POPULARITY
In this special episode on Early Identification and Delay of Type 1 Diabetes, Dr. Neil Skolnik this emerging area with Dr. Jay Shubrook. This special episode is supported by an independent educational grant from Sanofi. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Jay Shubrook, D.O. - Professor and Director of Diabetes Services, Touro University. Past Chair, The American Diabetes Association Primary Care Advisory Group, Past Chair of the American College of Diabetology. Selected References and Resources referred to the in the Podcast: Webinar Registration (Apr 28, 2025 10:00 AM): Early Detection Saves Lives: Implementing Type 1 Diabetes Screening in Pediatric and Primary Care References: Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes. Diabetes Care 2024;47(8):1276–1298 An Anti-CD3 Antibody, Teplizumab, in Relatives at Risk for Type 1 Diabetes. N Engl J Med 2019;381:603-613 Resources for Auto-antibody Testing: Type 1 Diabetes TrialNet Centers of Excellence Locations Type 1 Risk test Trialnet
Dr. Sapna Kudchadkar is the Anesthesiologist-in-Chief of the Johns Hopkins Children's Center and Vice Chair for Pediatric Anesthesiology and Critical Care Medicine at Johns Hopkins University School of Medicine. She completed her training in pediatrics, pediatric intensive care, anesthesiology, and pediatric anesthesiology at Johns Hopkins Children's Center and the Johns Hopkins Hospital, during which she also received her Ph.D. in clinical investigation at the Johns Hopkins Bloomberg School of Public Health. Dr. Kudchadkar is now the lead PI for the "PICU Up!" study, a 10-site randomized trial of a multifaceted early mobility program for critically ill children.Learning Objectives: By the end of this podcast, listeners should be able to: 1. Discuss the best ways to prevent delirium in young children, including sedative medication selection and non-pharmacologic techniques.2. Describe the optimal level of sedation for a child who requires invasive mechanical ventilation for acute respiratory failure and the staffing needed to achieve this safely.3. Discuss how to obtain hospital resources to support early mobilization and motivate a team to accomplish these goals.Selected References: 1. Traube, C., Silver, G., Gerber, L. M., Kaur, S., Mauer, E. A., Kerson, A., Joyce, C., & Greenwald, B. M. (2017). Delirium and Mortality in Critically Ill Children: Epidemiology and Outcomes of Pediatric Delirium*. Critical Care Medicine, 45(5), 891–898. https://doi.org/10.1097/CCM.00000000000023242. Traube, C., Silver, G., Kearney, J., Patel, A., Atkinson, T. M., Yoon, M. J., Halpert, S., Augenstein, J., Sickles, L. E., Li, C., & Greenwald, B. (2014). Cornell Assessment of Pediatric Delirium. Critical Care Medicine, 42(3), 656–663. https://doi.org/10.1097/CCM.0b013e3182a66b763. Wieczorek B, Ascenzi J, Kim Y, Lenker H, Potter C, Shata NJ, Mitchell L, Haut C, Berkowitz I, Pidcock F, Hoch J, Malamed C, Kravitz T, Kudchadkar SR. PICU Up!: Impact of a Quality Improvement Intervention to Promote Early Mobilization in Critically Ill Children. Pediatr Crit Care Med. 2016 Dec;17(12):e559-e566. doi: 10.1097/PCC.0000000000000983. PMID: 27759596; PMCID: PMC5138131.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.
Sunday Worship
Selected References
Host Casandra Grundstrom is joined by special guest Professor Sandeep Purao. He is a Trustee Professor in the Information and Process Management Group and Associate Director of the Hoffman Center for Business Ethics at Bentley University. He is also a Visiting Professor at Agder University in Norway. His current research focuses on the design and evaluation of digital solutions for complex societal problems. Sandeep's work has been published in MIS Quarterly, Information Systems Research, Journal of MIS, ACM Computing Surveys, ACM Transactions, Journal of the Medical Internet Research and others, and funded by federal agencies, private foundations, and industry consortia. He holds a Ph.D. in Management Information Systems from the University of Wisconsin-Milwaukee.In this episode, we finish our design theme series by exploring designing for societal good through projects on a more micro-scale for elderly communities when practicing self-management of illness and empathy as part of the design process, as well as designing counters to political polarization in fake news and echo chambers. Commencing the new year off on a positive note, with insights from Sandeep about bringing about change in a world and finding joy in what we do. We are academic superheroes!References:Hao, H., Garfield, M. and Purao, S. 2021. Risk Factors that Contribute to the Length of Homeless Shelter Stays: Evidence-based Regression Analyses. International Journal of Public Health, Forthcoming.Herwix, A., Haj-Bolouri, A., Rossi, M., Chiarini-Tremblay, M., Purao, S., and Gregor, S. 2022. Ethics in Information Systems and Design Science Research: Five