Biological system in animals and plants for gas exchange
POPULARITY
Categories
145 episodes with respiratory
126 episodes with respiratory
54 episodes with respiratory
39 episodes with respiratory
40 episodes with respiratory
26 episodes with respiratory
14 episodes with respiratory
26 episodes with respiratory
12 episodes with respiratory
12 episodes with respiratory
16 episodes with respiratory
25 episodes with respiratory
49 episodes with respiratory
13 episodes with respiratory
13 episodes with respiratory
6 episodes with respiratory
9 episodes with respiratory
12 episodes with respiratory
10 episodes with respiratory
21 episodes with respiratory
52 episodes with respiratory
11 episodes with respiratory
12 episodes with respiratory
19 episodes with respiratory
8 episodes with respiratory
18 episodes with respiratory
9 episodes with respiratory
7 episodes with respiratory
9 episodes with respiratory
9 episodes with respiratory
9 episodes with respiratory
9 episodes with respiratory
6 episodes with respiratory
6 episodes with respiratory
7 episodes with respiratory
8 episodes with respiratory
5 episodes with respiratory
13 episodes with respiratory
11 episodes with respiratory
4 episodes with respiratory
5 episodes with respiratory
4 episodes with respiratory
4 episodes with respiratory
7 episodes with respiratory
5 episodes with respiratory
15 episodes with respiratory
6 episodes with respiratory
3 episodes with respiratory
3 episodes with respiratory
4 episodes with respiratory
4 episodes with respiratory
4 episodes with respiratory
5 episodes with respiratory
7 episodes with respiratory
Some of the most common respiratory myths are still showing up at the bedside. But it's not your fault — most of us were never taught what an oxygenation problem versus a ventilation problem looks like in real time.In this episode, Melody Bishop RT explains how respiratory therapists think through oxygenation and ventilation to choose the right intervention and recognize when a patient is ready to breathe on their own. We're calling out the old dogma and myths that can delay treatment and worsen patient outcomes!Topics discussed in this episode:Ventilation vs. oxygenation: the core building blocksV/Q mismatch explainedABG findings for low-flow vs. high-flow vs. BiPAPWhen CO₂ is the problem and the benefits of BiPAPKey indicators it's time to intubate and the dangers of waitingThe myth of resting patients on ventilationHow to accurately assess spontaneous breathing trialsCOPD, oxygen, and the hypoxic drive mythWhat nurses should know about working with RTsConnect with Melody:https://melodybishoprt.com/Mentioned in this episode:Xshears are the best shearscheck em out here: https://xshear.com//discount/Rapid10 and you can use code RAPID10 to get 10% off your purchaseAND If you are planning to sit for your CCRN and would like to take the Critical Care Academy CCRN prep course you can visit https://www.ccrnacademy.com and use coupon code RAPID10 to get 10% off the cost of the course!CONNECT
Tune in to this extraordinary conversation exploring the important interplay between respiratory viruses and non-communicable diseases like diabetes, obesity, and cardiovascular disease. Why do people with chronic conditions face higher risks from infections? Could there be such a thing as "long-flu"? What are the long-term effects of viral infections? And why are viruses so tricky? Join our three leading scientists as they unpack the bidirectional connection, clarify this unique opportunity to leverage awareness and the fundamental importance of joining forces across disciplines: Marco Goeijenbier(ESWI Board Member, intensivist at Spaarne Gasthuis and Senior Scientist at Erasmus MC), Tor Biering-Sørensen (cardiologist and Founding Head of the Center for Translational Cardiology in Copenhagen), and Kirsty Short (NHMRC research fellow, University of Queensland). They will explain this pivotal moment to rethink disease prevention, reveal insights from the groundbreaking giga DANFLU trial, and show how the Interdisciplinary Disease Collaboration on Respiratory Infections and NCDs (IDC) is connecting the dots from lab bench to hospital bedside.
Join us for a breakdown of all the various viral illnesses circulating this time of year. All of these should be taken seriously.
Why Tuberculosis is still the most deadly infectious disease.Attention, DNA detectives! We've got a rat on the loose – but don't worry, not the snitching, double-agent kind. We're talking about the whiskered, hyper-skilled, tiny agents who aren't snitching - they're sniffing out one of the world's deadliest diseases: tuberculosis (TB).Tuberculosis might sound old-timey, but it's still the globe's top infectious killer– growing tougher, more drug-resistant, and hitting hardest where access to care falls short. So for our Season 5 finale, host Dr. Kaylee Byers digs into TB's fascinating backstory, and teams up with microbiologist Dr. Jennifer Guthrie to figure out why this ancient disease still has such a tight grip, and how genomics is helping track its every move. Along the way, Dr. Zolelwa Sifumba shares her story as a multidrug-resistant TB survivor, and how her treatment journey fuels her advocacy today.Buckle up: this investigation has it all : science, politics, global inequities… and a squad of extraordinary rats.Special thanks to APOPO for sending us field recordings and interviews from their HeroRAT training program.Highlights(3:42) The history of TB(8:19) Why TB sits at the top of the global disease podium(15:30) Meet Zolelwa - a multi-drug-resistant TB survivor(30:48) The power of education–Show Notes/Resources:1. Giant Rats Trained to Sniff Out Tuberculosis in Africa- National Geographic2. The Making of a HeroRAT: From Tiny Pup to Life-saving Hero- APOPO3. Tuberculosis: an ancient disease that remains a medical, social, economical and ethical issue- Journal of Preventive Medicine and Hygiene4. History of World TB Day- CDC5. The history of tuberculosis- Respiratory Medicine6. Chapter 12: An introductory guide to tuberculosis care to improve cultural competence for health care workers and public health professionals serving Indigenous Peoples of Canada- Canadian Journal of Respiratory, Critical Care, and Sleep Medicine7. Everything is Tuberculosis- John Green
In this episode, we review the high-yield topic of Airflow, Pressure, and Resistance from the Respiratory section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Dead Spaces and Vent Rates from the Respiratory section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
The holidays are upon us but respiratory viruses like COVID-19, Flu, and RSV don't make great gifts. In this episode, Dr. Suzanne Bornschein, State Epidemiologist at the Rhode Island Department of Health, shares the best ways to keep viruses from spreading to our friends, to our loved ones, and in our communities. For more information and data, visit health.ri.gov/respiratoryviruses.
In this episode, we review the high-yield topic of Response to Exercise from the Respiratory section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
Oral Arguments for the Court of Appeals for the Seventh Circuit
Oak Lawn Respiratory and Rehab v. United States Small Business A
In this episode, we review the high-yield topic of Pressure Volume Curve from the Respiratory section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
Interview with Molly N. Huston, MD, and William A. Strober, MD, MSCI, authors of Biofeedback vs Respiratory Retraining for Inducible Laryngeal Obstruction: A Randomized Clinical Trial. Hosted by Paul C. Bryson, MD, MBA. Related Content: Biofeedback vs Respiratory Retraining for Inducible Laryngeal Obstruction
Interview with Molly N. Huston, MD, and William A. Strober, MD, MSCI, authors of Biofeedback vs Respiratory Retraining for Inducible Laryngeal Obstruction: A Randomized Clinical Trial. Hosted by Paul C. Bryson, MD, MBA. Related Content: Biofeedback vs Respiratory Retraining for Inducible Laryngeal Obstruction
In this episode, we review the high-yield topic of Response to High Altitude from the Respiratory section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of H1 Blockers from the Respiratory section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Pleural Effusion from the Respiratory section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
The Ministry of Health, Wellness and Elderly Affairs advises the public that we are currently in the flu season which runs from October to March. During this period, the ministry notes an increase in people having respiratory viruses. Therefore, residents are urged to take proactive steps to protect themselves from respiratory illnesses such as washing hands frequently, avoiding close contact with individuals who are sick, wearing a mask, covering mouth and nose when coughing and sneezing, cleaning and disinfecting commonly touched spaces and getting vaccinated.
