Podcasts about QT

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Latest podcast episodes about QT

LDT 晨禱祭壇
2025-07-03【清晨 QT 敬拜禱告時刻】頌讚生命泉源都在基督國度裡面〔詩篇EP114〕

LDT 晨禱祭壇

Play Episode Listen Later Jul 3, 2025 45:34


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】耶和華所立的根基在聖山上。…論到錫安,必說:這一個、那一個都生在其中,而且至高者必親自堅立這城。…歌唱的,跳舞的,都要說:我的泉源都在你裡面。(詩 87:1,5,7) 【今日經文】詩篇 87:1-7 ▶https://reurl.cc/7V9EL5 【演奏歌曲】主祢聖名配得讚美 - 鋼琴獨奏 by J-vi 【敬拜歌曲】敬拜耶穌 - 讚美之泉 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【07.02 禱告日記】《終日求告神顯出憑據幫助安慰我》▶https://reurl.cc/z5g8oe 【07.01 禱告日記】《呼求神使我們回轉得見神的慈愛》▶https://reurl.cc/DqNLj6 【2025.06 代禱信】《帶領夥伴從靈修進入到生活實踐》▶https://bit.ly/46qXED0 【06.30 禱告日記】《渴想朝見住在神殿中全心倚靠神》▶https://reurl.cc/gRgzGR ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的靈修筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #敬拜耶穌 #讚美之泉 -- Hosting provided by SoundOn

Wine About It
The End of An Era | Wine About It #132

Wine About It

Play Episode Listen Later Jul 2, 2025 110:19


This week on Wine About It:Maya and QT elope and then immediately spiral into chaos.There's wine, exes, baseball, and a surprise attack from Coots.Also — QT wants to make out, Maya gets a call from her baseball ex, and yes... Ludwig shows up.✨ Bonus Content: https://patreon.com/wineaboutit

LDT 晨禱祭壇
2025-07-02【清晨 QT 敬拜禱告時刻】終日求告神顯出憑據幫助安慰我〔詩篇EP113〕

LDT 晨禱祭壇

Play Episode Listen Later Jul 2, 2025 45:52


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】主啊,求你憐憫我,因我終日求告你。…耶和華啊,求你將你的道指教我;我要照你的真理行;求你使我專心敬畏你的名!…求你向我顯出恩待我的憑據,叫恨我的人看見便羞愧,因為你─耶和華幫助我,安慰我。(詩 86:3,11,17) 【今日經文】詩篇 86:1-17 ▶https://reurl.cc/gYkkOV 【演奏歌曲】願祢降臨 - 鋼琴獨奏 by J-vi 【敬拜歌曲】祢的愛 - CHC → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【07.01 禱告日記】《呼求神使我們回轉得見神的慈愛》▶https://reurl.cc/DqNLj6 【2025.06 代禱信】《帶領夥伴從靈修進入到生活實踐》▶https://bit.ly/46qXED0 【06.30 禱告日記】《渴想朝見住在神殿中全心倚靠神》▶https://reurl.cc/gRgzGR 【06.29 禱告日記】《求神追趕四圍仇敵彰顯神的至高》▶https://bit.ly/448j06T ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的靈修筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #祢的愛 #CHC -- Hosting provided by SoundOn

黎明之光-纽澳行道会牧者QT,读经,灵修分享

分享主題: 在患難中呼求上帝 分享經文: 詩篇 86:1~17 分享牧者: 徐小勇 傳道 聖經朗讀: Laura 姊妹 -- Hosting provided by SoundOn

黎明之光-纽澳行道会牧者QT,读经,灵修分享

分享主題: 禱告的理由 分享經文: 詩篇 86:1~17 分享牧者: 黃希 牧師 聖經朗讀: Laura 姊妹 -- Hosting provided by SoundOn

黎明之光-纽澳行道会牧者QT,读经,灵修分享

分享主題: 耶和華點名的時候,你在哪裡? 分享經文: 詩篇 87:1~7 分享牧者: 林華灼 弟兄 聖經朗讀: Laura 姊妹 -- Hosting provided by SoundOn

黎明之光-纽澳行道会牧者QT,读经,灵修分享

分享主題: 把福音傳給萬民 分享經文: 詩篇 87:1~7 分享牧者: 王聰吉 牧師 聖經朗讀: Laura 姊妹 -- Hosting provided by SoundOn

LDT 晨禱祭壇
2025-07-01【清晨 QT 敬拜禱告時刻】呼求神使我們回轉得見神的慈愛〔詩篇EP112〕

LDT 晨禱祭壇

Play Episode Listen Later Jul 1, 2025 45:03


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】拯救我們的神啊,求你使我們回轉,叫你的惱恨向我們止息。…耶和華啊,求你使我們得見你的慈愛,又將你的救恩賜給我們。我要聽神─耶和華所說的話;因為他必應許將平安賜給他的百姓─他的聖民;他們卻不可再轉去妄行。(詩 85:4,7-8) 【今日經文】詩篇 85:1-13 ▶https://reurl.cc/NY5DGp 【演奏歌曲】我們歡迎君王降臨 - 鋼琴獨奏 by J-vi 【敬拜歌曲】恩典之流 - 約書亞 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.30 禱告日記】《渴想朝見住在神殿中全心倚靠神》▶https://reurl.cc/gRgzGR 【2025.06 代禱信】《帶領夥伴從靈修進入到生活實踐》▶https://bit.ly/46qXED0 【06.29 禱告日記】《求神追趕四圍仇敵彰顯神的至高》▶https://bit.ly/448j06T 【06.28 禱告日記】《呼求神起來審判讓基督掌管全地》▶https://reurl.cc/VYyxLA ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的靈修筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #恩典之流 #約書亞 -- Hosting provided by SoundOn

LDT 晨禱祭壇
2025-06-30【清晨 QT 敬拜禱告時刻】渴想朝見住在神殿中全心倚靠神〔詩篇EP111〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 30, 2025 45:15


