Podcasts about tdap

How serious is whooping cough? Is whooping cough going around? How long does whooping cough last? What is the pertussis vaccine? What are the symptoms of whooping cough? Discussing pertussis in adults, treatment for whooping cough symptoms, pertussis vaccines and more with Alyssa Kuban, MD, associate medical director at Texas Children's Pediatrics Cypress. American Medical Association CXO Todd Unger hosts.

This week's episode takes a closer look at what's often left unsaid about vaccines before they're administered. I'm joined by Alexandra from Just the Inserts, who specializes in interpreting medical documents and decoding the fine print. Together, we break down what true informed consent should look like, discuss the history of vaccination, and examine the inserts for TDAP (during pregnancy), RSV, Hepatitis B (for infants), and the vitamin K shot at birth. We also explore contraindications, alternatives to vitamin K, and considerations for more individualized vaccine schedules. Click HERE to access today's shownotes.

Maingalarpar! Today, travel medicine specialists Drs. Paul Pottinger ("Germ") & Chris Sanford ("Worm") answer your travel health questions:Do I need anything beyond meningococcal vaccination before the Hajj?How can I prepare better for the chaos of TSA rules at the airport?Should I get a Tdap before visiting Peru?Is my phone subject to search when I cross the border?Is the USA the only high-income nation with measles transmission now?Are there harms from taking TOO MUCH vitamin A?What do you think of the resignation of FDA's top vaccine official?What should I do if I lose my glasses while I'm overseas?Should I stock up on antibiotics when I'm at a pharmacy overseas?Is it safe to rent a car internationally?We hope you enjoy this podcast! If so, please follow us on the socials @germ.and.worm, subscribe to our RSS feed and share with your friends! We would so appreciate your rating and review to help us grow our audience. And, please send us your questions and travel health anecdotes: germandworm@gmail.com.Our Disclaimer: The Germ and Worm Podcast is designed to inform, inspire, and entertain. However, this podcast does NOT establish a doctor-patient relationship, and it should NOT replace your conversation with a qualified healthcare professional. Please see one before your next adventure. The opinions in this podcast are Dr. Sanford's & Dr. Pottinger's alone, and do not necessarily represent the opinions of the University of Washington or UW Medicine.

With the Wind with Dr. Paul – Show 172: Pediatric Perspectives – Nutrition for Moms: Preconception and Early Pregnancy with Scott Hankinson, M.D. Presenters: Dr. Paul Thomas, Scott Hankinson, M.D. Length: Approximately 34 minutes Web Resources Discussed: VAX FACTS Book (Paperback): https://indiepubs.com/products/vax-facts/ VAX FACTS Book (Signed Author's Copy): https://www.kidsfirst4ever.com/store/p10/Personalized_and_Signed_Author%E2%80%99s_Copy_of_VAXFACTS%E2%80%93_What_to_consider_before_vaccinating_at_all_ages_and_all_stages_of_life.html Happy Bugs by Erin Hankinson and Dr. Scott Hankinson: https://www.amazon.com/Happy-Bugs-Erin-Hankinson/dp/B0BQXW571C Whole Foods Health – YouTube Pregnancy Series: https://www.youtube.com/@Wholefoodshealth Doctors and Science: https://www.doctorsandscience.com/ Kids First 4Ever: https://www.kidsfirst4ever.com/#/ Key Points (with time stamps): 00:00:40 – Dr. Paul's Intro: Dr. Paul introduces the VAX FACTS book and how to get your signed copy. 00:01:35 – Show Introduction: Dr. Paul previews a vital conversation on preconception and early pregnancy nutrition with OB-GYN Dr. Scott Hankinson. 00:03:03 – Nutrition and the Microbiome: Dr. Hankinson describes the profound impact of a diverse, high-fiber diet on both mom and baby's long-term health. 00:06:00 – Epigenetic Effects: Nutrition choices today can positively or negatively influence generations to come. The research shows it, and Dr. Hankinson breaks it down. 00:07:57 – The Vitamin D Connection: Discover how keeping vitamin D levels above 50 ng/mL can help prevent pregnancy complications like preeclampsia and miscarriage. 00:10:25 – Teaching Kids Gut Health: Dr. Hankinson shares his new children's book, Happy Bugs, which helps kids understand gut flora and the importance of a healthy microbiome. 00:12:18 – Caution Around Pregnancy Vaccines: Dr. Hankinson joins Dr. Paul in calling for true informed consent, raising concerns about the safety and necessity of Tdap, flu, RSV, and COVID shots during pregnancy. 00:15:22 – What Every Parent Should Ask: Before consenting to any intervention, Dr. Hankinson urges families to ask: “Where is the safety data?” Summary: In this empowering Pediatric Perspectives episode, Dr. Paul welcomes OB-GYN and educator Dr. Scott Hankinson for a critical discussion about the foundational role of nutrition during preconception and early pregnancy. They unpack the latest data on epigenetics, gut health, and vitamin D, while sounding the

Tonight, Abby presents her research on the adolescent portion of the vaccine schedule. We'll discuss the Meningococcal vaccine, the HPV vaccine (Gardasil), and briefly touch on the TDaP booster. This is installment 2 of our series on vaccines. You can find the first here: https://rumble.com/v6lk9ka-the-vaccine-conversation-s5-ep17.html?e9s=src_v1_ucp And here, you can find a list of vaccine research resources Abby has compiled and will continue to update: https://docs.google.com/document/d/1ctSD3J4I-aVNO3JSeopqIXRZkXDdUq4NhqgubGxHN4s/edit?usp=sharing ---------- Support the show and get bonus UNHINGED episodes ---------- LOCALS - https://conspiracypilled.locals.com/ MERCH - https://conspiracypilled.com/collections/all Join the DISCORD - https://discord.gg/c8Acuz7vC9 Give this podcast a 5 Star Review - https://ratethispodcast.com/conspiracypilled ---------- SPONSOR ---------- NORTH ARROW COFFEE - https://northarrowcoffee.co Use code CONSPIRACY10 to get 10% off your order! ------- FOLLOW THE HOSTS ------- Abby — @abbythelibb_ on X and InstagramLiz —- @adelethelaptop on XJon —- @Kn0tfersail on XMusic by : Tyler Daniels Become a supporter of this podcast: https://www.spreaker.com/podcast/conspiracy-pilled--6248227/support.