Perspectives. Communications of the AIS, Forthcoming.Khouri, Y., Purao, S., & Duffy, M. 2018. The Influence of Values on the Use of Citizen Services: The Elderly Perspective. In Proceedings of the 24th Americas Conference on Information Systems (AMCIS).Purao, S., Murungi, D. M., & Yates, D. 2021. Deliberative Breakdowns in the Social Representation Process: Evidence from Reader Comments in Partisan News Sites. ACM Transactions on Social Computing, 4(2), 1-35.Purao, S., Hao, H., and Meng, C. 2021. The Use of Smart Home Speakers by the Elderly: Exploratory Analyses and Potential for Big Data. Big Data Research. Elsevier.Purao, S., & Garfield, M. 2020. Process Modeling in Humanitarian Settings: A Case Study and Lessons Learned. In Proceedings of the 28th European Conference on Information Systems (ECIS).Purao, S. 2002. Design research in the technology of information systems: Truth or dare. Unpublished Manuscript, Georgie State University.Selected References on Design:Baldwin, C.Y., Clark, K.B. and Clark, K.B., 2000. Design rules: The power of modularity (Vol. 1). MIT press.Cross, N., 1982. Designerly ways of knowing. Design studies, 3(4), pp.221-227.Simon, H.A., 1996. The sciences of the artificial. MIT press.Suh, N.P. and Suh, P.N., 1990. The principles of design (No. 6). Oxford University Press. Other References:Al Gore's Budgets' - https://www.ccair.org/guest-blog-what-i-learned-from-spending-three-days-with-al-gore/Sandeep Purao's Website - https://purao.us/research-projects/ Vanessa Otero Political Polzarization- https://libguides.geneseo.edu/newsliteracy/identifying-major-news-sources
Visit our website BeautifulIllusions.org for a complete set of show notes and links to almost everything discussed in this episode*A note about the audio in this episode - due to COVID this conversation was recorded in a large garage on a brisk 40 degree November Sunday, so there’s a bit of natural reverb, along with the buzz of propane heaters and leaf blowers audible in the background. Like so many things over the past 9 months, it’s not optimal, but we make the best of a challenging situation, and the cleaned up audio is certainly listenable, if not quite up to BI's usual standards.*Selected References:2:09 - The Elf on the Shelf (Say Goodbye to the Santa Claus Lie, Against the Santa Lie)2:24 - Listen to “Santa Claus Is Coming to Town” as performed by Bing Crosby (YouTube video) and read about the history of the song and the lyrics 3:28 - See “Let’s Bench the Elf on the Shelf” (Psychology Today, 2012) or “You’re a Creepy One, Elf on the Shelf” (The Atlantic, 2012)4:45 - Magical realism13:58 - See the Magical thinking Wikipedia entry and “Why Everyone Believes in Magic (Even You)” (Live Science, 2012) and “Do You Believe in Magic?” (New York Times, 2007) and “All Paths Lead to Magical Thinking” (Psychology Today, 2013)16:08 - See “Should parents lie to kids about Santa Claus? We asked the experts.” (Popular Science, 2019) which draws on the opinions of philosophy professor David Kyle Johnson and psychology professor Cyndy Scheibe16:48 - According to Piaget’s theory of cognitive development, “The concrete operational stage is the third stage of Piaget's theory of cognitive development. This stage, which follows the preoperational stage, occurs between the ages of 7 and 11 (middle childhood and preadolescence) years, and is characterized by the appropriate use of logic. During this stage, a child's thought processes become more mature and "adult like". They start solving problems in a more logical fashion.”18:15 - See “What should I tell my kids about Santa?” (BBC, 2018) or “What psychologists really think about you lying to your kids about Santa” (Washington Post, 2016) or “Should parents lie to children about Santa?” (EurekAlert, 2016)21:04 - See “Against the Santa Lie” which is a blog post by David Kyle Johnson that contains the hate mail he received based on his Op-Ed piece “SORRY, VIRGINIA…” (Baltimore Sun, 2009)31:51 - See “Santa Claus: Real Origins & Legend” (History.com) and “From St. Nicholas to Santa Claus: the surprising origins of Kris Kringle” (National Geographic)33:33 - Originally published anonymously on December 23, 1823, the poem “A Visit from St. Nicholas” by Clement Clarke Moore, changed Santa from a figure who was, until that time, traditionally depicted as a thinner, less jolly, horse-riding disciplinarian, a combination of mythologies about the British Father Christmas, the Dutch Sinterklaas, and the fourth-century bishop Saint Nicholas, into the cheerfully chubby, magical, gift-giver, complete with his eight reindeer, with whom we are now well acquainted. Moore claimed authorship of the poem, which is popularly known today as “Twas the night before Christmas” in 1836, but this claim is now in question and many believe the author was actually the writer Henry Livingston. 