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】我羨慕渴想耶和華的院宇;我的心腸,我的肉體向永生神呼籲。…他們行走,力上加力,各人到錫安朝見神。…在你的院宇住一日,勝似在別處住千日;寧可在我神殿中看門,不願住在惡人的帳棚裡。(詩 84:2,7,10) 【今日經文】詩篇 84:1-12 ▶https://bit.ly/45O0fa6 【演奏歌曲】聖靈的江河 - 鋼琴獨奏 by J-vi 【敬拜歌曲】帶我進入祢的同在 - 讚美之泉 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.29 禱告日記】《求神追趕四圍仇敵彰顯神的至高》▶https://bit.ly/448j06T 【06.28 禱告日記】《呼求神起來審判讓基督掌管全地》▶https://reurl.cc/VYyxLA 【06.27 禱告日記】《全心聽從神大大張口神豐盛充滿》▶https://reurl.cc/2K5Yqn 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的靈修筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #帶我進入祢的同在 #讚美之泉 -- Hosting provided by SoundOn

黎明之光-纽澳行道会牧者QT,读经,灵修分享

分享主題: 你活過來了嗎? 分享經文: 詩篇 85:1~13 分享牧者: 張力夫 牧師 聖經朗讀: Laura 姊妹 -- Hosting provided by SoundOn

黎明之光-纽澳行道会牧者QT,读经,灵修分享

分享主題: 上帝必將好處賜給我們 分享經文: 詩篇 85:1~13 分享牧者: 王聰吉 牧師 聖經朗讀: Laura 姊妹 -- Hosting provided by SoundOn

Quigley Tuesdays
That Unghostly Guest

Quigley Tuesdays

Play Episode Listen Later Jun 30, 2025 66:49


It's a GUEST EP featuring THE MOST FAMOUS MAN FROM TOWN. ChatJQT predicts a League Cup result, Kane Drummond picks up a QT honour, we delve into our FAMOUS GUEST'S life story before some very average quizzing & we put our fingers on the pulse of the hottest topics in almost Chesterfield-adjacent culture this week.

The Movie Defenders
Ep 202: Good Morning, Vietnam

The Movie Defenders

Play Episode Listen Later Jun 29, 2025 199:41


Today with our amazing friend Stephanie Ewry, we celebrate the work of one of the greatest comedians of all time by breaking down the incredible Robin Williams in Good Morning, Vietnam. In what is arguably his best performance, Robin does what Robin does... make us laugh. And that's what we do the entire show today! We also pick each of our Top 5 Robin Williams films of all time. So get out the vinyl records, don't start the jeep if it's already running, and keep the MD PC on the QT or we might end up MIA or put on KP... it's time for Good Morning, Vietnam on The Movie Defenders podcast! Click here to listen and connect anywhere: https://linktr.ee/moviedefenders 00:00:00 Intro and What We've Been Watching 00:29:25 Top 5 Robin Williams Movies 00:57:53 Good Morning, Vietnam Discussion Begins 01:35:51 1st Time On the Air 01:43:52 And if you doooooooooooooo 01:53:21 Teaching English 02:04:36 Fake News 02:22:09 Frenchie Bombs 02:29:38 Fan Mail 02:35:11 Meet the Troops 02:51:32 Confronting Tuan 03:02:39 Goodbye, Vietnam Special thanks to our amazing Patreon supporters! Alex Kirkby  Alexis Helman Barrett Young Bart German Brett Bowen Daryl Ewry Doug Robertson Ena Haynes Eric Blattberg Jason Chastain Josh Evans Joshua Loy Katherine Boulware Kevin Athey Mark Nattress Mark Martin Megan Bush Michael Puckett Nick Nagher Randal Silver Sean Masters Stephanie Ewry Attack of the Killer Podcast

LDT 晨禱祭壇
2025-06-29【清晨 QT 敬拜禱告時刻】求神追趕四圍仇敵彰顯神的至高〔詩篇EP110〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 29, 2025 45:53


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】求你也照樣用狂風追趕他們,用暴雨恐嚇他們。願你使他們滿面羞恥,好叫他們尋求你─耶和華的名!…使他們知道:惟獨你─名為耶和華的─是全地以上的至高者!(詩 83:15-16,18) 【今日經文】詩篇 83:1-18 ▶http://bit.ly/3TiPhSt 【演奏歌曲】奔跑不放棄 - 鋼琴獨奏 by J-vi 【敬拜歌曲】奔跑不放棄 / 榮耀的呼召 - 讚美之泉 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.28 禱告日記】《呼求神起來審判讓基督掌管全地》▶https://reurl.cc/VYyxLA 【06.27 禱告日記】《全心聽從神大大張口神豐盛充滿》▶https://reurl.cc/2K5Yqn 【06.26 禱告日記】《求神的臉發光眷顧栽種恢復我們》▶https://reurl.cc/bWMLNo 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的靈修筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #奔跑不放棄 #榮耀的呼召 #讚美之泉 -- Hosting provided by SoundOn

LDT 晨禱祭壇
2025-06-28【清晨 QT 敬拜禱告時刻】呼求神起來審判讓基督掌管全地〔詩篇EP109〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 28, 2025 45:43


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】神站在有權力者的會中,在諸神中行審判,…你們當為貧寒的人和孤兒伸冤;當為困苦和窮乏的人施行公義。…神啊,求你起來審判世界,因為你要得萬邦為業。(詩 82:1,3,8) 【今日經文】詩篇 82:1-8 ▶https://reurl.cc/paQ024 【演奏歌曲】委身之歌 - 鋼琴獨奏 by J-vi 【敬拜歌曲】耶穌永遠掌權 - 讚美之泉 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.27 禱告日記】《全心聽從神大大張口神豐盛充滿》▶https://reurl.cc/2K5Yqn 【06.26 禱告日記】《求神的臉發光眷顧栽種恢復我們》▶https://reurl.cc/bWMLNo 【06.25 禱告日記】《求神因自己名的榮耀來搭救我們》▶https://reurl.cc/aeQxrZ 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #耶穌永遠掌權 #讚美之泉 -- Hosting provided by SoundOn

黎明之光-纽澳行道会牧者QT,读经,灵修分享

分享主題: 脫困的禱告 分享經文: 詩篇 83:1~18 分享牧者: 周薔 師母 聖經朗讀: Laura 姊妹 -- Hosting provided by SoundOn

Big Brother Recaps & Live Feed Updates from Rob Has a Podcast
Big Brother 26: A Weekly Big Brother Season Retrospective

Big Brother Recaps & Live Feed Updates from Rob Has a Podcast

Play Episode Listen Later Jun 27, 2025 131:39


This week, Taran and QT discuss Season 26 of Big Brother!

Reality TV RHAP-ups: Reality TV Podcasts
Big Brother 26: A Weekly Big Brother Season Retrospective

Reality TV RHAP-ups: Reality TV Podcasts

Play Episode Listen Later Jun 27, 2025 131:39


This week, Taran and QT discuss Season 26 of Big Brother!