The stomach virus, COVID, cold, flu, RSV and whooping cough are going around. We're in the thick of germ season. Dr. Vickie Petz Kasper tells you the truth about how germs spread and how you can stay well and avoid catching them.  Tis the season to be coughing, catching all the germs and getting sick.  Whew, there really is a lot going around right now. So how can you keep from getting sick?  You've probably heard that the stomach bug is going around. The most common cause is the Norovirus. And January is typically flu and RSV season, and COVID levels are high. All three are increasing and this is not unexpected. Why is that? Well, because of all the travel and family gatherings, the number of people you are in close contact with on a daily basis usually consists of your immediate family, friends, and co workers. But over the river and through the woods, all those germs are coming to gather at Grandmother's house to spread like wildfire.   In this special edition episode, we're going to talk about how these six infections spread and what you can do to prevent it. But first, we need to go to mini medical school and learn about viruses and bacteria.  Pop quiz! Of the six diseases I mentioned, all but one is a virus. Do you know which one is caused by a bacteria? Norovirus, the common cold, flu, RSV, whooping cough, or COVID. Not sure? Well, listen close. I'll tell you as we review each one. But first, some basics. What is a virus? Well, it's a fragment of genetic information like DNA or RNA, and it's inside this protective shell that's called a capsid. And a lot of them look like a ball with these spiky things on it. They don't have any cells, and they're tiny. Their goal is to perpetuate, and they need a host to reproduce. And humans, well, we're so hospitable. We work great. First they attach to their host, and then they enter the host, and then they start replicating inside the host. Then they assemble more viral particles and whoosh, release them. And that, my friends, is a very, very brief overview and simplistic overview of how they make you sick.   One more thing. If you have a viral infection, an antibiotic will not do one frazzling bit of good. And that's what it says in all the medical textbooks, "Not one frazzling bit of good." And I know you want an antibiotic because you've got a lot of things to do and you want to get well fast. If you go to urgent care, you can probably snag a Z Pak pretty easily. But, if you have a viral infection, it won't do one frazzling bit of good. Now, why am I so passionate about that? I'll get to it in a sec, but let's first talk about bacteria. They're different. Bacteria are also tiny, but they have a single living cell. Some bacteria are actually good, and they keep you healthy.  And that's why taking an antibiotic when you don't need one is bad for you. Because if you kill off all the bacteria in your gut, that upsets the gut microbiome  for a long, long time. And what happens in the gut microbiome? Well, that's where neurotransmitters are made and where the immune system is regulated. I have some links in the show notes from previous episodes if you want to learn more about how the gut actually affects your brain and your mood.  Now, on the other hand, if you do have a bacterial infection, you need an antibiotic. Okay? Got it? Antibiotics are for bacteria, not viruses. Let's move on, starting with the stomach bug, which really isn't a bug at all. And I bet you already guessed that the stomach virus is caused by one of those spiky little pieces of genetic material that needs you to be its host.  The most common cause of the stomach virus is the Norovirus, and this one spreads easily, so it's super contagious. People with Norovirus infection can shed billions of invisible viral particles. That's billions, but it only takes a few to make you sick. And it doesn't really seem fair to stack the deck that way, especially since the end result is diarrhea, nausea, vomiting, and stomach cramps, and possibly headache, body aches, and fever. You get it from sick people, contaminated food or water, and surfaces. Now that last one's really important, and that's the reason that I always, always use the little wipes. to wipe down the handlebar of the grocery cart and I wash my hands as soon as I can.  And once you're exposed to the Norovirus, it takes about 12 to 48 hours to get sick. So it usually makes the runs through the household pretty quickly. You can get infected with Norovirus by ingesting little bitty tiny pieces of feces or vomit from an infected person. Yeah, mom and dad. That's why you're at risk when little Johnny brings this home from school. All that barehanded cleaning and caring for your sick splattering little one puts you at risk for going down for the count, too. Your biggest defense is wash your hands. with soap and water. Wash them often, and wash them good. And keep your hands out of your mouth, eyes, and nose.  This virus grows really nicely in big Petri dishes, otherwise known as cruise ships. And that's why they installed 974 hand sanitizer stations right in front of the food troughs. Hand sanitizer doesn't really work that great for this particular virus. Turns out good old fashioned hand washing is much better. So, maybe that cart wiping isn't doing much good, but it certainly won't hurt. Anyway, be careful what you touch and keep it out of your mouth and nose, and wash your hands. Now let's move on to the common cold. Quick question, virus or bacteria? You got it. Virus. Specifically the rhino virus. And remember, rhino means nose  and it's also a type of Corona virus.  That's right. Corona virus first identified in the 1960s and effectively killed by Lysol. Says it right there on the label.  Next question. If the common cold is caused by a virus, will an antibiotic help you recover faster? Nope. Can it hurt?  I hope you said yes, and if not, go ahead and hit rewind. The symptoms of a cold usually last less than a week, but can last up to two weeks. And they include runny, stuffy nose, headache, body aches, sore throat, fever, coughing, and sneezing. There's a link in the show notes on how to differentiate a cold from allergies. Different viruses are spread in different ways. The common cold is spread through droplets from an infected person and they find you when that person coughs or sneezes. You can breathe them in or you can get infected by touching a contaminated surface then touching your eyes, nose, or mouth. That's why it's recommended that you cough or sneeze into your elbow. Because if you cover your mouth and nose with your hands and then shake hands or touch something or a surface, then the virus uses that as an opportunity to hitch a ride onto someone else's hands. Then, if they touch their eyes, nose, or mouth, they're infected. So wash your hands and keep them out of your mouth, eyes, and nose.   Another virus that spreads by droplets is influenza. These droplets are spread when people with flu cough, sneeze, or even talk. You can also get it from touching surfaces than touching your mouth, nose, or eyes, but that's actually less common. Most of the time you catch it directly from another person. These little viral particles are within droplets that land right in your mouth or nose. And, relatively speaking, these droplets are kind of big. They're greater than 5 microns in diameter, so they don't really travel far because gravity just pulls them to the ground within about 3 feet. Now, once you're exposed, the virus goes to work pretty quickly and you typically get sick a couple of days later. Now, flu season is definitely upon us and it's spreading. When I was young, my mom had the flu and she said, She thought she was going to die and kind of hoped she would. Now personally, I don't ever recall having the flu. But it's serious. It can be fatal. And there are lots of different types of flu, and some cause more severe illness than others. So far this year, there have been 9 pediatric deaths, and it's early in the season. 3. 1 million cases of flu have been reported, resulting in 37, 000 hospitalizations and 15, 000 deaths. According to the CDC, flu is on the rise.  How do they know? Let's take a look at how the data is collected because it might surprise you.  They look at emergency room visits, hospitalizations, and the number of tests done for certain diseases and the percent positivity. And there are benchmarks for those. But that wouldn't really give us a total picture, would it? Because some people don't go to the doctor or the hospital.  Want to know a secret?   They're looking at your poop. No, not yours individually, but collectively. They study wastewater and test feces for these viruses. I mean, it's kind of brilliant, albeit really gross.  They even have a poop dashboard. Of course, they have a more sanitized named for it. It's a Wastewater data. There's a link in the show notes if you're interested or if you don't believe me. And honestly, it's pretty fascinating if you're ready to geek out. I just wonder if they advertise on LinkedIn, looking for a CPA, a chief poop analyst. Qualifications must understand virology, statistics, and have a high tolerance for gross things. And maybe they got the idea from Teenage Mutant Ninja Turtles. Who knows? Okay, enough of that.  Now we call influenza flu for short and moving on, we call respiratory Syntcial virus, RSV for short. And the normal RSV season is late fall to winter, though that, again was thrown out with a lot of other things during the pandemic.  Wanna guess how it spreads? Just like the flu and the common cold, RSV spreads through droplets. You already knew it was a virus, I mean, it's right there in the title. But, it's the same old viral tactic. Somebody who's infected coughs or sneezes, the droplet travels the short distance between you, and  you breathe it in. This virus can survive on hard surfaces like door handles and tables for many hours. So, if you touch it and introduce it into your mouth, nose, or eyes, It can spread that way. It can also live on your hands or a used tissue, but not for very long. So what should you do?  That's right. Wash your hands and don't touch your face. Now, this is important. RSV can infect anyone at any age and more than once in their lifetime. In fact, nearly everyone gets it before their second birthday. But here's the deal. Babies can get really sick from it. And you can give it to them by kissing their face. So yeah, Grandma, this is one reason that new moms tell you, Don't kiss my baby. The other is the herpes virus, which causes fever blisters, but it can be fatal to newborns.  RSV can cause severe illness, hospitalization, pneumonia, and death in older adults too. So if you're sick, stay at home. Seriously, don't share your germs. When it comes to respiratory viruses, clean air also helps. That means HEPA filters for indoor air, or if you live in the South, you can probably open some windows except maybe those 13 or so days when we get bitter cold and ice. Anyway, just wash your hands and cover your mouth and nose when you cough or sneeze, spray the Lysol, keep your distance, wipe down the surfaces. There's just not a lot of variety in these recommendations and following them just might protect a vulnerable little baby or a precious elderly grandma. And that logically helps me segue to COVID. You knew we were going to talk about COVID, didn't you? Transmission rates are really high right now. And here's a test I bet you'll ace. Is COVID a bacteria or a virus?  Bingo. Let's go a step further. COVID 19 is a coronavirus. And remember, there are lots of different kinds, but there is something very unique about COVID, and that is how it's spread. And hopefully you already know this, but let me remind you that COVID 19 is not spread the same way as the common cold, RSV, or the flu. And this is one of the things that made it so scary and dangerous. You see, COVID is airborne. Instead of hanging out in big heavy droplets that fall quickly to the floor, it floats along through the air. So you can literally get it from someone who isn't even in the same room with you. Think about a small bathroom where someone has coughed and then you go in, breathe in the little viral demons and get sick. It even traveled through ventilation systems in heavily populated apartment complexes. For the most part, the COVID virus spreads among people who are nearby. Basically, talking distance, coughing, sneezing, singing, and even breathing distance. And the louder you talk or sing, the further these little particles travel. We call it aerosolization.  I mean, think about hairspray in an aerosol can. You spray it, it gets on your jewelry, the mirror, your glasses, your husband comes in and starts fanning the air. Except these particles aren't big enough to declare their presence floating in the air.  Depending on the ventilation, airborne diseases can travel more than six feet and hang around for hours floating in the air.  Fortunately, there are not a lot of airborne diseases, but there are a few, like tuberculosis and measles. which is also on the rise and will likely continue to increase.   Remember when we didn't know how COVID was spread? I traveled to my daughter's during that time to see my grandbaby and drove eight hours without stopping to eat and only once to get gas and go to the bathroom. I wore gloves and an N95.  I never got into washing my groceries but I did wear an N95 a lot plus I worked in a hospital so there's that. Now you can touch a contaminated surface and get COVID through your eyes, mouth, and nose. So do the drill. Wash your hands. Don't touch your face. But it's that airborne aspect that made it different. Besides the fact that it was a novel coronavirus and we just didn't have any immunity.   The pandemic highlighted the need for America to get healthy too. Obesity was associated with poorer outcomes. And now we have GLP 1 agonists, which are helping people control obesity because it's so much more than willpower and determination. I put a link in the show notes about GLP 1 agonist and obesity, but listen, we still need to be physically active and eat whole food.  Now, we've talked about five viruses, Norovirus, rhinovirus that causes the common cold, influenza, RSV, and COVID, but what about whooping cough? Virus or bacteria?  You guessed it, whooping cough is caused by Pertussis Bordetella. And this bacteria is very contagious. It spreads easily through the air when someone coughs. And boy, do they cough. Sounds like a big wheeze before this violent coughing fit and a shower of germs. It lasts a long time and people are contagious for two weeks. And that cough can linger for months. You may be wondering, if it's a bacteria, should you take an antibiotic? And the answer is yes. But, for this one, you've got to take them early.  Not everyone gets that classic whoop. that gives it its name. Some people just get a little tickle and a cough and maybe they don't even know they're sick or their doctor tells them they have bronchitis or a sinus infection. And those are the ones you've got to watch out for because they can spread it. And like RSV in babies, it can be life threatening. Babies don't cough, they quit breathing. And one third of infants less than one year old who get whooping cough require hospitalization. Wow, that's serious. And that is why, when I was practicing obstetrics, I always recommended that my pregnant patients and everyone who was going to be around the newborn get a booster shot called Tdap. It stands for tetanus, diphtheria, acellular pertussis. Now let me stop right there. And I want you to hear me.  I really wanted to do this episode because promoting health is the whole goal of this podcast. I want to give you information, motivation, inspiration. to take measures to protect and improve your health. When it comes to seasonal illnesses, it's important to have a good baseline health and a strong immune system. That means a healthy gut microbiome, a healthy weight, and controlling risk factors like diabetes and hypertension.  I really care about you and I have no intention of wading into controversial waters.  So, if you have strong emotions when it comes to vaccines, Push stop on this podcast. But I really do care about you and I'm gonna keep this part really short. But if you want to have a further discussion about vaccines, I will literally schedule a call with you. Just email me, DrVickie@healthylooksgreatonyou.com and we can talk about it. Please don't send me hate mail, but if you do, I'll respond with love and grace  because I don't want this information which is rooted in solid science, evidence, research, medicine, and statistics to interfere with our relationship.  I'm not asking you to respect my opinion or anyone else's because this is not about opinion and it's not about respect.  But you see, that is something that changed with the pandemic. Distrust was sown  and maybe deserved. Maybe there was something nefarious, but there was also a lot we just didn't know. And as we learned and we learned quickly, things changed. Anyway, talk to your doctor is the best advice I can give you.  I remember when the chicken pox vaccine came out, my son was two years old and he had asthma. And I was a little leery because it was a new vaccine. I talked to my pediatrician and he advised giving it. Two years later, my son's preschool had to shut down because every single kid had chicken pox. Except my one little vaccinated boy. They even had to cancel preschool graduation because yeah, that's a thing. Instead of telling you what I do or what I know or how I feel, let me preface all of this by saying I've been a medical doctor for three decades. I was chief medical officer of a hospital for seven years, including the pandemic years, and I know what I saw firsthand. I do a lot of research from reputable sources for each podcast episode. So if you trust me, keep listening, but again, if you have strong feelings, now is the time to stop listening and you can tune back in next week. We'll pick up on the dementia series and talk about things we can agree on. I mean, we don't all have to agree on everything to be friends, do we?   Okay, I already told you that I recommended that all my pregnant patients get Get Tdap to protect their babies, and this is based on recommendations from the CDC, the American Academy of Pediatrics, and the American College of Obstetrics and Gynecology, all reputable organizations. They also recommend the flu shot. Now, vaccine reactions are real. but they're rare. I don't personally know of a pediatrician who does not vaccinate their children. They see firsthand what these infectious diseases can do.  Now, I'll admit doctors have various opinions because they have various perspectives and we call that bias. Think about it. If a doctor only works in an outpatient clinic, they may have tons of experience treating some infection and what they do supports their beliefs.  But they don't know what goes on in the emergency room or the hospital. And the doctors that do have a different bias. And this was especially true during COVID.  There were a lot of sayings that went around during COVID, like, what about the obesity epidemic? Why are we not talking about that? And I think we should be talking about it. Or what happened to the flu? Did it suddenly disappear? Well, it turns out that social distancing, washing your hands, wearing a mask, avoiding crowded places prevents the flu too. It's recommended that everyone over the age of 6 months get a flu shot.  And if you're concerned about mercury or thimerosal, you'll be glad to know that single use vials of the flu shot don't contain any and haven't in many, many years. Now, remember I told you that I've never had the flu? You see, after my mom had it, she made sure we were vaccinated every year. And I continue to get the flu shot every year. I gave it to my kids every year. It is a killed virus. And you cannot get the flu from the flu shot. And yes, I know, you may have gotten the flu shot and then gotten the flu. And there's several reasons for that. Number one, the vaccine typically is only between 40 and 50 percent effective. Number two, it takes a couple of weeks before it works, and you might have gotten exposed to the flu right before you got the vaccine or right after before your immunity kicked in. You may also get the flu right after you drink a Coke.  That doesn't mean the aluminum can caused it, and I'm sorry if that was a little snarky, but correlation does not equal causation, and that's super important when you're looking at data rather than anecdotal experiences.   I remember how excited we were at the hospital when the COVID vaccine was delivered. I even took a video on my phone. It made a huge difference in the death rate we were seeing. And as soon as it was available, I got the COVID vaccine and all the boosters until the virus mutated enough to not really cause severe disease in most healthy people. I would still get it if it prevented COVID. But unlike what we thought at first, the COVID vaccine does not prevent COVID or the spread of COVID, just the severity of the disease, hospitalization, and death.  Not that that's not important.  The RSV vaccine is recommended for people age 60 and over. And there is a form of it that's available for newborns who are at risk.  Again, Tdap is recommended for pregnant women during every pregnancy and for anyone who's going to care for the baby.  Vaccines in pregnancy, like flu and Tdap, are given later so that those maternal antibodies can help protect the baby when they're too young to be vaccinated.   I know, attitudes have really shifted about vaccines. I remember when I was in the second grade, they lined us up at school and shot us in the arm with the same air gun to vaccinate us against smallpox. Remember smallpox? That disease has literally been eradicated from the face of the earth by vaccines. We all got it at school, and I'm not even sure our parents knew we were going to get it, but my mom is an ardent supporter of vaccines. Wanna know why? In a word, surely. You see, she had a cousin who was in an iron lung at the age of 17 from polio. It was a dreaded disease and the vaccine was a huge victory against this debilitating illness.   I guess people have a reason for believing what they believe. If you've seen devastation from an illness or from a vaccine, you're gonna have strong feelings and rightfully so. I've seen what I've seen and you've seen what you've seen. So, please send me an email if you want to continue the conversation. But I think we can all agree, keep your germs to yourself, wash your hands, get some fresh air, don't touch your face, and stay healthy. Because healthy looks great on you.        The information contained in this podcast is for educational purposes only and is not considered to be a substitute for medical advice. You should continue to follow up with your physician or health care provider and take medication as prescribed. Though the information in this podcast is evidence based, new research may develop and recommendations may change. RESOURCES: Is it allergies? Weight loss injections What causes obesity? Gut Health, food and mood Wastewater dashboard Email me        

It appears that Viral Hemorrhagic Fevers – Lassa Fever, Ebola and Marburg virus are getting all the press. However, Pertussis (whooping cough) is an area that needs focus. The cases for 2024 are at least four-times higher than in 2023, and many departments have not offered the required Tdap booster to protect healthcare personnel. An additional dose of Tdap was first recommended in 2005 and then again in 2011. Pertussis is not on the radar, and we need to ensure that healthcare providers are protected. This session addresses vaccine, personal protective equipment and post-exposure medical follow up.

Saturday, November 9: Girls Beer Sports: Sexy Tdap by FiredUp Network

Shawna and LaLa cover it all this week—from hurricane recovery in Florida to an unforgettable Halloween night with Gio and Giulina. Shawna gives an eye-opening review of a luxury, but disability unfriendly resort, while LaLa dishes on a tense exchange with Gio's doctor over the Tdap vaccine. They also chat about their memorable visit with Brian Kilmeade, diving into history, liberty, and plenty of laughs.

Welcome Back to another episode of "You ask, We Answer"! As Abrysvo (RSV vaccine) now has some time on the market, some women may find themselves with a subsequent pregnancy after first receiving the injection in the prior pregnancy. Is another RSV vaccine recommended with each pregnancy, like TDap? The answer to that question depends on where you live. We will discuss in this episode. PLUS, have you heard of CLITOXIN? Its a little botulinum toxin injected into the clitoris for "enhanced sexual response". Is that evidence-based? Is there data for that?! Listen in for details.

Michelle Fiscus, MD, FAAP from the Association of Immunization Managers (AIM) joins host Chris Stallman, CGC to discuss respiratory virus season and what pregnant people can do to help protect their babies against RSV, COVID-19, Seasonal Influenza (flu) and whooping cough (pertussis).   Resources mentioned in this episode: Association of Immunization Managers: Immunizationmanagers.org BOOSTRIX Tdap Vaccine - MotherToBaby Pregnancy Study

Tdap is an inactivated vaccine that protects you against three different illnesses: tetanus, diphtheria, and pertussis. Pertussis is commonly known as whooping cough. The Tdap vaccine is recommended between 27 and 36 weeks of pregnancy. The main reason any vaccine is recommended during pregnancy is for the passive immunity your baby receives. Vaccines are a complex and often controversial topic. This episode follows a systematic approach that includes thorough research to evaluate the safety and efficacy of the Tdap vaccine.     Thank you to our sponsor   Zahler goes above and beyond to use high-quality bioavailable ingredients like the active form of folate, bioavailable iron, and omega 3s. The Zahler Prenatal +DHA is my #1 recommendation for a high-quality prenatal vitamin. In October 2024, you can save 40% off the Zahler Prenatal +DHA on Amazon with the code PREPOD40. You can always see the current promo code for the Zahler prenatal vitamin by clicking here.     Read the full article and resources that accompany this episode.     Join Pregnancy Podcast Premium to access the entire back catalog, listen to all episodes ad-free, get a copy of the Your Birth Plan Book, and more.     Check out the 40 Weeks podcast to learn how your baby grows each week and what is happening in your body. Plus, get a heads up on what to expect at your prenatal appointments and a tip for dads and partners.     For more evidence-based information, visit the Pregnancy Podcast website.

In this episode we talk what is the most popular beer brand in each state, UK has a huge road win at Ole Miss and week 5 of college football is in the books.  Week 6 pick'em, what state would be the best and worst name for a kid, two vastly different Halloween costumes for sale, a side of pimento cheese, steak butter and more!

Hi, travel health listeners! Today, travel medicine specialists Drs. Paul Pottinger ("Germ") & Chris Sanford ("Worm") answer your travel health questions:When should I get a tetanus booster?Why do I toot when I fly? Why does flu usually come from Southeast Asia each winter? Wassup with Alaskapox?Why are viruses named for the place where they are discovered?Can I safely get a tattoo in Thailand?Tips for traveling with young kids?We hope you enjoy this podcast! If so, please subscribe to our RSS feed and share with your friends! We would so appreciate your rating and review to help us grow our audience. And, please send us your questions and travel health anecdotes: germandworm@gmail.com.Our Disclaimer: The Germ and Worm Podcast is designed to inform, inspire, and entertain. However, this podcast does NOT establish a doctor-patient relationship, and it should NOT replace your conversation with a qualified healthcare professional. Please see one before your next adventure. The opinions in this podcast are Dr. Sanford's & Dr. Pottinger's alone, and do not necessarily represent the opinions of the University of Washington or UW Medicine.