33:38 - Using imagery from the poem “A Visit from St. Nicholas,” the famous political cartoonist Thomas Nast is credited with creating the first illustrations of Santa as we know him today. In total, 33 of Nast’s Santa drawings were published in Harper’s Weekly from 1863 to 1886. In addition to his Santa contributions, Nast’s drawings of Uncle Sam, the Republican Party elephant, and the Democratic Party donkey, among others, are widely credited as forming the basis of popular depictions used today. For more see “A Civil War Cartoonist Created the Modern Image of Santa Claus as Union Propaganda” (Smithsonian Magazine, 2018) and “The Man, the Myth, the Legend: Thomas Nast’s Santa Claus” (Daily Art Magazine, 2019)36:44 - For the complete history of Rudolph see “Rudolph the Red-Nosed Reindeer” (History.com)36:54 - The “Rudolph the Red-Nosed Reindeer” TV special was created by Rankin/Bass Animated Entertainment and released in 1964, and although it is at this point undoubtedly considered a Christmas classic, it is not universally beloved as some of its plot points and themes are questionable by today’s social standards. For more on this perspective see “Don’t Subject Your Kids to Rudolph” (The Atlantic, 2020). To hear the noise his nose makes, check out this video. 37:11 - Listen to “Run, Rudolph, Run” by Chuck Berry (YouTube video)41:25 - See “Gift exchange” (Britannica) - “Gift exchange may be distinguished from other types of exchange in several respects: the first offering is made in a generous manner and there is no haggling between donor and recipient; the exchange is an expression of an existing social relationship or of the establishment of a new one that differs from impersonal market relationships; and the profit in gift exchange may be in the sphere of social relationships and prestige rather than in material advantage” - and “The History and Complexities of Gift Giving” (Reporter Magazine from the Rochester Institute of Technology) 45:06 - See the Feast of the Seven Fishes Wikipedia entry or “An Eye-Opening Look at the Feast of the Seven Fishes” (Saveur Magazine, 2018) or “The Origin of the Feast of the Seven Fishes” (Eataly)45:56 - Listen to “The Two Cultures” episode of the the Context podcast from November 201846:08 - Listen to Beautiful Illusions Episode 04 “Too Cultured”48:30 - See “Is It OK To Lie About Santa And The Tooth Fairy?” (NPR, 2019)52:50 - Google Santa TrackerThis episode was recorded in November 2020The “Beautiful Illusions Theme” was performed by Darron Vigliotti (guitar) and Joseph Vigliotti (drums), and was written and recorded by Darron Vigliotti
Your eyes may fool you... Keep your differential diagnosis open. Selected References Aravindhan N, Chisholm DG. Sulfhemoglobinemia presenting as pulse oximetry desaturations. Anesthesiology. 2000;93:883–884. Gharahbaghian L et al. Methemoglobinemia and Sulfhemoglobinemia in Two Pediatric Patients after Ingestion of Hydroxylamine Sulfate. West J Emerg Med. 2009 Aug; 10(3): 197–201 Ginimuge PR et al. Methylene Blue: Revisited. J Anaesthesiol Clin Pharmacol. 2010 Oct-Dec; 26(4): 517–520. Mack E. Focus on diagnosis: co-oximetry. Pediatr Rev. 2007;28:73–4. So T-Y et al. Topical Benzocaine-induced Methemoglobinemia in the Pediatric Population. J Pediatr Health Care. 22(6):335–339.
Intro:Welcome back to Talking About Glaucoma, a podcast of indeterminate length and frequency. I’m your host Robert Schertzer, a Glaucoma Specialist from Vancouver, BC Canada. To help produce future shows more frequently, I will no longer include artwork and chapter markings. Hopefully this will get me back on track to publishing new episodes each month this coming year. As always, contact me at podcast@iguy.org if you have a glaucoma topic that you would like to discuss with me on a future episode.In this episode, I talk with Murray Johnstone from Seattle about pulsatile flow through the Trabecular Meshwork and collector channels. We discuss the imaging improvements over the years that have made this possible including the latest phase-based OCT scans that result in nanometre resolution instead of the micrometre resolution of spectral domain scans that most of us are using in clinical practice.Show Notes:This topic spans decades of work that began prior to his fellowship and resumed around the year 2000 as the imaging technology began to become available to prove the theory. Aqueous outflow drugs increase the outflow pulsatility, not just flow. Goldmann thought the TM was rigid preventing he and Asher from being able to explain the pulsatile nature of the flow. The ocular pulse drives movement of the TM, which is not rigid. The drugs that improve outflow, do so by altering the blood flow to achieve their effect. This is literally a stroke volume.The theoretical sensitivity to motion is in picometer with the newer phase-based OCTs, that of the movement of electrons in an atom, though practically we achieve nanometer resolution. This is sensitivity of motion of the TM walls, and not the resolution