be seeing in 10 years from now? What is the percentage uptick going to be in, in 20 years from now in 50 years from now, when these individuals who are 19 25, 30 today are in their seventies and eighties, and they've had this, whatever it is, and something gets snake venom as a little, a teaser for the wa watch the water here. But some, some people think it's some crazy stuff. And, and, and what are the effects of that going to be longterm, right? Where, where are the statistics going to go from here if it's already at 40%? And that is super, extremely alarming. I know I have had experiences with more people in my life suffering from heart conditions than I've ever seen. And so it's, it's very concerning. So the next thing that I'm going to pull up for you here is going to be. The Netflix situation. So Netflix stock plunged 37%. And it's open and it's open today as it heads for its biggest drop in a decade. So Netflix stock plunged 37% on open as it has for the biggest drop in a decade. Now it also goes on to say that the streaming giant is set to lose 50 billion, billion dollars in value after shutting 200,000 subscribers in the first quarter, as viewers complain, there's nothing to watch at least nothing that doesn't have to do with grooming your children or but what we'll, we'll talk about that in a minute here. So it goes on to talk about their reasons of what they believe it is the reasoning behind all of this. And so a lot of people have attributed this to the woke agenda of Netflix and even one of those individuals was Elon Musk himself. Iron man, I think we should normalize calling Elon Musk Ironman. He's the Tony stark of the modern era era. So Elon Musk tweet it on April 20th at 3:10 AM. Wow. What a G the woke mind virus is making Netflix and watchable. There's literally a show about a man. Believing he can get pregnant and some girl behind him holding his beer belly. If you think that's the type of content that the general public wants to see is the same shit that you're pushing in Silicon valley to your employees, that they eat up because you have bananas in the, in the break room and a knapsack in the, in the back office for them to sleep in. And you're this cool woke place. Like if you think that's what the general population is, your dad wrong, and you will see that when 30% of your stock drops after pushing woke agendas and pregnant men and small children twerking in, in acuities and all of this bullshit on top of just having shitty content like Netflix, hasn't had bangers in like a while. The only thing that's worth watching on Netflix is Ozark. And besides that, which comes out next week, if you're watching this in real time, which is a great show they just have garbage content. I literally can't think of three or five shows that I would watch on Netflix right now. I see literally, no reason why anybody should have a Netflix subscription unless they're watching a single show and then dropping the subscription. Somebody who responded to that Prenay pat hall, who said woke mind. Virus is the biggest threat to the civilization. While I said civilization, where to the civilization and Elon Musk said, yes, somebody else said, which is niche gamer said not just Netflix movies in general, video games, TV, it's all infested with current year trend woke garbage for fear, offending a green haired freak next to the band button, nothing original anymore at all. Except the media coming out of places like Japan or Korea ironically. Hmm. That's interesting. And the Lama said true. This shows the he's expecting video. So a new Netflix show says he's expecting to a man who becomes pregnant with some viewers turns. Edit at it's woke programming. Yeah. That's not how that works, buddy. And like, there's literally, like, I've seen people Google this, I guess we should Google this too. Like, can men, men straight, like who can man straight, let's see what Google has to say about that. This is literally a thing. It says having a period, this is the first thing that comes up on Google. When you search who can menstruate having a period is not a feminine thing. And people of all genders, men straight, including non binary, people, age, gender people, and even plenty of men menstruation doesn't change anything about your gender. It's just something that bodies do. Excuse me. Where am I as a man going to men straight from? Because if it's my ass, that's disgusting. And if it's my the thing on the front of me, Madame. And it's bleeding and just a bunch of men are walking around with their dicks bleeding. I think that we would have people literally going into a panic. No men can not menstruate, not one bit. We don't have a uterus that's shedding its lining. We do not believe from our penis or our butts for that matter. It is not a thing. You can not hold a child because you did not have a uterus. You did not have eggs to fertilize and you can not menstruate because your uterus that you don't have is not shedding its lining, sorry. No Google, no trans hub.org. Menstruating is not something that bodies do. It is something that happens to females because they're a female because of their chromosomes, because they're able to bear children, which this man from this Netflix show is not able to do. Sorry to tell you. So I am so could not be more happy to see that Netflix is stock is dropping as a result of this. I could not be more happy to see that Disney is taking the brunt of this woke agenda too. And I think they're next up on the list. I really do think that Disney is going to be the next person who has to deal with the the wokeness that they have turned their business into and the results that are going to come from that. So now the next thing we're going to look at is going to be the what's in the water documentary. I do think that this is a very I think that this is a very important conversation to have. I do think that there's some questions that I have to, and I, I do believe that there's some interesting information in here and there's some very compelling. And I, and I'm not going to discount it, but I also have some questions and I also have some concerns. So if you've watched wash the water, we're just going to watch a couple of minutes of the intro and then we're going to discuss it. If you have not watched it, you should go watch it right now. You can go to rumble and just type in, watch the water, which I'm doing at the moment, and you can pull it right up and watch it. It's, it's, it's quite unbelievable to me that this is I mean, there's enough people watching it to where it is circulating, but it's not a mainstream conversation and there's enough evidence and enough things that are brought up here that are very interesting and very compelling. And if you watch it if you're somebody who is very Very mindful of the information that you watch. It's it's, if nothing else, it's very entertaining and it's approach. So I would recommend just giving it a shot and if nothing else, it's a 45 minutes of your time and you may learn something and maybe you have some good entertainment as a result. So let's go ahead and I will pull up this right now and we will watch this together, at least the first couple of minutes of it, and then we will discuss it. Cause I think there's a really interesting conversation to be had surrounding this. So here we go we're good to go. So earlier this month, a lot of you may remember a post that I made on my telegram channel. There was a lot of concern about the water and not to drink it. And there were certain things that I could say and could not. And I referenced that certain people's lives might be at risk. And one of those people is here with me now, Dr. Brian artists. Thanks a lot for being here. I do really appreciate the opportunity to do this. Yeah. This is actually going to be the only time I've ever been nervous in any interview. I'm not kidding. Like I've never been nervous to discuss anything in relationship to the COVID pandemic whatsoever, but this has bothered me and it scared me putting things out is probably oftentimes the best way to protect yourself. But people have lost their lives over what you're about to tell the, I have to get this off my chest, my spirits, like screaming to say something and bring it to the forefront to protect as many innocent lives as possible. That's all I've been trying to do since may of 2020. As when I read Anthony  memo on room desk severe, when I actually just hyperlinked clicked the links to the studies that he was quoting, saying that room Desiree were safe and effective. I knew right away that he was lying. I knew right away that this drug was going to be used to mass murder, a whole bunch of innocent people in America that did not need to die. Then he was going to sell the world on the idea in the media that they were dying of a virus. When in fact I knew they were being poisoned to death with this drug, I knew 30% of all people were going to experience multiple organ failure, kidney failure, septic shock, and hypotension. That's what the study said. Now we're a year and a half after that. And it's exactly the numbers that I said based on those studies, I'm pretty much called the room desk of your guy, but where I go, which is odd for a retired chiropractor to be referenced as a pharmaceutical guy. But it is true.  is a very toxic, deadly drug. There are a lot of medical doctors and professionals who will mention it that as it's just proven to be ineffective. It is not ineffective. It is very toxic and deadly. It is known and proven to actually injure specific organs in your body. It targets specific organs. This is a part of why I think my spirit is so moved to make sure this gets out. Is that a in January, January 21st of this year. So it's just two months ago, the FDA decided to authorize. Rim death severe as the only drug to be authorized to be used in all newborns in this country. I can't, I cannot even fathom the men or women in charge that would actually do that. So it's now been moved since January 21st, 2022. It's been moved out of hospitals as the only drug to be used only allowed in hospitals, this entire pandemic. Now they're moving it into, in and out of hospital care for children. As young as newborn seven pounds heavy through the 18 year pediatric age range, it's the only authorized drug. There is nothing else that they're allowing for COVID-19 treatment. And I find that incredibly evil. And then they've also now canceled monoclonal antibody uses throughout the United States and all us territories for COVID-19 early treatment. And they're moving room desperate. Infusion centers, where they were using monoclonal antibodies as the only IB infusion drug allowed. I've been moved with one singular purpose since may of 2020. When I read Anthony Fowchee memo about rim death, severe, I felt this spark inside of me that I now had to go voice to the world, a warning to try to protect as many innocent lives as possible from being killed. So let's talk about what happened. It all started with a text. There's a medical doctor that I admire and love because he is nonstop from the beginning of COVID has had the ability to project information and say to people around the world, you do not have to fear COVID we have an answer. This guy has been on many stages with me. He's still practicing. So one thing that I think he said there that is a compelling as the conversation around REM does severe. So REM does severe was the one that they've actually pushed and allowed in the hospitals. And there's a big push from this conversation where he believes that REM does a, is being utilized to actually do the deed at the end of the COVID situations where people are dying. And then it's the kind of the final situation of what what's been. And then, so where, where we go deeper into this conversation with what's in the water, as he actually discusses what he believes is water treatment plants that are being utilized to disseminate. I believe the virus where he actually talks about the fact that he believes that within these water treatment facilities, they are tainting the water with what he believes based on the information. So this is where it gets a little crazy is where he talks about everybody talks about the woo woo Han bat situation. And if at the very beginning. You mentioned anything about the bats you get hit with a big a big misinformation sticker on there. And, and, and now the only one where you get a misinformation stickers, if you actually Google anything or post anything about snit, And COVID, and he ties a bunch of data into the idea that it is not a virus. It is not viral in nature. It is a venom and the snake venom was disseminated through the water and finished off through the REM desert veer, which was also included the snake venom of a king Cobra and of a crate, I believe is the other poisonous snake that he gets into. And so it turns out to be a crazy, crazy connecting of dots. And we'll watch a few more minutes of this year and, and discuss a little bit more about it, but I, I recommend watching the entire thing. So I do think that's very important to do let me go ahead and take a look and see if we can find some compelling parts of this conversation, surround the water and surrounding REM desert veer and the snake by them. Cause I, I think it's an important conversation to have let's, let's see if we can find the here, give me let's let's watch it again. Gilly ad bought two facilities that deal with biological studies from Genentech in 2011, and then brought 55 of their executives into Gilliad in 2011. Just when that king Cobra study started, Gil yet is the manufacturer of room. Deciview guess what's been known since 2005 below. The nicotine receptors in the brainstem being injured by Cobra venom in Viper venom. Guess what drug does that or hydroxychloroquine and chloroquine rim death, severe packaged and stored as it is delivered to hospitals comes in a little glass file. It's called lyophilized powder. It actually has a white tee yellowish tint. Guess what colors snake venom has when it's stored then to be diluted in sodium chloride or distilled water to be administered IV, or if people are buying king Cobra venom lyophilized they mix it in the same preparation as listed on the fact sheet for rim DESA, severe to actually take Cobra venom or any other Viper venom and injected into horses to make monoclonal and. When you read the emergency use authorization for him to severe, it states this one from January 21st, that every practitioner who administered this to a COVID patient pediatric or not, you have to evaluate for what's called prothrombin time. Prothrombin time means if it increases the prothrombin time, it means it's taking your blood's ability to cooperate in making it longer. So it thins your blood, you can't clot, right? You will internally bleed to death with rim death, severe. It is stated on the emergency salvation. Every patient has to have its prothrombin time checked before you give it rim severe. And during treatment, do you know what do you know what king Cobra venom does to the blood? It makes it so that it can't clot. It makes it so it can't clock. One of the evidences is it's prothrombin time. And if you look at the CDC website and then H is website. Adverse events from deciview called Beckley. It actually lists, it actually says it increases prothrombin time, which is exactly what king Cobra venom does to the human body and rim desk. Severe is lyophilized peptides, proteins of king Cobra venom. The university of Arizona published last summer, the paper, when they actually evaluated the blood samples and tissues of people who died, hundreds of them from two different hospitals after being treated for COVID, which means they got what drug rim deciview when they evaluated their blood. The title of their published article is welcome back. Why do some people seemingly perfectly. Die from COVID and others. Don't it's a question. Baffling experts during this pandemic, that's sure is a new research from the university of Arizona suggests we're closer to getting an answer as team 12, just winners explains. It seems to boil down to an enzyme. That's also found in rattlesnake venom. What does this rattlesnake have to do with COVID-19 depths? Shh. We turned much of my research in my lab towards COVID a year and a half ago. Chilton says he got blood samples from more than a hundred patients in a New York ICU. They