Send us a Text Message.Welcome back to the July Q&A with Cynthia & Trisha. Today we kick off the episode with one mother's story of her transition from OB to midwife to an unintentional free birth her 9 pound, 4 oz baby born at home in her bathroom and then the premium medical bill she received from her OB for "extra counseling time." Next, we jump into our questions starting with:Do twin moms need extra medical help to get their labor going because the mother's uterus is more stretched out?What is your opinion on faith-based midwives and how their beliefs may influence how they care for you?Do you have any tips for managing the postpartum period with a toddler?What do you recommend regarding the TDAP vaccine in pregnancy?Does having a hemorrhoid that bleeds pose any risk to giving birth at home?And in the extended version of today's episode available on Patreon and Apple subscriptions, you'll hear the following:Should I be worried about gaining 55 pounds "already" in my pregnancy?What is your opinion on low progesterone and what do you recommend for supplementing? (You'll hear which product is no longer FDA-approved, after years of use.)Is it normal to leak colostrum in pregnancy and does it indicate anything about my milk supply?As always, we close with a round of quickies touching on Botox in pregnancy, breastfeeding acne, NSTs, breastfeeding and tooth decay, breast pumps, compressions stockings, toddler immune systems, fashion trends, and foods we won't touch.Thank you for your wonderful questions as always, and please keep them coming at 802-438-3696 or 802-GET-DOWN.**********Down to Birth is sponsored by:Davin & Adley-- The perfect nursing and pumping bra combinedSilverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Our favorite nutritional products to nourish yourself before, during, and after pregnancy.Use promo code: DOWNTOBIRTH for all of the above sponsors.DrinkLMNT -- Purchase LMNT with this unique link and receive a free 8-day supply. Be sure to use the unique link to buy yours today. Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

SummaryIn this episode we chat with Dr. Romy Ghosh about what pregnancy care looks like when under the care of an Obstetrician. She chimes in on routine tests and procedures in pregnancy, including dating ultrasounds, prenatal labs, and genetic testing. She explains the importance of these tests and how they help monitor the health of both the mother and baby. Dr. Ghosh also talks about the vaccines offered during pregnancy, such as Tdap, RSV, and flu vaccinations. She highlights the role of RhoGAM in preventing complications for Rh-negative mothers. The conversation emphasizes the importance of patient education and the benefits of collaborative care with doulas. In this conversation, Dr. Romy Ghosh discusses various aspects of prenatal care and what patients can expect during pregnancy and childbirth. She emphasizes the importance of individualized care and shared decision-making, highlighting the need for patients to find a provider who aligns with their preferences and values. Dr. Ghosh also discusses the significance of certain tests and procedures, such as the 20-week scan and gestational diabetes testing. She explains the routine procedures during labor and the immediate postpartum period, including the administration of postpartum Pitocin and vitamin K. Overall, the conversation emphasizes the importance of trust, communication, and personalized care in ensuring a positive birthing experience.  TakeawaysRoutine tests and procedures in pregnancy include dating ultrasounds, prenatal labs, and genetic testing.Vaccines offered during pregnancy include Tdap, RSV, and flu vaccinations.RhoGAM is important for Rh-negative mothers to prevent complications.Patient education is crucial in understanding the purpose and benefits of these tests and vaccines.Collaborative care with doulas can provide additional support and guidance throughout pregnancy. Finding a provider who offers individualized care and aligns with your preferences is crucial for a positive birthing experience.Certain tests and procedures, such as the 20-week scan and gestational diabetes testing, are highly recommended for their potential to detect abnormalities and ensure the well-being of both the mother and baby.During labor, routine procedures include monitoring vital signs, checking the cervix, and administering postpartum Pitocin to prevent postpartum hemorrhage.The immediate postpartum period involves evaluating the placenta, assessing for tearing, and administering erythromycin, vitamin K, and hepatitis B vaccination to the baby.Open communication, trust, and shared decision-making between the patient and provider are essential for a positive birthing experience.Patients should research and interview potential providers and consider seeking recommendations from labor and delivery nurses.  Dr. Romy Ghosh, MD, FACOG can be found on Instagram here: @dr.romyghoshwww.austinregionalclinic.com/doctors/romy-ghosh  Thank you to our sponsor, Birth, Baby! Academy. You can find them at www.BirthBabyAcademy.comPlease feel free to reach out to us with any recommendations for show episode ideas. If you'd like to be a guest, email us with some information about yourself and what type of podcast you'd like to record together. Thank you for all of your support and don't forget to follow and review our podcast, Birth, Baby!  Instagram: @‌BirthBabyPodcastEmail: BirthBabyPodcast@gmail.comWebsite: https://birthbabypodcast.transistor.fm/  Intro and Outro music by Longing for Orpheus. You can find them on Spotify! (00:00) - Routine Tests and Procedures in Pregnancy (19:40) - Vaccines During Pregnancy (21:49) - RhoGAM for Rh-Negative Mothers (25:07) - Patient Education and Empowerment (26:02) - The Importance of Individualized Care and Shared Decision-Making (27:59) - Key Tests and Procedures in Prenatal Care (30:24) - The Significance of the 20-Week Scan (32:42) - Routine Procedures During Labor (36:19) - The Role of Trust, Communication, and Personalized Care (42:32) - The Immediate Postpartum Period (45:23) - Finding the Right Provider

Please Subscribe and Review: Apple Podcasts | RSS Submit your questions for the podcast here News Topic: Dr Malcolm Kendrick: We have a judgment (Part 1) Show Notes: Addicted to Nicorette Snippet from episode 126 Dark Horse Wouldn't Put it Past ‘Em: The 228th Evolutionary Lens with Bret Weinstein and Heather Heying Links to vaccine related X posts by @AaronSiriSG: Chicken Pox HepB Polio Pertussis (Whooping Cough)   Questions:    Nicotine Pouches Anonymous writes: Nicotine pouches have taken the tech sales world by storm, as they have taken many worlds by storm. At first, you notice a coworker or boss lipping them, then at a team dinner after a cocktail or two you become curious and try one. Then you want a shared experience at work so you begin bumming some around the office with friends. Next thing you know you're buying sleeves of them and using 4-6 a day… Because of the little research on them, most info on nicotine is in relation to cigarettes or tobacco chew, which both of these things I would imagine are way worse and have many more chemicals and bad shit in them, and are linked to poor cardio vascular health and increase risk of stroke, cancer and clogged arteries. Beyond the addictive nature of nicotine, what major health risks am I inviting in by using these nicotine pouches? (The brand I'm using is Zyn). Am I potentially hardening or clogging my arteries? Or increasing my cancer risk? Mouth cancer or otherwise? Weirdly enough I've actually noticed some potential health benefits of using them. My urge to drink alcohol has pretty much vanished. I would usually have a couple cocktails Thursday nights to unwind from the stressful week and get ready for the weekend, then continue drinking through the weekend having about 3-4 drinks a day (beer, wine or cocktails) to reward myself for the week. Now, I'll go weeks without drinking at all, or maybe the occasional 2 lite beers a week or a glass or two of red a week. Before, once I had my first drink, I would continue to seek out more drinks (but usually never more than 4 or maybe 5). Now, if I have one or two I can easily walk away from booze. It's like that little urge to seek more has just gone away. They have a similar effect on food, diminishing the urge to overeat or eat junk foods. I know everything is a trade off. But to me it seems like swapping alcohol for nicotine pouches is a fairly positive trade off. But please let me know what you think, would love to know your thoughts on the potential negatives of these little lip pillows.   Prenatal/Childhood vaccines  Maizy writes: Dear Robb and Nikki, my boyfriend and I (28yrs old) (long time listeners) are expecting our first child at the end of summer! We are in Vancouver, Canada. There's a lot of pressure and confusion around the vaccines for pregnant mama and baby. They especially want me to get a TDaP shot, antibiotics during labour (if I'm Strep B positive) and then there's the Vitamin K shot at birth, the antibiotic eye drops, and then there's the whole infant/childhood vaccine schedule… We are in over our head and don't know what to do or believe. They put the fear of God into you. They basically tell you your baby might die unless you do the “recommended” protocol. We want to do the right thing and give our baby the healthiest start we can. But we didn't get the Covid Jabs and have lost a lot of faith in the mainstream sick-care system. Seeking any advice. Thank you!   Sponsor: The Healthy Rebellion Radio is sponsored by our electrolyte company, LMNT. Proper hydration is more than just drinking water. You need electrolytes too! Check out The Healthy Rebellion Radio sponsor LMNT for grab-and-go electrolyte drink mix packets and the new LMNT Sparkling electrolyte performance beverage! Click here to get your LMNT electrolytes  

In this episode Dr. Joel Warsh, board-certified pediatrician and father, joins us to chat all about the newborn stage and options that we moms have to get more informed, educated, and have better resources to be able to make informed decisions!He answers questions like:What are your TOP 3 questions to ask when it comes to interviewing a pediatrician when a mom is pregnant?What are your thoughts on the TDAP vaccine when pregnant? Hepatitis B vaccine: What is it, and why would our baby need it or not need it at birth?Vitamin K, what is it and why would our babies need it or not need it?What is the hospital's eye ointment and why would our babies need it or not need it?When is best to bathe our newborns?When should newborns recover their birth weight by? And when is it a true concern and supplementing is needed?How often should we wake the newborns up during this sleepy first couple of weeks?At what point can we allow THEM to let us know day vs night?How frequent should newborns pee and poop during those weeks to have confirmation that they are eating properly?What are the top tips to protect their immune system when it comes to our lifestyle and boundaries with social outings and people?Do all babies need to follow the CDC recommended vaccine schedule? Do we as moms have flexibility to choose the quantity and schedule of our kid's vaccines? What are your favorite vaccine resources to get informed?Do all breastfed babies need Vitamin D supplement?What's the best newborn routine "schedule" to follow.When do you recommend adding a nighttime routine?What are your recommendations of things to look for in a nanny or daycare?Any red flags to keep an eye out for? Their breathing patterns? Noises? Skin rashes? Fever? Congestion? How would you treat a low fever?When is it time to take baby to the pediatrician or urgent care instead?This and much more, a great listen for first time moms and even moms of multiples who want to make better, more informed decisions this time around! There's always so much room to learn and grow.And below, you'll find info on Dr Joel Warsh:InstagramBook prereleaseParenting communitySupplementsRequest preview of book chapters:drgator@integrativepediatrics.comSend us a Text Message.Follow us on Instagram for more updates, bts and ask us episode questions @momfriendspodYou can also follow us on our personal accounts @rrayyme & @laura.gimbertAnd remember to subscribe so you don't miss any of our episodes, out every Tuesday!This podcast does not provide any medical advice. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen.

This episode completes the tragic story of Avi's passing by hospital error.  This is Part 2.Although the cause of his original problem was TDap vaccine we did get him well after two heart attacks and a stroke. There was nothing wrong with his brain and his heart and body were healing after we initially got him well with homeopathy and botanicals and music. He was set to come home the day he died. The point of this episode is to encourage anyone who has experienced a fatal hospital error of a loved to talk about it, write about it, do a solo show about it. We need all of our stories in order to change the way hospitals operate. We must have access to natural medicine, to homeopathy in particular in the ICU. Once you experience what can be done to help alleviate suffering through these methods, to see how a person can get out of an induced coma we must realize this is our inherent right. To use what we know to heal. Overturn the upshot of the Flexner Report. Bring back natural medicine to all phases of healing. Have a well-trained homeopath and naturopathic medical doctors at all hospitals. With our health or sick care system crumbling we must have alternatives, we must make our way to a whole new paradigm in hospital care, let alone any other care.Have a blessed week and thanks for listening!XOdrheatherherington.com.  e: drheatherh@icloud.com. Support the Show.#transformingtrauma #medicalfreedom #homeopathy #loveheals #naturopathicmedicine #druglessmedicine #energymedicine #expressiveartsheal #empoweredvoices #knowledgeispower #singtohealthyroids #erasetoxiclegacies #peaceispossibleNew book: Transforming Trauma, a drugless and creative path to healing PTS and ACE is published by Hammersmith Books is available globally.Also Surviving a Viral Pandemic through the lens of a naturopathic medical doctor. On Amazon both paperback and eBookFlawed, a novel - an eccentric family saga - is on Amazon both paperback and eBookThe Sting of Absence, a novel - coming soon!!Workshops and retreats coming.website: drheatherington.comemail: drheatherh@icloud.comBreathe in and out slowly and gently wherever you are. We will survive this dark time of the world. It starts with you: standing, jumping, singing in the light of the divine.

Shasta Regional Medical Center was fined $155,000 for violations in 2023. Also, a new all-you-can-eat sushi restaurant is now in the old IHOP building, and students in Butte County can get the Tdap (or DTaP) and HPV vaccines free of cost at several upcoming clinics.

Richmond and Henrico Health Districts officials have distributed 945 immunizations for 714 students in Henrico and Richmond public schools this spring, according to the RHHD. The immunizations were part of an effort that began in February and will run through the late spring and summer. To date, RHHD officials have held 27 immunization events in public schools. Students have been vaccinated against tetanus, diphtheria, and pertussis (Tdap); and meningitis (MenACWY). The vaccines were administered by RHHD nurses who coordinated with and supported Richmond and Henrico public school nursing staff. “We've really hit the ground running this spring,” said RHHD Public...Article LinkSupport the show

Title: A Parent's Guide to Healthy Children: Insights from Pediatric Perspectives Presenters: Dr. Paul: Host, advocating for children's health from a critical and informed perspective. Elizabeth Mumper, M.D.: Guest, a pediatrician with a focus on the impact of vaccines on children's health. Length: 23 minutes and 48 seconds Key Points: Discussion on a new ebook by Children's Health Defense titled "A Parent's Guide to Healthy Children," covering health from preconception to early childhood. Concerns about administering vaccines during pregnancy, with a critical examination of the efficacy and safety of flu, TDAP, COVID, and RSV vaccines for pregnant women. The impact of environmental toxins on children's health and strategies for promoting neurological development and gut health in infants. Reevaluation of the CDC's vaccination schedule based on emerging data on vaccine risks and the changing environmental context affecting children's health. The importance of informed consent and supporting parents in making health decisions free from pharmaceutical influence. Summary: This episode of Pediatric Perspectives, hosted by Dr. Paul, features Dr. Elizabeth Mumper discussing critical issues regarding children's health, particularly in relation to vaccination practices and environmental factors. The conversation revolves around the content of a new ebook aimed at guiding parents through healthy practices from preconception to early childhood. Both experts express concerns about the safety and necessity of administering certain vaccines during pregnancy, citing specific examples and studies that question mainstream vaccine recommendations. They advocate for a cautious approach to vaccination, emphasizing the importance of environmental health, gut flora, and avoiding toxins. The episode also highlights the significance of informed consent and challenges the one-size-fits-all approach to pediatric care. Conclusion: Dr. Paul and Dr. Mumper conclude that parents should be empowered to make informed health decisions for their children, supported by critical analysis and a comprehensive understanding of both the risks and benefits of medical interventions. The ebook mentioned is presented as a valuable resource for parents seeking to navigate the complexities of raising healthy children in today's world, offering an alternative perspective to the prevailing medical advice influenced by pharmaceutical interests.

