Podcasts about Trichinosis

We see more and more wildlife diseases in headlines these days.  In this episode host, Kolby Morehead, sat down with Bear Hunting Magazine columnist and Arkansas Game & Fish Commision veterinarian, Dr. Jenn Ballard. We hear about her journey to becoming a wildlife vet, gain a healthy perspective on wildlife diseases, and hear a couple of fun bear stories.Don't forget to subscribe to Bear Hunting Magazine

Listen along as the guys are all over the map!  Find out the signature seasoning to put on pork and what the guys are eating nowadays.  Sensational sauces are welcome.  Be sure to cook your bear meat above medium-rare.  Take care!   https://waltons.com/ | www.meatgistics.com

Listen along as the guys are all over the map!  Find out the signature seasoning to put on pork and what the guys are eating nowadays.  Sensational sauces are welcome.  Be sure to cook your bear meat above medium-rare.  Take care!   https://waltons.com/ | https://www.meatgistics.com

When I was growing up, people didn't fret much about food safety. Trichinosis from undercooked pork was about all I heard about. But today people hear about much more: norovirus, salmonella, campylobacter, staphylococcus, listeria, and there's much more. So what in the world is happening? Our guest, Timothy Lytton, distinguished university professor and professor of law at Georgia State University knows an awful lot about this. He's the author of a seminal book entitled "Outbreak: Foodborne Illness and the Struggle for Food Safety." Interview Summary When your book came out, I was so excited to see it, because there was so much talk out there in the general world about food safety, but to have somebody with a kind of your legal background take this on and put it all into a single volume, I thought was extremely helpful. So let me begin with a basic question. So how did you get interested in food safety and why do a book on it? You know, our political world is largely characterized by an ongoing debate about people who favor government regulation against people who favor letting free markets run their own course. I found this debate somewhat unsatisfying. I'm really interested in a lot of ways that government activities and market activities interact. In fact, in most contexts we have not really two alternatives, one between government regulation and the other free markets. But instead, we have a complex interaction between public and private efforts to try and govern health and safety problems. This really is characteristic of what I would call complex regulatory systems. They involve at least kind of what you might think of as three legs of a stool. On the one hand, you have government regulation, you have private governance, supply chain management, and other things that companies do to protect health and safety. You have liability, lawsuits and liability insurance. These three legs of the stool really are interactive and they together comprise what I would call a complex regulatory system. And food safety's really a great example of this and I think it was for me an important way to try and illustrate to people that our regulatory world is a lot more complex than the choice between government regulation and free markets.   There are a lot of places where business and government interests are at odds and government needs to keep a watchdog eye on business and make sure that they behave in ways that are consistent with the public good. You would think that government and business interests would align, that it's not in a business' interest have an unsafe food product that goes out there because all kinds of bad publicity and litigation and things like that can happen. So is it not true that there's alignment of goals?   I think there's alignment of goals. I think it's also fair to say that sometimes there's a difference of opinion as to just how aggressive or ambitious food safety regulation ought to be. On the one hand, industry tends to be a little bit more cautious. They may be worried about costs for food safety advances that may be unproven and government may be very nervous about making sure that consumers are properly protected they may be a bit more aggressive. I think one thing that is important to keep in mind is that even though there are those tensions, there's a very powerful interdependence between the efforts of government regulators to try and advance food safety and the efforts of private industry supply chain managers. In fact, a lot of the standards that grow out of the system are standards that have come out of collaboration between them. So for example, standards for agricultural water quality that help reduce the microbial contamination of water that is used to irrigate crops. Those originated in technical committees that were put together by industry associations, but those technical committees included members who came from government regulatory agencies. By the same token, when government came around trying to develop guidance and regulations to govern agricultural water quality, they called on industry in the notice and comment period. So the same group of experts have been really working over the course of the last two and a half decades on water quality standards. They've been doing it in different institutional venues, sometimes in industry technical committees and sometimes in the government's notice and comment process and sometimes in informal ways at conferences where they also meet and merge with academics. But, there's an enormous amount of collaboration that comes out of this ongoing conversation that is occurring in these different institutional venues.   Thanks for that background. I'd like to ask you about the system's approach to food safety that you proposed. But before we do that I'd like to ask kind of a broader question about where we stand with food safety in the US. So the industry is quick to claim that US has the safest food supply in the world. Is that really true? And how big of a problem is food safety in America?   You know, it really depends on how you measure it. The CDC estimates that each year from foodborne illness there are 3000 deaths, 128,000 hospitalizations, and 48 million cases of acute gastroenteritis. That really means serious enough illness to include diarrhea or vomiting or nausea that would be strong enough to keep a person out of work for a day or away from school. Now when you think about it in terms of deaths, that is 3,000 people a year who die from foodborne illness or foodborne-related illness. That's much less than something like tobacco which is close to half a million, or obesity which is closer to quarter million, or auto accidents which is about 34,000. In that context, the number of deaths from foodborne illness is relatively low as public health problems go. On the other hand, if you think about the 48 million episodes of acute gastroenteritis each year, people being sick enough to really have to knock off a day of work and in some cases getting much sicker than that, that's an enormous number. That is one out of six Americans every year. That is far more than the number of Americans who are injured in falls, car accidents, cutting, cycling, poisoning, and fire burn injuries all put together. It is orders of magnitude larger than those other things. So in that sense foodborne illness is a significant public health problem. And since we dedicate resources to things like falls in the home or car accident injuries, we probably should also be paying attention to food safety.   