The Dragon is Cast Down (3) (Audio) David Eells - 4/17/22   The Origins of Evil Claire Pienaar - 4/12/22 (David's notes in red)   After Riaan and I watched “Watch the Water" from Stew Peters, we hit the floor and prayed and interceded for those family members who have been duped by the Beast System. Then I asked the Lord if this documentary interview with Dr Ardis was true, and received by faith at random, Psa 92:15  To show that Jehovah is upright; He is my rock, and there is no unrighteousness in him. I closed my eyes and had a vision. I saw a big needle, and the scene zoomed out and looked like it was being re-wound, like movies that you rewind.    The needle became a big black snake, then the snake became a large dragon or serpent with legs and wings. It stood up on its back legs and flapped its wings, it had horns and and a forked red tongue. It was aggressive and angry. (Representing the dragon/serpent of Revelations 12 who tries to destroy the Man-child and Woman and failing at that goes to make war on the rest of her seed.)   Then I started praying in the Spirit and I saw a white sword come and attack this serpent or dragon from behind me. (This represents the Word which we've heard from the beginning. Isa. 30:21 and thine ears shall hear a word behind thee, saying, This is the way, walk ye in it; when ye turn to the right hand, and when ye turn to the left.) It was a shiny metal and it pierced the dragon or serpent where its heart should have been but there was no heart, just a black hole.    Then I remembered the Word of the Lord concerning the serpent in Gen 3:15 and I will put enmity between thee and the woman, and between thy seed and her seed (Jesus): he shall bruise thy head, and thou shalt bruise his heel.   I thought, "Why pierce the place where the heart is supposed to be?" And the thought came to me, "Maybe to show me what complete darkness looks like?"    The vision ended and I fell asleep. When I awoke, I thought "Why wasn't the head crushed?” (Rev 12:9  And the great dragon was cast down, the old serpent, he that is called the Devil and Satan, the deceiver of the whole world; he was cast down to the earth, and his angels were cast down with him. The Dragon, the old serpents, head, Satan, was bruised by the seed of the Woman, Jesus, when He bound the strong man and told His seed to plunder him. The heel of Jesus is the end time body of Jesus who the serpent/Dragon will bruise by putting to death their flesh. Man-child, Woman and the Dragon  Rev. 12:1-12  And a great sign was seen in heaven: a woman arrayed with the sun, and the moon under her feet, and upon her head a crown of twelve stars; 2 and she was with child; and she crieth out, travailing in birth, and in pain to be delivered. 3 And there was seen another sign in heaven: and behold, a great red dragon, having seven heads and ten horns, and upon his heads seven diadems. 4 And his tail draweth the third part of the stars of heaven, and did cast them to the earth: and the dragon standeth before the woman that is about to be delivered, that when she is delivered he may devour her child. 5 And she was delivered of a son, a man child, who is to rule all the nations with a rod of iron: and her child was caught up unto God, and unto his throne.  The Man-child Reformers are Coming to Help: I had a vision early this Good Friday morning, 4-15-22. I saw two beautiful birds, one a grown up and another a baby. They were dressed in the same way with a blue (representing heavenly) coat and white (representing sanctified) breast.  The Baby was nesseled underneath the right wing of his mother. Then I saw the baby take flight and very shortly landed by another bird dressed the same way.  It then nesseled beneath the right wing of that bird.    (I saw no egg, the baby had already been born and was able to fly. I knew immediately that this baby was the Man-child leaving its mothers care and caught up to the throne authority of the Father and under the shadow of His wings. Today is Passover, the crucifixion of the Lamb, Jesus, in the Man-child Body. On the third day, the 17th, was resurrection day or catching up to the throne day. 17 is the number of preservation through an evil time when the crucifiers do their work. 17 is the chosen number of “Q” also.    Possibly a parallel is being shown between the Man-child body and Trump. Daniel was promoted over the Kingdom as Cyrus Conquered Babylon on the same night.  Operation Disclosure: Thurs. 14 April Charlie Ward: GESARA/NESARA is happening this weekend. [It was working on the 1st but they said they would announce it to the public around Easter. BTW, Easter is the pagan name for the goddess Ishtar used in the KJV in Acts 12:4, but it is translated from the Greek Pascha, [Hebrew Pesach] meaning passover. Ishtar was the pagan goddess that fell down out of heaven into the Euprates river in an egg.)   Considering my revelation of the Father and Mother of the Man-child I then I read to them Operation Disclosure's revelation of this day. “An hour before Sunrise Fri. morning 15 April the Planets Jupiter, Venus, Mars and Saturn will be lined up in the Southeast Sky. (So we have the heavenly bodies of the Jupiter the King Planet, representing the Father, Venus, representing the mother planet, and then Mars, representing the war planet, and Saturn, representing the Devil planet. After the Father and Mother bring forth the Man-child and his throne authority war begins in the heavens and the devil as the dragon of Babylon is being cast down.)   Then I read the first verse text sent in for this morning:   Deb  (Mat.21:5) Tell ye the daughter of Zion, Behold, thy King cometh unto thee, Meek, and riding upon an ass, And upon a colt the foal of an ass...(9) And the multitudes that went before him, and that followed, cried, saying, Hosanna to the son of David: Blessed is he that cometh in the name of the Lord; Hosanna in the highest. (Hosanna means, “Oh Save, Heal, Deliver, oh Lord.) Back to our Rev. 12 text: 6 And the woman fled into the wilderness, where she hath a place prepared of God, that there they may nourish her a thousand two hundred and threescore days. The War in Heaven 7 And there was war in heaven: Michael and his angels going forth to war with the dragon; and the dragon warred and his angels; 8 And they prevailed not, neither was their place found any more in heaven. 9 And the great dragon was cast down, the old serpent, he that is called the Devil and Satan, the deceiver of the whole world; he was cast down to the earth, and his angels were cast down with him. 10 And I heard a great voice in heaven, saying, Now is come the salvation, and the power, and the kingdom of our God, and the authority of his Christ: for the accuser of our brethren is cast down, who accuseth them before our God day and night. 11 And they (The Saints) overcame him because of the blood of the Lamb, and because of the word of their testimony; and they loved not their life even unto death. 12 Therefore rejoice, O heavens, and ye that dwell in them. Woe for the earth and for the sea: because the devil is gone down unto you, having great wrath, knowing that he hath but a short time. (Not only are the Saints given authority to cast down Satan and his demons from the second heaven to earth but when they return with the Lord they have a hand in casting him below the earth.) The Dragon Persecutes the Woman 13 And when the dragon saw that he was cast down to the earth, he persecuted the woman that brought forth the man child. 14 And there were given to the woman the two wings of the great eagle, that she might fly into the wilderness unto her place, where she is nourished for a time, and times, and half a time, from the face of the serpent. 15 And the serpent cast out of his mouth after the woman water as a river, that he might cause her to be carried away by the stream. (As we will see, this could be representative of the “Watch the Water” Documentary where the venom of the serpent is found in the vaccines and is being distributed through the water supply in order to change the DNA. This could represent the seed of the serpent which would certainly be carrying the Woman away from the seed of Adam and Christ.) 16 And the earth helped the woman, and the earth opened her mouth and swallowed up the river which the dragon cast out of his mouth. 17 And the dragon waxed wroth with the woman, and went away to make war with the rest of her seed, that keep the commandments of God, and hold the testimony of Jesus: The Seed of The Serpent Covid Snake Venom Documentation: Interview Transcript of Dr. Ardis and Stew Peters By: holistic health online - 4/14/22  “Watch The Water” Documentary FULL   Dr. Brian Ardis: It's an honor to be here. I just want to say thank you, everyone, who's put any faith and trust in me to be able to convey truth… I have to get this off my chest. My spirit is screaming to say something and bring it to the forefront to protect as many innocent lives as possible. That's all I've been trying to do since May of 2020.   As you know, I read Anthony Fauci's memo on Remdesivir and when I actually clicked the links to the studies that he was quoting, saying that Remdesivir was safe and effective, I knew right away that he was lying. I knew right away that this drug was going to be used to mass murder a whole bunch of innocent people in America that did not need to die. Then he was going to sell the world on the idea in the media that they were dying of a virus, when in fact I knew they were being poisoned to death with this drug. I knew 30% of all people were going to experience multiple organ failure, kidney failure, septic shock and hypertension. That's what the study said.   Now, we're a year and a half after that, and it's exactly the numbers that I said based on those studies. I'm pretty much called "the Remdesivir guy" everywhere I go, which is odd for a retired chiropractor to be referenced as a pharmaceutical guy. But it is true Remdesivir is a very toxic, deadly drug. There are a lot of medical doctors and professionals who will mention that, and it's proven to be ineffective. It is not just ineffective; it is very toxic and deadly. It is known and proven to actually injure specific organs in your body.   It targets specific organs. This is a part of why I think my spirit is so moved to make sure this gets out. On January 21st of this year 2022 – so just two months ago – the FDA decided to authorize Remdesivir as the only drug to be authorized to be used in all newborns in this country. I can't even fathom the men or women in charge would actually do that. Since January 21st of 2022, it's the only drug to be used, only one allowed in hospitals for this entire pandemic. Now they're moving it into hospital care for children as young as newborns, 7 lbs. through the 18 year pediatric age range. It's the only authorized drug. There is nothing else that they're allowing for COVID 19 treatment. And I find that incredibly evil.   And then they've also now canceled monoclonal antibody uses throughout the United States and all US territories for COVID 19 early treatment. And they're moving remdesivir to the infusion centers where they were using monoclonal antibodies as the only IV infusion drug allowed. I have been moved with one singular purpose since May of 2020. When I read Anthony Fauci's memo about Remdesivir, I felt this spark inside of me that I now had to go voice to the world, a warning to try to protect as many innocent lives as possible from being killed. So let's talk about what happened.   It all started with a text. There's a medical doctor that I admire and love because he is nonstop from the beginning of COVID and has had the ability to project information and say to people around the world, you do not have to fear COVID. We have an answer. This guy has been on many stages with me. He still practices right now medicine and is an ER doc and he sent me a text. It actually was dated December 1st and I did not see it until like December 18th. I don't know how I didn't see it, but the text read, "Hey Dr. Ardis, if you got bit by a rattlesnake, would you go to a hospital and get anti venom?"   I realized he must have seen an interview I did on Infowars. So Kate Dailey had done an interview with me and wanted to go over my thoughts of monoclonal antibodies. Well, I had been given some research studies that actually bothered me. I didn't like the idea based on the data in these research studies. I didn't think monoclonal antibodies were safe. Long term, not short term, but long term. Now, I read the actual text message, got in the shower, and while I was in the shower, I was sitting there thinking, why would he send me that text? It has nothing to do with COVID. So I'm going through this and I'm thinking about the text and all my brain keeps going to is why is he mentioning anti venom.   Is there something about antivenom? So I went and got on the Internet and I wanted to know what is Antivenom. Only to find out that most antivenoms are monoclonal antibodies or polyclonal antibodies. And then I got it. Then I knew why he sent it to me. He wanted me to immediately see a question that he knew I would say, of course I'm going to go to the hospital and get anti venom. So in his mind, I think he knew this was a way or God inspired him to send me this message. Then go figure out why it is you would say yes. This is where it all started.   I will repeat what Steve Kirsch said to an audience with me last month. He said, "If the CDC says something to do, you do the opposite. If the NIH says to do something, or the FDA, do the opposite." I'm sitting there realizing that anti venom is monoclonal antibodies, and then I immediately revert back to, in my own head, that I'm not trusting anything the CDC and or FDA says. Is our federal health agencies recommending monoclonal antibodies for COVID 19? No, they're not. They've been badmouthing monoclonal antibodies this whole time.   They stripped them out of Florida when De Santis wanted to use them. And then January 21st of this year, they totally stripped out monoclonal antibodies. They do not want you touching monoclonal antibodies. They also didn't want you, from the beginning, to touch hydroxychloroquine. They also don't want you touching ivermectin. They also don't want you touching N acetyl cysteine (NAC) so that the things they tell you to avoid we know they're telling you to avoid because they work. So, I realized that the federal health agencies were actually not supporting monoclonal antibodies, and we believe that this is because they intentionally don't want people to recover.   ...I cannot believe the amount of evil behind this pandemic with what I've realized since then. I realized, all of a sudden, that monoclonal antibodies are anti venom. The federal government doesn't want us using anti venom. Why are they bashing anti venom and why are we finding that anti venom works against COVID? Is it not a virus? Is it instead a venom? This is what I want to know. Is COVID a venom? Is this why they don't want you using monoclonal antibodies.   Let me ask you a question. Do you believe the mass media is controlled? Of course, you actually do believe that. So you believe that whatever's being pumped out in the media is being orchestrated and controlled, across all of it.   All right. So in my head, I was like, okay, how do they keep people on that story? So there's this mass media group who are telling a huge story. They're all telling the same story around the world. Whenever anybody says anything against that narrative, what do they use now to combat that in the mainstream media?   Stew Peters: Disinformation?   Dr Brian Ardis: Yeah, they call them fact checkers. Fact checking is the opposite of fact checking. The arbiters of lies are the fact checkers.   By definition, fact checkers are there to divert you from truth and take you back to a narrative that is being sold worldwide, right? If it's true that COVID could actually be snake venom, (And how I came to that conclusion was they don't support the use of anti venom called monoclonal antibodies because they work.) The easiest way to figure that out is, has that ever been fact checked? I wanted to know was there ever any mention that the source could have been a snake? And oh, my God, I couldn't believe it. Over and over and over in the media in January and February of 2020 there are non-stop publications that the original source could either be from bats, snakes or pangolins. And every time the snake is mentioned, fact checkers – One, two, three, four, five, six, constantly fact check it and spin it back to the bats. There's no fact checking about bats. They keep you looking at bats.   In the beginning, in January of 2020, the scientists inside of China said this can't be from bats. These bats hibernate. And it's the winter. When they did genetic sequences from the antibodies in the people who were sick in Wuhan, they found that their genetic sequence was not most like bats. They were most like two snakes. Proteins from the Chinese Krait and the King Cobra. Then I find in April of 2020 there was a research study published in France where they're finding that the receptors in the brain called nicotinic acetyl-choline-sterase receptors are actually bound most tightly to snake venom of the krait and cobra is what they're finding, and that the spike protein from SARS-CoV-2 is most identical to Chinese krait and king cobra venom.   Then I find out that there's an actual doctor, Bing Liu, who works at the University of Pittsburgh in May of 2020. He works in a computational lab dealing with genetic sequencing and he's been researching for five months; the sequencing of spike proteins, trying to solve the mystery of SARS-CoV-2 victims. He says he's got a "big thing", too; A big press release. They're going to actually announce all their findings.    HEADLINE: Set back in the quest to understand coronavirus after a researcher is shot and killed. 37 year old Bing Liu was on the verge of making significant findings on COVID 19.   And that's when I freaked out. Also, all of the clips in the media when they interviewed his boss, who is still at the University of Pittsburgh, he said that they were going to publish the work they found through Bing Liu's work in their department. That's never been published. I'd like to know why a year and a half later, it's never been published. Where is it?   And then, all of a sudden, the realization came to me that this is the "great lie." When I say that they have lied to you about everything in relationship to COVID, they've even lied about the viral part of COVID. Now you have to understand here, my entire stance for the last year and a half has been to educate, warn people about hospital protocols because of a drug called Remdesivir. So in this realization that this could all be related to venom, something bothered me in the January 21st issue that came out from the FDA about Remdesivir in this 42 page document. It actually says there's only one drug that cannot be co administered with Remdesivir at the same time because it negates the antiviral properties of Remdesivir. And that drug is hydroxychloroquine.   In January 2020, there's this incredible study that's published where over a ten year period a company has been funding a research study gene-mapping all the genes of the venoms and proteins and peptides inside of King Cobra venom. And in January 2020, they published their findings. Oh, ask me if I was shocked when I saw that there were 19 toxic venom proteins that they isolated that specifically target organs in your body.   So I go to the funding part of this study. And I want to know who funded this and how many companies. It says that the majority of the company and studie's funding came from a company called Genentech. Genentech is a subsidiary of a company called Roche. I don't know anything about these companies. I never heard of them. The employees of Genentech, who were the authors of the study, said they have a conflict of interest because they actually hold shares and stocks in Roche. Genentech, I've never heard of Genentech. Is there a correlation between Genentech and Gilead? This is not a joke. I typed it on Internet. Is there a connection to Genentech and Gilead? Oh, my God. Gilead had bought two facilities that deal with biological studies from Genentech in 2011 and then brought 55 of their executives into Gilead in 2011 just when that King Cobra study started. Gilead is the manufacturer of Remdesivir.   Guess what's been known since 2005. Guess what blocks the nicotine receptors in the brain stem from being injured by cobra venom and viper venom. Guess what drug does that? Hydroxychloroquine and chloroquine.   Remdesivir, packaged and stored as it is delivered to hospitals, comes in a little glass vial. It's called Lyophilized powder. It actually has a white yellowish tint. Guess what color snake venom has when it's stored; then to be diluted in sodium chloride or distilled water to be administered in an IV. Also, If people are buying King Cobra Venom Lyophilized (powdered form), they mix it in the same preparation as listed on the fact sheet for Remdesivir to actually take cobra venom or any other viper venom and inject it into horses to make monoclonal antibodies.   When you read the emergency use authorization for Remdesivir, it states this from January 21st, that every practitioner who administers this to a COVID patient, pediatric or not, you have to evaluate for what's called prothrombin time. Prothrombin time means if it increases the trauma time, it means it's taking your blood's ability to coagulate and making it longer so it thins your blood. You can't clot, right? You will internally bleed to death with Remdesivir. It is stated on the emergency use authorization. Every patient has to have their prothrombin time checked before you give them Remdesivir and during treatment.    Do you know what King Cobra venom does to the blood? It makes it so that I can't clot. You know, one of the evidences is it's prothrombin time. And if you look at the CDC website and the NIH website on the adverse events from Remdesivir, it actually says it increases prothrombin time, which is exactly what King Cobra venom does to the human body. And Remdesivir is the lyophilized peptide proteins of King Cobra venom.   The University of Arizona published a paper last summer where they actually evaluated the blood samples and tissues of hundreds of people who died, from two different hospitals after being treated for COVID, which means they got Remdesivir. Why do some people who are seemingly perfectly healthy die from COVID and others don't? It's a question baffling experts during this pandemic.   NEWS REPORT: A new research from the University of Arizona suggests we're closer to getting an answer. It seems to boil down to an enzyme that's also found in rattlesnake venom. What does this rattlesnake have to do with COVID 19 deaths?   We turned much of my research in my lab towards COVID a year and a half ago. Chilton says he got blood samples from more than 100 patients in a New York ICU. They either had no COVID, or  a mild, moderate or severe case of the virus. He did some fancy  artificial intelligence in his lab and discovered two distinct patterns in the people who were dying from COVID.   Dr. Brian Ardis: These patterns, number one, told us that the vital organs were in trouble, but the other looked as if they were being attacked by some enzyme.   He says he then found the highest concentration of this enzyme that has ever been found in humans. These levels, attacking internal organs means multiple organ failure and death.   So where do the rattlesnakes come into play? This enzyme is a humanized version, part of the same family as the active ingredient in snake venom. In simple terms, this enzyme related to rattlesnake venom that's been found in humans is likely causing tremendous damage, leading to COVID 19 deaths.   And then they take you through all of the elevated enzymes in the blood samples of these people that are naturally found in rattlesnake venom and viper venom that are in levels they've never seen before. Do you wonder how they got there? 5 to 10 days of Remdesivir. They've known since 2005 if you inject a mouse with cobra venom, like they're doing with Remdesivir, injecting into your veins, it actually causes a cytokine storm in the lungs of all animals. I am convinced that COVID 19 is not a respiratory virus of any kind. It is actually venom poisoning. And they're using, I believe, synthesized peptides and proteins from venoms of snakes, and they're administering them and targeting them to certain people.   Now, the amazing thing about these 19 toxins found in cobra venom, they're specifically sequenced to target specific organs, like the pancreas in a diabetic, like the heart in a heart disease patient, like the liver in a hepatitis patient.   So if I die because I'm a cancer patient, or if I die from some sort of liver related function because I've had liver problems, if I die, then it'll be undetectable. It'll be untraceable. They're going to chalk it up, of course, to whatever underlying disease the person was suffering from.   This is the most original of all bioweapons ever. Snake venom. I mean, we know how poisonous snakes are. This is the most obvious bioweapon ever. When I say this is the most evil thing I've ever encountered in my entire life. Could you ever have imagined the one greatest symbol of evil in all of Christendom. What is the symbol of evil in Christianity? The serpent. The serpent! Can you think of anything more evil than envenomating the entire world with snake venom and then injecting snake venom into your veins. And then using mRNA technology that they've been isolating from snake venom for years that they know are unusually stable, more stable than any other mRNA they've isolated from other natural organisms for decades.   In 2015, they took mRNA from cobra venom, krait venom, and they actually wrapped the mRNA in nanoparticle hydrogel. How often have you heard about that with these new mRNA vaccines? And they made it even more stable. Then they actually added what's called dynabeads to those nanoparticles surrounding the mRNA of snake venom. And it made it even more stable and made it last longer. It made it easier to get inside of your cells. Do you know what dynabeads are? Magnetic metal nanoparticles.   CLIP FROM BLACKLIST: The movie actor says, "Your prayers have been answered, Donald. Apparently I'm dying. I've been poisoned by someone within my organization. Someone with access to an offshore account that was used to fund recent attacks against me. 11 people had access to that account. Last evening, I called those 11 to a dinner to confront them. What happened next? I only remember pieces. The restaurant. What it looked like. Where it was. I remember holding a glass of wine, not drinking it. Although I'm sure I must have. I need you to find the pharmaco-toxicologist who I believe crafted the deadly cocktail and get the antidote from him.   He's known as The Apothecary, a druggist whose potions hijack the immune system, causing any number of allergic reactions. Each one impossible to identify unless you know what you're looking for. An exotic venom might replicate a drug overdose. A personally tailored allergic reaction might trigger cardiovascular collapse.   The apothecary can create embolisms, aneurysms, inhibit respiration, induce paralysis. We're looking for cortico-steroids. Broncho-dilator. Go, go, go.   I've lived my entire adult life surrounded by the corona of death. Sometimes I even longed for it. But lately I find I'm not willing to go gentle into that good night.   There's good news. The lab did find one distinct element in the molecular structure of the drops taken from Robert Ball's apartment. A peptide unique to the venom of the red-headed Krait."   Dr. Brian Ardis: When I saw this movie clip, I knew. I knew I was right. I knew I was supposed to see that because it was confirmation to me that other people knew this was planned all along, which we've known this is a plan. [In the movie] the FBI figures out that it's actually peptides found in krait venom that poisoned Reddington. In the show, you learn that he was poisoned by drinking. It was put in his drink. And then I realized something. I realized how they've been spreading this.   I had actually told my wife six months prior to this that it's very odd when you go on the CDC website that they have this wastewater surveillance tab on the COVID data tracker site. And they have 400 water testing sites in 37 cities in this country. What no one knows is the data from the CDC between January of 2020 and September of 2020 in relationship to their water testing of these 37 cities. They only let people know they were doing it in September of 2020 and now releasing that data. They now just announced two weeks ago, Walensky did, of the CDC, that they're now upping their water testing, they say, and have been reporting to media outlets that how it works is they are PCR testing our wastewater because we, as we get COVID 19, are pooping it in the water and we're going to test our wastewater. And we can tell the city when there's high amounts of SARS-CoV-2 in the water, they can actually tell that same community four or five days later is going to be an outbreak of COVID 19 in that city.   Stew Peters: Wait a minute. That's backwards.   Dr. Brian Ardis: That is completely backwards. If a community has had SARS-CoV-2 go through their body, they already had their symptoms when they eliminated the virus, supposedly the virus is out of their body and it ends up in your wastewater, you no longer have symptoms. How could you know and then be able to confirm in the future 4 to 5 days from now when we find it in your wastewater supply from your city. When we see it being shed in your water 4 to 5 days later, we can actually tell you there's going to be an outbreak in your city? It's not because there's an outbreak in the city, just like in the show Black List. I had to break this down for every aspect of COVID.   