Dr. Lisa Law and Dr. Randy Taplitz share the latest evidence-based recommendations from ASCO on vaccines in adults with cancer. They discuss recommended routine preventative vaccinations, additional vaccinations and revaccinations for adults undergoing HSCT, CD19 CAR-T treatment, or B cell-depleting therapy, guidance for adults with cancer traveling outside the U.S., and recommendations for vaccination of household and close contacts of adults with cancer. Dr. Law and Dr. Taplitz also share their insights on the guideline, including the importance of this guideline for adults with cancer and their clinicians, future advances in research, and current unmet needs. Read the full guideline, “Vaccination of Adults with Cancer: ASCO Guideline” at www.asco.org/supportive-care-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/supportive-care-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO.24.00032       The ASCO Specialty Societies Advancing Adult Immunization (SSAAI) Project is supported by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award to the Council of Medical Specialty Societies (CMSS) (with 100 percent funded by CDC/HHS). The contents are those of the authors and do not necessarily represent the official views of nor endorsement, by CDC/HHS or the U.S. Government. Brittany Harvey: Hello, and welcome to the ASCO Guidelines Podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts.  My name is Brittany Harvey, and today, I am interviewing Dr. Lisa Law from Kaiser Permanente and Dr. Randy Taplitz from City of Hope Comprehensive Cancer Center, authors on “Vaccination of Adults with Cancer: ASCO Guideline.” Thank you for being here, Dr. Law and Dr. Taplitz. Dr. Lisa Law: Thank you. Dr. Taplitz: Thank you, Brittany. Brittany Harvey: Before we discuss this guideline, I'd like to take note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Taplitz and Dr. Law, who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes.  So then, to dive into the content, here first, Dr. Taplitz, can you provide a general overview of both the scope and purpose of this guideline on vaccination of adults with cancer? Dr. Randy Taplitz: Yes, so people with cancer often experience a compromised immune system due to a variety of factors. This includes chronic inflammation, impaired or decreased function of the hematopoietic system, and treatments that compromise their immune function. Because of this, people with cancer are at a higher risk for infection, including with vaccine-preventable diseases. Also, response to vaccines in patients with cancer may well be affected by this underlying immune status, and their anticancer therapy, as well as the severity of the underlying malignancy. The purpose of vaccination in this group of patients is to prevent infection or to attenuate the severity of the disease when infection cannot be fully prevented.   This ASCO review builds on a 2013 guideline by the Infectious Diseases Society of America, or IDSA, and uses what's called a systematic literature review of 102 publications between 2013 and 2023. This includes 24 systematic reviews, 14 randomized clinical trials, and 64 non-randomized studies. The largest body of evidence in these studies, not surprisingly, addresses COVID vaccines on the efficacy and safety of vaccines used by adults with cancer or their household contacts. ASCO convened an expert panel to review this evidence and formulate recommendations for vaccinations in this population. Brittany Harvey: Understood. I appreciate that context, Dr. Taplitz. So then, next, Dr. Law, I'd like to review the key recommendations of this guideline. The guideline addresses four overarching clinical questions. So starting with the first question, what are the recommended routine preventative vaccinations for adults with cancer? Dr. Lisa Law: Thank you, Brittany. Before I start, I just want to wholeheartedly thank the first author of this paper, Dr. Mini Kamboj, Dr. Elise Kohn from the NCI, as well as the ASCO staff in putting this publication and guideline together. It is a very, very important guideline, and I echo everything Dr. Taplitz just said.  So going back to your question, what are the recommended routine preventative vaccines for adults with cancer? As per this guideline, there are about 7 to 8 based on patient age and risk. Namely, they are: seasonal flu, RSV for those aged 60 or above, COVID-19, Tdap, Hepatitis B, Shingrix, Pneumococcal vaccine, and the HPV vaccine. These vaccines should ideally be given two to four weeks before therapy. However, non-live vaccines can be given anytime during or after chemo, immunotherapy, hormonal treatment, radiation, or surgery. Brittany Harvey: Excellent. Thank you for reviewing those vaccinations and the timing of them as well. So then, following those recommendations, Dr. Taplitz, what additional vaccinations and revaccinations are recommended for adults undergoing hematopoietic stem cell transplantation, CD19 CAR-T treatment, or B-cell depleting therapy?  Dr. Randy Taplitz: Many studies have shown that stem cell transplant recipients essentially lose immunity from childhood immunizations, and we know that these individuals are very vulnerable to infection, particularly in the first year after transplant. Revaccination is critical to help restore their immunity. The optimal timing of vaccination is based on our understanding of adequate immune reconstitution with B and T-cell recovery so that the individual can mount a response to the vaccine. We know that a lot of factors influence this immune reconstitution, including the age of the stem cell transplant recipient, the source of the donor, the time from transplant, graft-versus-host disease prophylaxis, the treatment and severity of graft-versus-host disease, and the vaccine type and antigens used.   There are a number of bodies throughout the world, IDSA as I mentioned, CDC, American Society for Transplant and Cellular Therapy, European Society for Blood and Marrow Transplant, and European Conference for Infections and Leukemia. All of these bodies have guidelines that approach vaccination in stem cell transplants. However, variation does exist in the use of a variety of things including whether to use immune predictors to help guide vaccination, and there is really not consensus on whether this immune predictor guided vaccination is more likely to produce a protective immune response versus a standardized schedule. In addition, the duration of protection is incompletely understood.  The bottom line in these guidelines is that they recommend complete revaccination starting for most vaccines at 6 to 12 months after stem cell transplant, in order to restore vaccine-induced immunity. And I just want to go through a few of the particulars. For COVID-19, which is a three-dose series in the primary series, influenza - generally high-dose influenza - and pneumococcal vaccine, PCV20 in general, ultimately four doses, can be administered, starting as early as three months after transplant. Although there is really not much data to guide the use of the recombinant zoster vaccine in allogeneic stem cell transplant, the vaccine can be administered after the end of antiviral prophylaxis, which in general is 12 to 18 months after allogeneic and 3 to 12 months after autologous stem cell transplant. Some of the other vaccines, such as hepatitis B, Tdap, meningococcal vaccines, and HPV revaccination in those less than 45 are also recommended.   I want to also spend the moment talking about the two recently licensed RSV vaccines, which were essentially studied in less compromised hosts and really without any immunogenicity data in stem cell transplant, and thus, there is no recommendation in this guideline for the use of these vaccines after transplant. Live vaccines, such as MMR and varicella – varicella would be in varicella-seronegative patients without a prior history of varicella – should be delayed for at least two years and only given in the absence of active graft-versus-host disease or immunosuppression.  Moving briefly to CAR T, which is an immunotherapy that involves adoptive cell therapy, given the available data and after a review by the group, it was recommended that adults with hematopoietic malignancies receiving CAR T therapy directed against B-cell antigens should receive influenza and COVID-19 vaccines either two weeks before lymphodepletion or no sooner than three months after the completion of therapy. Administration of non-live vaccines preferably should occur before CAR T treatment or at least 6 to 12 months after, following the same timing as what we recommend for stem cell transplant. There is really little data to guide the safety and timing of administration of live vaccines after CAR T therapy.   In terms of adults receiving B-cell depleting therapy, they are generally unable for time to mount an effective humoral response but may have at least partially intact cellular immune responses. They are encouraged to be revaccinated for COVID-19 no sooner than six months after completion of B-cell depleting therapy, and they should receive influenza vaccine approximately four weeks from the most recent treatment dose for patients on chronic therapy. For other non-seasonal immunizations, vaccines ideally should be given two to four weeks before commencing anti-CD20 therapy or delayed until 6 to 12 months after completion, except for the recombinant zoster vaccine, which can be given one month after the most recent dose of B-cell depleting therapy. Brittany Harvey: I appreciate you reviewing each of those vaccinations and when they should be given, and reviewing the available data – albeit, limited data – in these situations.  So beyond these routine preventative vaccinations and revaccinations that you've both just described, Dr. Law, what additional vaccinations does the expert panel recommend for adults with cancer traveling outside the United States? Dr. Lisa Law: Good question. As per these ASCO guidelines, adults with solid or blood cancer traveling outside of the United States should follow the CDC standard recommendations for their destination. For the 2024 CDC Yellow Book, travel vaccines, in general, should be delayed until three months from the last chemotherapy or, and for those with solid tumors, ideally when the disease is in remission. Of note, hepatitis A, typhoid, inactivated polio, Hep B, rabies, meningococcal vaccine, and Japanese encephalitis vaccines are considered to be safe. In all cases of travel, patients should be counseled by their healthcare provider about the travel timing, with the additional attention to the regional seasonality of infections, for instance, influenza is more common in late summer in Australia, and also with attention to any outbreaks that may be occurring globally at the time of travel. Brittany Harvey: Absolutely. Those are key points for clinicians to discuss with their patients as they consider upcoming travel.  So then, the final clinical question that the panel addressed, Dr. Taplitz, what vaccinations does the panel recommend for household and close contacts of adults with cancer?  Dr. Randy Taplitz: Thank you. Yes, it is recommended that all household members and close contacts, when possible, be up to date on their vaccinations. And the only further thing I would say is that there are some special considerations for the use of live vaccines in household contacts, particularly in stem cell transplant recipients. Contacts of people who receive stem cell transplants should preferably receive inactivated influenza vaccines. As was mentioned, MMR and varicella vaccines are both safe to administer to close contacts. Vaccine strain transmission to immunocompromised hosts has not been associated with MMR use in family members.   Eleven cases of the varicella vaccine strain transmission are described in the published literature, but none occurred in compromised hosts. Because the vaccine strain can cause severe and fatal varicella in profoundly immunocompromised people, precautions are advised to avoid close contact with a person with a vaccine-induced rash. For household contact travelers, MMR and yellow fever vaccines are considered safe. Oral cholera should be avoided. For smallpox vaccines, the second-generation ACAM2000 has rarely been associated with vaccinia transmission and should be avoided because of this. But the live replication-deficient MVA-based JYNNEOS vaccine is felt to be safe for household contacts of immunocompromised individuals. Brittany Harvey: I appreciate you reviewing the importance of vaccination for household and close contacts, and some of those precautions that individuals should take. I appreciate you both for reviewing all of these recommendations.  So then in your view, Dr. Law, what is the importance of this guideline, and how will it impact both clinicians and adults with cancer? Dr. Lisa Law: In my opinion, this is a very important guideline that is long overdue in the oncology community and will have a huge impact on both clinicians and adults with cancer. Over the years, I have often been asked by my colleagues and patients, “Can I have the flu vaccine, and if so, when?” So this guideline really is going to be helpful. More importantly, our cancer patients are living much longer. They may have years of quality of life even with third or fourth line of treatment, especially, for instance, like CAR T for myeloma and lymphoma. However, we know that with additional treatment, that carries a substantial risk of infection complication among these immunocompromised patients. So it is of paramount importance to inform our patients and colleagues to be proactive in advocating preventive therapy ahead of time, meaning trying to get the patients appropriately vaccinated as early as possible to generate immunity.  Another case in point is the Shingrix vaccine. I used to see lots of shingles, but ever since we have the recombinant Shingrix, I have fewer encounters. And this is huge because post-herpetic neuralgia robs a patient's quality of life. So, again, it is very important to recommend appropriate vaccines for our cancer patients.  Brittany Harvey: Absolutely. It is key to ensure patients receive these preventative vaccines, and we hope that this guideline puts an emphasis on that for clinicians and patients.  So finally, to wrap us up, Dr. Taplitz, what are the current gaps in knowledge regarding the vaccination of people with cancer? Dr. Randy Taplitz: There are a number of really important gaps in knowledge and really critical unmet needs that require research and other dedicated efforts. Among these are, and I think paramount, are really the participation of people with cancer with varied types of immunocompromise in vaccine trials. Where vaccine trials are only for cancer patients, obviously is ideal, testing vaccines in the appropriate population. But when that's not feasible, pre-existing cancer should not preclude eligibility, and inclusion of cohorts of people receiving anticancer treatment should be incorporated prospectively. So that's really critical because the quality of our guidelines is based upon the data. We use the data for developing guidelines and gathering more data in the particular patient population is really, really critical.  Secondly, work for creating more immunogenic vaccines and research to understand the immune response to vaccines after immuno-depleting therapies, particularly with newer therapies such as CAR T and newer B cell therapies, bispecific antibodies, etc. is really critical. We need to really understand the immune response and have the most potent vaccines available to these people who may have impaired immune responses.  Switching gears a little bit, we really need mechanisms to promote institutional commitment to integrate and sustain immunization best practices for people with cancer. This will largely be through multidisciplinary, team-based approaches, protocol-based vaccination standing orders, and leveraging data sharing so that we can all be on the same page with giving vaccines to these individuals. We also need education and evidence-based decision-making tools, emphasizing preventive care through immunization, the availability of educational resources to clinicians and patients to address commonly asked questions and also misconceptions about vaccination, that's absolutely critical.  And finally, I think we need to develop strategies for addressing unique challenges and factors contributing to vaccine hesitancy during cancer therapy. We need to focus on patient and clinician communication, and very importantly, we need to consider health equity considerations in the development and approach to vaccines in these compromised patients. Brittany Harvey: Definitely, we'll look forward to research and advances in these areas that you've just described to support these guidelines and increase vaccine uptake.  So I want to thank you both so much for your work on this important guideline, and thank you for your time today, Dr. Law and Dr. Taplitz. Dr. Lisa Law: Thank you.  Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/supportive-care-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast, and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.      