🧭 REBEL Rundown 📝 Introduction Welcome to the Rebel Core Content Blog, where we delve into crucial knowledge for emergency medicine. Today, we share insightful tips from PEM specialist Dr. Elise Perelman, shedding light on respiratory challenges in infants, toddlers, and young children during the viral season. Understanding that most cases involve typical viruses, we aim to equip you with diagnostic pearls to identify more serious pathologies. Click here for Direct Download of the Podcast. 🔍 Recognizing Respiratory Patterns Pearl #1: Look at Your PatientBegin exams from the doorway. Observing patterns such as accessory muscle usage can reveal a patient’s respiratory effort. Specify whether the work of breathing occurs during inspiration, expiration, or both. Inspiratory work indicates difficulty getting air in, while expiratory work suggests trouble pushing air out. Silent tachypnea may point to other issues, like acidemia or pneumothorax. 🩺 Localizing Sounds for Accurate Diagnosis Pearl #2: Localize the SoundBreathing noises signal varied respiratory issues. Stridor, often heard on inspiration, results from obstructions above the thoracic inlet. Conversely, wheezing, generally linked to exhalation, indicates obstructions in the lower airways. Watch for signs like ‘silent chest’—a dangerous, severe obstruction, and distinguish grunting as a bodily mechanism to prevent alveolar collapse. Correctly identifying the sound assists in determining the appropriate intervention. 💉 Tailoring Treatment for Effective Results Once a sound is localized, treatments vary. We explore Soder from nasal congestion, typically needing supportive care and suctioning. Stridor from conditions like croup is eased with interventions to reduce airway swelling, such as steroids or inhaled epinephrine. Conversely, wheezing in infants is often due to bronchiolitis—not bronchospasms—and over-treatment is to be avoided. Supportive measures including suction, hydration, and oxygen are preferred unless improvement warrants bronchodilators. 🌬️ Intervening with Severe Asthma In severe cases of asthma or bronchiolitis, where standard at-home treatments fail, immediate adjunct therapies like intramuscular epinephrine become essential. Administering this quickly can alleviate obstruction when inhalants aren’t effective due to low air movement. 🦓 Navigating the Zebras of Respiratory Cases When recognizing Zebras—uncommon cases overshadowed by routine diagnoses—remain vigilant for histories or presentations that don’t conform. Conditions like pneumonia, bacterial tracheitis, and even myocarditis may mimic more common issues. 📌 Conclusion As attending physicians, our role extends beyond conventional treatment—it’s about discerning the atypical from the typical. Dr. Perelman urges continual reassessment, emphasizing reliance on observational skills as much as technological aid. Keeping keen on respiratory nuances ensures we catch those outlier cases, paving the way for adept medical care despite the overwhelming prevalence of viral infections.Stay tuned for more pearls and insights in our future posts, as Dr. Perelman shares further strategies for effective pediatric emergency care. For more resources, continue exploring our faculty’s valuable contributions on our site. Until then, stay safe and perceptive in your practice. Post Peer Reviewed By: Mark Ramzy, DO (X: @MRamzyDO), and Marco Propersi, DO (X: @Marco_Propersi) 👤 Guest Elise Perlman MD Pediatric Emergency Medicine Assistant Professor, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Meet The Team 🔎 Your Deep-Dive Starts Here REBEL Core Cast – Pediatric Respiratory Emergencies: Beyond Viral Season Welcome to the Rebel Core Content Blog, where we delve ... Pediatrics Read More REBEL CAST – IncrEMentuM26 Speaker Spotlight : Drs. Tarlan Hedayati, Jess Mason and Simon Carley Host Dr. Mark Ramzy shines a spotlight on three distinguished ... Resuscitation Read More REBEL Core Cast 145.0: Understanding QTc Prolongation: Causes, Risks, and Management The QT interval is a vital part of ECG interpretation, ... Procedures and Skills Read More REBEL Core Cast 144.0: Tourniquet Tips In this episode of the Rebel Core Content podcast, Swami ... Procedures and Skills Read More REBEL CAST – IncrEMentuM26 Speaker Spotlight : George Willis and Mark Ramzy 🧭 REBEL Rundown 📝Introduction In this exciting episode of REBEL ... Endocrine, Metabolic, Fluid, and Electrolytes Read More REBEL Core Cast – DKA: Beyond the Basics Part 2 – SCOPE DKA-Trial Managing diabetic ketoacidosis (DKA) requires careful consideration of fluid therapy, ... Endocrine, Metabolic, Fluid, and Electrolytes Read More The post REBEL Core Cast – Pediatric Respiratory Emergencies: Beyond Viral Season appeared first on REBEL EM - Emergency Medicine Blog.
A large population study links trimethoprim-sulfamethoxazole to a rare yet nearly threefold higher risk of severe acute respiratory failure in healthy adolescents and young adults, reinforcing FDA warnings and the need for careful monitoring. Two extensive Cochrane reviews—including over 132 million people—confirm that HPV vaccination dramatically reduces cervical cancer, high-grade precancers, and anogenital warts without increasing serious adverse events. Kentucky's deadly pertussis surge highlights declining vaccine coverage and the critical role of maternal Tdap and timely childhood immunization to protect the most vulnerable infants.
Respiratory vaccines are not just infection-fighters—they're cardiovascular protectors.
Premature infants are incredibly resilient—but their journey can involve long-term health, developmental, and behavioral challenges that many parents aren't told about. This episode explores these realities in depth, from respiratory and neurological risks to sensory and emotional impacts, along with the lasting effects the NICU can have on families. It's a compassionate, empowering look at what life after the NICU truly means.Dr. Brown's Medical: https://www.drbrownsmedical.com The Infant-Driven Feeding™ (IDF) Program: https://www.infantdrivenfeeding.com/ Our NICU Roadmap: A Comprehensive NICU Journal: https://empoweringnicuparents.com/nicujournal/ NICU Mama Hats: https://empoweringnicuparents.com/hats/ NICU Milestone Cards: https://empoweringnicuparents.com/nicuproducts/ Newborn Holiday Cards: https://empoweringnicuparents.com/shop/ Empowering NICU Parents Show Notes: https://empoweringnicuparents.com/shownotes/ Episode 77 Show Notes: https://empoweringnicuparents.com/episode77 Empowering NICU Parents Instagram: https://www.instagram.com/empoweringnicuparents/ Empowering NICU Parents FB Group: https://www.facebook.com/groups/empoweringnicuparents Pinterest Page: https://pin.it/36MJjmHThank you for listening to the Empowering NICU Parents Podcast. Be sure to subscribe and leave us a review—it helps other families find us. We're grateful to be part of this incredible community. Visit www.empoweringnicuparents.com for resources and support.