LDT 晨禱祭壇
2025-06-27【清晨 QT 敬拜禱告時刻】全心聽從神大大張口神豐盛充滿〔詩篇EP108〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 27, 2025 45:38


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】我的民哪,你當聽,我要勸戒你;以色列啊,甚願你肯聽從我。在你當中,不可有別的神;外邦的神,你也不可下拜。我是耶和華─你的神,曾把你從埃及地領上來;你要大大張口,我就給你充滿。(詩 81:8-10) 【今日經文】詩篇 81:1-16 ▶https://reurl.cc/GnMKvy 【演奏歌曲】能不能 - 鋼琴獨奏 by J-vi 【敬拜歌曲】我們歡迎君王降臨 - 讚美之泉 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.26 禱告日記】《求神的臉發光眷顧栽種恢復我們》▶https://reurl.cc/bWMLNo 【06.25 禱告日記】《求神因自己名的榮耀來搭救我們》▶https://reurl.cc/aeQxrZ 【06.24 禱告日記】《被神揀選恢復敬拜牧養神的百姓》▶https://reurl.cc/xNndpZ 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #我們歡迎君王降臨 #讚美之泉 -- Hosting provided by SoundOn

LDT 晨禱祭壇
2025-06-26【清晨 QT 敬拜禱告時刻】求神的臉發光眷顧栽種恢復我們〔詩篇EP107〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 26, 2025 45:16


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】萬軍之神啊,求你回轉!從天上垂看,眷顧這葡萄樹,保護你右手所栽的和你為自己所堅固的枝子。…耶和華─萬軍之神啊,求你使我們回轉,使你的臉發光,我們便要得救!(詩 80:14-15,19) 【今日經文】詩篇 80:1-19 ▶https://reurl.cc/NY3Wvm 【演奏歌曲】主祢聖名配得讚美 - 鋼琴獨奏 by J-vi 【敬拜歌曲】恢復我 - 約書亞 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.25 禱告日記】《求神因自己名的榮耀來搭救我們》▶https://reurl.cc/aeQxrZ 【06.24 禱告日記】《被神揀選恢復敬拜牧養神的百姓》▶https://reurl.cc/xNndpZ 【06.23 禱告日記】《追隨記念神的手引領不叫神擔憂》▶https://reurl.cc/9D20aY 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #恢復我 #約書亞 -- Hosting provided by SoundOn

Wine About It
30daph is Our Guest Today | Wine About It #131

Wine About It

Play Episode Listen Later Jun 25, 2025 64:21


This week on Wine About It:Maya and QT sit down with the effortlessly cool Daph for stories, scandals, and Cheddar Bay Biscuits.There's mom tea, cheating trauma, and a deep dive into Daph's relationship drama.Also: church, cosmetic surgery fears, and QT's high school ex gets Googled. ✨ Bonus Content: https://patreon.com/wineaboutit

The PainExam podcast
Herpes Zoster & Post Herpetic Neuralgia- For the Pain Boards & your Patients!

The PainExam podcast

Play Episode Listen Later Jun 24, 2025 27:40


Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

LDT 晨禱祭壇
2025-06-24【清晨 QT 敬拜禱告時刻】被神揀選恢復敬拜牧養神的百姓〔詩篇EP105〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 24, 2025 45:18


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】又揀選他的僕人大衛,從羊圈中將他召來,叫他不再跟從那些帶奶的母羊,為要牧養自己的百姓雅各和自己的產業以色列。於是,他按心中的純正牧養他們,用手中的巧妙引導他們。(詩 78:70-72) 【今日經文】詩篇 78:56-72 ▶https://reurl.cc/nmeekX 【演奏歌曲】我們歡迎君王降臨 - 鋼琴獨奏 by J-vi 【敬拜歌曲】恢復敬拜 - 讚美之泉 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.23 禱告日記】《追隨記念神的手引領不叫神擔憂》▶https://reurl.cc/9D20aY 【06.22 禱告日記】《真心呼求神的憐憫不要虛假悔改》▶https://reurl.cc/3Kve49 【06.21 禱告日記】《信服神仰賴神的救恩不貪而無厭》▶https://reurl.cc/ae29gZ 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #恢復敬拜 #讚美之泉 -- Hosting provided by SoundOn

LDT 晨禱祭壇
2025-06-25【清晨 QT 敬拜禱告時刻】求神因自己名的榮耀來搭救我們〔詩篇EP106〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 24, 2025 45:34


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】求你不要記念我們先祖的罪孽,向我們追討;願你的慈悲快迎著我們,因為我們落到極卑微的地步。拯救我們的神啊,求你因你名的榮耀幫助我們!為你名的緣故搭救我們,赦免我們的罪。…這樣,你的民,你草場的羊,要稱謝你,直到永遠;要述說讚美你的話,直到萬代。(詩 79:8-9,13) 【今日經文】詩篇 79:1-13 ▶https://reurl.cc/5KeDE7 【演奏歌曲】願祢降臨 - 鋼琴獨奏 by J-vi 【敬拜歌曲】我們呼求 - 讚美之泉 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.24 禱告日記】《被神揀選恢復敬拜牧養神的百姓》▶https://reurl.cc/xNndpZ 【06.23 禱告日記】《追隨記念神的手引領不叫神擔憂》▶https://reurl.cc/9D20aY 【06.22 禱告日記】《真心呼求神的憐憫不要虛假悔改》▶https://reurl.cc/3Kve49 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #我們呼求 #讚美之泉 -- Hosting provided by SoundOn

AnesthesiaExam Podcast
Post Herpetic Neuralgias: Epidurals, Paravertebral Blocks and more!