One thing that's been very unique to COVID is this sense of loss of taste and smell that lasts for months, even years. Holy cow. I had no idea they already knew this happened to people when you drink it. For the people who are the natural healers or the individuals who've got bitten when they actually suck the venom of cobra into their mouth and then spit it out, they have this loss of taste and smell that can last 12 months to a year and a half. It's just from having been exposed in the mouth, which is exactly what's happening when it's being put into our water.   Now, the thing about the water is this: they are using the water systems because they can target specific demographics. They are absolutely confident that the peptides they have chosen for COVID, circulated throughout the Earth and throughout the populace, and the vaccines and the mRNA in the vaccines specifically target organs like your spleen and your pancreas. For diabetics, that's a concern. Brain tissue, liver tissue, lung tissue and heart tissue. So if you already have a disease process of inflammation of any of those organs, you are the ones that they are targeting.   Stew Peters: So are the people that work at my water treatment facility are aware of this? Are they in on it.   Dr. Brian Ardis: No, no, the CDC is in on it. And the CDC is working with contracting companies to make sure they do it.   There are nicotine receptors in your brainstem that control your diaphragm. Your diaphragm has to contract to be able to allow oxygen to get into your lungs. They are using krait venom and cobra venom and calling it COVID 19. You're drinking it. It's getting it into your brainstem and it's paralyzing your diaphragm's ability to breathe. I cannot say this enough.   In the very beginning of COVID, it was being reported around the world that the least demographic represented in hospitals being hospitalized for COVID 19 were smokers. Around the world, it was less than 5% of everybody in hospitals were actually smokers. And they found that odd, only because this was a respiratory virus. Wouldn't it be that the people who are shoving tobacco and nicotine in their lungs would be more apt to be traumatized by a novel respiratory virus? But that's not what they saw.   What was amazing is when this started getting reported in the first six months of COVID in 2020 around the world, guess what our federal government did? Anthony Fauci, the NIH, CDC and the FDA all came out and started pumping in the media that there's no better time than right now to quit smoking. And they actually lied to you and they lied to the entire world and said smokers are being hospitalized at rates higher than any other demographic. Well, the truth is, these nicotine receptors that are affected by cobra venom and krait venom that control your ability to breathe, was causing your oxygen levels to fall. On a pulse oximeter it looks like you have pneumonia. But you didn't. You were being paralyzed. Actually, you couldn't breathe and your heart rhythm was actually being dropped by the same receptors.   Nicotine binds to those receptors and then the venom can't bind, so it can't paralyze your diaphragm. They knew and we're theorizing in France in April of 2020 when they figured out that it was the nicotine receptors that control the diaphragm's ability to breathe was what the spike protein was targeting, because it most looked like the neurotoxin of krait and cobra venom. They started theorizing that studies needed to be done, that we start giving people nicotine to protect them from getting COVID.   It absolutely is known that nicotine is protective against COVID 19 because it stops these venoms from damaging and connecting to these nicotine receptors in your brain that control your diaphragms ability to breathe. But once you go into a hospital because you can't breathe, if you're not a smoker and you don't do the nicotine they put you on Remdesivir. Remdesivir is venom from a cobra. It's attaching itself to the nicotine receptors in your brain. You then can't breathe and then at the same time, it destroys the inside of your of your lungs through what's called a cytokine storm. That is what cobra venom does.   And then they say they've got to put you on a ventilator. They're putting you on ventilators because then they can actually murder you by euthanizing you with drugs that act similarly to the venom. They have to sedate you because when they go to shove a tube down your trachea to get into your lungs, you'll pull it out. You'll pull it out, or you'll fight them as they're trying to shove it in there. So they have to sedate you. So they use morphine, fentanyl,  Lorazepam or midazolam. These drugs act on the same centers of your brain that control the diaphragm's breathing. These drugs are euthanizing drugs, and they actually will put you on these protocols at the same time they have you on Remdesivir. The entire attempt is to slow down your breathing and your diaphragm and you will die. They've got the cocktail down pat.   The average person dies on day nine of COVID 19, hospitalized treatment. They only authorize, per the NIH, two five day treatments of Remdesivir. It's amazing that the ninth day is the day that most people die in February of 2020. The Wall Street Journal was allowed to produce an article, and they particularly speak to the word “virus” in coronavirus pandemic. And in this article it actually states that the Latin definition for virus, originally and historically, virus means venom.   So I started to wonder, well, what about the name Corona? Does it have a Latin definition or a definition at all? So I actually looked up what's the definition on Dictionary.com and it brings up 13 definitions. Corona religiously, ecclesiastically means gold ribbon at the base of a miter. I didn't know what a miter was, so I copied it and pasted it and then hit images. So this actually could read the pope's venom pandemic. It also can read Crown. Corona means crown also in Latin terms. Visually, we see kings represented with a crown symbol. So put that together for me. King Cobra venom. It actually could read King Cobra Venom pandemic. I've said this for about a year now that I actually believe this is more of a religious war on the entire world. I've been adamant about that. Actually, the message of Christ forever was He's the master healer and faith precedes all miracles, not vaccines.   So why are we actually putting more faith in drugs? And why is a man of the cloth [the Pope] supposedly putting more faith in science and a drug than he is in telling people to pray to God? God's greatest creation was you, and you are made up of a DNA strand of genetics that are unique to you. If I was going to do something incredibly evil, how ironic would it be that the Catholic Church or whoever would use the one symbol of an animal that represents evil in all religion, which is either the snake or the dragon, which is actually just a snake with legs. You take that snake or that serpent and you figure out how to isolate genes from that serpent. And get those genes of that serpent to insert itself into your God given created DNA. I think this was the plan all along; to get the serpents, the evil ones, DNA into your God created DNA and they figured out how to do it with this mRNA technology, they are using mRNA, which is mRNA extracted from, I believe, the king cobra venom.   And I think they want to get that venom inside of you and make you a hybrid of Satan. No longer just belonging to God or a creation of God's. When I say that the mRNA inside of the Pfizer and Moderna shots is actually derived from snake venom. Yeah, it just sounds crazy, right? But I want you to read from July 6th, last year, 2021, the co-founder of Moderna read the title, show it to the camera.   Moderna is using mRNA technology to treat venomous snake bites. It goes on to say that he's going to help create and co-found a company based in San Francisco that actually is going to solely work on creating anti venom drugs for snakebites.   Guess who funds this thing? The Department of Defense, the Welcome Trust Fund and the United Nations. Incredible. All right. So this is great.   Let's just wrap our heads around that for a second. How many snake bite victims are there? It's like 100,000 people. 100,000 people will die from snake bites. But this is enough for the Department of Defense and for the United Nations to get on board and to fund such a venture?   Dr. Hoffe out of Canada after evaluating his vaccinated patients, was able to determine those who had received them had elevated  d-dimers, and he checked that because they all complained of extreme fatigue, like long hauler's COVID symptoms. And he was enlightened to do this d-dimer test and then found every single one of them had elevated d-dimer. Now I want you to read on Medscape: What is it that medical doctors are trained to look for when they see elevated d-dimers? So read the title and I want you to read the fifth bullet point.   How are elevated d-dimer levels interpreted? Snake venom poisoning. So even medical doctors are trained to look for elevated d- dimers and to know that this is a possible snake venom poisoning. And notice they didn't use the word snake bite victim or snake venom poisoning. And I was like, Oh, my God, it's in the mRNA shots for sure. This is why you're seeing this. They even talk about it on here that d-dimer is a reflection of fibrinogen and its ability to control coagulation, and that it's usually at normal low levels inside of people who are fine. But then these d-dimers get extremely elevated after snake venom poisoning.   The kidney failure caused by Remdesivir is the number one organ targeted by King Cobra venom. It's the number one. There isn't anything in relationship to symptom-a-tology of COVID 19 injuries post COVID 19 vaccines treatment with Remdesivir that cannot be correlated back in research studies to venom from cobras, kraits and other vipers.   So when somebody gets bit by a snake, particularly a king cobra or a krait, what is the long term prognosis for these people? If you have been injected you've had gene sequences put into you or peptides put into you from a venom. And that actually continues, particularly one bite after another. Those disease processes become even more exaggerated. This is why they want to continue doing the booster shot program…   FOLLOW-UP: Dr. Ardis Answers the Top Questions About “Venom Theory”:  https://www.brighteon.com/14d31e23-e80f-4247-a882-c148ac4ea53f   Transcript of the first 15 minutes:   Dr. Ardis: “I've worried that the information was going to be so monstrous that many people would deflect immediately and not trust the information or not want to consider even looking at it.   I was hoping that when I brought this to Mike Adams that any gaps in the story would be filled in by other experts in their fields.   I'm not an expert in all fields. I'm not an expert in water supplies. So I just want to clear up this water supply thing. (With the help of Mike Adams.)   The one thing that's been the biggest negative has been people saying, “There's no way this is in the water. How can you even say they're poisoning the water with snake venom?” etc.   I want people to understand something; water has not been my story. This is not even the biggest part of the story. I've just wanted to save people's lives from the hospital protocols.   As I have said from the very beginning; for the last 2 years, “Whatever the bioweapon is, even when I thought it was just a  virus engineered in a lab, that it's not very good or effective because less than 1% of the entire world population has died from it. I never thought the whole “water source thing” was dangerous or horrific and everyone should focus on the water. (In fact Stew Peters was the one who came up with the title for our “Watch the Water" interview and documentary.)   Mike Adams: About the 'water thing'; I find it a little bit surprising that some people were giving you push-back on the water issue. It's as if they've forgotten the decades of water Fluoridation. The water supply has been meticulously and systematically poisoned with toxic fluoride , which is a near toxic chemical that is dripped into the water supply. It usually comes in the form of a powder (just like Remdesivir) and then it's reconstituted into a solution.   Every municipal water treatment center has a machine that drips quote “the proper dose” of the poison into the water supply folks! So how can people say they're not poisoning us in the water? And secondly, What about Flint Michigan and all the lead poisoning that occurred in that event? What about the poisoning of Du Ponte chemicals in the water supply? I mean, come on people! To say that you can't be poisoned in the water supply is just ignorant!…   Dr. Ardis: When people keep asking me, “What proof do you have that it's in the water?” How about if you just look at what the CDC's been doing; What they've actually been testing this whole time looking for the bioweapon called SARS COV 2.     They have 400 water testing sites in different cities all around the country. They are doing PCR testing on your water looking for the weapon. They are looking for this so called “virus” in your water. (Some argue but that's the waste water they are testing.) But they are gonna filter that water and it's going to become your drinking water and I can't see any evidence yet that the CDC has proven that they're not only testing the water for SARS COV 2 (this really deadly pathogen according to them) and then at the same time filtering it out of your water before returning it back to you. I've never seen that evidence or read anything about that.   All I've seen is, “We are testing all these sites; looking for SARS COV 2 in the water and they've been using this sole method for predicting outbreaks in your city! They are only looking at the water! So if this is what they are using to predict outbreaks in your town then logically it must be being recirculated back into the water source (that's coming through our taps.)   So, I just want people to know, if the CDC is looking in your water for SARS COV 2, maybe we should find out if they are actually filtering it out of the water as they find it!   Mike Adams: So, what they are testing is waste water. But as you say the sewage water gets treated and turned back into drinking water. What you say is true that what is coming out of someones tap was coming out of someone's toilet up the river. So the question becomes, “Are these water districts who treat the water removing SARS COV 2? Do they remove potentially snake venom peptides (from pharmaceuticals or other sources). What are they removing or not removing and we don't have an answer to that question yet.   Dr. Ardis: I don't know either. But the enlightening fact is that governments around the world have been doing waste water surveillance testing for SARS COV 2 this whole time. So my question is, “Have they been poisoning the water right under our noses and we never knew it?”   People are saying, “How did Ardis come to this?” The truth is and I really want to convey this point; The story for me is NOT the water. My whole agenda for 2 years has been to save peoples lives from (these evil) hospital protocols. It just took a new direction when I got a text from Dr. Richard Bartlett that said, “If you got bit by a rattle snake would go get anti-venom?”   Ever since then the entire scope of Covid -19 and the reality of what it really is has completely transformed, regardless of the source of how they are distributing it!   There is enough evidence now to start looking to see. Is it true that the bioweapon itself is being distributed through gain of function or they've just been dumping synthetic peptides of venomous into the water, or aerosolizing them; however they are king distributed.   Is it true that the bioweapon is snake venom or animal venom peptides and if so go test the people. The University of Arizona said that individuals treated for Covid 19 whose tissue and blood samples were studied; that the amount of this enzyme called SPLA-2 that was present looked like snake venom had been coursing through their veins. This is the same enzyme found in rattle snake venom.   We need to start looking at, “Is it possible that these components found in venom are orchestrating this whole plan. Because when you start looking at the mRNA vaccine side effects; almost all of them can be tied to a specific snake venom component. You can also look at the SARS COV 2 side effects like loss of taste and smell. These are actually side effects of snake venom and not customarily  a side effect of viruses which has been very “mysterious.”   Mike Adams: So I'm glad that you mentioned multiple vectors of exposure because Dr. Lee Merrick believes that this has probably been distributed in cities as a contact poison to distribute it through skin penetrating nano particles which were part of the Eco Health Alliance's proposal to DARPA for release in China in the bat caves. You mentioned water as a vector and also an aerosolized   release as a possible vector.   I think what you are trying to convey to people is, “Hey, don't get stuck on the 'water'. There are multiple vectors. The point is maybe it's in the air, maybe it's on contact surfaces, maybe it's in the water, but these people are being deliberately exposed to these nano particles that you're saying were derived from the structure of venom peptides because those molecules are extremely toxic and are generating the side effects that we're seeing. Is that a fair summary of what you are saying?   Dr. Ardis: Yes. By the way, Dr. Lee Merrick texted me this morning and said, “Dr. Ardis, You're going to have to show me evidence about this water sourcing and snake venom.” And I texted her back and said, “Dr. Merrick, you're missing the point. I need everybody to go look at the weapon! I don't care where it is (or the mode of distribution.) Look Dr. Merrick, they are finding it in the water. Our government agencies are spending millions of dollars finding it in the water. It's obviously in the water also; whether through shedding in the feces of they are actively poisoning us, just as with fluoride.”   Just know the weapon is venom. Treat it like an envemomation  and you'll solve the riddle of the mystery of SARS COV 2 “infections” and the side effects of the vaccines, and the hospital protocols being used for Covid 19 “infections.” They all have something in common. They all find these snake venom- like properties in the side effects and in the enzymes in the bodies of Covid 19 patients.   Mike Adams: Yeah. That's what's fascinating. It was shocking how closely the symptoms match up. And also you've provided a tremendous amount of documentation. So there's been a lot of due diligence on your part. Scientific American absolutely did publish a story in 2020 that is mentioned in your presentation that talks about the SARS COV 2 has the most similarity  with snakes because of the code ons and the genetic similarity and CNN covered it as well as other scientific journals etc.   So when people say there's no research to back this up; I don't know what they're watching or what they are not watching we put it all up on the screen for everybody.   Dr. Ardis: The thing that kind of solidified it all for me was when the British Medical Journal Global News published last year that, “Right now there are 2 health crisis going around at the same time around the world which were, “Snakes bites and Covid 19.” They didn't say, “Bat bites and Covid -19.” They have one research and development in common; only one opportunity to handle both crisis.   The code-on usage bias, as we showed from the studies in Jan. 2020 is a specific term that specifies the genetic origin. Well, this study found that the code-on usage bias for SARS COV 2 was most identical to the Chinese common Krait and the King Cobra. NOT bats. SNAKES.   Mike Adams: Well, you've brought a lot of research to the table and one of the reactions today from the Left wing media is, “Oh, this is crazy. Snake venom. Crazy conspiracy. Where do these people get this stuff?” Right? They are attacking you and Stew Peters. (who by the way has had his house SWATED by the FBI twice in the past week; Go figure.) But it's all in the research. It's all in the articles. But the funny thing is, by attacking you over this they are forcing people to think about snake venom for the first time.   Dr. Ardis: And the British Medical Journal is saying that the two main crisis around the world right now are snake bites and Covid -19. So maybe we should be looking at SNAKE VENOM! ...     Doctors Don't Even Know! Millions of People are Swallowing Venom-Derived Pharmaceuticals Made from Pit Vipers, Gila monsters, Leeches, Rattlesnakes and Death-stalker Scorpions Thursday, April 14, 2022 by: Mike Adams   https://www.naturalnews.com/2022-04-14-millions-people-swalling-venom-derived-pharmaceuticals-rattlesnakes-pit-vipers-death-stalker-scorpions.html   PHARMA SNAKES: Thirteen Irrefutable FACTS About Snake Venom, Big Pharma and Biological Weapons Friday, April 15, 2022 by: Mike Adams   As the concept of “venom theory” has reverberated around the world this week, many people are shocked to realize how many pharmaceutical medications are derived almost entirely from rattlesnake venom, Gila Monster reptile venom, pit viper venom, scorpion venom and other such sources. A pain treatment drug named Prialt (see Prialt.com) is actually synthesized by copying the poison of the Magical Cone Snail (conus magus). This poison produces hallucinations, confusion, altered states of consciousness and more. The insert sheet for the Prialt drug carries bizarre warnings such as, “Patients have become unresponsive or stuporous while receiving PRIALT.” Patients who are made unconscious by the drug may appear to be perfectly conscious, almost as if they are in a zombie state. The warning sheet explains, “During these episodes, patients sometimes appear to be conscious and breathing is not depressed. If reduced levels of consciousness occur, discontinue PRIALT until the event resolves…” We acknowledge that drugs like Prialt may have practical, beneficiary applications for people who are suffering chronic pain, yet who are unable to take highly addictive opioids for a variety of reasons. However, we take issue with the fact that drug companies and doctors seem to be hiding the origins of these medications from patients. Most doctors aren't even aware that toxins, poisons and venoms are used as the templates to synthesize extremely toxic peptides that are frequently used in prescription medications, including drugs for heart attacks, diabetes, high blood pressure and more. Reptile venoms can be weaponized and turned into large-scale chemical weapon systems Even worse, these reptile venoms can be weaponized and mass produced, then used in a large-scale chemical attack on the population by introducing these toxins into food, water, air or contact surfaces. Just as fentanyl can be weaponized through aerosolization and drone delivery, these reptile venom peptides can also be weaponized and used to mass murder large numbers of people. Some observers believe this has already happened, and that the mRNA “vaccines” currently being injected into people may deposit instructions for venom peptide synthesis into the cells of the body. If true, this would turn your body into a reptilian venom factory from the inside. It might also explain why so many side effects of covid vaccines seem to align so closely with the known effects of envenomation (being bitten by a snake, a viper, a scorpion, etc). Dr. Bryan Ardis covers this in detail in part 3 of my recent interview with him. Many people say this third part is by far the most informative, and it's all backed by meticulous scientific research: Brighteon.com/0d74ac38-dcf9-44e6-99f6-96c6a59abcf9 As ToxinTech.com explains on their website, touting the pharmaceutical potential for the venom peptides in their library: The biological function of animal venoms is to immobilize and kill prey or predator in seconds to minutes… venom toxins target… neuromuscular, cardiovascular, hemostatic and other life functions. Toxins bind to targets with high affinity and are chemically stable. For the record, we do not ascribe nefarious intent on the part of ToxinTech. However, we recognize that ToxinTech's venom library may be exploited and misused by bad actors to create weapons of mass destruction, all based on venom peptides which are engineered to kill. Interestingly, the ToxinTech home page feature image asks a rather blunt question that could be easily misconstrued: Designed Toxins… Have a Target? In the context of biosciences, this means a molecular target such as a specific enzymatic pathway or channel such as calcium channels or sodium channels. But to the mind of a bad actor with nefarious intent, they might wish to target humanity, for example, with a venom-based depopulation weapon. 13 irrefutable facts about snake venom, Big Pharma and bioweapons We've spent much of this week researching the venom peptide industry, and what we've found is rather astonishing. In fact, I think it's one of the biggest stories in the history of modern pharmaceutical medicine. Here's what we know so far: Fact #1 – Big Pharma routinely uses venom and venom peptides for drug discovery. Around 150,000 animal species are known to produce toxins, and scientists estimate that 20 million toxins exist (only a small fraction have been studied). Fact #2 – Massive venom libraries already exist (20,000+ venom peptides) and are marketed to the pharma industry for drug discovery. Two such companies are Venomtech (UK) and ToxinTech (USA). Fact #3 – One venom library company celebrates how its venoms for Big Pharma are able to “immobilize and kill prey .. in seconds or minutes.” They explain that venoms are “Perfected by millions of years of evolution” in order to target “neuromuscular, cardiovascular, hemostatic and other life functions.” (ToxinTech.com home page, sourced April 14, 2022) This means that venom library licensing companies recognize the toxicity of the compounds they are offering to drug companies. In fact, they state so in their own marketing materials. Fact #4 – Reptile venoms can be weaponized and made into biological weapons. Protein sequences are provided by the venom library companies, allowing gain-of-function research to engineer venom peptides into viral payloads or mRNA therapeutics. Because venoms are poisons, the knowledge of how to engineer and synthesize those poisons at the amino acid level is also knowledge of how to build biological or chemical weapons. Fact #5 – Dozens of pharmaceuticals derived entirely from animal venom already exist. Many are FDA approved. A full chart has been published by Natural News and is also shown below. Fact #6 – Pharma appears to be HIDING the venom origins of their products, making few or no disclosures on marketing websites about the actual origin of their drugs. You would have to read the insert sheets and understand latin names to know that their drugs come from animal venom. Fact #7 – Nearly zero doctors or patients know about the venom origins of venom-derived medications. Thus, patients are swallowing actual reptile venom molecules but being told by their doctors that it is “medication.” The FDA's approving of a venom as a medication does not magically transform it into something that is non-toxic. The toxicity is simply reframed as “therapeutic” by the FDA, which then hands the pharmaceutical company a market monopoly to sell a molecule that was actually pirated from nature. Fact #8 – Venom molecules and venom peptides are mass synthesized in pharmaceutical factories. This is a common practice. This is referred to by numerous scientific and bioscience resources, including the World Economic Forum. Fact #9 – Venoms and venom peptides are synthesized as “chemically stable” (ToxinTech.com) and are routinely delivered via liquid solutions without any preservatives. (They need no special preservatives to maintain their structure and function.) Nanocarriers are also available to further stabilize the venom peptides. (https://pubmed.ncbi.nlm.nih.gov/31223083/). Fact #10 – Venoms can be touted by pharmaceutical companies as “naturally occurring,” because they are. Yet this label can be misleading since people equate the word “natural” with “healthful” or “safe.” Fact #11 – Because venom peptides are stable in solution, they can be weaponized and mass produced, then distributed via air, water, food or contact surfaces. This means that it is entirely plausible that mass poisoning via venom peptides could be accomplished through the water supply, or the food supply, or dropped on cities via drones, etc. These are not outlandish ideas in the least. The US Dept of Homeland Security just recently conducted chemical weapons simulation tests in New York City, releasing “non-toxic gas” in city parks and subway stations in order to study this very thing. If it's a “crazy conspiracy theory,” then somebody needs to tell DHS, because they've been drilling for this exact scenario. Fact #12 – Some toxins are skin-penetrating and can be absorbed merely by TOUCHING. (Not a venom, but a toxin or poison.) This was all admitted in an Ecohealth Alliance proposal to DARPA, as covered in this story: Leaked DARPA document, DRASTIC analysis confirms attack on humanity using aerosolized, skin-penetrating nanoparticle spike proteins. Fact #13 – Venoms and venom peptides produced for pharma are so stable that they survive stomach acid, which means the venom peptides are stable in solution, including in rather acidic (reactive) solutions. This means they do not automatically break down in city water, either. If venom toxins were not highly stable molecules, they would not be very good venoms in the first place. As ToxinTech explains, “millions of years of evolution” has perfected the functionality of these molecules.