Episode Overview This week on the Essential Wellness Podcast, we focused on how to make the most of your doTERRA wholesale account—with a special spotlight on BOGO Week savings and strategies. dōTERRA Leaders Claudine and Lori shared simple, practical ways to earn free products, maximize rewards orders, and use promotions to save big—especially during BOGOs. They also explained how sharing doTERRA can help members earn dōTERRA Dollars. doTERRA Ordering & Rewards Overview Key Takeaways: Two ways to order: Standard Orders and Loyalty Rewards Orders (LRP) LRP allows flexible monthly customization Benefits of rewards orders include: Discounted shipping Free Product of the Month Points accumulation for free oils VIP early-access perks New subscribers receive a surprise welcome gift November Promotions & Savings Key Takeaways: Free Product of the Month: Breathe® (with a 125 PV rewards order processed before the 15th) 20% off Melissa this month Access to the Holiday Collection (limited supply—order early!) Tips to maximize savings using: Bundles Wellness kits The BOGO Bundle Holiday items and BOGO bundles move fast—shop early for best availability Essential Oils Benefits Overview Key Oils & Blends Highlighted: On Guard®, Breathe®, Purify, Adaptiv®, Shinrin-Yoku®, Copaiba Uses Include: Allergies & immune support Respiratory health Mood balance & emotional grounding Relaxation & stress relief Home purification Additional Highlights: Shinrin-Yoku® shown in studies to help lower blood pressure Deep Blue® + Copaiba recommended for muscle, joint, and inflammation support Featured immune bundle: Clove + Wild Orange + Siberian Fir Essential Oils & BOGO Deals Key Takeaways: Oils spotlighted: Wild Orange, Siberian Fir, Clove—great for diffusing, immune support, muscle tension, and dental care BOGO Week runs November 17–21 BOGO Week features instant rewards when orders process Free BOGO e-book available (recipes, usage, tips) Join the Essential Wellness Facebook group for: Daily updates Extra education Community support Refer-a-Friend & Bonus Programs Key Takeaways: Refer-a-Friend program gives new customers a free year of membership with their first purchase Members earn rewards when friends join using their personal link Power of Three + Power of Three Boost explained as an income pathway Double Fast Start bonuses end in November Recommended resources: Wellness Lifestyle Assessment Live chat Weekly calls and ongoing support Essential Oils for Everyday Health Key Highlights: Lavender recommended as a must-have travel oil for burns, reactions, and bug bites Tips for using Shinrin-Yoku® with CPAP machines (diffuse gently or apply topically) Practitioner favorites: Siberian Fir + Copaiba, and the Taming the Tiger protocol Clove spotlighted for its antioxidant and dental benefits Reminder: BOGO Week starts November 17 Next week's episode focuses on thyroid health _______________________________________________________ Essential Wellness Podcast: Your weekly drop for essential oils and everyday wellness. This podcast is for anyone who wants to feel confident using doTERRA essential oils—for your health, your home, and your everyday life. Each week, our Essential Wellness Collective will share simple tips, recipes, and protocols to make oils easy to understand and effortless to use.
Aubrey Masango speaks to Prof Ismail Kalla, Pulmonologist & Intensivist Physician at Lenmed, to discuss pneumonia, still the world’s single largest infectious killer of children under five and a formidable threat to older adults and vulnerable populations everywhere. Prof Kalla also explains concrete steps you can take to prevent infection. Tags: 702, Aubrey Masango show, Aubrey Masango, Bra Aubrey, Prof Ismail Kalla, Pneumonia, Respiratory health, Covid 19, Influenza The Aubrey Masango Show is presented by late night radio broadcaster Aubrey Masango. Aubrey hosts in-depth interviews on controversial political issues and chats to experts offering life advice and guidance in areas of psychology, personal finance and more. All Aubrey’s interviews are podcasted for you to catch-up and listen. Thank you for listening to this podcast from The Aubrey Masango Show. Listen live on weekdays between 20:00 and 24:00 (SA Time) to The Aubrey Masango Show broadcast on 702 https://buff.ly/gk3y0Kj and on CapeTalk between 20:00 and 21:00 (SA Time) https://buff.ly/NnFM3Nk Find out more about the show here https://buff.ly/lzyKCv0 and get all the catch-up podcasts https://buff.ly/rT6znsn Subscribe to the 702 and CapeTalk Daily and Weekly Newsletters https://buff.ly/v5mfet Follow us on social media: 702 on Facebook: https://www.facebook.com/TalkRadio702 702 on TikTok: https://www.tiktok.com/@talkradio702 702 on Instagram: https://www.instagram.com/talkradio702/ 702 on X: https://x.com/Radio702 702 on YouTube: https://www.youtube.com/@radio702 CapeTalk on Facebook: https://www.facebook.com/CapeTalk CapeTalk on TikTok: https://www.tiktok.com/@capetalk CapeTalk on Instagram: https://www.instagram.com/ CapeTalk on X: https://x.com/CapeTalk CapeTalk on YouTube: https://www.youtube.com/@CapeTalk567 See omnystudio.com/listener for privacy information.
Moderator: James Rathmell, M.D. Participants: Jie Sun, M.D., Ph.D. and Clyde Matava, M.B.Ch.B.., M.Med., M.H.S.C. Articles Discussed: Effect of Intravenous, Inhalational, or Combined Anesthesia Maintenance on Postoperative Respiratory Adverse Events in Children Undergoing Adenotonsillectomy (AmPRAEC): A Multicenter Randomized Clinical Trial Choice of Anesthetic Maintenance Is Not Merely a Matter of Preference, but One of Safety: Insights from the AmPRAEC Study Transcript
Samantha Rux with OSF HealthCare joined Wake Up Tri-Counties to talk about the respiratory illness season and what illnesses are prevalent at the moment. Hand, foot, and mouth disease is on the rise in young children, especially those in daycare, according to OSF HealthCare pediatricians. Classic symptoms include red blisters on the hands, feet, and inside the mouth, along with fever, sore throat, and irritability. While most cases are mild and treated at home, parents should consult a doctor if high fever or worsening symptoms persist. Experts stress the importance of handwashing and disinfecting surfaces to limit the spread. In encouraging news, hospitals report fewer RSV hospitalizations this season, thanks to new prevention tools like maternal vaccines and infant antibodies. It's never too late to get flu, COVID-19, or RSV vaccinations to protect yourself and others. Talk with your primary care provider today regarding vaccinations. Find more information from the OSF HealthCare newsroom here.