AnesthesiaExam Podcast

Play Episode Listen Later Jun 24, 2025 27:40


Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

The PMRExam Podcast
Post Herpetic Neuralgia- An Update

The PMRExam Podcast

Play Episode Listen Later Jun 24, 2025 27:40


Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

Emergency Medical Minute
Episode 962: HEART Score

Emergency Medical Minute

Play Episode Listen Later Jun 23, 2025 4:16


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

Keeping Abreast with Dr. Jenn
100th Episode - The Answers to Breast Health Dr Jenn Once Wished She Had

Keeping Abreast with Dr. Jenn

Play Episode Listen Later Jun 23, 2025 52:55


Welcome to the 100th episode of Keeping Abreast! In this powerful episode of Dr. Jenn answers questions from her listeners and dives deep into the most commonly asked questions over the years. She discusses the evolution of breast cancer screening, emphasizing the importance of self-examination and the innovative QT scan technology. I address the challenges faced by breast cancer survivors, the role of hormone replacement therapy and the real reasons women feel worse after treatment and what to do about it.  Dr Jenn discusses the significance and impactful difference of personalized health care. I share my views on taking a holistic view of health, encouraging women to take charge of their well-being and to address emotional trauma as part of recovery. This episode highlights the need for a shift in how breast cancer care is approached, focusing on prevention and self-care. She gives women what she once wishes she had, real answers, a new approach and hope.  In This Episode You Will Learn:- Self-breast examination is crucial for early detection.- The ARIA test provides real-time risk assessment for breast cancer.- QT scan technology offers a safer alternative to traditional imaging.- Post-treatment, many women experience significant health challenges.- Hormone replacement therapy can be safe after breast cancer with proper monitoring.- Emotional trauma plays a significant role in recovery from breast cancer.- Personalized health approaches are essential for effective treatment.- Education about breast cancer and its treatment is vital for patients.- Women deserve to thrive after a breast cancer diagnosis, not just survive.- Health is a continuous journey that requires ongoing attention and care.To talk to a member of Dr. Jenn's team and learn more about working privately with RHMD, visit: https://jennsimmons.simplero.com/page/377266?kuid=327aca17-5135-44cf-9210-c0b77a56e26d&kref=vOKy0sAiorrKTo get your copy of Dr. Jenn's book, The Smart Woman's Guide to Breast Cancer, visit: https://tinyurl.com/SmartWomansBreastCancerGuideTo purchase the auria breast cancer screening test go here https://auria.care/ and use the code DRJENN20 for 20% Off.Connect with Dr. Jenn:Website: https://www.realhealthmd.com/Facebook: https://www.facebook.com/DrJennSimmonsInstagram: https://www.instagram.com/drjennsimmons/YouTube: https://www.youtube.com/@dr.jennsimmons

LDT 晨禱祭壇
2025-06-23【清晨 QT 敬拜禱告時刻】追隨記念神的手引領不叫神擔憂〔詩篇EP104〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 23, 2025 45:16


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】他們在曠野悖逆他,在荒地叫他擔憂,何其多呢!…他們不追念他的能力(原文是手)和贖他們脫離敵人的日子;…他卻領出自己的民如羊,在曠野引他們如羊群。(詩 78:40,42,52) 【今日經文】詩篇 78:40-55 ▶https://reurl.cc/VYkm2n 【演奏歌曲】聖靈的江河 - 鋼琴獨奏 by J-vi 【敬拜歌曲】一生跟隨祢 - 約書亞 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.22 禱告日記】《真心呼求神的憐憫不要虛假悔改》▶https://reurl.cc/3Kve49 【06.21 禱告日記】《信服神仰賴神的救恩不貪而無厭》▶https://reurl.cc/ae29gZ 【06.20 禱告日記】《仰望持守神的話語傳承神的教訓》▶https://reurl.cc/bWLbx6 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #一生跟隨祢 #約書亞 -- Hosting provided by SoundOn

LDT 晨禱祭壇
2025-06-22【清晨 QT 敬拜禱告時刻】真心呼求神的憐憫不要虛假悔改〔詩篇EP103〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 22, 2025 45:19


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】他們卻用口諂媚他,用舌向他說謊。因他們的心向他不正,在他的約上也不忠心。但他有憐憫,赦免他們的罪孽,不滅絕他們,而且屢次消他的怒氣,不發盡他的忿怒。(詩 78:36-38) 【今日經文】詩篇 78:32-39 ▶https://reurl.cc/paO6zb 【演奏歌曲】奔跑不放棄 - 鋼琴獨奏 by J-vi 【敬拜歌曲】呼求祢憐憫 - 生命河靈糧堂 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.21 禱告日記】《信服神仰賴神的救恩不貪而無厭》▶https://reurl.cc/ae29gZ 【06.20 禱告日記】《仰望持守神的話語傳承神的教訓》▶https://reurl.cc/bWLbx6 【06.19 禱告日記】《追念神大能作為看見神開的道路》▶https://reurl.cc/9DjpbX 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #呼求祢憐憫 #生命河靈糧堂 -- Hosting provided by SoundOn

LDT 晨禱祭壇
2025-06-21【清晨 QT 敬拜禱告時刻】信服神仰賴神的救恩不貪而無厭〔詩篇EP102〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 21, 2025 45:11


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】他們心中試探神,隨自己所欲的求食物,…因為他們不信服神,不倚賴他的救恩。他卻吩咐天空,又敞開天上的門,降嗎哪,像雨給他們吃,將天上的糧食賜給他們。(詩 78:18,22-24) 【今日經文】詩篇 78:9-31 ▶https://reurl.cc/o8WgLq 【演奏歌曲】委身之歌 - 鋼琴獨奏 by J-vi 【敬拜歌曲】祢是唯一 - CHC → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.20 禱告日記】《仰望持守神的話語傳承神的教訓》▶https://reurl.cc/bWLbx6 【06.19 禱告日記】《追念神大能作為看見神開的道路》▶https://reurl.cc/9DjpbX 【06.18 禱告日記】《在夜間不住舉手禱告尋求神安慰》▶https://reurl.cc/1K6AZm 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #祢是唯一 #CHC -- Hosting provided by SoundOn