of an image.How does this flow vary by location within the angle and from moment to moment? This is a live dynamic process. They have published numerous studies in both normal and abnormal outflow patients. Questions to answer include how this flow is altered by laser, meds, stent procedures? Does the act of doing the measurements also alter the flow? It is non-contact and non-invasive therefore should not be altering the flow but white-coat syndrome could have an influence. Perhaps in the future, we can instill a drop in the patient’s eye, measure the change in pulsatile flow, and be able to tell whether a particular medication will actually be effective.We measure 12 seconds of 31 million seconds in a patient’s year when we check IOP several times per year. By determining pulsatile outflow we have the potential to achieve new diagnostic and treatment options for our patients. This is analogous to how cardiology is using imaging modalities in patient care.Selected References for this episode related to pulsatile flow:1. Johnstone MA, Grant WM. Microsurgery of Schlemm’s canal and the human aqueous outflow system. Am J Ophthalmol 1973;76:906-917.2. Johnstone MA, Grant WG. Pressure-dependent changes in structures of the aqueous outflow system of human and monkey eyes. Am J Ophthalmol 1973;75:365-383.3. Johnstone MA. Pressure-dependent changes in configuration of the endothelial tubules of Schlemm’s canal. Am J Ophthalmol 1974;78:630-638.4. Johnstone MA. Pressure-dependent changes in nuclei and the process origins of the endothelial cells lining Schlemm’s canal.5. Johnstone MA. The aqueous outflow system as a mechanical pump: evidence from examination of tissue and aqueous movement in human and non-human primates. J Glaucoma 2004;13:421-438.6. Johnstone MA. A New Model Describes an Aqueous Outflow Pump and Explores Causes of Pump Failure in Glaucoma. In: Grehn H, Stamper R, eds. Essentials in Ophthalmology: Glaucoma II. Heidelberg: Springer, 20067. Johnstone MA. Aqueous Outflow: The case for a new model. Review of Ophthalmol 2007;14:79-84.8. Schacknow P, Samples J, eds. Aqueous Veins. The Glaucoma Book. New York: Springer, 2010:65-78.9. Johnstone M, Martin E, Jamil A. Pulsatile flow into the aqueous veins: manifestations in normal and glaucomatous eyes. Exp Eye Res 2011;92:318-327.10. Li P, Reif R, Zhi Z, Martin E, Shen TT, Johnstone M, Wang RK. Phase-sensitive optical coherence tomography characterization of pulse-induced trabecular meshwork displacement in ex vivo nonhuman primate eyes. J Biomed Opt 2012;17:076026.11. Li P, Shen TT, Johnstone M, Wang RK. Pulsatile motion of the trabecular meshwork in healthy human subjects quantified by phase-sensitive optical coherence tomography. Biomed Opt Express 2013;4:2051-206512. Johnstone MA, Saheb H, Ahmed II, Samuelson TW, Schieber AT, Toris CB. Effects of a Schlemm canal scaffold on collector channel ostia in human anterior segments. Exp Eye Res 2014;119:70-76.13. Johnstone MA. Intraocular Pressure Regulation: Findings of Pulse-Dependent Trabecular Meshwork Motion Lead to Unifying Concepts of Intraocular Pressure Homeostasis. J Ocul Pharmacol Ther 2014;30:88-93.13. Sun Y, Li P, Johnstone M, K W, T S. Pulsatile motion of trabecular meshwork in a patient with iris cyst by phase-sensitive optical coherence tomography. Quantitative Imaging in Medicine and Surgery 2015;5:171-17314. Xin C, Wang RK, Song S, Shen T, Wen J, Martin E, Jiang Y, Padilla S, Johnstone M. Aqueous outflow regulation: Optical coherence tomography implicates pressure-dependent tissue motion. Exp Eye Res 2017;158:171-186.15. Carreon T, van der Merwe E, Fellman RL, Johnstone M, Bhattacharya SK. Aqueous outflow - A continuum from trabecular meshwork to episcleral veins. Prog Retin Eye Res 2017;57:108-133.16. Wang K, Johnstone MA, Xin C, Song S, Padilla S, Vranka JA, Acott TS, Zhou K, Schwaner SA, Wang RK, Sulchek T, Ethier CR. Estimating Human Trabecular Meshwork Stiffness by Numerical Modeling and Advanced OCT Imaging. Invest Ophthalmol Vis Sci 2017;58:4809-4817.17. Xin C, Song S, Johnstone M, Wang N, Wang RK. Quantification of Pulse-Dependent Trabecular Meshwork Motion in Normal Humans Using Phase-Sensitive OCT. Invest Ophthalmol Vis Sci 2018;59:3675-3681.Production information:This episode was originally recorded March 2016 during the Annual Meeting of the American Glaucoma Society in Ft Lauderdale using two Shure SM58 microphones with a Marantz PMD661 digital recorder. Mixing and sound levelling were FINALLY completed in November 2018 on a MacBook Pro and an iMac using Hindenberg Journalist Pro software. There was a great deal of background noise requiring generous use of noise gate and compression filters, with reverb added back to bring the voices back to life. Narration was overdubbed using a Blue Yeti Microphone with Journalist Pro.Opinions expressed in this podcast are those of the speakers and are not intended to be taken as the standard