Wise Divine Women - Libido - Menopause - Hormones- Oh My! The Unfiltered Truth for Christian Women
In this episode of the Wise Divine Women podcast, Dana Irvine and Dr. John Oertle discuss the latest advancements in breast cancer research, focusing on recurrence rates, the role of circulating tumor cells, and the importance of optimizing the immune system. Dr John's main goal is to enlighten Americans and people worldwide that there is a groundbreaking study published in Nature is shining a light on a hidden risk: respiratory infections can reawaken dormant breast cancer cells, accelerating recurrence. Read the article and research links They explore the impact of environmental toxins on cancer, the necessity of early detection through testing, and the effects of respiratory infections on cancer patients. The conversation also touches on the role of vaccines in immune response and the potential future of peptides in cancer treatment, emphasizing the need for advocacy in accessing innovative therapies.Envita Medical Center Want to listen to our first episode together? Wise Divine Women podcast, host Dana Irvine speaks with Tammy Morrow and Dr. John Oertle about the intersection of faith, health, and innovative cancer treatmentsTakeawaysRecurrence rates for stage one breast cancer can be as high as 20-30%.Circulating tumor cells can be detected even in early-stage cancers.Optimizing the immune system is crucial for cancer patients.Environmental toxins may trigger cancer development.Testing for circulating tumor cells can aid in early detection.Respiratory infections can impact cancer recurrence and growth.Vaccines may enhance immune response in cancer treatment.Peptides show promise in cancer treatment but require careful dosing.Advocacy for access to innovative treatments is essential.Education and awareness are key for patients in managing their health.Chapters00:00 Introduction to Breast Cancer Research01:04 Understanding Recurrence Rates in Breast Cancer03:51 The Role of Circulating Tumor Cells09:38 Maximizing Outcomes Through Immune System Support17:18 Challenges in Oncology: Insurance and Testing21:20 Environmental Toxins and Cancer Prevention23:43 Impact of Respiratory Infections on Cancer25:15 The Role of IL-6 in Cancer Growth28:25 Monitoring Cancer Recurrence Post-Infection29:37 Vaccines and Immune Response33:14 Immunotherapy and Immune System Dynamics37:45 The Future of Peptides in Cancer Treatment46:05 Access to Preventive HealthcareI hope you enjoyed this episode! Please leave a review and share with friends and family Want to learn more about my offerings? Please visit danairvine.com I invite you to schedule a Soul Session to lern about how we can work together or dive right in and book a Women's Hormone Transformation
Martin is a renowned authority in Breath Science, bringing together an impressive blend of expertise as a Respiratory and Sleep Scientist, Exercise Physiologist, and Behavioural Science Practitioner. With over 15 years of experience in research, clinical work, and training, Martin is not only a consultant, scientist and educator but also a passionate advocate for healthy, connected living. Martin is the founder of Performance Through Health and The School of Breath Science. Who is committed to his vision of creating a world where people can achieve optimal health and happiness his unique blend of academic rigor, clinical expertise, and personal passion positions him at the forefront of the Breath Science field, making him a trusted figure in helping others achieve their best health and raising the standard of scientific understanding in the breath and wellbeing space. SHOWNOTES:
Respiratory syncytial virus (RSV) continues to pose a serious health threat—particularly to infants, older adults, and immunocompromised individuals—making it critical for pharmacy professionals to stay up to date on prevention and treatment options. This episode covers the latest FDA-approved RSV therapies, including vaccines and monoclonal antibodies, while highlighting clinical pearls for use across care settings. Tune in to stay informed and better support patients during the upcoming respiratory season.HOSTJoshua Davis Kinsey, PharmDVP, EducationCEimpactGUESTKalen Manasco, PharmD, BCPS, BCPPS, FCCP, FPPAProfessorUniversity of Florida College of PharmacyJoshua Davis Kinsey and Kalen Manasco have no relevant financial relationships with ineligible companies to disclose. Pharmacists, REDEEM YOUR CPE HERE!CPE is available to Health Mart franchise members onlyTo learn more about Health Mart, click here: https://join.healthmart.com/CPE INFORMATION Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Differentiate between RSV vaccines and monoclonal antibody therapies, including their indications and target patient populations.2. Identify key counseling points and administration considerations associated with currently available RSV vaccines and monoclonal antibody therapies.0.05 CEU/0.5 HrUAN: 0107-0000-25-312-H01-PInitial release date: 11/3/2025Expiration date: 11/3/2026Additional CPE details can be found here.
Respiratory syncytial virus (RSV) continues to pose a serious health threat—particularly to infants, older adults, and immunocompromised individuals—making it critical for pharmacy professionals to stay up to date on prevention and treatment options. This episode covers the latest FDA-approved RSV therapies, including vaccines and monoclonal antibodies, while highlighting clinical pearls for use across care settings. Tune in to stay informed and better support patients during the upcoming respiratory season. HOSTJoshua Davis Kinsey, PharmDVP, EducationCEimpactGUESTKalen Manasco, PharmD, BCPS, BCPPS, FCCP, FPPAProfessorUniversity of Florida College of PharmacyJoshua Davis Kinsey and Kalen Manasco have no relevant financial relationships with ineligible companies to disclose. Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE INFORMATIONLearning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Differentiate between RSV vaccines and monoclonal antibody therapies, including their indications and target patient populations.2. Identify key counseling points and administration considerations associated with currently available RSV vaccines and monoclonal antibody therapies.0.05 CEU/0.5 HrUAN: 0107-0000-25-312-H01-PInitial release date: 11/3/2025Expiration date: 11/3/2026Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagram
Send us a textOn this episode, we interview Dr. Wigdan Farah, a pulmonologist in Mayo Clinic's Division of Pulmonary & Critical Care Medicine to discuss several respiratory conditions seen commonly in pilots seeking medical certification -- then review aeromedical implications and requirements.
Porcine Reproductive and Respiratory syndrome, more commonly know as PRRS, is the most economically damaging disease to the US pork industry. According to studies done by Iowa State University, it is estimated that PRRS cost producers $1.2 billion dollars in 2024. That staggering statistic is exactly why Extension Swine Outreach Specialist Jeff Morris is invested in sharing information about the disease.See omnystudio.com/listener for privacy information.
Kyle & Ben discuss ways to progress athletes towards optimal breathing, from expanding tidal volume (depth of breaths) to maximizing respiratory frequency (breath rate).» Respiratory Roundtable [Ep.191]: https://www.youtube.com/watch?v=KMt5Hjf7zjY&t» Breathe Way Better with Kyle Ruth: https://www.youtube.com/watch?v=uhr1u23gw20&t» Watch on YouTube: https://youtu.be/f5BSJM2TY4Q» View All Episodes: https://zoarfitness.com/podcast/» Hire a Coach: https://www.zoarfitness.com/coach/» Shop Programs: https://www.zoarfitness.com/product-category/downloads/» Follow ZOAR Fitness on Instagram: https://www.instagram.com/zoarfitness/Support the show
On Friday, Oct. 17, the Physician Enterprise hosted a Grand Rounds session discussing evidence-based updates for respiratory immunization clinical guidelines. We also have this additional resource available related to fall viruses and immunizations:5-Minute Check In: Fall Viruses and Vaccinationshttps://youtu.be/PowPADYqzGA?si=x_G3XJY_335rcdW2