The Good, The Pod and The Ugly
SQUIB SZN: E5: DJANGO UNCHAINED

The Good, The Pod and The Ugly

Play Episode Listen Later Jun 20, 2025 66:48


Send us a textSPECIAL NOTE: SEASON 15 OF THE GOOD, THE POD AND THE UGLY CELEBRATES THE USE OF THE PRACTICAL AND DIGITAL EFFECT KNOWN AS THE SQUIB. IRL GUN VIOLENCE IS INTOLERABLE AND RENOUNCED BUT... CINEMATIC VIOLENCE WILL BE CELEBRATED IN A WAY WILL DISTURB SOME LISTENERS.  After five years, a ban has been lifted—momentarily. For this single episode, the pod's ironclad rule against discussing a Quentin Tarantino film that has divided our hosts is broken. The director is set free. And Jack goes fugitive this week as TGTPTU discusses the all-so-deliciously-squibby DJANGO UNCHAINED (2012).   Set just a few years before the Civil War to allow Tarantino to have his favorite racial epithet spoken a stunning 110 times—yikes!—juicy bloody condoms burst all across the faux climax of this Neo-Spaghetti Western as Django (the “d” is silent, played by Jamie Foxx) takes his revenge on the Francophile plantation owner, phenology enthusiastic, and curator of the ahistorical bloodsport of Mandingo fighting viz. “Monsieur” Calvin J. Candie (Leonardo DiCaprio) for the death of immigrant German dentist+bounty-hunter Dr. King Schultz (Christoph Waltz) all lensed by regular QT collaborator Robert Richardson.  This ep, Ken takes issue with the treatment and ambiguity of sexual violence (not?) portrayed in the film, its lazy writing, and that the picture was made after and is not Inglorious Basterds; Thomas, who claims to be both a Boomer and German this episode, brings irrelevant and irreverent German Facts (an unused example: “‘Gesundheit' is a German's way of saying: How tall is your gay son?”); and Ryan violates the unspoken rule of keeping talk of Quentin Tarantino on the QT. At least all three hosts agree the triple-threat Actor+Writer+Director Tarantino is best as a just double threat.  So tune in for an episode that answers the age-old question: What if TGTPTU hosts finally take on Quentin Tarantino—and no one does an impression?  Next week Jack returns. Content Warning: Django Unchained not merely contains but is brimming with a specific racial slur using a hard-r by characters of various races and classes as directed (and written) to do so by a White filmmaker. Django Unchained also contains, and glosses over, sexual violence.   THEME SONG BY: WEIRD A.I.Email: thegoodthepodandtheugly@gmail.comFacebook: https://m.facebook.com/TGTPTUInstagram: https://instagram.com/thegoodthepodandtheugly?igshid=um92md09kjg0Bluesky: @goodpodugly.bsky.socialYouTube: https://www.youtube.com/channel/UC6mI2plrgJu-TB95bbJCW-gLetterboxd (follow us!):Podcast: goodpoduglyKen: Ken KoralRyan: Ryan Tobias

LDT 晨禱祭壇
2025-06-20【清晨 QT 敬拜禱告時刻】仰望持守神的話語傳承神的教訓〔詩篇EP101〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 20, 2025 45:11


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】因為,他在雅各中立法度,在以色列中設律法;是他吩咐我們祖宗要傳給子孫的,…好叫他們仰望神,不忘記神的作為,惟要守他的命令。不要像他們的祖宗,是頑梗悖逆、居心不正之輩,向著神,心不誠實。(詩 78:5,7-8) 【今日經文】詩篇 78:1-8 ▶https://reurl.cc/3K0QNM 【演奏歌曲】能不能 - 鋼琴獨奏 by J-vi 【敬拜歌曲】我渴望看見 - 讚美之泉 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.19 禱告日記】《追念神大能作為看見神開的道路》▶https://reurl.cc/9DjpbX 【06.18 禱告日記】《在夜間不住舉手禱告尋求神安慰》▶https://reurl.cc/1K6AZm 【06.17 禱告日記】《讚美神施行審判救一切謙卑的人》▶https://reurl.cc/yRdMe6 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #我渴望看見 #讚美之泉 -- Hosting provided by SoundOn

LDT 晨禱祭壇
2025-06-19【清晨 QT 敬拜禱告時刻】追念神大能作為看見神開的道路〔詩篇EP100〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 19, 2025 45:18


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】我便說:這是我的懦弱,但我要追念至高者顯出右手之年代。…你的道在海中;你的路在大水中;你的腳蹤無人知道。你曾藉摩西和亞倫的手引導你的百姓,好像羊群一般。(詩 77:10,19-20) 【今日經文】詩篇 77:10-20 ▶https://reurl.cc/OYlp8g 【演奏歌曲】主祢聖名配得讚美 - 鋼琴獨奏 by J-vi 【敬拜歌曲】讚美中信心不斷升起 - 讚美之泉 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.18 禱告日記】《在夜間不住舉手禱告尋求神安慰》▶https://reurl.cc/1K6AZm 【06.17 禱告日記】《讚美神施行審判救一切謙卑的人》▶https://reurl.cc/yRdMe6 【06.16 禱告日記】《看見神的審判砍斷惡人高舉義人》▶https://reurl.cc/gRdyjp 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #讚美中信心不斷升起 #讚美之泉 -- Hosting provided by SoundOn

Wine About It
Kaya is On The Hunt | Wine About It #130

Wine About It

Play Episode Listen Later Jun 18, 2025 63:56


This week on Wine About It:Maya and QT are joined by Kaya Piker — and Hasan — for a truly chaotic episode.There's haunting, bullying, and a mouse that just won't quit.They talk relationships, internet hate, and the one apology Hasan still deserves. ✨ Bonus Content: https://patreon.com/wineaboutit

LDT 晨禱祭壇
2025-06-18【清晨 QT 敬拜禱告時刻】在夜間不住舉手禱告尋求神安慰〔詩篇EP99〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 18, 2025 45:22


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】我在患難之日尋求主;我在夜間不住地舉手禱告;我的心不肯受安慰。我想念神,就煩躁不安;我沉吟悲傷,心便發昏。…我想起我夜間的歌曲,捫心自問;我心裡也仔細省察。(詩 77:2-3,6) 【今日經文】詩篇 77:1-9 ▶https://reurl.cc/vQYbDN 【演奏歌曲】願祢降臨 - 鋼琴獨奏 by J-vi 【敬拜歌曲】不放手 - CHC → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.17 禱告日記】《讚美神施行審判救一切謙卑的人》▶https://reurl.cc/yRdMe6 【06.16 禱告日記】《看見神的審判砍斷惡人高舉義人》▶https://reurl.cc/gRdyjp 【06.15 禱告日記】《在困苦中讚美求神顧念所立的約》▶https://reurl.cc/Gn1grW 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #不放手 #CHC -- Hosting provided by SoundOn

LDT 晨禱祭壇
2025-06-17【清晨 QT 敬拜禱告時刻】讚美神施行審判救一切謙卑的人〔詩篇EP98〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 17, 2025 45:02