of care for glaucoma treatment. Please always weigh the complete clinical picture and involve patients with any decisions in their care.Contact information:Murray Johnstone, MDClinical ProfessorUniversity of WashingtonDepartment of OphthalmologySeattle, WA USAjohnstone.murray@gmail.comRobert M Schertzer, MD, MEd, FRCSCpodcast@iguy.orgTwitter - http://twitter.com/robschertzeror http://iguy.tv/twitterBlog - http://wholelottarob.comor http://iguy.tv/blogFacebook - http://facebook.com/talkingaboutglaucomaFacebook glaucoma support group - https://www.facebook.com/groups/glaucomapatientgroup/or http://iguy.tv/patientsupportOffice website - http://westcoastglaucoma.comor http://iguy.tv/officeTheme music “Middle East Gold” ©Daniel Schertzer 2010 and published by Les Prods DOSWA Enr© 2018 DOSWA Prods Enr/Robert M Schertzer MD. MEd, FRCSCClosing remarks:That’s our show for today. Thanks for your patience as I slowly post new episodes including a talk about the new glaucoma drug Rhopressa. Please rate this show on iTunes as this is the best way for other people to find the show.You can subscribe using iTunes, PocketCasts, GooglePlay, Stitcher or wherever fine podcasts are found, and new episodes will appear in your podcast player as they come out. Please tell your friends and colleagues about the show.Drop me a line at podcast@iguy.org with your comments, visit WholeLottaRob.com, WestCoastGlaucoma.com, or follow me on twitter @robschertzer. Links to all of these are in the show notes. Remember to keep fighting glaucoma by early detection so that nobody loses vision from this group of diseases.
Intro:Welcome back to Talking About Glaucoma, a podcast of indeterminate length and frequency. I'm your host Robert Schertzer, a Glaucoma Specialist from Vancouver, BC Canada. To help produce future shows more frequently, I will no longer include artwork and chapter markings. Hopefully this will get me back on track to publishing new episodes each month this coming year. As always, contact me at podcast@iguy.org if you have a glaucoma topic that you would like to discuss with me on a future episode.In this episode, I talk with Murray Johnstone from Seattle about pulsatile flow through the Trabecular Meshwork and collector channels. We discuss the imaging improvements over the years that have made this possible including the latest phase-based OCT scans that result in nanometre resolution instead of the micrometre resolution of spectral domain scans that most of us are using in clinical practice.Show Notes:This topic spans decades of work that began prior to his fellowship and resumed around the year 2000 as the imaging technology began to become available to prove the theory. Aqueous outflow drugs increase the outflow pulsatility, not just flow. Goldmann thought the TM was rigid preventing he and Asher from being able to explain the pulsatile nature of the flow. The ocular pulse drives movement of the TM, which is not rigid. The drugs that improve outflow, do so by altering the blood flow to achieve their effect. This is literally a stroke volume.The theoretical sensitivity to motion is in picometer with the newer phase-based OCTs, that of the movement of electrons in an atom, though practically we achieve nanometer resolution. This is sensitivity of motion of the TM walls, and not the resolution of an image.How does this flow vary by location within the angle and from moment to moment? This is a live dynamic process. They have published numerous studies in both normal and abnormal outflow patients. Questions to answer include how this flow is altered by laser, meds, stent procedures? Does the act of doing the measurements also alter the flow? It is non-contact and non-invasive therefore should not be altering the flow but white-coat syndrome could have an influence. Perhaps in the future, we can instill a drop in the patient's eye, measure the change in pulsatile flow, and be able to tell whether a particular medication will actually be effective.We measure 12 seconds of 31 million seconds in a patient's year when we check IOP several times per year. By determining pulsatile outflow we have the potential to achieve new diagnostic and treatment options for our patients. This is analogous to how cardiology is using imaging modalities in patient care.Selected References for this episode related to pulsatile flow:1. Johnstone MA, Grant WM. Microsurgery of Schlemm's canal and the human aqueous outflow system. Am J Ophthalmol 1973;76:906-917.2. Johnstone MA, Grant WG. Pressure-dependent changes in structures of the aqueous outflow system of human and monkey eyes. Am J Ophthalmol 1973;75:365-383.3. Johnstone MA. Pressure-dependent changes in configuration of the endothelial tubules of Schlemm's canal. Am J Ophthalmol 1974;78:630-638.4. Johnstone MA. Pressure-dependent changes in nuclei and the process origins of the endothelial cells lining Schlemm's canal.5. Johnstone MA. The