Early detection saves lives, but today's tools are often invasive, slow, or used too late. In this episode, Breath Diagnostics CEO Ivan Lo explains how a non-invasive breath test can detect volatile organic compounds (VOCs) associated with disease—positioning breath as a first-line screen for early-stage lung cancer and potentially pneumonia and TB. We cover the science (why breath can capture near real-time biological change), sensitivity/specificity signals from 800+ patients, and a go-to-market/regulatory plan that prioritizes post-op pneumonia (shorter trials, no entrenched standard of care) before lung cancer screening. We also discuss platform economics (low-cost disposables, existing LC-MS infrastructure), trial scale and cost, and how breath could support ongoing monitoring after treatment. Investors get a clear view of timelines, risks, and upside; founders get lessons on platform positioning, capital efficiency, and sequencing indications. Highlights include...Why breath (VOCs) can surface disease signals minutes–hours after biological changeFirst-line screening thesis vs. liquid biopsy and CT workflowsEarly data: ~94% sensitivity / 85% specificity across 800+ patients (lung cancer context)Regulatory path: post-op pneumonia first (faster FDA route), lung cancer nextUnit economics: low-cost cartridge + existing LC-MS labs (hub-and-spoke)Clinical design: trial scale, costs, and companion-diagnostic “cocktail” potentialPlatform beyond oncology: pneumonia, TB, inflammation, RUO for pharmaChapters00:00 Intro & why early detection needs a rethink00:47 What Breath Diagnostics does (the “breath bag”)03:34 VOCs 101: why breath can be earlier than blood06:41 First-line screen vs. confirmatory tests08:19 Will this be ubiquitous at annual visits?11:53 Commercialization path & funding realities12:37 Pneumonia first: faster FDA route14:09 Lung cancer timeline & business model15:34 Hospital economics & pneumonia savings18:24 Trial scale/costs; disposable chip economics20:34 Team, funding strategy, and sequencing22:08 Early data and a “false negative” biopsy case24:12 TAM & eligibility (20M Americans qualify)25:06 What success looks like (2–3 years)27:00 Investor closing thoughts
In this week's episode, we spotlight the phenomenal egg-laying Chinese Goose, take a deep dive into the chicken's respiratory system, share our recipe for Pumpkin Scones, and find some retail therapy with vintage goose collectables. Grubbly Farms - click here for our affiliate link.https://www.anrdoezrs.net/click-100963304-15546963Pre and Probiotic and Vitamin and Electrolyte Powders!Bright and Early Coffee - use code CWTCL15 for 15% off of any bagged coffee. K Cups always ship free!https://brightandearlycoffee.com/Omlet Coops- Use Our Affiliate Link and COFFEE10 code for 10% off!https://tidd.ly/3Uwt8BfBreed Spotlight is sponsored by Murray McMurray Hatcheryhttps://www.mcmurrayhatchery.com/Metzer Farms Waterfowlhttps://www.metzerfarms.com/Nestera UShttps://nestera.us/cwtclUse our affiliate link above for 5% off your purchasePumpkin Chocolate Chip Scones - https://coffeewiththechickenladies.com/farm-fresh-egg-recipes/pumpkin-chocolate-chip-scones/CWTCL Websitehttps://coffeewiththechickenladies.com/CWTCL Etsy Shophttps://www.etsy.com/shop/CoffeeWChickenLadiesAs Amazon Influencers, we may receive a small commission from the sale of some items at no additional cost to consumers.CWTCL Amazon Recommendationshttps://www.amazon.com/shop/coffeewiththechickenladiesSupport the show
Dr. Marc Salzberg, President, CEO, and Chief Medical Officer at Airway Therapeutics, is developing a drug AT-100 to prevent bronchopulmonary dysplasia (BPD) in preterm infants, a severe condition with no existing treatment. These infants are at high risk for BPD because of a low level of a protective protein that reduces inflammation and clears infections from their underdeveloped lungs. The drug's mechanism of action suggests it has potential for treating other inflammatory conditions such as asthma, COPD, and severe pneumonia. Marc explains, "We're focusing on developing drugs or interventions for severe respiratory conditions for prevention or treatment of severe respiratory conditions. And our first project is focusing on the respiratory condition that preterm neonates have, which is called bronchopulmonary dysplasia, and cannot be treated or prevented yet. It's a very severe condition. And that really triggered my interest in getting engaged because it's going to be a paradigm shift if we manage to bring this drug to market." "The protein that we're developing is an endogenous protein that we all have. In the past years or decade, it has been discovered that this protein has a very essential function in fighting inflammation and infection on a daily basis. Now, there are certain conditions or instances where the protein is low-functioning. For instance, in preterm-born babies, but also in adults with severe respiratory inflammation, with pneumonias, with asthma, or COPD. In all those cases where protein is low, those are the instances where you actually need it most. So, replacing it in those instances is a kind of logical rationale for the concept for the treatment that we're developing." #AirwayTherapeutics #BPD #InflammatoryDiseases #Zelpultidealfa #PrematureBabies #PretermBabies airwaytherapeutics.com Listen to the podcast here
Dr. Marc Salzberg, President, CEO, and Chief Medical Officer at Airway Therapeutics, is developing a drug AT-100 to prevent bronchopulmonary dysplasia (BPD) in preterm infants, a severe condition with no existing treatment. These infants are at high risk for BPD because of a low level of a protective protein that reduces inflammation and clears infections from their underdeveloped lungs. The drug's mechanism of action suggests it has potential for treating other inflammatory conditions such as asthma, COPD, and severe pneumonia. Marc explains, "We're focusing on developing drugs or interventions for severe respiratory conditions for prevention or treatment of severe respiratory conditions. And our first project is focusing on the respiratory condition that preterm neonates have, which is called bronchopulmonary dysplasia, and cannot be treated or prevented yet. It's a very severe condition. And that really triggered my interest in getting engaged because it's going to be a paradigm shift if we manage to bring this drug to market." "The protein that we're developing is an endogenous protein that we all have. In the past years or decade, it has been discovered that this protein has a very essential function in fighting inflammation and infection on a daily basis. Now, there are certain conditions or instances where the protein is low-functioning. For instance, in preterm-born babies, but also in adults with severe respiratory inflammation, with pneumonias, with asthma, or COPD. In all those cases where protein is low, those are the instances where you actually need it most. So, replacing it in those instances is a kind of logical rationale for the concept for the treatment that we're developing." #AirwayTherapeutics #BPD #InflammatoryDiseases #Zelpultidealfa #PrematureBabies #PretermBabies airwaytherapeutics.com Download the transcript here
Boswellia opens airways, reduces bronchial and sinus swelling... And don't miss the following topics that Terry will also discuss on this show: Obesity is Killing Us and Our Hearts Help for “Sundowning” How to Abuse Your Liver Herb of the Day: Ashwagandha 3 Unexpected Benefits of Vitamin D
With the Wind with Dr. Paul – Show 186: Pediatric Perspectives: Respiratory Illness Preparedness – Deep Dive Into Iodine with David Brownstein, M.D. Presenters: Dr. Paul, David Brownstein, M.D. Length: Approximately 28 minutes ________________________________________ Summary: In this episode, Dr. Paul welcomes back David Brownstein, M.D., to take a deep dive into iodine's overlooked but essential role in human health. Dr. Brownstein shares decades of clinical insights into how iodine deficiency contributes to rising rates of cancer and chronic illness, explains the shortcomings of iodized salt, and emphasizes iodine's importance for children, pregnancy, and immune function. He also introduces his low-cost home respiratory preparedness protocol using nebulized iodine and peroxide. ________________________________________ Key Points (with time stamps): • 00:00:40 – Dr. Paul's Intro: Announcement about VAX FACTS availability and where to order. • 00:02:00 – Introduction of Dr. Brownstein: Overview of his integrative medical practice and focus on iodine's critical role in health. • 00:03:08 – Essential Role of Iodine: Dr. Brownstein explains iodine as a required nutrient for every cell, with major concentrations in glandular tissues. • 00:04:18 – Deficiency and Disease: How iodine deficiency leads to cysts, precancerous changes, and cancers of the thyroid, breast, ovaries, prostate, and pancreas. • 00:06:30 – Cancer Prevention: Evidence that iodine sufficiency may prevent or reverse disease pathways, including cancer. • 00:07:49 – Why We're Deficient: Soil depletion, industrial toxins, and halides (bromide, fluoride) contributing to widespread iodine deficiency. • 00:12:43 – Public Health History: The introduction of iodized salt in the 1920s, its impact on goiter prevention, and why iodized salt is still insufficient for overall health. • 00:19:20 – Case Study: Clinical experience showing breast tissue recovery and avoidance of surgery through iodine supplementation. • 00:21:35 – Use in Children: Safe dosing approaches for children and how iodine supports conditions like Hashimoto's. • 00:23:05 – Respiratory Preparedness Kit: Brownstein outlines his clinical protocol of nebulized iodine and hydrogen peroxide as a low-cost home therapy for respiratory illnesses, including COVID-19 and RSV. • 00:26:12 – Closing: Dr. Brownstein directs listeners to his website for more resources; Dr. Paul reminds viewers of VAX FACTS and Kids First 4Ever coaching. ______________