Henrico County Public Schools will host clinics at each middle and high school this winter to provide required vaccines for students entering grades 7 or 12 in the 2024-25 school year. To enroll students in Henrico County Public Schools, parents must ensure their children have up-to-date immunizations for their ages. Meningococcal conjugate vaccine (MenACWY) is required for all students entering grades 7 and 12. Students who are entering grade 12 who have not received a dose of the vaccine also need to receive a booster shot. Tetanus, diphtheria, and pertussis vaccine (Tdap) is also required for students entering grade 7,...Article LinkSupport the show

GOLD 2024 KOAH Kılavuzu Güncellemesi Türkçe özetine devam ediyoruz. Önceki bölümlerde kılavuzun birinci ve ikinci bölümlerini özetlemiştik. Bu bölümde ise kılavuzun 3. bölümünü (KOAH'ın Önlenmesi ve Yönetimi) ana hatlarıyla özetlemeye çalışacağız. GİRİŞ KOAH yönetimindeki genel amaç; semptomları, alevlenmeyi ve riskleri azaltmaktır. Stabil KOAH tedavisindeki amaçlar içinde; semptomları tedavi etmek, egzersiz toleransını arttırmak, sağlık durumunu geliştirmek, hastalık gidişatı önlemek, alevlenmeleri önlemek ve tedavi etmek ve mortaliteyi azaltmak yer alır. KOAH hastalarında tedaviyi yönlendirmek amacıyla havayolu obstrüksiyonunun ciddiyeti, semptomlar, alevlenme geçmişi, risk faktörlerine maruz kalma ve komorbiditeler değerlendirilmelidir. Bu bölüm KOAH'lı hastaların yönetiminden ve önleme stratejilerinden bahsedeceğiz. Kanıt Düzeyleri Kanıt temelli önerilere yer verildiğinde, bu önerilerin kanıt düzeyleri parantez içinde şu şekilde sunulmuştur: (Kanıt A). Aşağıdaki tabloda Kanıt Düzeyleri ve anlamları yer almaktadır: Kanıt KategorisiKanıt KaynağıARandomize Kontrollü ÇalışmalarABelirgin sınırlılık veya taraflılık içermeyen yüksek kaliteli zengin kanıtlarBÖnemli sınırlılıkları olan randomize kontrollü çalışmalarBSınırlı kanıtlarCRandomize olmayan çalışmalarGözlemsel çalışmalarDPanel konsensus değerlendirmesi Risk Faktörlerini Belirleme ve Maruz Kalmayı Azaltma Risk faktörlerinin belirlenmesi ve maruziyetin azaltılması yalnızca KOAH'ın birincil önlenmesi için değil aynı zamanda yönetimin bir parçası olarak da önemlidir.  Sigara içmek en sık karşılaşılan ve kolayca tanımlanabilen bir risk faktörüdür (KOAH'lıların %40'ı sigara içmektedir), bu yüzden sigara içen tüm bireylerin sigarayı bırakması sürekli olarak teşvik edilmelidir (Kanıt A). Sigarayı bırakma, KOAH'ın doğal seyrini etkileme konusunda en büyük kapasiteye sahiptir. Günlük semptomları iyileştirir ve alevlenme sıklığını azaltır. Mesleki tozlara, dumanlara ve gazlara, ev içi veya ev dışı hava kirliliğine maruziyetin azaltılması da önemlidir. Etkin havalandırma, çevreyi kirletmeyen ocaklar ve benzeri müdaheleler önerilmelidir (Kanıt B). Klinisyenler mümkünse potansiyel tahriş edici maddelere sürekli maruz kalmaktan kaçınmaları konusunda hastalara tavsiyede bulunmalıdır (Kanıt D). Aşılanma İnfluenza aşısı, KOAH'lılarda ciddi hastalanmayı (hastane yatışı gerektiren durumlar gibi) ve ölümü azaltır. Sadece birkaç çalışma KOAH alevlenmelerinde influenza aşısını değerlendirmiş ve kişi başına düşen toplam alevlenme sayısında anlamlı azalma olduğunu göstermiştir. İnfluenza aşısı KOAH'lı hastalara önerilmektedir (Kanıt B). Pnömokok aşıları, pnömokok konjuge aşısı ( PCV20 veya PCV15) ve pnömokok polisakkarit aşısı (PPSV23) 65 yaş üzeri bireyler için onaylanmıştır. Ayrıca 19-64 yaş arasında kronik akciğer hastalığı olan, organ nakilli, sigara içen bireyler için de önerilmektedir. Aşılanma konusunda bir doz PCV15 sonrasında PPSV23 ya da sadece bir doz PCV20 önerilmektedir (Kanıt B). Pnömokok aşısı toplum kökenli pnömoni riskini ve KOAH alevlenme sıklığını azaltmaktadır (Kanıt B). Kronik kalp/akciğer hastalığı, immün yetmezlikli hastalar, bakımevi hastaları, ciddi RSV enfeksiyonu geçirme riskine sahiptir. CDC'ye göre her yıl RSV kaynaklı 60.000-160.000 hastane yatışı olmakta ve 6.000-10.000 ölüm görülmektedir. Bu yüzden RSV aşısı 60 yaş üstü kişilerde veya kronik kalp/akciğer hastalığı olan kişilerde önerilmektedir (Kanıt A). Ergenlik çağında Tdap aşısı olmayan KOAH'lılar için Tdap aşısını (Kanıt B) ve 50 yaşın üzerindeki KOAH'lı kişiler için zonaya karşı koruma için Zoster aşısını (Kanıt B) önermektedir. COVİD-19 aşısı tüm KOAH'llı hastalar için önerilmektedir (Kanıt B). Stabil KOAH'ta Farmakolojik Tedavi  Semptomların ve alevlenme sıklığının ciddiyetine göre tedavi planı belirlenir. Tedavi semptomlara göre arttırılabilir veya azaltılabilir. Başlangıçtaki farmakoterapi hastanın hangi GOLD grubunda olduğuyla başlar:

In 2024, the Ministry of Health will provide Tdap (Tetanus, Diphtheria and Acellular Pertussis) vaccination to all pregnant mothers at all government primary health clinics. The vaccination is aimed at protecting newborn babies against the three highly infectious and serious diseases. Prof Dr Nazimah Idris, President of the Obstetrical & Gynaecological Society of Malaysia, joins the show to explain why it's important for pregnant women to protect their infants with this vaccination, and to address any concerns about the safety of the vaccine.Image Credit: Shutterstock

This week, join Kate, Mark, Henry and Gary (from his carport) as they discuss third trimester Tdap for prevention of infant pertussis, atogepant for preventing migraines, POCUS for diagnosing small bowel obstruction, and whether any medications work for treating gastroparesis

Episode 147: Routine Prenatal CareWritten by Elika Salimi, MSIV. Western University of Health Sciences, College of Osteopathic Medicine of the Pacific. Comments and editing by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice._____________________Elika: So, we're going to talk about some general principles of prenatal care and some of the most important diagnostic methods that we mainly use for taking care of pregnant women. I will forewarn you that there will be a ton of details in this talk, and I do recommend possibly taking notes as things can get easily confusing. This way you can have something to refer back to whenever you have a pregnant patient of your own.Arreaza: You can also download the episode notes from our website.Elika - So your patient is pregnant and she comes to you for care. How do we go about it? Well, this is assuming she had it at home urine pregnancy positive test and we got a blood hCG on her and everything's good and we know she's pregnant. Ok so now what happens next?Arreaza – We need to confirm the patient wants to keep the pregnancy.Elika - First, we're going to talk about the frequency of the check-ups. In this case, we are talking about a situation where the mother is coming to her appointments as she was supposed to but we all know that sometimes that doesn't happen if everything is going as it is supposed to then typically we get the initial examination at about 10 weeks of gestation and then until the 28th week there should be monthly visits, then from the 28th through the 36th there should be biweekly visits, and from the 36th week until birth, the visits are every week.Areaza – What´s next?Elika - Now I'd like to note that during the prenatal period, informed consent is very important and it should be obtained during this time because you want to prevent and manage any ethical conflicts that might exist between the mother and possibly the healthcare providers because we all know that any pregnancy can become high-risk at some point and pregnant individuals should be informed about the potential need for a c-section for example and be encouraged to discuss any concerns ahead of time. Elika - Now while we're talking about ethics, if the doctor finds him/ or herself in a situation where the patient is asking for something that the Dr does not feel comfortable with such as a certain type of treatment or a certain method of delivery or if they're, let's say, desiring an abortion and the doctor doesn't do abortions, then in this case you would refer the patient to a physician that is comfortable with the patient's desired outcome or treatment. And this is perfectly legal and fine just as long as you help the patient find somebody else. Arreaza – Abortion is legal in most states, but check your local regulations.Elika - So as mentioned earlier, the initial visit occurs at about 10 weeks of gestation. We start with checking their personal and family history and finding out about any previous pregnancies including at what GA baby born and weight if they know, any complications, gestational diabetes or preeclampsia, any history of postpartum hemorrhage requiring blood transfusion, any abortions (if present at what GA), and the method of deliveries, whether it was vaginal or a cesarean and what kind of C-section they had done. These are very important for you to obtain from your patient. You will also assess for depression and domestic partner violence.Arreaza – In California, we have a wonderful service called CPSP: Comprehensive Perinatal Services Program. What comes next? Elika - Upon receiving the history, we will do the gynecological examination and send in some samples. We will also send her to do some lab work. Now what do those labs entail? Well, we are going to get a CBC such as screening for anemia, we will also do TSH but only in people who have possible signs of thyroid disorder so not everybody needs to get this. And, we are going to send for a blood typing to find out about their ABO group and the Rhesus status. We will also obtain a urine analysis to screen for proteinuria and asymptomatic bacteriuria because in pregnancy, unlike outside of pregnancy, you do need to treat asymptomatic bacteriuria. We will also ensure that the mother is on prenatal vitamins, so folic acid, if not already, and iron, if indicated, and vitamin B6 if the patient has signs of nausea or hyperemesis gravidarum and this can be combined with doxylamine. Usually, pregnant women don't get a glucose screening test at the first visit unless let's say they have high risk of diabetes or they there was glucose in the urine. Arreaza – I like the topic of diabetes in pregnancy. So, in a high-risk population, we want to make sure a pregnant patient does not have diabetes, or pregestational diabetes.Elika - We will also screen for STI's including HIV, syphilis, hepatitis B, Hep C, and we also check for gonorrhea and chlamydia (pap) screening particularly in those under 25, or over 25 with high risk of infection. We will also test for rubella and varicella. Some places also order a QuantiFERON gold for tuberculosis. There are certain women that have indications for third-trimester screening for STI's on top of the ones that they already got in their first trimester. Those include chlamydia, gonorrhea, HIV, syphilis, and Hep B, and C but each of those have its own indications so for the purposes of time I will let you look that up on your own.Arreaza – Summary: Physical exam and labs to rule out preexisting conditions that may interfere with pregnancy, either infectious or metabolic, to mention some diseases. Elika - And finally, we will do an ultrasound assessment to get a more accurate reading of the fetus's gestational age.Arreaza – What comes after the first trimester?Elika- So like I mentioned they're going to need to be following up and some particular things need to be done at specific weeks. So we are going to discuss those. At every follow visit you need to obtain: the patient's weight, BP and other vitals, fetal heart sounds, the baby's measurement from the mother's pubic symphysis up until the fundus of the uterus, as well as a urine analysis to check for any glucose or protein in the urine because we are always concerned of possible preeclampsia or gestational diabetes. Another examination that I should mention is a Doppler ultrasound and this is usually indicated if there is suspected fetal growth restriction or if there's pregnancy-induced hypertension or if there's suspected fetal deformities or there is growth discordance in multiple pregnancies.Now we are going to discuss assessing for any abnormalities in the fetus. All pregnant women regardless of age should be offered noninvasive and aneuploidy screening test before 20 weeks of gestation. The 1st trimester combined screening occurs at about 10 to 13 weeks gestation, where we can order some blood tests for the mom such as the amount of hCG in maternal serum, as well as PAPP-A, on top of nuchal translucency that will see on the ultrasound. There is also the triple screen at 15-20 weeks which consists of ordering hCG, alpha-fetoprotein aka AFP, and estriol then there's also the quad screen test at 15-22 weeks gestation that consists of hCG, AFP, Estriol and Inhibin A. We also have the cell free fetal DNA testing that can occur after 10 weeks gestation at which the fetal DNA is isolated from the maternal blood specimen for genetic testing and this one actually happens to be the most sensitive and specific screening test for common fetal aneuploidies, and it is used for secondary screening after the ultrasound.Arreaza – Actually that test is done in all our patients on Medi-Call (cfDNA).Elika - If any of the screening tests are abnormal then we can provide counseling to mothers for more invasive diagnostic tests such as chorionic villus sampling, amniocentesis, and cordocentesis. At that point, you want to refer the patient to perinatology. Finally, in general an anatomical scan occurs ~18-22 weeks. Arreaza – Excellent, we have done the non-invasive genetic screening. What's next? Elika - Now we are going to talk about what happens in the third trimester specifically and what test you need to order. In the third trimester, you will order a CBC again, particularly at 24 weeks you want to do a repeat hemoglobin. We will also do the indicated repeat STI checks. We are also going to do gestational diabetes screening with the oral glucose test that I briefly mentioned earlier at around 24-28 weeks. This is usually done with a 50g 1 hr glucose tolerance test and if abnormal then a 100g 3 hour glucose test. You will also be repeating the Rh antibody just to make sure that the mother is still Rh negative because at 28 weeks, Rh negative mother should be administered RhoGAM 300 mcg intramuscularly and they need to get it again within 72 hours of delivery. Don't forget to give a TDAP vaccine at 27 weeks. And at 36 weeks you need to be obtaining a GBS culture (vaginal and rectal) for the patient just to make sure that there is no colonization because if there is then the patient is going to need GBS prophylaxis at admission because colonization by these bacteria can cause chorioamnionitis and neonatal infection such a sepsis. Overall when third trimester approaches you're going to make sure the plans for delivery have been properly scheduled or discussed with the patient and typically around 34 weeks you also want to check with your patient to see if they desire sterilization and obtain a consent if they will be having a C-section and they want to be sterilized after that. In those not requesting sterilization, it is a good idea to discuss what they want to do after this pregnancy for birth control since it is not safe to get pregnant again for another year. From 36 weeks' gestation, use Leopold maneuvers for assessment of fetal presentation but I'll let you look that up on your own. At this time, you may also use ultrasound as needed to confirm fetal lie and placental position.Patients with maternal conditions such as gestational diabetes or gestational hypertension/pre-eclampsia, or fetal condition such as heart defects or fetal growth restriction need to get biweekly NST/BPP tests at clinic in the third trimester because there is an increased risk of fetal hypoxic injury or death. An NST is basically a non-stress test that measures fetal heart rate reactivity to fetal movements. BPP /biophysical profile is a noninvasive test that evaluates the risk of antenatal fetal death usually after the 28th gestational week and what it consists of is the ultrasound assessment of fetal movement, fetal tone, fetal breathing, and amniotic fluid volume or we can also perform a contractions stress test that basically measures fetal heart rate reactivity in response to uterine contractions. Arreaza – I like talking about obesity. Weight gain is expected during pregnancy. Patients with normal weight are expected to gain 25-35 pounds. Patients with obesity are recommended to gain 11-20 only.Summary: Now I know that this was very extensive talk with a ton of details but if you took notes and refer back to it then I think things will somewhat make more sense and come together that way. The best thing we can do is try to adhere to guidelines to make sure that we don't miss anything. Sometimes it could be particularly difficult to manage patients that don't or can't come to their appointments regularly and you may sometimes have to give them bad news and what not so overall it is not always happy moments we face but the best we can do is try to give them the best care possible to avoid complications and have the patient deliver a healthy baby. Thank you for listening to me once again and hopefully I'll be back again soon on another talk on an OB/GYN related topic soon. Thank you very much. _____________________Conclusion: Now we conclude episode number 147, “Routine Prenatal Care.” Future Dr. Salimi gave an excellent summary of the care provided during the different trimesters of pregnancy. Remember to collect a detailed history, perform a comprehensive physical exam, and order the labs to rule out pre-existing conditions that could interfere with pregnancy or detect complications early to start timely interventions or refer to a higher level of care. This week we thank Hector Arreaza, Elika Salimi, and Verna Marquez. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:AAP, ACOG. Guidelines for Perinatal Care. American College of Obstetricians and Gynecologists Women's Health Care Physicians; 2017Zolotor AJ, Carlough MC. Update on prenatal care. Am Fam Physician. 2014; 89(3): p.199-208. pmid: 24506122.World Health Organization. WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience. World Health Organization; 2016Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR. Recommendations and Reports. 2021; 70(4): p.1-187. doi: 10.15585/mmwr.rr7004a1Murray ML, Huelsmann G, Koperski N. Essentials of Fetal and Uterine Monitoring. Springer Publishing Company; 2018Royalty-free music used for this episode: Space Orbit by Scott Holmes, downloaded on July 20, 2022 from https://freemusicarchive.org/music/Scott_Holmes/.