In pregnancy, thrombophilias or blood clotting disorders can either be inherited or  acquired. As you can imagine, blood clotting is not a preferred state in pregnancy a condition laden with micovessels which could clot easily. Inherited thrombophilias are usually genetic in nature and increase the risk for thromboembolic disease. During pregnancy, the potential for these disorders to be problematic is enhanced because pregnancy is a hypercoagulable state.   The most severe sequela is a resulting DVT (deep vein thrombosis) or a blood clot in a deep vein.  DVTs can be life threatening and very serious.  Acquired thrombophilias are primarily the result of systemic autoimmune disease resulting in antibodies that predispose the body to clot.   A term commonly used for acquired thrombophilias is antiphospholipid syndrome or APS and this condition can occur as a primary condition, or it can occur in the presence of systemic lupus erythematosus (SLE) or other autoimmune conditions. Thrombophilias in pregnancy are reviewed in detail in this episode as well as how to manage and treat them throughout the pregnancy, labor and postpartum period.   We'd love to hear your feedback.  Our practice website can be found at: Maternal Resources: https://www.maternalresources.org/ Remember to subscribe wherever you get your podcasts.  Please consider leaving us a review on iTunes Our Social Channels are as follows Twitter: https://twitter.com/integrativeob YouTube: https://www.youtube.com/maternalresources IG: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB  