QUICK TIP THURSDAY: Rosemary (the plant) or esesential oil is amazing for healthy hair, brain function and focus, healthy digestion and feelings of knowledge and transition. Make this roller ball today for focus: 5 drops rosemary 5 drops lemon 5 drops peppermint Top with fractionated coconut oil Join our FACEBOOK COMMUNITY for more support and encouragement to refill daily with faith, self care, health, wellness and essential oil education! Follow Kari on Insta JOIN ME IN THE FASTER WAY TO FAT LOSS PROGRAM with my coach Lynzi! Create Your Custom Essential Oil Kit Get my non toxic products here: https://doterra.me/n2pgTr Email hello@thewellteam.com Schedule a free 30 minute consult for potential coaching with Kari here VISIT www.THEWELLTEAM.COM for all coaching programs, blog and essential oil education! FREEBIES: FREE:PEACEFUL HOME PLAN 2 minute wellness routine FREE: 30 day Bible Reading Plan
This podcast is sponsored by YARAL Pharma. In this episode, we are focusing on the management of hypothyroidism -- a treatable, but not curable condition – and will explore unique challenges for patients with hypothyroidism in long-term care – from tolerability and formulation considerations to consistent dosing and patient needs. Dr. Tamara Ruggles is not affiliated with YARAL Pharma. All views and opinions regarding hypothyroidism are solely her own and are not attributable to YARAL or the Pharmacy Podcast Network. IMPORTANT SAFETY INFORMATION for levothyroxine sodium capsules INDICATION AND USAGE Levothyroxine sodium capsules are L-thyroxine (T4) indicated for adults and pediatric patients 6 years and older with: Hypothyroidism - As replacement therapy in primary (thyroidal), secondary (pituitary), and tertiary (hypothalamic) congenital or acquired hypothyroidism Pituitary Thyrotropin (Thyroid-Stimulating Hormone, TSH) Suppression - As an adjunct to surgery and radioiodine therapy in the management of thyrotropin-dependent well differentiated thyroid cancer Limitations of Use: Levothyroxine sodium capsules are not indicated for suppression of benign thyroid nodules and nontoxic diffuse goiter in iodine-sufficient patients as there are no clinical benefits and overtreatment with Levothyroxine sodium capsules may induce hyperthyroidism. Levothyroxine sodium capsules are not indicated for treatment of transient hypothyroidism during the recovery phase of subacute thyroiditis WARNING: NOT FOR THE TREATMENT OF OBESITY OR FOR WEIGHT LOSS Thyroid hormones, including levothyroxine sodium capsules, either alone or with other therapeutic agents, should not be used for the treatment of obesity or for weight loss. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects. Contraindications Uncorrected adrenal insufficiency Warnings and Precautions Cardiac adverse reactions in the elderly and in patients with underlying cardiovascular disease: Initiate Levothyroxine sodium capsules at less than the full replacement dose because of the increased risk of cardiac adverse reactions, including atrial fibrillation Myxedema coma: Do not use oral thyroid hormone drug products to treat myxedema coma Acute adrenal crisis in patients with concomitant adrenal insufficiency: Treat with replacement glucocorticoids prior to initiation of levothyroxine sodium capsules treatment Prevention of hyperthyroidism or incomplete treatment of hypothyroidism: Proper dose titration and careful monitoring is critical to prevent the persistence of hypothyroidism or the development of hyperthyroidism Worsening of diabetic control: Therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements. Carefully monitor glycemic control after starting, changing, or discontinuing thyroid hormone therapy Decreased bone mineral density associated with thyroid hormone over-replacement: Over-replacement can increase bone reabsorption and decrease bone mineral density. Give the lowest effective dose Adverse Reactions Common adverse reactions with levothyroxine therapy are primarily those of hyperthyroidism due to therapeutic overdosage. They include the following: General: fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating Central Nervous System: headache, hyperactivity, nervousness, anxiety, irritability, emotional ability, insomnia Musculoskeletal: tremors, muscle weakness Cardiovascular: palpitations, tachycardia, arrythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest Respiratory: dyspnea Gastrointestinal (GI): diarrhea, vomiting, abdominal cramps, elevations in liver function tests Dermatologic: hair loss, flushing Endocrine: decreased bone mineral density Reproductive: menstrual irregularities, impaired fertility Adverse Reactions in Children Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in children receiving levothyroxine therapy. Overtreatment may result in craniosynostosis in infants and premature closure of the epiphyses in children with resultant compromised adult height. Seizures have been reported rarely with the institution of levothyroxine therapy. Hypersensitivity Reactions Hypersensitivity reactions to inactive ingredients (in this product or other levothyroxine products) have occurred in patients treated with thyroid hormone products. These include urticaria, pruritis, skin rash, flushing, angioedema, various GI symptoms (abdominal pain, nausea, vomiting and diarrhea), fever, arthralgia, serum sickness and wheezing. Hypersensitivity to levothyroxine itself is not known to occur. Drug Interactions: Many drugs and some foods can exert effects on thyroid hormone pharmacokinetics (e.g., absorption, synthesis, secretion, catabolism, protein binding, and target tissue response) and may alter the therapeutic response to Levothyroxine sodium capsules. Administer at least 4 hours before or after drugs that are known to interfere with absorption. See full prescribing information for drugs that affect thyroid hormone pharmacokinetics and metabolism. To report SUSPECTED ADVERSE REACTIONS, contact Yaral Pharma Inc. at 1-866-218-9009, or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. For Full Prescribing Information, including Boxed Warning, go to www.yaralpharma.com/levothyroxine-pi.
It's respiratory virus season again, and experts say to look out for the flu, COVID-19 and RSV. Infectious diseases specialist Dr. Allison McGeer explains what the data shows about how severe this year might be, as well as how Canadians can protect themselves.For transcripts of The Dose, please visit: lnk.to/dose-transcripts. Transcripts of each episode will be made available by the next workday. For more episodes of this podcast, click this link.Fill out our listener survey here. We appreciate your input!
Send us a textAntenatal Corticosteroid in Twin-Pregnant Women at Risk of Late Preterm Delivery: A Randomized Clinical Trial.Lee SM, Park HS, Choi SR, Lee J, Kim HJ, Park JY, Oh KJ, Cho GJ, Oh MJ, Chung JH, Kim SM, Kim BJ, Kim SY, Hong S, Jung YM, Lee SJ, Seong JS, Kim H, Oh S, Lee J, Jin YR, Kim JH, Cho HY, Park CW, Park JS, Jun JK.JAMA Pediatr. 2025 Sep 22:e253284. doi: 10.1001/jamapediatrics.2025.3284. Online ahead of print.PMID: 40982289Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
The state sees history-making job numbers for August despite the unemployment rate remaining steady. We take a closer look.Then, the Southern Poverty Law Center begins an annual tour this time to explain the impact of the Big Beautiful bill on Mississippians.Plus, it's the time of year that healthcare providers recommend folks be vaccinated to prevent the respiratory illness likely to spread during the winter months. Hosted on Acast. See acast.com/privacy for more information.