Chief Medical Officer at Northwestern Medicine Central DuPage Hospital Dr. Kevin Most joins the Steve Cochran Show to discuss to explore the significance of children's physical check-ups, effective methods for managing vertigo, and how artificial intelligence is helping detect colon polyps. Dr. Kevin Most's Steve Cochran Show Notes: Kids going to college – Don't forget about their health Do your kids take a prescription medicine, if yes do they have enough? If the meds are delivered by mail order, have you changed the address to the school address Understand that once your child is 18 they have rights to their health privacy, and doctors can't share information with you without their permission. If you want to be able to have a doctor speak with you about their health, they must fill out a HIPPA form for the state the school is in Check to make sure your insurance is covered in the state they will be in, or be ready to pay out of network fees Are their immunizations up to date? In Illinois MMR, Tdap and meningitis are required. Consider influenza, Covid, hep A and B and HPV- college setting is classic for out breaks Artificial Intelligence role in colon polyps detection: 20 million colonoscopies are done each year in the US Studies have shown that the rate of detection for early cancerous polyps decreases as the day goes on, fatigue? Estimates are that 8-10 % of early colon cancer are missed on initial colonoscopy, resulting in 13,500 colon cancers missed in the US These cancers in most cases are found at the next interval colonoscopy, majority still at a treatable stage. This past week the FDA approved an artificial intelligence assisted colonoscopy device- MAGENTIC-COLO This device uses the video captured in real time, analyzes the images and identifies areas that are concerning based on data collected It then highlights the areas on the video monitor that the Gastroenterologist is viewing, drawing attention to the area of concern. The study showed an increase of detection by 26%, which translated into a 21% decrease in colon cancer occurrence The equipment will be available in the US within the next few weeks Many companies working on AI-based skin cancer apps that would be used with your iPhone: 6.3 billion smartphones – what health data will be collected and how will AI impact its use Researchers from Stanford are looking at developing an app that can identify skin cancer using AI generated data Their current data shows that their algorithm is on par with 21 board certified dermatologists FDA is a bit slower on approving devices such as these as it does not involve a physician for the determination Tele Derm is very popular now, with high quality, high resolution cameras, where a dermatologist is interpreting the image There are many companies developing the direct to consumer diagnostic testing/interpretation in the dermatology world Why is this taking so long? There is no data base of images collected in an organized way, as it is often the eye of the dermatologist who makes the decision. In April of this year the FDA made expectations clear as to how these devices would be regulated, initially they are looking at a device that would aid a physician, similar to the colon cancer device The FDA focus is on devices that make clinicians more accurate, not removing the clinician from the patient interaction This important step allows for education, advice, and transition of care if needed Currently there is a website Mole Mapper, built at Oregon Health University, that aids a patient in collecting information on specific moles on their body, tracks them with photos , looking for changes Not for diagnosis at this time, but more to gather information on moles that are changing and have a record of that to share with their physician Mole Mapper is hoping to continue to collect data so that at a date in the future it will be used to diagnose skin cancer at a much earlier time Will we see an increase in Fatal Heart Attacks as Heat and Air Quality worsen: One million individuals die from Heart attacks in the United States each year We know that the air quality has an impact on cardiovascular health We also know that extreme heat stresses the cardiovascular system as it works to aid in cooling A study completed in China looked at the impact of heat waves and poor air quality on cardiovascular incidents Researchers in China found that 3% of all deaths due to heart attacks could be attributed to the combo of extreme heat and poor air quality. They looked at records of over 200,000 individuals who died from a heart attack over a five year period They then looked back at the temperature and air quality on the days of the deaths. They found that there was a 18% increase in the risk of fatal heart attacks during 2 day heat waves where air quality was poor and heat indexes were above the 90th percentile. They did not find the same when the temperature was cold and in the 10th percentile, it only showed a 4% increase risk The findings for adults over the age of 80 was more concerning and showed that this group is more susceptible to the effects of heat and air pollution. Key message is keep individuals who may be susceptible to heat and poor air quality in an environment that is cooler and air quality can be maintained. NIH launches long COVID clinical trials to identify treatment options : Patients with Long Covid have been frustrated with treatment options, mainly the lack of options NIH last week announced new clinical trials focused on the treatment of Long Covid, this is the worlds largest comprehensive study of Long Covid, with 11 different trials being rolled out The goal is to enroll 40,000 patients before the end of the year The treatments include Paxlovid, other drugs, devices, other therapies including trials with light therapy. Each trial focused on the symptoms associated with Long Covid The trials are part of the NIH RECOVER initiative which received more than $1 Billion dollars from Congress in December of 2020, to address these conditions It has taken time as the NIH had to clearly define the condition, which has more than 200 symptoms. Understand the number of possible patients is key to building the studies The NIH has admitted they still do not have a good idea as to the number of individuals with this condition as data collection and definitions are not good, but estimates are close to 65 million around the world The list of trials and sites should be available soon and a few trials are now currently open for enrollment, go to recovercovid.org Each trial will have specific criteria and restrictions The trials will continue to roll out over the next 3 months, under the following groups RECOVER-VITAL will focus on treating SARS-CoV-2, the virus that causes COVID-19, when it stays in the body and causes the immune system to damage bodily organs. Trial participants will be given the antiviral Paxlovid for longer dosing regimens to see if it improves long COVID symptoms.  Currently open to enrollment RECOVER-NEURO will examine treatments for cognitive dysfunctions related to long COVID, like brain fog, memory problems and difficulty with attention. , This will open in the next few weeks RECOVER-SLEEP will test interventions to help sleep patterns or the ability to sleep after having COVID-19. One trial will focus on hypersomnia, or excessive sleep, while another will focus on problems falling or staying asleep. This will open in a few months and will look at the use of some medications RECOVER-AUTONOMIC will target symptoms associated with the autonomic nervous system, which controls a range of bodily functions including heart rate, breathing and the digestive system. Exercise and fatigue: NIH is also developing a fifth platform looking at the inability to exercise and fatigue. Bronny James suffered cardiac arrest Monday and is in stable condition: On Monday Bronny James, the 18 yo son of Lebron James, suffered a cardiac arrest while practicing at USC He was transported to the hospital spent a night in the ICU and was deemed to be in stable condition the next day and moved out of the ICU, he was discharged from the hospital on Thursday He will continue to have further testing to assure he can safely return to practice  Sudden cardiac Arrest is the cause of death in about 2,000 individuals under the age of 25 each year, Overall he found himself at the highest risk by being black and a basketball player, when we look at all student athletes  This often occurs when the electrical activity of the heart causes the main pumping chamber the ventricle, to  fibrillate causing a poor or irregular heart beat that disrupts the heart's pumping activity This is not like a heart attack where blockage of blood to the heart muscle occurs This is much more common in men and more common in basketball, with football players being the next highest risk Coaches and staff need to be trained to give CPR, use an AED and act quickly Controversy over what should a preparticipation physical include Parents often see this as a hassle to get their healthy child a physical before sports start EKG's are not routinely done, Echocardiograms are not routinely done for High School students, College athletes are under more scrutiny and receive much more extensive evaluations. Bronny actually had both an EKG as well as a specialized echocardiogram just a few months earlier What can cause sudden cardiac death in young adults-Hypertrophic  Cardiomyopathy (HCM) is the most common- this is a thickening of the muscle in the lower chambers of the heart (ventricles) that can cause an abnormal rhythm esp during exercise. HCM is often inherited disease, known as an enlarged heart. HCM is diagnosed with an echocardiogram Having this condition will often preclude you from playing any sport competitively These individuals will often have a implantable defibrillator placed to protect them Other causes can be preexisting abnormal electrical activity of the heart either genetic or anatomic- both causing unusual electrical activity and thus fibrillation RSV- Vaccine for adults and Monoclonal Antibodies for infants: This past winter we saw the impact of RSV- Respiratory Syncytial Virus  on both children and adults This is a seasonal illness that in most cases causes an aggravating cold, but in young children and older adults we should it has a bigger impact, causing hospitalization and pneumonia We know young children do not have immunity until after they have an infection, often before the age of 2, they are vulnerable to severe RSV as both their lungs and their immune system are not fully developed In adults we lose our immunity to RSV as we age This summer we had the roll out of vaccine for those over 60 and a monoclonal antibody shot for those under 2, to give us our first year of protections in both of these age groups In June, the FDA approved 2  RSV Vaccines for those over the age of 60- it would be a single dose shot, after discussion with your physician In July, the FDA approved a monoclonal antibody treatment for newborns and infants entering their first RSV season, this would be given as a preventative option. The pediatric shot is interesting as it is not a vaccine, it is the antibodies needed to fight an infection if you were to get one Both the antibody shot for kids as well as the vaccine for adults does not stop the illness but reduces hospitalizations significantly It is interesting that the adult  vaccine was developed using the technology we use for the flu shot, not the mRNA process we used for Covid There is a clinical trial going on right now for a vaccine for women who are pregnant, allowing them to share their antibodies with the newborn, thus protecting them thru the vulnerable first 2 years of life. What about the “tweeners” those between 2 and 60 years old, this group doesn't need a vaccine as the chance for severe illness in this age is rare, so the focus is on high risk individuals These options will certainly raise some questions and conversations with your doctor A tornado that ripped through a major Pfizer pharmaceutical plant in North Carolina on Wednesday "almost completely destroyed" the plant's warehouse: We talk about the impact of heat, with dehydration and heat stroke. We talk about cold and frostbite The bigger impact of weather is being felt now with the devastation of the Pfizer factory in North Carolina on July 19th We talked about the drug shortages in the US the day before the tornado hit, as we discussed the closing of the Chemotherapy plant in India, the next day a tornado hits here. This factory makes sterile injectables that are used in every hospital, these are drugs that are given thru an IV or injected. It is estimated that this plant provided 8 % of the injectable medications used in US Hospitals These include drugs used for infections, for surgery, for pain and other conditions Most hospitals got away from being a warehouse and are relying on medications and supplies being delivered daily, with warehousing kept locally and in smaller amounts in the hospital The impact of this will be felt in a short period of time, as short as a few months and how long it will last depends on how nimble Pfizer is, to shift manufacturing See omnystudio.com/listener for privacy information.

In this special holiday episode Dr's J and Santhosh discuss diseases of the red, white and blue! Along the way they cover the founding of the country, old timey fireworks, poorly made sound effects, lockjaw, spore forming bacteria, tracking holiday injuries, revolutionary war fatalities, explosives as disease vector, antitoxin, Tdap, gender injury disparity, the circulatory system, raynauds, the five stages of heatstroke and more! So sit back and relax as we independently teach you holiday medicine!Further Readinghttps://medium.com/@writinginbluink/the-patriotic-disease-cca8b2d66cfbhttps://jamanetwork.com/journals/jama/article-abstract/186112Support Us spiritually, emotionally or financially here! or on ACAST+Twitter: @doctorjcomedy @toshyfroInstagram: @travelmedicinepodcastGmail: travelmedicinepodcast@gmail.comSpotify: https://open.spotify.com/show/28uQe3cYGrTLhP6X0zyEhTFacebook: facebook.com/travelmedicinepodcastPatreon: https://www.patreon.com/travelmedicinepodcast Supporting us monthly has all sorts of perks! You get ad free episodes, bonus musical parody, behind the scenes conversations not available to regular folks and more!! Your support helps us to pay for more guest interviews, better equipment, and behind the scenes people who know what they are doing! https://plus.acast.com/s/travelmedicinepodcast. Hosted on Acast. See acast.com/privacy for more information.