Episode Summary:Ever heard that an inherited thrombophilia, a.k.a. clotting disorder could be implicated in miscarriages and unexplained infertility?In this week's episode we touch on Factor V Leiden, Prothrombin and MTHFR. (Note that I'm a bit of a fast talker in this one, so get ready to ingest some quick info!)The majority of women with these conditions have healthy pregnancies, but if you do have unexplained infertility and/have suffered losses, these might be worth a look. Much of the time, it's best to work with the cards you've been dealt. Sometimes simple lifestyle changes and a boost from natural medicine can assist with reducing the effects of these genetic mutations. This week's episode contains some quick DIY information for those seeking insight on the connection between unexplained infertility or miscarriages and blood clotting disorders. Tune in TODAY!Thanks for Listening:Thanks so much for listening to our podcast! If you enjoyed this episode and think others would love to hear it, please share it using the social media buttons on this page. Do you have some feedback or questions about this episode or want to be a guest on the show? Leave a comment in the section below or visit the website to contact me!www.naturnalife.comSubscribing to The Podcast:If you would like to get automatic updates of new podcast episodes, you can subscribe to the podcast on Apple Podcasts, Stitcher, Spotify, Amazon, or whatever your favorite podcast app is!Leave Us an Apple Podcasts Review:Ratings and reviews from our listeners are extremely valuable to us and greatly appreciated. They help our podcast rank higher on Apple Podcasts, which exposes our show to more awesome listeners like you. So if you have a minute, please leave a review on Apple Podcasts.