aqueous outflow system as a mechanical pump: evidence from examination of tissue and aqueous movement in human and non-human primates. J Glaucoma 2004;13:421-438.6. Johnstone MA. A New Model Describes an Aqueous Outflow Pump and Explores Causes of Pump Failure in Glaucoma. In: Grehn H, Stamper R, eds. Essentials in Ophthalmology: Glaucoma II. Heidelberg: Springer, 20067. Johnstone MA. Aqueous Outflow: The case for a new model. Review of Ophthalmol 2007;14:79-84.8. Schacknow P, Samples J, eds. Aqueous Veins. The Glaucoma Book. New York: Springer, 2010:65-78.9. Johnstone M, Martin E, Jamil A. Pulsatile flow into the aqueous veins: manifestations in normal and glaucomatous eyes. Exp Eye Res 2011;92:318-327.10. Li P, Reif R, Zhi Z, Martin E, Shen TT, Johnstone M, Wang RK. Phase-sensitive optical coherence tomography characterization of pulse-induced trabecular meshwork displacement in ex vivo nonhuman primate eyes. J Biomed Opt 2012;17:076026.11. Li P, Shen TT, Johnstone M, Wang RK. Pulsatile motion of the trabecular meshwork in healthy human subjects quantified by phase-sensitive optical coherence tomography. Biomed Opt Express 2013;4:2051-206512. Johnstone MA, Saheb H, Ahmed II, Samuelson TW, Schieber AT, Toris CB. Effects of a Schlemm canal scaffold on collector channel ostia in human anterior segments. Exp Eye Res 2014;119:70-76.13. Johnstone MA. Intraocular Pressure Regulation: Findings of Pulse-Dependent Trabecular Meshwork Motion Lead to Unifying Concepts of Intraocular Pressure Homeostasis. J Ocul Pharmacol Ther 2014;30:88-93.13. Sun Y, Li P, Johnstone M, K W, T S. Pulsatile motion of trabecular meshwork in a patient with iris cyst by phase-sensitive optical coherence tomography. Quantitative Imaging in Medicine and Surgery 2015;5:171-17314. Xin C, Wang RK, Song S, Shen T, Wen J, Martin E, Jiang Y, Padilla S, Johnstone M. Aqueous outflow regulation: Optical coherence tomography implicates pressure-dependent tissue motion. Exp Eye Res 2017;158:171-186.15. Carreon T, van der Merwe E, Fellman RL, Johnstone M, Bhattacharya SK. Aqueous outflow - A continuum from trabecular meshwork to episcleral veins. Prog Retin Eye Res 2017;57:108-133.16. Wang K, Johnstone MA, Xin C, Song S, Padilla S, Vranka JA, Acott TS, Zhou K, Schwaner SA, Wang RK, Sulchek T, Ethier CR. Estimating Human Trabecular Meshwork Stiffness by Numerical Modeling and Advanced OCT Imaging. Invest Ophthalmol Vis Sci 2017;58:4809-4817.17. Xin C, Song S, Johnstone M, Wang N, Wang RK. Quantification of Pulse-Dependent Trabecular Meshwork Motion in Normal Humans Using Phase-Sensitive OCT. Invest Ophthalmol Vis Sci 2018;59:3675-3681.Production information:This episode was originally recorded March 2016 during the Annual Meeting of the American Glaucoma Society in Ft Lauderdale using two Shure SM58 microphones with a Marantz PMD661 digital recorder. Mixing and sound levelling were FINALLY completed in November 2018 on a MacBook Pro and an iMac using Hindenberg Journalist Pro software. There was a great deal of background noise requiring generous use of noise gate and compression filters, with reverb added back to bring the voices back to life. Narration was overdubbed using a Blue Yeti Microphone with Journalist Pro.Opinions expressed in this podcast are those of the speakers and are not intended to be taken as the standard of care for glaucoma treatment. Please always weigh the complete clinical picture and involve patients with any decisions in their care.Contact information:Murray Johnstone, MDClinical ProfessorUniversity of WashingtonDepartment of OphthalmologySeattle, WA USAjohnstone.murray@gmail.comRobert M Schertzer, MD, MEd, FRCSCpodcast@iguy.orgTwitter - http://twitter.com/robschertzeror http://iguy.tv/twitterBlog - http://wholelottarob.comor http://iguy.tv/blogFacebook - http://facebook.com/talkingaboutglaucomaFacebook glaucoma support group - https://www.facebook.com/groups/glaucomapatientgroup/or http://iguy.tv/patientsupportOffice website - http://westcoastglaucoma.comor http://iguy.tv/officeTheme music “Middle East Gold” ©Daniel Schertzer 2010 and published by Les Prods DOSWA Enr© 2018 DOSWA Prods Enr/Robert M Schertzer MD. MEd, FRCSCClosing remarks:That's our show for today. Thanks for your patience as I slowly post new episodes including a talk about the new glaucoma drug Rhopressa. Please rate this show on iTunes as this is the best way for other people to find the show.You can subscribe using iTunes, PocketCasts, GooglePlay, Stitcher or wherever fine podcasts are found, and new episodes will appear in your podcast player as they come out. Please tell your friends and colleagues about the show.Drop me a line at podcast@iguy.org with your comments, visit WholeLottaRob.com, WestCoastGlaucoma.com, or follow me on twitter @robschertzer. Links to all of these are in the show notes. Remember to keep fighting glaucoma by early detection so that nobody loses vision from this group of diseases.