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】你從天上使人聽判斷。神起來施行審判,要救地上一切謙卑的人;那時地就懼怕而靜默。…你們許願,當向耶和華─你們的神還願;在他四面的人都當拿貢物獻給那可畏的主。(詩 76:8-9,11) 【今日經文】詩篇 76:1-12 ▶https://reurl.cc/NYvApe 【演奏歌曲】我們歡迎君王降臨 - 鋼琴獨奏 by J-vi 【敬拜歌曲】得勝的歌 - 讚美之泉 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.16 禱告日記】《看見神的審判砍斷惡人高舉義人》▶https://reurl.cc/gRdyjp 【06.15 禱告日記】《在困苦中讚美求神顧念所立的約》▶https://reurl.cc/Gn1grW 【06.14 禱告日記】《求神記念拯救毀滅仇敵恢復聖所》▶https://reurl.cc/YYx0Yo 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #得勝的歌 #讚美之泉 -- Hosting provided by SoundOn

LDT 晨禱祭壇
2025-06-16【清晨 QT 敬拜禱告時刻】看見神的審判砍斷惡人高舉義人〔詩篇EP97〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 16, 2025 45:28


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】惟有神斷定;他使這人降卑,使那人升高。…但我要宣揚,直到永遠!我要歌頌雅各的神!惡人一切的角,我要砍斷;惟有義人的角必被高舉。(詩 75:7,9-10) 【今日經文】詩篇 75:1-10 ▶https://reurl.cc/OYOaRA 【演奏歌曲】聖靈的江河 - 鋼琴獨奏 by J-vi 【敬拜歌曲】耶和華坐著為王 - 讚美之泉 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.15 禱告日記】《在困苦中讚美求神顧念所立的約》▶https://reurl.cc/Gn1grW 【06.14 禱告日記】《求神記念拯救毀滅仇敵恢復聖所》▶https://reurl.cc/YYx0Yo 【06.13 禱告日記】《進入聖所看見親近神得永遠福分》▶https://reurl.cc/zqddEQ 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #耶和華坐著為王 #讚美之泉 -- Hosting provided by SoundOn

LDT 晨禱祭壇
2025-06-15【清晨 QT 敬拜禱告時刻】在困苦中讚美求神顧念所立的約〔詩篇EP96〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 15, 2025 45:49


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】神自古以來為我的王,在地上施行拯救…求你顧念所立的約,因為地上黑暗之處都滿了強暴的居所。不要叫受欺壓的人蒙羞回去;要叫困苦窮乏的人讚美你的名。(詩 74:12,20-21) 【今日經文】詩篇 74:12-23 ▶https://reurl.cc/OYO6nv 【演奏歌曲】奔跑不放棄 - 鋼琴獨奏 by J-vi 【敬拜歌曲】舉起禱告的手 - 豐盛教會 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.14 禱告日記】《求神記念拯救毀滅仇敵恢復聖所》▶https://reurl.cc/YYx0Yo 【06.13 禱告日記】《進入聖所看見親近神得永遠福分》▶https://reurl.cc/zqddEQ 【06.12 禱告日記】《清心專注愛神不對惡人心懷不平》▶https://reurl.cc/2KdzE4 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #舉起禱告的手 #豐盛教會 -- Hosting provided by SoundOn

LDT 晨禱祭壇
2025-06-14【清晨 QT 敬拜禱告時刻】求神記念拯救毀滅仇敵恢復聖所〔詩篇EP95〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 14, 2025 45:29


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】求你記念你古時所得來的會眾,就是你所贖、作你產業支派的,並記念你向來所居住的錫安山。求你舉步去看那日久荒涼之地,仇敵在聖所中所行的一切惡事。…你為甚麼縮回你的右手?求你從懷中伸出來,毀滅他們。(詩 74:2-3,11) 【今日經文】詩篇 74:1-11 ▶https://reurl.cc/Dq0AzN 【演奏歌曲】委身之歌 - 鋼琴獨奏 by J-vi 【敬拜歌曲】祢的救恩 - 讚美之泉 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.13 禱告日記】《進入聖所看見親近神得永遠福分》▶https://reurl.cc/zqddEQ 【06.12 禱告日記】《清心專注愛神不對惡人心懷不平》▶https://reurl.cc/2KdzE4 【06.11 禱告日記】《順服神話語約束守住神產業延續》▶https://reurl.cc/NYe749 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #祢的救恩 #讚美之泉 -- Hosting provided by SoundOn

The Church of Tarantino
Bible Study 6: Kill Bill Vol.1 (Chapter 9)

The Church of Tarantino

Play Episode Listen Later Jun 13, 2025 78:45


On our latest edition of The Bible Study, The Reverend and his guests, Elwood Jones (Asian Cinema Film Club) and Lex Briscuso (Film Writer for IGN & Slash Film) take a deep dive into the 9th chapter from the digital copy of Kill Bill Vol.1. Along the way they discuss Tarantino's use of anime to cover mature themed scenes, why QT never used animation in any of his other films, if O-Ren was possibly The Bride's best friend in the D.I.V.A.S. and why anime worked so well in this film.Elwood Jones:Listen to the Asian Cinema Film Club: https://podcasts.apple.com/us/podcast/asian-cinema-film-club/id1282298451Listen to the Movies & Tea Podcast: https://podcasts.apple.com/us/podcast/movies-and-tea/id1365362345Listen to the Game Warp Podcast: https://podcasts.apple.com/us/podcast/game-warp/id1472613756Follow Elwood Jones on his Socials:Facebook: @richard.smethurst.33Instagram: @elwoodjones99Twitter: @Elwood_JonesLex Briscuso:Follow Lex on her Socials:Facebook: @Lex.BriscusoInstagram, Twitter (X) & Letterboxd: @NikonAmericaBecome a member of The Church of Tarantino:Follow us on our Socials:Facebook / Instagram / Threads / Blue Sky & Letterboxd: @ChurchOfQTPodEmail: TheChurchOfTarantino@gmail.comWe're also on the Rabbit Hole Podcast Network: https://rabbitholepodcasts.com/the-church-of-tarantino/