Show note at pharmacyjoe.com/episode613 . In this episode, I'll discuss using Andexanet Alfa vs Prothrombin Complex Concentrate for factor Xa inhibitor reversal in acute major bleeding. The post 613: Andexanet Alfa vs Prothrombin Complex Concentrate for Factor Xa Inhibitor Reversal in Acute Major Bleeding appeared first on Pharmacy Joe.

Show note at pharmacyjoe.com/episode613 . In this episode, I ll discuss using Andexanet Alfa vs Prothrombin Complex Concentrate for factor Xa inhibitor reversal in acute major bleeding. The post 613: Andexanet Alfa vs Prothrombin Complex Concentrate for Factor Xa Inhibitor Reversal in Acute Major Bleeding appeared first on Pharmacy Joe.

Show note at pharmacyjoe.com/episode608 . In this episode, I ll discuss Low dose versus standard dose four-factor prothrombin complex concentrate for factor Xa inhibitor reversal in spontaneous and traumatic intracranial hemorrhage. The post 608: Low dose versus standard dose four factor prothrombin complex concentrate for factor Xa inhibitor reversal in spontaneous and traumatic intracranial hemorrhage appeared first on Pharmacy Joe.

Welcome to Ask Stago, The Podcast dedicated to provide expert answers to your expert questions in hemostasis. In today episode, our expert Pierre Bourgeat, will discuss about the Prothrombin time reagent characteristics with a specific focus on the ISI and the type of activators. As usual, don’t forget to send any question you may have to Ask@stago.com, we will be glad to answer to it. To learn more: Listen to our podcast about MNPT determination: #7 How to determine the mean normal prothrombin time View the Webinar of Ian Jenning on stagowebinar.com Literature: Lusher, J. Screening and diagnosis of coagulation disorders. Am. J. Obstet. Gynecol. 1986; 175:778-783 Riley, R., Rowe, D., & Fisher, L. Clinical utilization of the international normalized ratio (INR). J. Clin. Lab. Anal. 2000; 14:101-114 WHO Technical Report Series, No. 610, 1977 Ian Jennings, PT/INR measurement for the management of VKA therapy, Stagowebinar.com, 3 October 2017 WHO Technical Report Series, No. 979, 2013 CLSI One-stage Prothrombin Time (PT) test and Activated Partial Thromboplastin Time (APTT) test; Approved guideline - second edition. CLSI document H47-A2 Wayne, PA: Clinical and Laboratory Standard Institute, 2008 Smith SA, Comp PC, Morrissey JH. Traces of factor VIIa modulate thromboplastin sensitivity to factors V, VII, X, and prothrombin. J Thromb Haemost. 2006;4(7):1553-1558. ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Content is scientific and technical in nature. It is intended as an educational tool for laboratory professionals and topics discussed are not intended as recommendations or as commentary on appropriate clinical practice.

Welcome to Ask Stago, the weekly podcast for Hemostasis laboratory professionals.  In today’s episode, we will provide you our best tips and tricks to calculate the mean normal prothrombin time for INR assay. To do so, Cécile Hourquet and Audrey Carlo are pleased to welcome Arnaud Rouvière, Manager of the International Application Engineer team of Stago. Source: WHO technical report series ; no. 979, 2013

Wie lebt es sich eigentlich mit Prothrombin-Gen-Mutation, Faktor II ?? Und was hat die Pille damit zu tun ? Chiara geht dem mal wieder auf den Grund ! Zu Gast haben wir die liebe Sylvia. Sie berichtet uns darüber, wie es sich mit dieser seltenen Genmutation lebt. Also bleibt gespannt ! Besucht uns gerne auch auf unserer Webseite : https://ptaontop.com/ Oder Folge uns auf Instagram um nichts zu verpassen :) --- Send in a voice message: https://anchor.fm/ptaontop/message

This episode covers prothrombin 20210 mutation!

Episode 23: Blood Clots: DVTThe sun rises over the San Joaquin Valley, California, today is August 14, 2020. Pain relief is a task that always keeps doctors very busy, especially if pain relief can be accomplished by a medication that is easily-administered, given at a convenient frequency, with no adverse effects, and with no addiction potential (specially to fight the so-called “opioid epidemic”). And if that medication contributes to healing the pain-causing condition, then that’s a perfect medication for pain relief. As a result of that endless search for a perfect pain reliever, the University of Southern California Health Sciences presented a new study on July 13, 2020, revealing that kappa opioids, a significantly less addictive opioid, may both preserve cartilage in joints and also ease pain in osteoarthritis (1). Sorry UCLA, we have to accentuate the positive regardless of the source. Go Bruins!  On August 11, 2020, we woke up to the news that Russia’s government registered the first COVID 19 vaccine in the world. President Vladimir Putin stated that his own daughter was inoculated with the vaccine and “she is feeling well and has high number of antibodies”. While some celebrated the Russian “big step for humanity”, some experts expressed concerns about safety, including the World Health Organization, warning Russia to adhere to standard protocols for testing a vaccine (2). Coronavirus has brought more than a disease to the world, it has brought extensive material for political debate and controversy. There is a joke that circulated in social media that may be relevant in this case: A patient asks her doctor, “When will this coronavirus be over?”, and the doctor answers, “I don’t know, I’m not that involved in politics”. We hope humanity steps up and joins forces to overcome this devastating disease.____________________________Welcome to Rio Bravo qWeek, the podcast of the Rio Bravo Family Medicine Residency Program, recorded weekly from Bakersfield, California, the land where growing is happening everywhere.The Rio Bravo Family Medicine Residency Program trains residents and students to prevent illnesses and bring health and hope to our community. Our mission: To Seek, Teach and Serve. Sponsored by Clinica Sierra Vista, Providing compassionate and affordable care to patients throughout Kern and Fresno counties since 1971. ____________________________“[As doctors, let’s], never forget that we have the opportunity to do more good in one day than most people have in a month."― Dr. Suneel DhandDear residents, how many opportunities did you have to do good today? It’s a great privilege to be instruments to relief pain, find a solution, and bring peace and happiness to your fellow men. It’s really a privilege. We have today an experienced doctor with whom I’ve had multiple conversations, and I’m very happy for having him in our residency program. Welcome, Dr Gonzalez.Question Number 1: Who are you? My name is Alejandro Gonzalez Perez, I am a second-year resident in the Rio Bravo Family Medicine Residency Program here in Clinica Sierra Vista, Bakersfield, California. I was born in Cuba where I finished medical school and completed a medical residency in Family medicine, and then a residency in Radiology. I am a father of three children, two boys and one girl. I enjoy spending time with my family and friends. My favorite music: Latin music. Favorite sport: I like to go to the gym but I enjoy seeing martial art combats. Favorite movies: action, fiction, and martial arts.Comment: I recently watched The Karate Kid in Netflix, it’s a good show, and they’ll have a sequel in Netflix this month with the same actors of the original movie. Question number 2: What did you learn this week?Currently I’m on the Cardiology rotation. My number one goal in this rotation is optimize treatment for patients in the inpatient and outpatient settings. For example, I am learning how to better handle medication for Heart failure, CAD, HTN, and arrhythmias. And, almost all the patients have combined diagnosis, so you need to select the appropriate medication for HF with CAD, or HF combined with CAD and HTN, or HF with Afib, etc. In addition, my knowledge about diagnostic tests has improved, ECG, Echocardiogram, Cardiac Cath, troponin management. Also, I have learned how to improve the interactions between different services in the hospital. I hadn’t had a previous rotation with Internal Medicine, but in this rotation, I’m spending time with some IM residents, and it’s been positive for me.Venous thromboembolism (VTE)VTE refers to a blood clot that starts in a vein. It is the third leading vascular diagnosis after heart attack and stroke, affecting between 300,000 to 600,000 Americans each year. The mos common presentations are: Deep vein thrombosis (DVT) of the lower extremity and pulmonary embolism (PE). PathophysiologyThe Virchow's triad proposes that VTE is a result of three conditions: Alterations in blood flow (i.e., stasis), Vascular endothelial injury, and Alterations in the constituents of the blood.The causes of venous thrombosis can be divided into two groups: hereditary and acquired.Hereditary causes: Factor V Leiden mutation, Prothrombin gene mutation, Protein S deficiency, Protein C deficiency, Antithrombin deficiency.Acquired risk factors: Prior thrombotic event, recent major surgery, presence of a central venous catheter, trauma, immobilization, malignancy, pregnancy, the use of oral contraceptives or heparin, myeloproliferative disorders, antiphospholipid syndrome (APS), and a number of other major medical illnesses. Of note, a special risk factor is the s-called “Sitting Disease” which, broadly speaking, is defined as a condition of increased sedentary behavior associated with adverse health effects.Provoked vs Unprovoked DVTThe term unprovoked deep vein thrombosis (DVT) implies that there is not an evident cause for DVT. In contrast, a provoked DVT is usually caused by a known event.Proximal vs Distal DVTProximal DVT is located in the popliteal, femoral, or iliac veins. Isolated distal DVT has no proximal component, it is located below the knee, and is confined to the calf veins (peroneal, posterior, anterior tibial, and muscular veins)Symptomatic vs Asymptomatic DVTSymptomatic DVT refers to the presence of symptoms that usually leads to the radiologic confirmation of DVT, whereas asymptomatic DVT refers to the incidental finding of DVT on imaging in a patient without symptoms (eg, computed tomography).Symptoms of DVTThrobbing or cramping pain in 1 leg (rarely both legs), usually in the calf or thigh.Swelling in 1 leg (rarely both legs)Warm skin around the painful area.Red or darkened skin around the painful area.Swollen veins that are hard or sore when you touch them. Diagnosis of DVTDuplex ultrasonography: It can detect blockages or blood clots in the deep veins.  It is the standard imaging test to diagnose DVT. Comment: Yeah! for POCUS in clinic?D-dimer: It rules out DVT if it is negative.Contrast venography: Dye is injected into a large vein in the foot or ankle deep veins in the leg and hip.  It is the most accurate test for diagnosing blood clots but it is an invasive procedure, for that reason, this test has been largely replaced by duplex ultrasonography, and it is used only in certain patients.Magnetic resonance imaging (MRI) and computed tomography (CT) scan. These tests can provide images of veins and clots, but they are not generally used to diagnose DVT.Treatment of DVTAnticoagulants: Anticoagulation (commonly referred to as “blood thinners”) is the mainstay of therapy for patients with deep vein thrombosis (DVT). Anticoagulation is indicated for all patients with proximal DVT and select cases of distal DVT. To decide on anticoagulation, we must weigh the benefits versus the risk of bleeding. The primary objective of anticoagulation is the prevention of further thrombosis and of early and late complications. Major early complications of DVT include clot extension, pulmonary embolism (PE), major bleeding (from anticoagulation), and death. Late complications include recurrent clot, post-thrombotic (post phlebitic) syndrome, and chronic thromboembolic pulmonary hypertension. The most frequently used injectable anticoagulants are: unfractionated heparin (IV), Low molecular weight heparin (LMWH) (SQ), and Fondaparinux (SQ). Anticoagulants that are taken orally (swallowed) include Warfarin and NOACs: Dabigatran, Rivaroxaban, Apixaban, and Edoxaban. All of the anticoagulants can cause bleeding, so people taking them have to be monitored to prevent unusual bleeding. Monitoring can be with INR (Warfarin) or clinically (NOAC). Thrombolytics: Thrombolytics (commonly referred to as “clot busters”) work by dissolving the clot. They have a higher risk of causing bleeding compared to the anticoagulants, so they are reserved for severe cases. Inferior vena cava filter: When anticoagulants cannot be used or don’t work well enough, a filter can be inserted inside the inferior vena cava (a large vein that brings blood back to the heart) to capture or trap an embolus (a clot that is moving through the vein) before it reaches the lungs. Thrombectomy/Embolectomy: In rare cases, a surgical procedure to remove the clot may be necessary.  Thrombectomy involves removal of the clot in a patient with DVT.   Embolectomy involves removal of the blockage in the lungs caused by the clot in a patient with PE.  Question number 3: Why is that knowledge important for you and your patients?In primary practice, we encounter patients with symptoms that may be suspicious for DVT. We must be able to diagnose and treat these patients in a timely manner to prevent further complications. DVT is just below MI and stroke in frequency.Question number 4: How did you get that knowledge?I got interested in this topic because of many previous patients I had with this condition. I investigated multiple sources, including, of course, Up to Date, Medscape, but this knowledge has been accumulated over the years of study.Question number 5: Where did that knowledge come from?Up to Date, Medscape, Family Practice Notebook, and Epocrates.____________________________Speaking Medical: Phlegmasia cerulean dolensby Dr. Valerie CivelliPhlegmasia cerulea dolens means “painful blue inflammation”. It is an uncommon but severe form of DVT which results from extensive blockage by a thrombus of the major and the collateral veins of an extremity. This phenomenon was discovered by Jonathan Towne a vascular surgeon in Milwaukee, USA. Phlegmasia cerulea dolens (PCD) is a precursor of frank venous gangrene. It is characterized by severe swelling, cyanosis and blue discoloration. The next time you look down at a leg that appears like it’s from the blue man group in Las Vegas or appears smurf-like, think of Phlegmasia cerulea dolens.  ____________________________Espanish Por Favor: Coáguloby Dr Valerie CivelliCoágulo may be a word difficult to pronounce, but it is very important in the context of DVT, MI, or stroke. You may guess what coágulo means by remembering the word anticoagulant. Yes, coágulo means blood clot. “Señor Pérez, usted tiene un coágulo en las piernas” means “Mr Perez, you have a blood clot in your legs”. Coágulo may be used by a patient who also has blood clots in her menstrual period during an episode of menorrhagia or during other excessive bleeding. Now you know the Spanish word of the week: Coágulo.____________________________For your Sanity by Drs. Steven Saito, Gina Cha, and Alyssa Der MugrdechianWhat’s black, long and hangs from an a*hole? A stethoscope.--Patient: Doctor, my son ate a firefly!--Doctor: Why did he do that?--Patient: He wanted a light snack. --Patient: Doctor, doctor, I’ve had a terrible stomachache after eating tamales.--Doctor: Were they fresh?--Patient: I don’t know, how can you tell?--Doctor:  How did they look when you removed the corn husk?--Patient: Were you supposed to remove the corn husk?Now we conclude our episode number 23 “Blood Clots: DVT”. Dr Gonzalez explained the basics of Deep Venous Thrombosis (DVT) and reminded us that DVT can be easily diagnosed by ultrasound, and that timely treatment prevents acute and chronic complications. Phlegmasia cerulean dolens is just another way to say “painful blue inflammation”, a severe type of DVT that occurs when the MAJOR and COLATERAL veins in a limb are occluded; then, were given the advice by Dr Civelli to recall the word anticoagulant to remember the Spanish word coágulo (blood clot). And we cannot finish this episode without mentioning the name of the first registered COVID-19 vaccine. It’s called Sputnik V. We tried several times to record that name in the intro, but we could not stop laughing. We honestly hope the Sputnik V is a great success regardless of its amusing name.This is the end of Rio Bravo qWeek. We say good bye from Bakersfield, a special place in the beautiful Central Valley of California, United States, a land where growing is happening everywhere.If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. Our podcast team is Hector Arreaza, Alyssa Der Mugrdechian, Alejandro Gonzalez, Steven Saito, Valerie Civelli, Gina Cha, and Ariana Lundquist. Audio edition: Suraj Amrutia. See you soon!_____________________References:University of Southern California - Health Sciences. (2020, July 13). Significantly less addictive opioid may slow progression of osteoarthritis while easing pain. ScienceDaily. Retrieved August 12, 2020 from www.sciencedaily.com/releases/2020/07/200713120014.htm“Russia registers COVID-19 vaccine, Putin says daughter already inoculated” by Yaron Steinbuch. August 11, 2020, New York Post.Sterns, Richard H, “Causes of hypotonic hyponatremia in adults”, Up to Date, retrieved on Aug 13, 2020. https://www.uptodate.com/contents/causes-of-hypotonic-hyponatremia-in-adults?search=potomania&source=search_result&selectedTitle=2~2&usage_type=default&display_rank=2