Trying to get rid of acne can feel like a science experiment with your face -- so we get to the bottom of what works and what doesn’t. We investigate the role of diet, stress and hygiene, and meet internet celebrity Dr Sandra Lee aka Dr Pimple Popper. We also speak to dermatologist Dr. Jonathan Weiss, MD and Prof. Huiying Li, PhD. Science Vs Live! Come see our live show on the science behind red wine, coffee and chocolate - could our favorite treats actually be good for us? Thursday 3/23 at The Bell House in Brooklyn, NYC. Get your tickets here. Our Sponsors: Audible Channel's Sincerely X - Go to audible.com/sincerelyx to listen. Audible and Amazon Prime members can listen for free. Ebay's Open for Business - Season 2 returns March 16th. You can listen on iTunes, Google Play, or wherever you get your podcasts. Credits: This episode has been produced by Senior Producer Kaitlyn Sawrey and Wendy Zukerman, as well as Heather Rogers, and Shruti Ravindran. Production assistance from Ben Keubrick. We’re edited by Annie Rose Strasser. Fact Checking by Michelle Harris. Sound engineering, music production and original scoring by Bobby Lord. Thanks to Dr Robert Delavalle, Grand View Research and Stevie Lane, Pat Walters, Rose Reid, the Zukerman family, Joseph Lavelle Wilson. Selected References:2016 Guidelines of care for the management of acne vulgaris2013 study on ‘good’ vs. ‘bad’ strains of P. Acnes by Dr. Huiying LiDr. Pimple Popper’s ‘Blackheads for Dayzzzz’ videoCochrane Review on Light Therapy for Acne TreatmentA great summary of up to date research on acne and acne treatment.
We head to a farm in Alabama to find out what happened after thousands of immigrants left the state. Did it create more jobs for Americans and what happened to the crime rate? We speak to economists Prof. Samuel Addy, Prof. Jennifer Hunt, and Prof. Brian Bell to find out. Science Vs Live! Come see our live show on the science behind red wine, coffee and chocolate - could our favorite treats actually be good for us? Thursday 3/23 at The Bell House in Brooklyn, NYC. Get your tickets here. Credits: This episode has been produced by Heather Rogers, Wendy Zukerman, and Shruti Ravindran. Kaitlyn Sawrey is our senior producer. Production assistance by Ben Kuebrich. We’re edited by Annie Rose Strasser. Fact Checking by Michelle Harris. Sound engineering, music production and original music written by Bobby Lord. Thanks to Dr Anna Piil Damm, Professor Charis Kubrin, Assistant Professor Jorg Spenkuch, Professor Kristin Butcher and Ramiro Martinez… as well as the Zukerman family. Selected References:2016 NAS report: The Economic and Fiscal Consequences of Immigration (with ‘key messages and conclusions’ starting on page 202.ACLU analysis of “Alabama Taxpayer and Citizen Protection Act,” HB 562003 analysis and 2015 analysis on how immigrants affect wages Brian Bell’s 2013 study on the effect of two different immigration waves on crime in the UKFBI’s Uniform Crime Reporting Database
Amal Mattu talks about ACS presentations, workup, and management in older adults, and why the atypical is typical! For the full shownotes and references, and to leave a comment, see: https://gempodcast.com Chest pain is one of the most common reasons why people present to the ED. The chief complaint of Chest Pain typically triggers an automatic EKG, and potentially a workup for acute coronary syndrome. However, many patients who are having ACS do not present with chest pain. Instead, they may have dyspnea, diaphoresis, nausea, vomiting, abdominal pain, or other non-specific symptoms. Which patients are most likely to present this way? Older adults. And the older the patient, the more likely they are to be chest-pain free when they present with an NSTEMI or STEMI. So it is up to the medical provider to be vigilant, consider possible angina equivalents, and order the right workup. Dr. Mattu talks us through some of the statistics of how often MIs occur without chest pain with age, how EKG interpretation may differ, and how management should differ vs how it does differ. Patients presenting with atypical symptoms are less likely to receive an aspirin or thrombolytics/PCI, and their mortality is higher. Selected References: 1. Mattu A, Grossman SA, Rose PL. Geriatric emergencies - A discussion-based review. Wiley Blackwell; 2016. 