Lionel challenges official narratives, focusing on the critical difference between correlation and cause across major news stories. Topics covered include skepticism toward claims linking Tylenol to autism, the motives behind alleged radicalization like Tyler Robinson, and the impact of tech giant content policing on free speech. Lionel explores deep concerns over America losing its identity and culture, featuring listener calls debating the rise of Sharia law. Learn more about your ad choices. Visit megaphone.fm/adchoices
Is that penicillin or amoxicillin allergy real? Probably not. In this episode, we explore how to assess risk, talk to parents, and refer for delabeling. You'll also learn what happens in the allergy clinic, why the label matters, and how to be a better antimicrobial steward. Learning Objectives Describe the mechanisms and clinical manifestations of immediate and delayed hypersensitivity reactions to penicillin, including diagnostic criteria and risk stratification tools such as the PEN-FAST score. Differentiate between low-, moderate-, and high-risk penicillin allergy histories in pediatric patients and identify appropriate candidates for direct oral challenge or allergy referral based on current evidence and guidelines. Formulate an evidence-based approach for evaluating and counseling families in the Emergency Department about reported penicillin allergies, including when to recommend outpatient referral for formal delabeling. Connect with Brad Sobolewski PEMBlog: PEMBlog.com Blue Sky: @bradsobo X (Twitter): @PEMTweets Instagram: Brad Sobolewski References Khan DA, Banerji A, Blumenthal KG, et al. Drug Allergy: A 2022 Practice Parameter Update. J Allergy Clin Immunol. 2022;150(6):1333-1393. doi:10.1016/j.jaci.2022.08.028 Moral L, Toral T, Muñoz C, et al. Direct Oral Challenge for Immediate and Non-Immediate Beta-Lactam Allergy in Children. Pediatr Allergy Immunol. 2024;35(3):e14096. doi:10.1111/pai.14096 Castells M, Khan DA, Phillips EJ. Penicillin Allergy. N Engl J Med. 2019;381(24):2338-2351. doi:10.1056/NEJMra1807761 Shenoy ES, Macy E, Rowe T, Blumenthal KG. Evaluation and Management of Penicillin Allergy: A Review.JAMA. 2019;321(2):188–199. doi:10.1001/jama.2018.19283 Transcript Note: This transcript was partially completed with the use of the Descript AI and the Chat GPT 5 AI Welcome to PEM Currents, the Pediatric Emergency Medicine podcast. As always, I'm your host, Brad Sobolewski, and today we are taking on a label that's misleading, persistent. Far too common penicillin allergy, it's often based on incomplete or inaccurate information, and it may end up limiting safe and effective treatment, especially for the kids that we see in the emergency department. I think you've all seen a patient where you're like. I don't think this kid's really allergic to amoxicillin, but what do you do about it? In this episode, we're gonna break down the evidence, walk through what actually happens during de labeling and dedicated allergy clinics. Highlight some validated tools like the pen FAST score, which I'd never heard of before. Preparing for this episode and discuss the current and future role of ED based penicillin allergy testing. Okay, so about 10% of patients carry a penicillin allergy label, but more than 90% are not truly allergic. And this label can be really problematic in kids. It limits first line treatment choices like amoxicillin, otitis media, or penicillin for strep throat, and instead. Kids get prescribed second line agents that are less effective, broader spectrum, maybe more toxic or poorly tolerated and associated with a higher risk of antimicrobial resistance. So it's not just an EMR checkbox, it's a label with some real clinical consequences. And it's one, we have a role in removing. And so let's understand what allergy really means. And most patients with a reported penicillin allergy, especially kids, aren't true allergies in the immunologic sense. Common misinterpretations include a delayed rash, a maculopapular, or viral exum, or benign, delayed hypersensitivity, side effects, nausea, vomiting, and diarrhea. And unverified childhood reactions that are undocumented and nonspecific. Most of these are not true allergies. Only a very small subset of patients actually have IgE mediated hypersensitivity, such as urticaria, angioedema, wheezing, and anaphylaxis. These are super rare, and even then they may resolve over time without treatment. If a parent or sibling has a history of a penicillin allergy, remember that patient might actually not be allergic, and that is certainly not a reason to label a child as allergic just because one of their first degree relatives has an allergy. So right now, in 2025, as I'm recording this episode, there are clinics like the Pats Clinic or the Penicillin Allergy Testing Services at Cincinnati Children's and in a lot of our peer institutions that are at the forefront of modern de labeling. Their approach reflects the standard of care as outlined by the. Quad ai or the American Academy of Allergy, asthma and Immunology and supported by large trials like Palace. And you know, you have a great trial if you have a great acronym. So here's what happens step by step. So first you stratify the risk. How likely is this to be a true allergy? And that's where a tool like the pen fast comes. And so pen fast scores, a decision rule developed to help assess the likelihood of a true penicillin allergy based on the patient's history. The pen in pen fast is whether or not the patient has a self-reported history of penicillin allergy. They get two points if the reaction occurred in the past five years. Two points if the reaction is anaphylaxis or angioedema. One point if the reaction required treatment, and one point if the reaction was not due to testing. And so you can get a total score of. Up to six points. If you have a score of less than three. This is a low risk patient and they can be eligible for direct oral challenge. A score greater than three means they're higher risk and they may require skin testing. First validation studies show that the PEN FFA score of less than three had a negative predictive value of 96.3%. Meaning a very, very low chance of a true allergy. And this tool has been studied more extensively in adults, but pediatric specific adaptations are emerging, and they do inform current allergy clinic protocols. But I would not use this score in the emergency department just to give a kid a dose of amoxicillin. So. For low risk patients, a pen fast score of less than three or equivalent clinical judgment clinics proceed with direct oral challenge with no skin testing required. The protocol is they administer one dose of oral amoxicillin and they observe for 62 120 minutes monitoring for signs of reaction Urticaria. Respiratory symptoms or GI upset. This approach is safe and effective. There was a trial called Palace back in 2022, which validated this in over 300 children. In adolescents. There were no serious events that occurred. De labeling was successful in greater than 95% of patients. And skin tested added no benefit in low risk patients. So if the child tolerates this dose, then you can remove that allergy immediately from the chart. Parents and primary care doctors will receive a summary letter noting that the challenge was successful and that there's new guidance. Children and families are told they can safely receive all penicillins going forward. And providers are encouraged to document this clearly in the allergy section of the EMR. So you're wondering, can we actually do this in the emergency department? Technically, yes, you can do what you want, but practically we're not quite there yet. So we'd need clearer risk stratification tools like the Pen fast, a safe place for monitoring, post challenge, clinical pathways and documentation support. You know, a clear way to update EMR allergy labels across the board and involvement or allergy or infectious disease oversight. But it's pretty enticing, right? See a kid you diagnose otitis media. You think that their penicillin allergy is wrong, you just give 'em a dose of amox and watch 'em for an hour. That seems like a pretty cool thing that we might be able to do. So some centers, especially in Canada and Australia, do have some protocols for ED or inpatient based de labeling, but they rely on that structured implementation. So until then, our role in the pediatric emergency department is to identify low risk patients, avoid over document. Unconfirmed reactions and refer to allergy ideally to a clinic like the pets. So who should be referred and good candidates Include a child with a rash only, especially one that's remote over a year ago. Isolated GI symptoms. Parents unsure of the details at all. No history of anaphylaxis wheezing her hives, and no recent serious cutaneous reactions. I would avoid referring and presume that this allergy is true. If they've had recent anaphylaxis, they've had something like Stevens Johnson syndrome dress, or toxic epidermolysis necrosis. Fortunately, those are very, very rare with penicillins and there's a need for penicillin during the ED visit without allergy backup. So even though we don't have an ED based protocol yet. De labeling amoxicillin or penicillin allergy can start with good questions in the emergency department. So here's one way to talk to patients and families. You can say, thanks for letting me know about the amoxicillin allergy. Can I ask you a few questions to better understand what happened? This is gonna help us decide the safest and most effective treatment for your child today, and then possibly go through a process to remove a label for this allergy that might not be accurate. You wanna ask good, open-ended questions. What exactly happened when your child took penicillin or amoxicillin? You know, look for rash, hives, swelling, trouble breathing, or anaphylaxis. Many families just say, allergic, when the reaction was just GI upset, diarrhea or vomiting, which is not an allergy. How old was your child when this happened? Reactions that occurred before age of three are more likely to be falsely attributed. How soon after taking the medicine did the reaction start? Less than one hour is an immediate reaction, but one hour to days later is delayed. Usually mild and probably not a true allergy. Did they have a fever, cold or virus at that time? Viral rashes are often misattributed to antibiotics, and we shouldn't be treating viruses with antibiotics anyway, so get good at looking at ears and know what you're seeing. And have they taken similar antibiotics since then? Like. Different penicillins, Augmentin, or cephalexin. So if they said that they were allergic to amoxicillin, but then somehow tolerated Augmentin. They're not allergic. If a patient had rash only, but no hive swelling or difficulty breathing, no reaction within the first hour. It occurred more than five years ago or before the kid was three. And especially if they tolerated beta-lactam antibiotics. Since then, they're a great candidate for de labeling and I would refer that kid to the allergy clinic. Generally, they can get them in pretty darn quick. Alright, we're gonna wrap up this episode. Most kids labeled penicillin allergic or amoxicillin allergic, or not actually allergic to the medication. There are some scores like pen fasts that are validated tools to assess risk and support de labeling. Direct oral challenge for most patients is safe, efficient, and increasingly the standard of care. There are allergy clinics like the Pats at Cincinnati Children's that can dela children in a single visit with oral challenges alone, needing no skin testing, and emergency departments can play a key role in identifying and referring these patients and possibly de labeling ourselves in the future. Well, that's all for this episode on Penicillin Allergy. I hope you learn something new, especially how to assess whether an allergy label is real, how to ask the right questions and when to refer to an allergy testing clinic. If you have feedback, send it my way. Email, comment on the blog, a message on social media. I always appreciate hearing from you all, and if you like this episode, please leave a review on your favorite podcast app. Really helps more people find the show and that's great 'cause I like to teach people stuff. Thanks for listening for PEM Currents, the Pediatric Emergency Medicine podcast. This has been Brad Sobolewski. See you next time.