Sustain
Episode 273: Maintainer Month 2025 with Federico Mena Quintero on GNOME

Sustain

Play Episode Listen Later Jun 13, 2025 46:11


Guest Federico Mena Quintero Panelist Richard Littauer Show Notes In this special Maintainer Month episode of Sustain, host Richard Littauer chats with Federico Mena Quintero, a foundational GNOME hacker and board member. Federico shares his journey from learning image processing in high school, becoming a key contributor to the GIMP project, and founding the GNOME desktop environment. He discusses the historical context, challenges, and achievements of GNOME and open source development. The conversation delves into the importance of maintaining infrastructural software, adapting to new technologies like the Rust programming language, and the socio-economic factors influencing the open source community's demographics. Press download now to hear more! [00:01:29] Federico describes GNOME as the “surface of your desk”- the visual and interactive layer of the Linux desktop. [00:02:16] Federico started writing image processing programs in high school and discovered GIMP (GNU Image Manipulation Program) and began contributing plugins. Encouraged by positive feedback, he continued developing filters and building community resources. [00:10:20] The proprietary Motif GUI toolkit used by GIMP prompted the creation of GTK (GIMP Toolkit), a free alternative. GTK was split from GIMP and became a foundation for GNOME. Miguel de Icaza learned about modular component design from Microsoft and brought those ideas to the GNOME team. [00:14:48] Federico explains KDE was already launched but used the non-free Qt toolkit and GNOME was created as a fully free alternative using GTK. [00:17:58] They discuss GNOME's long-term success which has thousands of contributors and institutional backing from its foundation. [00:21:06] Federico reflects on his privilege. He never had to apply for his first job because he was recruited and recognizes the barriers to entry for underrepresented communities. [00:24:32] The conversation turns to global south and diversity. Federico discusses the limitations on who can participate in open source due to time, money, and societal roles, and notes that women and people outside the Global North often face greater barriers. [00:30:37] Richard inquires what Federico means by “maintaining infrastructure.” He explains that open source today is less about new features and more about keeping infrastructure working. [00:32:59] Federico talks about a recent project to replace a vital but abandoned infrastructure component and emphasizes the need for sustainable maintenance strategies. [00:36:25] Federico became maintainer of Librsvg image rendering library from C to Rust. [00:40:00] Find out where you can follow Federico on the web. Quotes [00:31:10] “Software doesn't rot, but the environment around it changes.” Spotlight [00:40:57] Richard's spotlight is the book, 1491: New Revelations of the Americas Before Columbus. [00:41:49] Federico's spotlight is two books: Malintzin's Choices and James. Links SustainOSS (https://sustainoss.org/) podcast@sustainoss.org (mailto:podcast@sustainoss.org) richard@sustainoss.org (mailto:richard@sustainoss.org) SustainOSS Discourse (https://discourse.sustainoss.org/) SustainOSS Mastodon (https://mastodon.social/tags/sustainoss) SustainOSS Bluesky (https://bsky.app/profile/sustainoss.bsky.social) SustainOSS LinkedIn (https://www.linkedin.com/company/sustainoss/) Open Collective-SustainOSS (Contribute) (https://opencollective.com/sustainoss) Richard Littauer Socials (https://www.burntfen.com/2023-05-30/socials) Federico Mena Quintero Blog (https://viruta.org/) Federico Mena Quintero Mastodon (https://mastodon.social/@federicomena@mstdn.mx) GNOME (https://www.gnome.org/) GIMP (GNU Image Manipulation Program) (https://www.gimp.org/) GTK (https://www.gtk.org/) Librsvg (https://github.com/GNOME/librsvg) 1491: New Revelations of the Americas Before Columbus by Charles C. Mann (https://en.wikipedia.org/wiki/1491%3A_New_Revelations_of_the_Americas_Before_Columbus) La Malinche (https://en.wikipedia.org/wiki/La_Malinche) Malintzin's Choices by Camila Townsend (https://archive.org/details/malintzinschoice0000town) James by Percival Everett (https://en.wikipedia.org/wiki/James_(novel)) Credits Produced by Richard Littauer (https://www.burntfen.com/) Edited by Paul M. Bahr at Peachtree Sound (https://www.peachtreesound.com/) Show notes by DeAnn Bahr Peachtree Sound (https://www.peachtreesound.com/) Special Guest: Federico Mena Quintero.

LDT 晨禱祭壇
2025-06-13【清晨 QT 敬拜禱告時刻】進入聖所看見親近神得永遠福分〔詩篇EP94〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 13, 2025 45:32


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】等我進了神的聖所,思想他們的結局。…我的肉體和我的心腸衰殘;但神是我心裡的力量,又是我的福分,直到永遠。…但我親近神是與我有益;我以主耶和華為我的避難所,好叫我述說你一切的作為。(詩 73:17,26,28) 【今日經文】詩篇 73:15-28 ▶https://reurl.cc/3K2V49 【演奏歌曲】能不能 - 鋼琴獨奏 by J-vi 【敬拜歌曲】我心渴望 - 生命河靈糧堂 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.12 禱告日記】《清心專注愛神不對惡人心懷不平》▶https://reurl.cc/2KdzE4 【06.11 禱告日記】《順服神話語約束守住神產業延續》▶https://reurl.cc/NYe749 【06.10 禱告日記】《倚靠基督十架救贖得著赦罪潔淨》▶https://reurl.cc/YYzEQO 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #我心渴望 #生命河靈糧堂 -- Hosting provided by SoundOn

LDT 晨禱祭壇
2025-06-12【清晨 QT 敬拜禱告時刻】清心專注愛神不對惡人心懷不平〔詩篇EP93〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 12, 2025 45:24


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】神實在恩待以色列那些清心的人!至於我,我的腳幾乎失閃;我的腳險些滑跌。我見惡人和狂傲人享平安就心懷不平。(詩 73:1-3) 【今日經文】詩篇 73:1-14 ▶https://reurl.cc/RYZy0z 【演奏歌曲】主祢聖名配得讚美 - 鋼琴獨奏 by J-vi 【敬拜歌曲】純潔的心 - 約書亞 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.11 禱告日記】《順服神話語約束守住神產業延續》▶https://reurl.cc/NYe749 【06.10 禱告日記】《倚靠基督十架救贖得著赦罪潔淨》▶https://reurl.cc/YYzEQO 【06.09 禱告日記】《讓基督成為生命逃城經歷神救恩》▶https://reurl.cc/paekQl 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #純潔的心 #約書亞 -- Hosting provided by SoundOn

Wine About It
DougDoug's Here | Wine About It #129

Wine About It

Play Episode Listen Later Jun 11, 2025 68:51


This week on Wine About It:Maya and QT welcome the hilarious DougDoug to the couch.There's bacon soda, frat chaos, and a deep dive into Doug's podcasting dreams.He opens up about mental health, streaming struggles, and his very first kiss.✨ Bonus Content: https://patreon.com/wineaboutit