The 3-factor prothrombin complex concentrate (3FPCC) may be used off-label to treat refractory bleeding during cardiac surgery in children. This retrospective study examined the rate of clinical complications following the use of 3FPCC. Patients treated with 3FPCC were matched to controls for age, gender, prematurity, weight, cardiopulmonary bypass times, and cross-clamp times. Fifty-nine cases were individually matched to 59 controls based on propensity scores. 3FPCC was not associated with an increased risk of thromboembolic events, mortality, or need for postoperative extracorporeal membrane oxygenator support. These results suggest the safety of 3FPCC when used for refractory bleeding after cardiopulmonary bypass in children undergoing congenital heart surgery.   To view the article, click here.

Talk to a Dr. Berg Keto Consultant today and get the help you need on your journey (free consultation). Call 1-540-299-1557 with your questions about Keto, Intermittent Fasting, or the use of Dr. Berg products. Consultants are available Monday through Friday from 8:30 am to 9 pm EST. Saturday & Sunday 9 am to 5 pm EST. USA Only. Take Dr. Berg's Free Keto Mini-Course! Intermittent Fasting Basics: https://www.messenger.com/t/drericberg Acceptable Vegetables if on Warfarin(Coumadin): https://www.youtube.com/watch?v=kEc30... Dr. Berg talks about vitamin K1. It is a co-factor or a helper nutrient to make Prothrombin (clotting factor) and very important for making bone. There are also many different types of proteins like C and S in vitamin K1 which are anti-clotting. If you're in Coumadin, you can't take vitamin K1 because you have a blood thinner and couldn't consume a lot of leafy greens. He also discussed the other medication called Eliquis, which can allow you to consume leafy greens. Things That Block the Absorption of Vitamin K1 • Constipated • Liver Problem – Fatty Liver, Cirrhosis • Insulin Resistance • Gallbladder Problems • IBS - Damage within the Colon • Gastric Bypass Best Sources of Vitamin K1 • Leafy Greens • Spinach • Kale Dr. Eric Berg DC Bio: Dr. Berg, 51 years of age is a chiropractor who specializes in weight loss through nutritional & natural methods. His private practice is located in Alexandria, Virginia. His clients include senior officials in the U.S. government & the Justice Department, ambassadors, medical doctors, high-level executives of prominent corporations, scientists, engineers, professors, and other clients from all walks of life. He is the author of The 7 Principles of Fat Burning. ABOUT DR. BERG: https://bit.ly/2FwSQQT DR. BERG'S STORY: https://bit.ly/2RwY5GP DR. BERG'S SHOP: https://bit.ly/2RN11yv DR. BERG'S VIDEO BLOG: https://bit.ly/2AZYyHt DR. BERG'S HEALTH COACHING TRAINING: https://bit.ly/2SZlH3o Follow us on FACEBOOK: https://www.messenger.com/t/drericberg TWITTER: https://twitter.com/DrBergDC YOUTUBE: https://www.youtube.com/user/drericberg123 Send a Message to Dr. Berg and his team: https://www.messenger.com/t/drericberg

Ashley & Scott first met when he gave her a speeding ticket. Three months later, they started dating. This is their story. -- For more about Sarah’s Laughter, please visit our website at sarahs-laughter.com. Our podcast-only site is podcast.sarahs-laughter.com. You can follow us on social media linked here: Sarah’s Laughter on Facebook & Instagram, and @sarahs_laughter on Twitter. Sarah’s Laughter also holds the Baby Steps Fun Run, where we give away a $10,000 grant for expenses related to either adoption or fertility treatment. We also partner with local SART-listed fertility clinics to give away IVFs at the event. Check babystepsfunrun.com for details and schedule. *** Sarah’s Laughter is a 501(c)(3) non-profit public charity. If you’d like to help support what we do, including this podcast, please visit sarahs-laughter.com/give. Thank you. -- Want to share your infertility story on this podcast? Email us at podcast@sarahs-laughter.com

In this episode I ll: 1. Discuss an article about the prothrombin time and bleeding in hospitalized patients receiving rivaroxaban. 2. Answer the drug information question Is melatonin associated with physical dependence or addiction?” 3. Share a tip for responding to inpatient medical emergencies Show notes at pharmacyjoe.com/episode322. The post 322: Prothrombin time and bleeding in hospitalized patients receiving rivaroxaban, melatonin and physical dependence, and a tip for responding to inpatient medical emergencies appeared first on Pharmacy Joe.

A 5-year-old boy was playing with his older brother in front of their home when he was struck by a car. He sustained a femur fracture, splenic laceration, and blunt head trauma – the so-called Waddell’s triad. On arrival, he was in compensated shock, with tachycardia. He decompensates and needs blood. How do we manage his hemodynamics and when do we perform massive transfusion? Pediatric Massive Transfusion 40 mL/kg of blood products given at any time within the first 24 hours. Adolescents and Adult Massive Transfusion 6-8 units of packed red blood cells (PRBCs) Adults have about 5 L of circulating blood. Not including plasma, one could replace all circulating erythrocytes with about 10 units of PRBCS The best ratio of PRBCs:Plasma:Platelets is unknown, but consensus is 1:1:1. 1 unit of PRBCS is typically 300 mL of volume. The typical initial transfusion of PRBCs in children is 10 mL/kg. Massive transfusion in children is defined as 40 mL/kg of any blood product. Once you start to give a child with major trauma the second 10 mL/kg dose of PRBCs – start thinking about other blood components, and ask yourself whether you should initiate your massive transfusion protocol. The goal is to have the products ready to use in the case of the dynamic trauma patient. The Thromboelastogram (TEG) Direct measures the four components of clot formation. When there is endolethial damage and bleeding, the sequence that your body takes to address it is as follows:  Platelets migrate and form a plug Clotting factors aggregate and reinforce the platelets Fibrin arrives an acts like glue Other cells migrate and support the clot. R time – reaction time – the initial line in the tracing that shows time to beginning of clot formation. Treated with platelets K factor – kinetics of the clot –how much the clot allows the pin to move, or the amplitude. Treated with cryoprecipitate Alpha angle – the slope between the R and K measurements – reflects how quickly the fibrin glue is working. Treated with cryoprecipitate Ma – maximum amplitude – reflects the overall strength of the clot. Treated with platelets LY30 – the clot lysis at 30 min – is the decrease in strength of the clot’s amplitude at 30 min. Treated with an antifibrinolytics (tranexamic acid) Shape Recognition Red wine glass: a normal tracing with a normal reaction time and a normal amplitude. That patient just needs support and monitoring. Champagne glass: a coagulopathic TEG tracing – thinned out, with less amplitude. This patient needs specific blood products. Puffer fish or blob: a hyperfibrinolytic tracing. That patient will needs clot-stablizer. TEG – like the FAST – can be repeated as the clinical picture changes. The Trauma Death Spiral Lethal triad of hypothermia, acidosis, and coagulopathy. Keep the patient perfused and warm. Each unit of PRBCs contains 3 g citrate, which binds ionized calcium, causing hypotension. In massive transfusion, give 20 mg/kg of calcium chloride, up to 2 g, over 15 minutes. Calcium chloride is preferred, as it is ionically readily available – just use a larger-bore IV and watch for infiltration. Calcium gluconate could be used, but it requires metabolism into a bioavailable source of calcium. Prothrombin complex concentrate (PCC) Prothrombin complex concentrate (PCC) is derived from pooled human plasma and contains 25-30 times the concentration of clotting factors as FFP. Four-factor PCCs contain factors II, VII, IX and X, while 3-factor PCCs contain little or no factor VII. The typical dose of PCC is 20-50 units/kg In the severely hemorrhaging patient – you don’t have time to wait for the other blood products to thaw – PCC is a powder that is reconstituted instantly at the bedside. Tranexamic acid (TXA) Tranexamic acid (TXA), is an anti-fibrinolytic agent that functions by stopping the activation of plasminogen to plasmin, and the degradation of fibrin. The Clinical Randomisation of an Antifibrinolytic in Significant Hemorrhage (CRASH-2) investigators revealed a significant decrease in death secondary to bleeding when TXA was administered early following trauma. Based on the adult literature, one guideline is to give 15 mg/kg loading dose of TXA with a max 1 g over 10 minutes followed by 2 mg/kg/h for at least 8 h or until bleeding stops. Resuscitative Pearls Our goal here is damage control. Apply pressure whenever possible. Otherwise, resuscitate, identify the bleeding source, and slow or stop the bleeding with blood products or surgery. How Children are Different in Trauma In adults, we speak of “permissive hypotension” (also called “balanced resuscitation” or “damage control resuscitation”). The idea is that if we bring the adult patient’s blood pressure up to normal, we may be promoting clot rupture. To avoid this, we target a MAP of 65 and look for clinical signs of sufficient perfusion. Adults tolerate hypotension relatively well, and is sufficient until we send them to the OR or interventional radiology suite. In children, this is simply not the case. Hypotension in children is a sign of pre-arrest. Remember, they compensate with an increased systemic vascular resistance and tachycardia to maintain blood pressure. We should not allow children to become hypotensive – severe tachycardia alone should prompt us to resuscitate. In other words, permissive hypotension is not permissible for children. FAST is not sensitive enough to rule-out abdominal trauma. Fox et al in Academic Emergency Medicine found a sensitivity of 52%; with a 95% confidence interval [CI] = 31% to 73%. Often children even with high-grade splenic and liver lacerations can be managed non-operatively. If they are supported adequately, they are observed in the ICU and can avoid surgery in many cases. Unfortunately, a negative FAST cannot help with detecting or grading the laceration for non-operative management. In other words, feel free to use ultrasound – especially for things that we in the ED will react to and intervene on – but CT may help to manage the traumatized child non-operatively. General Guideline for Imaging in Pediatric Trauma CT Head and Neck, non-contrast: in concerning mechanisms of injury, patients that are difficult to assess (especially those under 3 months), those with a GCS of 13 or lower. CT Chest, IV contrast: for suspicion of vascular injury that needs exploration, especially in penetrating trauma. Otherwise, chest xray will tell you everything you need to know in children – especially in blunt trauma. Hemo or pneumothoraces are readily picked up by US or CXR. Rib fractures on CXR predict pulmonary contusions. If you are concerned about great vessel injury, then CT Chest may be helpful; otherwise consider omitting it. CT Abdomen and Pelvis, IV contrast: helpful in grading splenic and liver lacerations with goal to manage non-operatively. Abdominal tenderness to palpation, significant bruising, or a seat belt sign are concerning and would generally warrant a CT. Also, consider in liver function test abnormalities, or hematuria. Extremity injuries: in general can be evaluated with physical exam and plain films. However, some injuries in high-risk anatomically complex areas such as the hand and wrist, tibial plateau, and midfoot may be missed by plain films, and CT may be helpful here. Remember: you can help to mitigate post-traumatic stress and risk for adult healthcare aversion. Summary Massive transfusion in children is at 40 mL/kg of total blood products. Think about it if you are giving your second transfusion to the traumatized child. Do everything you can to support perfusion and avoid the death spiral of hypothermia, coagulopathy, and acidosis. Keep the child perfused with blood as needed, correct coagulopathy, avoid too much crystalloid, and make sure to use the least high-tech of all of these interventions – keep him dry and covered with warm blankets. Do a careful physical exam, and use CT selectively with an end-point in mind – the default is not the pan-scan – evaluate possible injuries depending on your suspicions from history, physical, and lab tests. Become familiar with the relatively new modalities in trauma such as TXA, cryoprecipitate and the emerging technology of thromboelestogram – red wine is good for you, champagne is weak, and a puffer fish is trouble. Selected References Dehmer JJ, Adamson WT. Massive transfusion and blood product use in the pediatric trauma patient. Semin Pediatr Surg. 2010 Nov;19(4):286-91. doi: 10.1053/j.sempedsurg.2010.07.002. Fox JC, Boysen M, Gharahbaghian L, Cusick S, Ahmed SS, Anderson CL, Lekawa M, Langdorf MI. Test characteristics of focused assessment of sonography for trauma for clinically significant abdominal free fluid in pediatric blunt abdominal trauma. Acad Emerg Med. 2011 May;18(5):477-82. Harvey V, Perrone J, Kim P. Does the use of tranexamic acid improve trauma mortality? Ann Emerg Med. 2014 Apr;63(4):460-2. Holscher CM, Faulk LW, Moore EE, Cothren Burlew C, Moore HB, Stewart CL, Pieracci FM, Barnett CC, Bensard DD. Chest computed tomography imaging for blunt pediatric trauma: not worth the radiation risk. J Surg Res. 2013 Sep;184(1):352-7. Nosanov L, Inaba K, Okoye O, Resnick S, Upperman J, Shulman I, Rhee P, Demetriades D. The impact of blood product ratios in massively transfused pediatric trauma patients. Am J Surg. 2013 Nov;206(5):655-60. Ryan ML, Van Haren RM, Thorson CM, Andrews DM, Perez EA, Neville HL, Sola JE, Proctor KG. Trauma induced hypercoagulablity in pediatric patients. J Pediatr Surg. 2014 Aug;49(8):1295-9. Scaife ER, Rollins MD, Barnhart DC, Downey EC, Black RE, Meyers RL, Stevens MH, Gordon S, Prince JS, Battaglia D, Fenton SJ, Plumb J, Metzger RR. The role of focused abdominal sonography for trauma (FAST) in pediatric trauma evaluation. J Pediatr Surg. 2013 Jun;48(6):1377-83. This post and podcast are dedicated to Larry Mellick, MS, MD, FAAP, FACEP. Thank you for your dedication to medical education, and sharing your warm bedside manner, extensive knowledge and talents, and your patient interactions with the world. Powered by #FOAMed — Tim Horeczko, MD, MSCR, FACEP, FAAP