Robert F. Kennedy Jr. was recently on the Joe Rogan Podcast and Twitter has erupted with arguments over scientific debate. Should scientists open themselves up to questioning? Can Americans hear opposing viewpoints and think for themselves? In this episode Jared asks these questions and challenges us all to be willing to be wrong. He discusses the critical need for open discussion and debate now more than ever. If you haven't listened to the Joe Rogan podcast with RFK Jr. yet - it really is a must hear for all Americans. Not everyone agrees on any topic, and even if you think you might disagree with what is being presented, there is only one way to find truth, and that is to explore multiple sides of the issue at hand.  Additional Information:The Joe Rogan Experience #1999 Robert Kennedy Jr.Children's Health DefenseVisit the podcast website here: VitalityRadio.comYou can follow @vitalityradio and @vitalitynutritionbountiful on Instagram, or Vitality Radio and Vitality Nutrition on Facebook. Join us also in the Vitality Radio Podcast Listener Community on Facebook. Shop the products that Jared mentions at vitalitynutrition.com. Let us know your thoughts about this episode using the hashtag #vitalityradio and please rate and review us on Apple Podcasts. Thank you!Please also join us on the Dearly Discarded Podcast with Jared St. Clair.Just a reminder that this podcast is for educational purposes only. The FDA has not evaluated the podcast. The information is not intended to diagnose, treat, cure, or prevent any disease. The advice given is not intended to replace the advice of your medical professional.

In this episode, Helen Y. Chu, MD, MPH, shares updates on RSV vaccines, including:An overview of vaccine candidates under investigationRecently FDA-approved RSV vaccines for older adultsConsiderations for the next respiratory viral seasonCoadministration of RSV vaccines with other respiratory viral vaccines (eg, influenza, SARS-CoV-2)Target populations for RSV vaccinationRSV prevention in infants with the maternal vaccine and monoclonalFaculty:Helen Y. Chu, MD, MPHAssociate Professor of MedicineDivision of Allergy & Infectious DiseasesUniversity of Washington School of MedicineSeattle, WashingtonLink to full program: https://bit.ly/3nb25xehttps://bit.ly/3nb25xeLink to downloadable slides: https://bit.ly/3TsXym5

Too busy to read The Lens? Listen to our weekly summary here! In this week's issue: A majority of ophthalmology researchers have incomplete financial disclosures with underreported physician-industry relationships.  Risk of retinal vascular occlusion after mRNA COVID-19 vaccination is extremely low and commensurate with historically used vaccines for influenza and Tdap. Ranibizumab and bevacizumab showed different risks for intraocular pressure increase compared to aflibercept in a nondiabetic cohort in Tuscany, Italy.

Historically, only 2 vaccinations were recommended during pregnancy. Due to the COVID-19 pandemic, that has now changed to 3 vaccines (influenza, TDAP, and COVID-19 vaccinations). In this session we will summarize and present an easy to follow summary of these vaccinations, especially for those going into the ABOG, Fall, oral board season. Here are tips to quickly describe the 4 currently available COVID-19 vaccines. Also, we will review the influenza vaccine, and provide high-level pearls regarding TDaP, including a recent FDA ruling regarding the TDaP vaccine. (Dr. Ashley Nicole…thank you for your voice memo! I KNOW you are going to rock your ABOG oral board!)

Here are the links for everything discussed in Episode 82. Times are also below so feel free to skip around and get to the updates that interest you.  (1:10) FDA adds new indication for Boostrix vaccine (6:44) FDA updated the authorized fact sheet for Evusheld PAXLOVID Patient Eligibility Screening Checklist Tool for PrescribersCDC website for COVID information - get boosted!FDA monkeypox response websiteConnect with The Rx Daily Dose:Twitter      Instagram      YouTube      Linkedin       WebsiteEmail: therxdailydose@gmail.comConnect with Ian Parnigoni PharmD. on social media:Twitter       Instagram       Linkedin  ★ Support this podcast on Patreon ★

It has been brought to my attention I missed one vaccine, the TDaP.  This vaccine is essentially a 'booster' to the DTaP, but especially common to give to women during each pregnancy.  Although I do not go into full detail of TDaP and ingredients, this week I am going to briefly pick back up our vaccine conversation series to cover this vaccine in length that I didn't go over in the DTaP episode. I STRONGLY encourage you to go to that episode and listen if you haven't yet.For those who requested this episode, I hope you enjoy:) Subscribe and hang out with me every Wednesday to stay up to date on this show.  If you enjoy, please share this on your social media and tag me (@brookebrewer20) and give me a rating/review. Thank you! Sponsors:Primally Pure Deodorant and natural skin care productshttp://www.primallypure.comUse code BROOKEB at checkout for 10% offRevitalize Mineralshttps://www.modere.comUse code 4842132 to save $10 off your first orderShow notes and references: Current CDC Vaccine Schedulehttps://www.cdc.gov/vaccines/schedules/index.htmlFDA website for package inserts: https://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm093833.htmTDaP Vaccine Insert: https://www.fda.gov/files/vaccines%2C%20blood%20%26%20biologics/published/Package-Insert---DAPTACEL.pdfVaccine Glossery and Detailshttps://vaccine.guide/vaccine-ingredients/overview/vaccine-ingredient-glossary-and-details/Harvard Study on VAERS reporting https://vaccine.guide/ncvia-vicp-vaers/vaccine-adverse-events-reporting-system/hhs-funded-vaers-investigation/VAERS: https://wonder.cdc.gov/controller/datarequest/D8;jsessionid=797FE3AAA91FB97BE41D68FE67EATDaP Just the Inserts: https://www.justtheinserts.com/tdap/Vaccine Court Payouts: https://vaccine.guide/ncvia-vicp-vaers/vaccine-injury-compensation-program/current-payout/Vaccine books I recommend: https://www.amazon.com/hz/wishlist/ls/SIVLXA2T1IDX?ref_=wl_share

Dr. Carole Keim MD takes listeners through vaccines in today's episode. She explains everything from how vaccines are created to common myths and misconceptions about them. She then details each baby and childhood vaccine, and what disease each prevents.Dr. Keim breaks down how vaccines work and what criteria they must meet in disease to be effective. She explains the four main types of vaccines and lays each vaccination out in a clear manner, covering what age your baby or child will be when they receive the vaccine and how the immune response works. These vaccines are proven to protect your baby against everything from tetanus to mumps to pertussis and more.This episode will cover: How vaccines workCriteria to create a vaccineThe 4 different types of vaccinesCommon myths or misconceptions about vaccinesSpecific vaccines (all routine childhood vaccines)Total number of vaccinesCommon side effects and red flags, how to treat How vaccines work: 00:44The purpose of vaccines is to trigger an immune response faster and with less harm than the original disease.The immune system is a lot like a microscopic team of superheroes, made up of white blood cells, antibodies, the complement system, and a few others.  These superheroes fight villains such as bacteria, viruses, and other pathogens.  If they cannot fight them fast enough, the villains will multiply and cause symptoms of disease.  Vaccines give your superhero team information about what the villains look like, so they can recognize them as soon as they enter the body, and fight them off quicker and easier.Vaccine criteria: 01:26In order to make a vaccine, certain conditions must be metIt has to be effective.  We must be able to become immune to the pathogen; diseases like RSV and HFM are ones we can catch multiple times.  Chickenpox is one that you become immune to after catching it once.The pathogen must not be able to mutate faster than the vaccine can be given - we do flu boosters annually because the flu virus mutates about that often.  HIV and common cold mutate too fast for a vaccine to be developed.The vaccine must be cost-effective; it has to be cheaper to prevent the disease than to treat itThere are 4 main types of vaccines: 02:31Inactivated (killed pathogens)Live attenuated (weakened pathogens)Toxoid (a piece of what's inside the pathogen)mRNA vaccines Inactivated vaccines 03:44Most common typeThe bacteria or viruses in the vaccine are killed, so your immune system can safely learn to recognize the pathogen that it is trying to fight off.  These vaccines do not have the potential to cause actual disease.  What they do is cause the immune system superheroes to practice fighting the villains, kind of like practicing on dummies, which may cause mild signs of illness - fever, sore muscles, crankiness, or other symptoms.  Examples: IPV (polio), HPV (human papillomavirus), HiB (Haemophilus influenzae B), pneumococcus (Streptococcus pneumoniae), meningococcus (Neisseria meningitidis), and Hepatitis A and B vaccines.Live attenuated vaccines 04:02Made from bacteria or viruses that have been exposed to chemicals that make them weaker than the natural or “wild type” bacteria or virus.  Since these pathogens are not killed completely, your superheroes aren't just practicing on dummies, they are actually fighting the weakened villains.  So it is possible to have symptoms of the disease, but milder.  Some people with weakened immune systems may not be able to fight them off, and can get the actual disease.  People taking steroid medications or immune suppressants, or who have HIV or other immune deficiencies should consult a doctor about whether it is safe to receive these vaccines.  Examples: oral polio vaccine, MMR (measles, mumps, and rubella), Varicella zoster (chickenpox), and rotavirus vaccines.Toxoid vaccines 04:55Made from just part of the pathogen, and protect against the kinds of bacteria that cause symptoms after the toxins inside them are released.  These toxin-carrying bacteria are like villains carrying around a bottle of poison, and the toxoid vaccine gives the superheroes the poison to sample and build up resistance to it.  Example: DTaP (diphtheria, tetanus, and acellular pertussis).MRNA vaccines 05:23Newest typemRNA is like a copy of instructions. These give your immune system something like a sewing pattern to print out and make the dummies for your body to fightExample: some COVID vaccinesMyths and misconceptions about vaccines: 05:45Many parents have concerns about vaccinating their children.  It only takes one serious reaction to call into question the safety of vaccines.  And it has been so long since the vaccine-preventable diseases have run rampant that we in the United States don't fully understand the scope of what is being prevented.  Here are some of the top concerns that I have heard from parents, and the truth behind them.Aluminum.  There is aluminum in vaccines, but the amount is far less than babies get from other sources.  The total amount of aluminum that babies get from vaccines in the first 6 months is 4.4mg.  Breastfed babies consume 7mg, formula-fed babies consume 38mg, and babies on soy formula consume 114mg of aluminum in the first 6 months of life.  Consuming aluminum vs. having it injected in a vaccine looks the same to the body, so the tiny amount of aluminum in vaccines will not harm your babyAntigens.  An antigen is any microscopic substance that has the possibility to elicit an immune response.  Babies are exposed to over a trillion antigens in the first year that naturally occur in the environment.  The entire vaccine series that children receive today contains just over 150 antigens.  A young baby's immune system can easily recognize these few antigens and make antibodies to the diseases without getting sick.Autism.  It has been proven that vaccines do NOT cause autism.  The age that children first start showing signs and can be tested for autism is 15-24 months.  This is the same age that children receive booster vaccines, so it is understandable that some parents think they are related. Long-term protection.  Vaccines will protect a person for just as long as if they got the original disease.  So a person who had chickenpox as a child is just as protected from getting it again as a person who has received the chickenpox vaccine.  Some people do not seroconvert (develop antibodies to that disease) - that depends on their immune system and is not a failure of the vaccine itself.Mercury.  There used to be a preservative called thimerosal in vaccines.  That preservative (which contains mercury) has been removed from all vaccines in the US that children receive.  The only vaccine that still contains thimerosal is the adult flu vaccine.Unnatural exposure.  Some people worry that getting exposed to a disease through an injection is not the same as getting it “naturally” by being exposed to a sick person.  This is not true; any disease will get into your bloodstream, which is where it is recognized by the body, and once in there the body has no idea how it got in.  So getting an injection looks exactly the same to your immune system as getting the disease from a sick person.Doctors DO NOT get paid to vaccinate childrenVaccines are NOT a punishment for children who are behaving badlySpecific vaccines: 10:47Hep B - 0, 2, 6 mos.  Hepatitis B is a viral infection that can be passed from mom to baby through the placenta or during delivery.  90% of babies born with HepB will develop chronic infection and are at risk of liver cancer later in life.DTaP - 2, 4, 6, 15 mos, 4 years.  Tdap - age 11, every 10 years.  DTaP has more diphtheria, Tdap has more tetanus. Bacterial infections.  Diphtheria causes severe sore throat and enlarged tonsils, and can block the airway from swelling/tonsils being so enlarged.  Tetanus makes spores that live in soil; any penetrating wound could have tetanus in it (nail/thumbtack, dog or cat bite) and tetanus is not killed by antibiotics so it must be prevented.  Pertussis is whooping cough and causes babies less than a year old to stop breathing.  Everyone who takes care of the baby should be current on their TDaP (within 10 years).  Polio - 2, 4, 6 mos, 4 years.  Polio is a virus that attacks nerves and causes paralysis.  Sometimes it's minor, and sometimes it's the diaphragm that's affected and they stop  breathing.  There is no specific treatment for polio.HiB - 2, 4, 6, 12-18 mos.  HiB (haemophilus influenzae B) bacterial infection that affects children less than 5 years, and especially those under 1 year of age.  It used to cause severe infections like epiglottitis, sepsis, pneumonia, and meningitis.  PCV - 2, 4, 6, 12-18 mos.  PCV = pneumococcal conjugate vaccine, pneumococcus is another name for streptococcus pneumonia, which is a kind of strep that gets into the bloodstream and causes sepsis, pneumonia, and meningitis.  PCV has 13 strains of strep in it right now.Rotavirus - 2, 4, 6 mos. Viral infection that causes severe diarrhea and dehydration in babies. Hep A - 12 and 18 mos. Hep A is a type of food poisoning, there's no specific treatment.  MMR - 1 and 4 years.  Measles causes high fever, rash, and can cause brain damage, hearing loss, and death.  Mumps causes parotitis (infection of salivary glands), but in boys also causes orchitis (inflammation of testicles) and can lead to sterility.  Rubella is a fever and rash; more dangerous to unborn babies, causes miscarriages and birth defects.VZV - 1 and 4 years.  Varicella Zoster virus (chickenpox) causes cold symptoms, fever, and an itchy and painful rash in children, and shingles in adults.  VZV in pregnancy causes miscarriages and birth defects.MCV - 11 and 16 years.  Meningitis A, C, W, Y are viruses that cause inflammation around the brain that develops quickly and can be fatal.  HPV - 11 years.  Human papilloma virus causes warts and dysplasia and can lead to cancer of the mouth, throat, anus, cervix, and penis.  Currently 9 strains of HPV in the vaccine.  Flu: recommended annually COVID: recommendations are still evolvingVaccines that are available but not given routinely: MenB, PPSV23, Dengue, Typhoid, japanese encephalitis, yellow fever, rabiesTotal numbers of vaccines: 22:351 at birth (Hep B)2 mos: DTaP, polio, HiB, Hep B, PCV, rotavirus - 1 or 2 combo vaccines, PCV and rota = 2 or 3 shots plus an oral vaccine4 mos: DTaP, polio, HiB, PCV, rotavirus - 1 combo plus PCV and rota = 2 shots and one oral6 mos: DTaP, polio, HiB, Hep B, PCV, rotavirus - 1 or 2 combo vaccines, PCV and rota = 2 or 3 shots plus an oral vaccine6+ mos: flu vaccine annually12-18 mos: 2 doses Hep A, 1 of DTaP, HiB, PCV, MMR, VZV.  5-7 shots depending on combos.4-6 years: DTaP, polio, MMR, VZV, typically given as 2 combo vaccines11 years: Tdap, MCV, 2 doses HPV16 years: MCV21+ years: Tdap every 10 years; booster if you have a wound and it's been less than 5 years, booster while pregnant9 shots and 3 oral before 1 year of age, 5-7 shots from age 1-2, 2 shots age 4-6, 4 at age 11, 1 at age 16 = 21-23 total shots before adulthood.  18 flu shots.  Common vaccine reactions: 23:53Birth: nothing; sometimes redness/swelling2-6 mos: redness and swelling (local reaction), can be as much as the entire thigh and still be considered normal.  Low grade fevers.12-18 mos and 4-6 years: muscle soreness, MMR and VZV cause fevers, VZV sometimes causes rash, other vaccines can cause local reactions11yrs: muscle soreness, local reaction with Tdap and MCV, fainting with HPV16 yrs: local reaction from MCVTdap boosters: muscle sorenessFlu, COVID: flu-like symptomsIt is NOT normal to have a body rash or vomiting after vaccines; those are signs of allergyLarge local reactions and muscle soreness can be treated with cool compresses (wet washcloth) and/or acetaminophen or ibuprofen.  Fever or flu-like symptoms: acetaminophen or ibuprofenI DON'T recommend pre-medicating your child before vaccinesIf your child has an adverse reaction to a vaccine, you should report it to VAERS (vaccine adverse event reporting system).  Remember that VAERS is like Yelp for vaccines, so take that about as seriously as you would a Yelp review.All of this information is also in The Baby Manual book, which is available for purchase. Remember it is always okay to call your doctor or emergency services if you have concerns about your baby's health.  Resources discussed in this episode:The Baby Manual - Available on AmazonVAERS--Dr. Carole Keim MD: linktree | tiktok | instagram