Respiratory syncytial virus vaccination in pregnancy (1:30), vasectomy (3:40), donanemab in Alzheimer disease (7:20), multicancer early detection (12:20), autism spectrum disorder (13:50), and acute pancreatitis (17:10).
Send us a textRespiratory Targets Associated With Lung Aeration During Delivery Room Resuscitation of Preterm Neonates. Rub DM, Hsu JY, Weinberg DD, Felix M, Nadkarni VM, Te Pas AB, Kuypers KLAM, Davis PG, Ratcliffe SJ, Kirpalani HM, Foglia EE.JAMA Pediatr. 2025 Aug 11:e252521. doi: 10.1001/jamapediatrics.2025.2521. Online ahead of print.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
Husband-and-wife team William Firth Wells and Mildred Weeks Wells conducted research that had the potential to make a big difference in the safety of indoor air. But it didn’t really have a significant impact on public health. Research: Associated Press. “Super-Oyster Is On its Way to Dinner Table Bigger and Better Bivalve Sports Pedigree.” 3/13/1927. https://www.loc.gov/resource/sn84020064/1927-03-13/ed-1/?sp=14 “Brought Back to Texas.” The Houston Semi-Weekly Post. 12/26/1889. https://www.newspapers.com/image/1196039760/ Decatur Daily Review. “Scientists Fight Flu Germs with Violet Ray.” 7/30/1936. https://www.newspapers.com/image/94335504/ Evening Star. “Scientific Trap-shooter.” 6/26/1937. https://www.loc.gov/resource/sn83045462/1937-06-26/ed-1/?sp=7&q=William+Firth+Wells&r=0.668,0.557,0.438,0.158,0 Fair, Gordon M. and William Weeks Wells. “Method and Apparatus for Preventing Infection.” U.S. Patent 2,198,867. https://ppubs.uspto.gov/api/pdf/downloadPdf/2198867 Hall, Dominic. “New Center for the History of Medicine Artifact - Wells Air Centrifuge.” Harvard Countway Library. https://countway.harvard.edu/news/new-center-history-medicine-artifact-wells-air-centrifuge “Incubator Is Now Oyster Nurse.” Washington Times. 10/1/1925. https://www.loc.gov/resource/sn84026749/1925-10-01/ed-1/?sp=12 Lewis, Carol Sutton. “Mildred Weeks Wells’s Work on Airborne Transmission Could Have Saved Many Lives—If the Scientific Establishment Listened.” Lost Women of Science Podcast. Scientific American. 5/22/2025. https://www.scientificamerican.com/article/a-public-health-researcher-and-her-engineer-husband-found-how-diseases-can/ Library and Archives Team. “William Firth Wells and Mildred Weeks Wells.” Washington College. https://www.washcoll.edu/people_departments/offices/miller-library/archives-special-collections/archives-blog/Wells%20papers.php Molenti, Megan. “The 60-Year-Old Scientific Screwup That Helped Covid Kill.” Wired. 5/13/2021. https://www.wired.com/story/the-teeny-tiny-scientific-screwup-that-helped-covid-kill/ Perkins JE, Bahlke AM, Silverman HF. Effect of Ultra-violet Irradiation of Classrooms on Spread of Measles in Large Rural Central Schools Preliminary Report. Am J Public Health Nations Health. 1947 May;37(5):529-37. PMID: 18016521; PMCID: PMC1623610. Randall, Katherine and Ewing, E. Thomas and Marr, Linsey and Jimenez, Jose and Bourouiba, Lydia, How Did We Get Here: What Are Droplets and Aerosols and How Far Do They Go? A Historical Perspective on the Transmission of Respiratory Infectious Diseases (April 15, 2021). Available at SSRN: https://ssrn.com/abstract=3829873 Riley, Richard L. “What Nobody Needs to Know About Airborne Infection.” American Journal of Respiratory and Critical Care Medicine. Volume 163, Issue 1. https://www.atsjournals.org/doi/10.1164/ajrccm.163.1.hh11-00 Simon, Clea. “Did a socially awkward scientist set back airborne disease control?” The Harvard Gazette. 3/7/2025. https://news.harvard.edu/gazette/story/2025/03/did-a-socially-awkward-scientist-set-back-airborne-disease-control/ “Texas State News.” McKinney Weekly Democrat-Gazette. 4/17/1890. https://www.newspapers.com/image/65385350/ WELLS MW, HOLLA WA. VENTILATION IN THE FLOW OF MEASLES AND CHICKENPOX THROUGH A COMMUNITY: Progress Report, Jan. 1, 1946 to June 15, 1949, Airborne Infection Study, Westchester County Department of Health. JAMA. 1950;142(17):1337–1344. doi:10.1001/jama.1950.02910350007004 WELLS MW. VENTILATION IN THE SPREAD OF CHICKENPOX AND MEASLES WITHIN SCHOOL ROOMS. JAMA. 1945;129(3):197–200. doi:10.1001/jama.1945.02860370019006 WELLS WF, WELLS MW. AIR-BORNE INFECTION. JAMA. 1936;107(21):1698–1703. doi:10.1001/jama.1936.02770470016004 WELLS WF, WELLS MW. AIR-BORNE INFECTION: SANITARY CONTROL. JAMA. 1936;107(22):1805–1809. doi:10.1001/jama.1936.02770480037010 Wells, W F, and M W Wells. “Measurement of Sanitary Ventilation.” American journal of public health and the nation's health vol. 28,3 (1938): 343-50. doi:10.2105/ajph.28.3.343 Wells, William Firth and Gordon Maskew Fair. Viability of B. coli Exposed to Ultra-Violet Radiation in Air.Science82,280-281(1935).DOI:10.1126/science.82.2125.280.b Wells, William Firth and Mildred Weeks Wells. Measurement of Sanitary Ventilation American Journal of Public Health and the Nations Health 28, 343_350, https://doi.org/10.2105/AJPH.28.3.343 Zimmer, Carl. “Air-Borne: The Hidden History of the Life We Breathe.” Dutton. 2025. See omnystudio.com/listener for privacy information.
© 2020-2026 Ivy Podcast Discovery LLC