Margaret Parker, MD, MCCM, speaks with Joshua N. Goldstein, MD, PhD, FACEP, FAHA. Dr. Goldstein works as an Associate Professor of Surgery at Harvard Medical School.

Margaret Parker, MD, MCCM, speaks with Joshua N. Goldstein, MD, PhD, FACEP, FAHA. Dr. Goldstein works as an Associate Professor of Surgery at Harvard Medical School.

Páll Önundarson describes a new method for monitoring clotting in patients treated with warfarin, which they tested in a non-inferiority, randomised clinical trial.

Hypercoagulation disorders are associated with an increased risk of blood clot (thrombus) formation. Factor V Leiden is the most common hereditary blood coagulation disorder in the United States, present in 5% of the Caucasian population and approximately 1.2% of the African American population. Prothrombin is the second most inherited clotting abnormality present in approximately 2% of the general population. Speaker: Denise Heaney, Ph.D., Roche Diagnostics

Sat, 1 Jan 2011 12:00:00 +0100 https://epub.ub.uni-muenchen.de/23408/1/cc10094.pdf Rossaint, Rolf; Spannagl, Michael; Innerhofer, Petra; Spahn, Donat R.; Sorensen, Benny

Prothrombin complex concentrates (PCCs) are used mainly for emergency reversal of vitamin K antagonist therapy. Historically, the major drawback with PCCs has been the risk of thrombotic complications. The aims of the present review are to examine thrombotic complications reported with PCCs, and to compare the safety of PCCs with human fresh frozen plasma. The risk of thrombotic complications may be increased by underlying disease, high or frequent PCC dosing, and poorly balanced PCC constituents. The causes of PCC thrombogenicity remain uncertain but accumulating evidence indicates the importance of factor II (prothrombin). With the inclusion of coagulation inhibitors and other manufacturing improvements, today's PCCs may be considered safer than earlier products. PCCs may be considered preferable to fresh frozen plasma for emergency anticoagulant reversal, and this is reflected in the latest British and American guidelines. Care should be taken to avoid excessive substitution with prothrombin, however, and accurate monitoring of patients' coagulation status may allow thrombotic risk to be reduced. The risk of a thrombotic complication due to treatment with PCCs should be weighed against the need for rapid and effective correction of coagulopathy.

Introduction: The appropriate strategy for trauma-induced coagulopathy management is under debate. We report the treatment of major trauma using mainly coagulation factor concentrates. Methods: This retrospective analysis included trauma patients who received >= 5 units of red blood cell concentrate within 24 hours. Coagulation management was guided by thromboelastometry (ROTEM(R)). Fibrinogen concentrate was given as first-line haemostatic therapy when maximum clot firmness (MCF) measured by FibTEM (fibrin-based test) was < 10 mm. Prothrombin complex concentrate (PCC) was given in case of recent coumarin intake or clotting time measured by extrinsic activation test (EXTEM) > 1.5 times normal. Lack of improvement in EXTEM MCF after fibrinogen concentrate administration was an indication for platelet concentrate. The observed mortality was compared with the mortality predicted by the trauma injury severity score (TRISS) and by the revised injury severity classification (RISC) score. Results: Of 131 patients included, 128 received fibrinogen concentrate as first-line therapy, 98 additionally received PCC, while 3 patients with recent coumarin intake received only PCC. Twelve patients received FFP and 29 received platelet concentrate. The observed mortality was 24.4%, lower than the TRISS mortality of 33.7% (P = 0.032) and the RISC mortality of 28.7% (P > 0.05). After excluding 17 patients with traumatic brain injury, the difference in mortality was 14% observed versus 27.8% predicted by TRISS (P = 0.0018) and 24.3% predicted by RISC (P = 0.014). Conclusions: ROTEM(R)-guided haemostatic therapy, with fibrinogen concentrate as first-line haemostatic therapy and additional PCC, was goal-directed and fast. A favourable survival rate was observed. Prospective, randomized trials to investigate this therapeutic alternative further appear warranted.

Introduction Prothrombin complex concentrates are recommended for rapid reversal of vitamin K anticoagulants. As they normalize levels of vitamin K dependent clotting factors and re-establish hemostasis, they may also be used as adjunctive therapy in patients with major bleeding. The aim of this study was to retrospectively evaluate the efficacy of prothrombin complex concentrates in the surgical setting. Methods The case notes of 50 patients requiring urgent oral anticoagulation reversal (n = 12) or with severe perioperative coagulopathic bleeding (n = 38) who received an infusion of prothrombin complex concentrate (Beriplex P/N(R) 500) at the surgical department of the University of Munich Hospital, Germany were retrospectively reviewed. Efficacy of prothrombin complex concentrate application was evaluated using the Quick test, reported as an international normalized ratio, hemodynamic measurements and requirement for blood products. Safety assessments included whole blood hemoglobin levels and specific parameters of organ dysfunction. Results Baseline characteristics were comparable, except that mean baseline international normalized ratio and hemoglobin levels were significantly higher (P < 0.01) in anticoagulation reversal than in bleeding patients. In anticoagulation reversal, the international normalized ratio was significantly reduced (from 2.8 +/- 0.2 at baseline to 1.5 +/- 0.1, P < 0.001) after one prothrombin complex concentrate infusion (median dose 1500 IU; lower quartile 1,000, upper quartile 2,000). No major bleeding was observed during surgery after prothrombin complex concentrate administration. Only one patient received platelets and red blood cell transfusion after prothrombin complex concentrate administration. In bleeding patients, infusion of prothrombin complex concentrate (median dose 2,000 IU; lower quartile 2,000, upper quartile 3,000) significantly reduced the INR from 1.7 +/- 0.1 at baseline to 1.4 +/- 0.1 (P < 0.001). This decrease was unrelated to fresh frozen plasma or vitamin K administration. Bleeding stopped after prothrombin complex concentrate administration in 4/11 (36%) patients with surgical bleeding and 26/ 27 (96%) patients with diffuse bleeding. Hemoglobin levels increased significantly from baseline in bleeding patients (P < 0.05) and mean arterial pressure stabilized (P < 0.05). No thrombotic events or changes in organ function were reported in any patient. Conclusions Prothrombin complex concentrate application effectively reduced international normalized ratios in anticoagulation reversal, allowing surgical procedures and interventions without major bleeding. In bleeding patients, the improvement in coagulation after prothrombin complex concentrate administration was judged to be clinically significant.

Introduction: Coronary artery disease progression after primary coronary artery bypass grafting may, beside classical atherosclerosis risk factors, be depending on genetic predisposition. Methods: We investigated 192 CABG patients (18% female, age: 60.9 +/- 7.4 years). Clinically cardiac adverse events were defined as need for reoperation (n = 88; 46%), reintervention (n = 58; 30%), or angina (n = 89; 46%). Mean follow-up time measured 10.1 +/- 5.1 years. Gene polymorphisms (ApoE, NOS3, LIPC, CETP, SERPINE-1, Prothrombin) were investigated separately and combined (gene risk profile). Results: Among classical risk factors, arterial hypertension and hypercholesterinemia significantly influenced CAD progression. Single ApoE, NOS3 and LIPC polymorphisms provided limited information. Patients missing the most common ApoE epsilon 3 allele (5,2%), showed recurrent symptoms (p = 0,077) and had more frequently reintervention (p = 0,001). NOS3 a allele was associated with a significant increase for reintervention (p = 0,041) and recurrent symptoms (p = 0,042). Homozygous LIPC patients had a higher reoperation rate (p = 0.049). A gene risk profile enabled us to discriminate between faster and slower occurrence of cardiac adverse events (p = 0.0012). Conclusion: Single APOE, LIPC and NOS3 polymorphisms permitted limited prognosis of cardiac adverse events in patients after CABG. Risk profile, in contrast, allowed for risk stratification.

Background: Growing evidence indicates that ambient air pollution is associated with exacerbation of chronic diseases like chronic pulmonary disease. A prospective panel study was conducted to investigate short-term changes of blood markers of inflammation and coagulation in response to daily changes in air pollution in Erfurt, Germany. 12 clinical visits were scheduled and blood parameters were measured in 38 male patients with chronic pulmonary disease during winter 2001/2002. Additive mixed models with random patient intercept were applied, adjusting for trend, weekday, and meteorological parameters. Hourly data on ultrafine particles (UFP, 0.01-0.1 mu m), accumulation mode particles (ACP, 0.1-1.0 mu m), PM(10) (particulate matter

The Scientific Committee of Molecular Biology Techniques (C-MbT) in Clinical Chemistry of the IFCC has initiated a joint project in co-operation with the European Commission, Joint Research Centre, Institute of Reference Materials and Measurements to develop and produce plasmid-type reference materials (RMs), for the analysis of the human prothrombin gene G20210A mutation. Although DNA tests have a high impact on clinical decision-making and the number of tests performed in diagnostic laboratories is high, issues of quality and quality assurance exist, and currently only a few RMs for clinical genetic testing are available. A gene fragment chosen was produced that spans all primer annealing sites published to date. Both the wild-type and mutant alleles of this gene fragment were cloned into a pUC18 plasmid and two plasmid RMs were produced. In addition, a mixture of both plasmids was produced to mimic the heterozygous genotype. The present study describes the performance of these reference materials in a commutability study, in which they were tested by nine different methods in 13 expert laboratories.. This series of plasmid RMs are, to the best of our knowledge, the first plasmid-type clinical genetic RMs introduced worldwide.