On this episode of The Devil's Advocate Podcast: Brandon and Franklin return for an update in the face of one of, if not, THE single biggest rollback of rights in American history. Oh, how we remember the unicorns prancing through poppy meadows the last time we recorded an episode of #TDAP... The #TDAPDark days were behind us; there was hope on the horizon!Well, we have some sad news to share with you:Shit is about to get really dark...

Nick's first career was a firefighter. He worked both in a largely residential rural fire department and was a contractor for USAP, firefighting in Antarctica.Nick was always doing something active, whether that be coaching soccer, playing soccer, hunting, fishing, building things, working in his huge organic garden, raising animals and being a father. He did not like sitting still and loved being productive. Slalom waterskiing was his favorite sport. Living a healthy lifestyle was a point of pride for Nick.Nick wanted a challenge so he returned to University to get his doctorate in audiology. With a background in public service and experience working for the government, he chose to take a position with the Department of the Army, as a civilian.   During his physical, he was administered a TDaP as part of his job requirement.  His life was forever changed....Support the show

[CW: Firsthand account includes description of the death of an infant. Skip approximately first 3 min to avoid.]What comes to mind when you hear the word tetanus? For many people, it's probably the horrible thought of stepping on a rusty nail or the every-so-often Tdap booster you get at your doctor's office. Thanks to the wide availability of this incredibly effective vaccine, not many of us have an image of what an infection with tetanus actually looks like or how deadly it can be. But that's not the case everywhere, especially in places with limited access to these life-saving vaccines. In this episode, we take you through the biology of the spore-forming, soil-dwelling, obligately anaerobic, Gram positive Clostridium tetani and the powerful paralytic neurotoxins it produces. We then venture into the history of this pathogen, a history that includes a tour through early medical texts and a discussion of the origins of epidemiology as viewed through the context of neonatal tetanus in the American South. We round out the episode by reviewing where tetanus still poses a substantial threat today and highlighting some very exciting ways this deadly pathogen may be used to treat cancer! Tune in to gain a newfound respect for this incredible microbe!See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Dr. John Toney, Director of Epidemiology at the James A Haley Veterans Hospital in Tampa, FL., presents this update on adult immunizations. He begins with an overview of recommended adult immunizations. Next, he discusses pneumococcal vaccines. Following this, Dr. Toney differentiates the different Flu vaccines, including the current vaccine for the 2021-2022 year. He also mentions potential universal flu vaccines currently under investigation. Other vaccines discussed include TDAP, the different Varicella zoster vaccines, Meningococcal, HBV, and HPV vaccines. Lastly, several helpful case studies are presented.

We are excited to announce that baby #2 is on the way and in this episode I'm sharing everything that's been going on from 25-30 weeks. More updates to come as baby continues to grow and things progress along the way. I have decided to do placenta encapsulation this time around. Head back on over to Episode 22 to get a recap on placenta encapsulation information. Listen back to Episode 33 (Day 10 of Heal Your Trauma, Mama) to learn more about building a mantra and affirmations to use in motherhood.  Directly from CDC website: Group B Streptococcus (group B strep, GBS) are bacteria that come and go naturally in the body. Most of the time the bacteria are not harmful, but they can cause serious illness in people of all ages. In fact, group B strep disease is a common cause of severe infection in newborns. While GBS disease can be deadly, there are steps pregnant women can take to help protect their babies. GBS Pregnant people should get a dose of Tdap during every pregnancy, preferably during the early part of the third trimester, to help protect the newborn from pertussis. Infants are most at risk for severe, life-threatening complications from pertussis. tdap-vaccine If there are any updates or more information you would like to hear about during the updates please reach out to me! Tidy Up Thursday Challenge: Be sure to use #mamatidyupthursday and tag @entering_motherhood on instagram if you are nesting, decluttering, or just cleaning up in your motherhood journey!  Join the Heal Your Trauma Mama 30 Day Event: https://www.enteringmotherhood.com/healyourtraumamama Instagram: entering_motherhood and sarah_marie_bilger Facebook Group: Entering Motherhood

In this episode, we're continuing the conversation about the first 24 hours after baby is born. The period of time immediately after birth is a beautiful and incredibly special time for parents and for baby. When we are intentional with it and have an idea of what we want that time and space to look like, it can even feel sacred.    With the rise of mother-baby friendly facilities in the last decade or so has come a greater awareness of the power of this beautiful time. However, not all facilities currently observe an undisturbed golden hour approach.    Listen in as we talk through some of the main components of this time and learn which parts of the process may be skippable, depending on your family's particular desires.  Highlights 01:52 Newborn exam 02:40 Immediate vaccination: your choices 03:22 Vitamin K 04:49 Eye ointment 07:13 Hep. B Series 08:55 Newborn screen 11:05 TDAP (mom) 12:03 Flu shot (mom) 12:55 Postpartum support 15:18 Newborn sleep 20:14 Breastfeeding 22:09 Decisions you can/should make Grab My FREE 5-Day Mini-Course: Pregnant?! Now What…?? Click here to snag a spot in my free course Links Free SAME PAGE DATE Download Follow Along www.instagram.com/samantha_legassick   https://www.facebook.com/groups/createdforbirtheducation

In this Episode we listen to baby Riley's story. Riley was too young to be vaccinated against pertussis. His tragic death occurred 2 days before Australia started recommending all pregnant women be vaccinated with TDaP in their 3rd trimester. Catherine tells us about Riley's life and death, and how it led her to start the Light for Riley campaign to spread the message of vaccinations during pregnancy. Catherine also goes on to share some of the harassment she has received from antivaxxers along the way. This is a must hear story and I hope you take the time to listen. Here is a link to the Immunization Foundation of Australia and the Light for Riley campaign. https://www.ifa.org.au/lightforriley

Dr. Toney presents an overview of adult vaccinations, focusing on the vaccines that are most important and relevant for the adult patient. He begins by discussing pneumococcal vaccines, whose guidelines can often be confusing because of the two different types of vaccines and their distinct administration schedules. He next talks about the influenza vaccine, differentiating the different types of vaccines, the efficacy of the flu shot, and potential future flu vaccine products. Next, he discusses the TDAP and the importance of receiving this vaccine given waning adult immunity for Pertussis. Dr. Toney also touches upon Shingles immunization and the significant advance of the recombinent shingles vaccine that is now available. Lastly, he discusses the MMR, Meningococcus, and Hepatitis vaccines.

Samantha Lynn is on the show today to talk about her journey - from being vaccine injured at 21 with the TDAP, GARDISIL, and HEP A and how she has spent years detoxing and healing herself. She is getting certified in nutritional therapy and has over 75 hours in vaccine education courses under her belt. I am excited to have her on today's show to share heaps of knowledge with you all! https://campsite.bio/samanthalynn.ntc It has never been more clear that we, the people, must unite to preserve our freedom. With the fight we had in CA fighting SB277, Oregon with SB442 and now SB895 and other medical mandates, with similar fights around the country against the systematic attempt to remove our medical choice and medical freedoms, I welcome you to listen in to Talia Like It Is. This is an becoming a global movement. Governments in Australia, Italy, and all over are following suit in the outrageous CDC schedule, and parents are fighting back.

Samantha Lynn is on the show today to talk about her journey - from being vaccine injured at 21 with the TDAP, GARDISIL, and HEP A and how she has spent years detoxing and healing herself. She is getting certified in nutritional therapy and has over 75 hours in vaccine education courses under her belt. I am excited to have her on today's show to share heaps of knowledge with you all! https://campsite.bio/samanthalynn.ntc It has never been more clear that we, the people, must unite to preserve our freedom. With the fight we had in CA fighting SB277, Oregon with SB442 and now SB895 and other medical mandates, with similar fights around the country against the systematic attempt to remove our medical choice and medical freedoms, I welcome you to listen in to Talia Like It Is. This is an becoming a global movement. Governments in Australia, Italy, and all over are following suit in the outrageous CDC schedule, and parents are fighting back. The idea is to take the “vaccine-choice” movement, the home birth/natural birth, home schooling/un-schooling and the “food-choice/anti-GMO” movement and blend them. It's all about INFORMED CONSENT with me, folks. Being properly informed and then making those decisions for your family how you see fit. Combining these movements is simply the next step in winning the fight to know what is going into our bodies and preserving that choice. I need more parents and soon-to-be parents to wake up and begin the research. Join me!

Every visit: Doptones, fundal height, vitals Four question: Vaginal bleeding, contractions, leaking fluid, fetal movement By Weeks: 20wks – get and review anatomy US 24wks – order glucola, cbc (check for anemia), discuss normal growing pains 28wks – Tdap and Rhogam if needed, discuss kick counts 32wks – Discuss BCM, sign tubal papers if needed, […]

  Introduction: From gestation to graduation, if it involves kids, you've tuned into the right place. I'm your host, Doc Smo, a board certified pediatrician with 35 years of experience and a whole lot to say. It's been a while since I have done a child health news update and there has been some very interesting stuff coming down the pipe recently. My journals have actually had some new studies that I thought you might be interested to hear about. Today, I thought I would bring my listeners some of this interesting new research and throw some ideas at you that might improve both your knowledge and just maybe, your children's health.   What are the experts thinking about and which child health issues are getting attention in the world of pediatrics?  Stay tuned to find out. You don't want to miss today's post, so warm up your mp3 player, turn up the volume of those buds, and get ready for the next edition of Portable Practical Pediatrics. Musical introduction Study #1- The Continuing Saga of Fruit Juice Fruit juice has gotten a bad reputation in the U.S. despite its heavy marketing by the fruit juice industry. It is considered a sugary drink that many researchers believe is at ground zero of the obesity epidemic in the U.S.  I've been preaching about the evils of fruit juice for years. I have been telling my patients and their families that eating fruit is healthy and great, but concentrating the sugar from fruit into juice and separating the sugar contained in the fruits from the fiber of the fruit is quite harmful. Fruit juice, I would tell them, contains way more sugar than eating the whole fruit since multiple pieces of fruit needed to be used to make one cup of fruit juice. The juice contains the sugar of many pieces of fruit! That was my story until April 2017, when, to my surprise, I opened my journal from the Academy of Pediatrics and see a meta analysis (that's a retrospective look at many studies combined) that concluded that fruit juice, in moderation, after a child's first birthday, that is not consumed in excess of six ounces/day, that is pasteurized, and not used as a frequent hydration source that could lead to dental decay, may not be harmful to a child's health.  Now, my eyes are falling out of my head when I read that 100% fruit juice may actually be considered a health enhancement in a child's diet, serving as a source of real fruit. This is heresy I say! This is way afield of the pediatric playbook!  I remember all the studies in the 1980's that showed malnutrition in toddlers consuming apple juice, albeit excessive quantities of apple juice. Have these authors forgotten about the pesticide Alar in apples that sent public health officials into cataclysmic spasms?  Could apple juice actually be a healthy food??? First, there was a study that showed that diluted apple juice is actually better at preventing dehydration in children with diarrhea than scientifically formulated rehydration drinks ***.   Now fruit juice is considered a healthy nutrient!  What planet am I on? Could the manufacturers of fruit juice actually have been right all these years? The debate continues so stay tuned- time will tell us. Study #2- Does Today's Whooping Cough Vaccine (Tdap) Effectively Prevent Whooping Cough? Followers of Portable Practical Pediatrics will be familiar with this important topic. I have done many posts on the subject in the past. *** It has becoming obvious to researchers who do vaccine research that the conjugated whooping cough vaccine that we currently use called Tdap is not protecting today's children the way the older whole cell vaccine did. This fact has been graphically demonstrated in a new study from Kaiser Permanente published in March of 2017. From their data, they found that the effectiveness of the Tdap vaccine in 10 year olds who received it was between 60-76% in the first year and rapidly fell to 9% effective by the fourth year. Recall, that older children only get one of these vaccines eve...