2. Glickman SW, Shofer FS, Wu MC, et al. Development and validation of a prioritization rule for obtaining an immediate 12-lead electrocardiogram in the emergency department to identify ST-elevation myocardial infarction. Am Heart J. 2012;163(3):372-382. http://www.ncbi.nlm.nih.gov/pubmed/22424007 3. Brieger D, Eagle KA, Goodman SG, et al. Acute coronary syndromes without chest pain, an underdiagnosed and undertreated high-risk group: Insights from the global registry of acute coronary events. Chest. 2004;126(2):461-469. http://www.ncbi.nlm.nih.gov/pubmed/15302732 4. Cannon AR, Lin L, Lytle B, Peterson ED, Cairns CB, Glickman SW. Use of prehospital 12-lead electrocardiography and treatment times among ST-elevation myocardial infarction patients with atypical symptoms. Acad Emerg Med. 2014;21(8):892-898. http://www.ncbi.nlm.nih.gov/pubmed/25155289 5. Alexander KP, Newby LK, Cannon CP, et al. Acute coronary care in the elderly, part I: Non-ST-segment-elevation acute coronary syndromes: A scientific statement for healthcare professionals from the american heart association council on clinical cardiology: In collaboration with the society of geriatric cardiology. Circulation. 2007;115(19):2549-2569. http://www.ncbi.nlm.nih.gov/pubmed/17502590 6. Canto JG, Rogers WJ, Goldberg RJ, et al. Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA. 2012;307(8):813-822. http://www.ncbi.nlm.nih.gov/pubmed/22357832 This podcast uses sounds from freesound.org by Jobro and HerbertBoland. Image credit: https://pixabay.com/en/pulse-trace-healthcare-medicine-163708/
Jeff Kline talks about PEs in older adults. What's different and what's the same for older vs younger patients? Find out here! See gempodcast.com/2016/06/02/pulmonary-emboli-in-older-adults/ for a full description, links, and to leave comments! Not a day goes by that an Emergency Physician doesn’t at least consider PE in a patient who presents with chest pain, dyspnea, or syncope. We have become familiar with using risk stratification tools like the Wells Score and the PERC criteria. But what do you do in older adults? All of them will automatically NOT be PERC negative because of their age. In this episode, with PE guru Jeff Kline, we discuss the presentation of PE in older adults, including the demographics, diagnosis, and how treatment may differ from younger adults in small, sub-massive, and massive PEs. Selected References: 1. Zondag W, Vingerhoets LM, Durian MF, et al. Hestia criteria can safely select patients with pulmonary embolism for outpatient treatment irrespective of right ventricular function. J Thromb Haemost. 2013;11(4):686-692. http://www.ncbi.nlm.nih.gov/pubmed/23336721 2. Beam DM, Kahler ZP, Kline JA. Immediate discharge and home treatment with rivaroxaban of low-risk venous thromboembolism diagnosed in two U.S. emergency departments: A one-year preplanned analysis. Acad Emerg Med. 2015;22(7):788-795. http://www.ncbi.nlm.nih.gov/pubmed/26113241 3. Kahler ZP, Kline JA. Standardizing the D-dimer assay: Proposing the D-dimer international managed ratio. Clin Chem. 2015;61(5):776-778. http://www.ncbi.nlm.nih.gov/pubmed/25816812 4. Kahler ZP, Beam DM, Kline JA. Cost of treating venous thromboembolism with heparin and warfarin versus home treatment with rivaroxaban. Acad Emerg Med. 2015;22(7):796-802. http://www.ncbi.nlm.nih.gov/pubmed/26111453 5. Zhang Y, Zhou Q, Zou Y, et al. Risk factors for pulmonary embolism in patients preliminarily diagnosed with community-acquired pneumonia: A prospective cohort study. J Thromb Thrombolysis. 2015. http://www.ncbi.nlm.nih.gov/pubmed/26370200 6. Sharp AL, Vinson DR, Alamshaw F, Handler J, Gould MK. An age-adjusted D-dimer threshold for emergency department patients with suspected pulmonary embolus: Accuracy and clinical implications. Ann Emerg Med. 2016;67(2):249-257. http://www.ncbi.nlm.nih.gov/pubmed/26320520 7. Kirschner JM, Kline JA. Is it time to raise the bar? age-adjusted D-dimer cutoff levels to exclude pulmonary embolism. Ann Emerg Med. 2014;64(1):86-87. http://www.ncbi.nlm.nih.gov/pubmed/24951413 8. Kline JA, Kabrhel C. Emergency evaluation for pulmonary embolism, part 2: Diagnostic approach. J Emerg Med. 2015;49(1):104-117. http://www.ncbi.nlm.nih.gov/pubmed/25800524 9. Kline JA, Courtney DM, Kabrhel C, et al. Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. J Thromb Haemost. 2008;6(5):772-780. http://www.ncbi.nlm.nih.gov/pubmed/18318689 Image credit: http://anthrocolors.deviantart.com/art/Lungs-for-fresh-air-edited-298950224 This podcast uses sounds from freesound.org by Jobro and HerbertBoland