LDT 晨禱祭壇
2025-06-11【清晨 QT 敬拜禱告時刻】順服神話語約束守住神產業延續〔民數記EP81〕

LDT 晨禱祭壇

Play Episode Listen Later Jun 11, 2025 45:29


※ 如果你渴望建立每天穩定靈修的生活,加入禱告的大軍,邀請你加入【晨禱祭壇 Line 社群】▶http://line.ldtmission.org → 我們每天會即時在 Line 發送晨禱直播影片,以及每天靈修的分享,可以跟其他夥伴彼此代禱有更多的連結。 ※ 今日晨禱 ※ 【焦點經文】凡在以色列支派中得了產業的女子必作同宗支派人的妻,好叫以色列人各自承受他祖宗的產業。這樣,他們的產業就不從這支派歸到那支派,因為以色列支派的人要各守各的產業。耶和華怎樣吩咐摩西,西羅非哈的眾女兒就怎樣行。(民 36:8-10) 【今日經文】民數記 36:1-13 ▶https://reurl.cc/K8gg4g 【演奏歌曲】願祢降臨 - 鋼琴獨奏 by J-vi 【敬拜歌曲】全然為祢 - 約書亞 → Worship & Prayer Leader:楊哲豪 Rogery Yang ※ 最新文章 ※ 【06.10 禱告日記】《倚靠基督十架救贖得著赦罪潔淨》▶https://reurl.cc/YYzEQO 【06.09 禱告日記】《讓基督成為生命逃城經歷神救恩》▶https://reurl.cc/paekQl 【06.08 禱告日記】《分散寄居各地帶領人敬拜連結神》▶https://reurl.cc/gRX17X 【2025.05 代禱信】《製作靈修實踐指南突破門訓挑戰》▶https://reurl.cc/nmbGM1 ※ 最新影片 ※ 【5 月影音代禱信】▶https://youtu.be/QfIOxK7nEGU ※ 晨禱邀請 ※ 【訂閱頻道,每天禱告】▶http://sub.ldtmission.org → 邀請你免費訂閱晨禱頻道,讓我們每天一同委身築起晨禱祭壇,復興我們生活的每一天。 【為晨禱事工線上奉獻】▶http://give.ldtmission.org → 邀請你用奉獻一同參與晨禱事工,使我們可以持續帶領世界各地的弟兄姐妹建立每天禱告的生活。 【讓我們為你個別代禱】▶http://msg.ldtmission.org →如果你需要有人個別為你私下代禱,邀請你傳私訊到此連結,我們會有同工與你一同禱告。 【Podcast 聽晨禱祭壇】▶http://podcast.ldtmission.org →你也可以在各平台上的 Podcast 收聽晨禱祭壇。 ※ 關於我們 ※ 【LDT 官方網站】▶http://ldtmission.org 【LDT 粉絲專頁】▶http://fb.ldtmission.org 【Rogery 的禱告日記】▶http://qt.ldtmission.org ※ 經文範圍 ※ 晨禱祭壇每天所使用的經文範圍是跟《活潑的生命》的靈修經文範圍一樣。邀請大家可以在晨禱結束後,有一段經文默想禱告的時間,寫下你的屬靈筆記,操練聆聽神的聲音。如果弟兄姊妹有需要的話,可以訂購《活潑的生命》QT月刊:(台灣)02-2931-9066 / www.duranno.tw 《一個火熱愛耶穌、用生命影響生命的門徒社群》 #晨禱 #敬拜 #禱告 #靈修 #全然為祢 #約書亞 -- Hosting provided by SoundOn

Pot Lucky: A Weed Sommelier Podcast
Dandelions and Sara Caplan

Pot Lucky: A Weed Sommelier Podcast

Play Episode Listen Later Jun 10, 2025 61:33


Sara Caplan (she/her) is a trans woman, comedian, and philosophy student based in Los Angeles, CA. She is a member of the improv teams QT's (UCB's first all-trans-GNC-nonbinary improv team) and Chill Touch. You can check out her thoughts on transness, philosophy, and whatever else is happening on her instagram @sararosecaplan Discussed This week: being trans improvisors, Dandelions, Ginger Bug, eating garbage for the nostaligaic comfort, room temp cans of spaghetti with utensils, NYC friends, long form and short form improv, discovery through games and play in a scene, Los Angeles, Polysemy, Ruderal, Groom of the Stool, the mark of a criminal, edible dandelion greens from an Asian grocery store, dandelion chips, weeds as medicines and a diuretic, the malleability of definitions, kufresh, the Hebrew Alphabet, being named after a horse, eastheitic flexibility, no one taught you the definition of the word chair, the Trechery of Images, words that leave you speachless, Denotation vs. Connotation, South Park fag episode, why a question has rhetorical impact, propaganda, categories being messy, and more!

AEW Unrestricted
QT Marshall Is Back!

AEW Unrestricted

Play Episode Listen Later Jun 5, 2025 44:35


QT Marshall wears A LOT of hats in AEW – mentor, wrestler, Vice President of Show and Creative Coordination – and he's back to talk about all of it. From orchestrating the viral Full Gear match featuring Big Boom AJ & Big Justice, to stepping away from AEW in 2023 and returning revitalized, QT pulls the curtain back on his real-life wrestling journey. He opens up about burnout, bodybuilding, and being the glue behind the scenes at AEW. Plus, hear the story behind the rise of Harley Cameron, how social media built a pay-per-view moment, and why QT's still lacing up his boots every weekend. AEW Unrestricted is sponsored by Upper Deck. Get closer to the ring than ever before. Unwrap your favorite AEW wrestling trading cards and build your collection today! Visit https://UpperDeck.com to learn more. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Wine About It
Vivian Wilson Talks Drag & Dating Shows | Wine About It #128

Wine About It

Play Episode Listen Later Jun 4, 2025 64:23


This week on Wine About It:Maya and QT sit down with the iconic Vivian Wilson for a reality TV deep dive.There's cursed witches, Jojo Siwa, and a shocking take on Batman v Superman.Plus — drag, dating shows, and Hasan... lots of Hasan. ✨ Bonus Content: https://patreon.com/wineaboutit

Wine About It
Pajama Party with The Yard | Wine About It #127

Wine About It

Play Episode Listen Later May 28, 2025 67:16


This week on Wine About It:Maya and QT invite The Yard over for a pajama party.There's discharge, tampon confusion, and a crash course in speculums.Slime gets distracted by his own hole, and Ludwig... may have pooped himself. ✨ Bonus Content: https://patreon.com/wineaboutit