As you think about trends and look at the drivers of food safety, the way farming is done in the US, the way food is transported and those sort of issues, are you expecting that the challenges will become even more serious as time goes on, or are these being reined in?   I think that things are moving in two different directions one of which is difficult for food safety and one of which is advantageous. On the difficult side: the industrialization of food; the mass production; the large and growing global markets; and the increasingly complex supply chains where we're getting a lot of our produce from around the world This makes the problem much more difficult because there is just a farther reach that regulations would have to get to in order to help protect consumers from the risk of contamination. Also the ability to track and trace back the root causes of contamination just becomes more difficult as the food system becomes increasingly global. On the other hand, there are a number of important advances in technology. In particular, advances in technology that relate to surveillance and tracing. The ability to actually isolate and create a DNA fingerprint for different pathogens that are harvested from people who are sick or are harvested from investigations where contamination might occur, and that allow public health authorities to actually discover and spot outbreaks as they occur more frequently. And also increasing sophistication in tracing them back to their root causes. That growing technology, that ability to spot and trace back the source of foodborne illness, I think, is probably something that is getting better and better over time.   That's good news to hear and fascinating description of this. So you talk about a system's approach to food safety. What do you mean by that?   When we think about food safety, what we want to do is realize that instead of just pushing on one of these legs of the stool - more government regulation or for less government regulation, greater industry vigilance or less industry vigilance, greater liability or increasing liability insurance for growers or other food producers - we need to think about how these things are interrelated. We need to think about how we can help them complement each other. So for example, it may be the case that what we want to do is relieve the government of its burden, to some degree, of inspection because the government just doesn't have their inspection resources, it needs to cover all of the food industry and it struggles to do so. On the other hand, retailers who sell the food actually have a global and robust system of third party audits and that is driven by economic incentives and it has a much farther reach than government. We might find ways to rely more on that and government can then shift its resources away from things like inspection, which is really doesn't have the resources to do comprehensively and spend more of its money on surveillance of foodborne illness, so we can spot outbreaks when they occur, as well as tracing investigations to figure out what are the root causes of those outbreaks. That requires a governmental infrastructure at the federal, state, and local level and on some levels increasingly at the global level, that really only government can put together and overlook and oversee and develop. And so these are ways in which we can think in a system's approach, that instead of just looking for government to do everything or industry to do everything we can sort of divide the different types of tasks that are required, to create a robust food safety system and look at the ways in which these different branches of the system can complement each other.   Let's look beyond our own borders and talk about how other countries address these issues. How does the US measure up to what other countries are doing?   We don't really know the answer to that question, we don't really know how well the US is actually doing. It's extremely difficult to figure out whether or not any particular regulation or intervention works. In fact, that's really the story of a lot of different regulatory areas, food is not different in this way. We spend an enormous amount of money on developing and implementing regulations, but very little money in trying to figure out how effective they have been or whether they've been efficient or whether there are better ways to do them. Those questions are very difficult to answer and they are enormously expensive. As a result, we don't really know how well the US food safety system is doing. That becomes a similar problem when we look at places like Germany or England or Japan to figure out, well, how well are they doing? It's pretty hard to measure that as well. So there's not even something to compare here. I think a lot of people have general impressions about whether food is safer in one country or another and this will depend on the sector. Food safety in meat is different than fluid milk and it's different than fresh produce or poultry. I think it's a difficult question to answer and I think you hear a lot of opinions about this, but most of those opinions are not really, I don't think, grounded very clearly in the kinds of careful measures we would need to have in order to have good reliable answer to that question.   I'd like to underscore something you just said that it's hard to know whether the food safety regulations that we have actually work. So why is that the case and what do you think are some of the greatest challenges facing the food safety system today?   It's just a very curious thing. When I was doing my research, I would ask people how well is your system working and they couldn't tell me. If you ask someone in industry, we put in a million dollars into marketing, what do we get for it? They will be able to come back to you in a year and tell you for the million dollars you put into marketing, in the budget, we got X number of sales. We can do the same thing with quality control. We give you a million dollars, what did we get for it? A year later they'll come back and say, "Well we had X number of fewer defective products." But when you ask a company executive we give you a million dollars for food safety last year, what do we get for it? They can't really tell you. They give you some vague story about how they have improved the culture around food safety and institution. The same is true with government officials. When I ask people at the USDA, you know how well are your food safety inspections going? Have they improved the quality of American food safety? They really couldn't even begin to answer that question. One of the top officials at USDA told me, "Gee, I'd really love to know the answer to that question." I think there are a couple reasons why. One is it's very hard to measure how much illness there is, of the estimates of 48 million episodes, that's really, you know, a projection based on statistics. Of those 48 million episodes only 800 involve identified outbreaks. So, we only have 800 that we actually are counting. Of those, there are only about 300 identifiable food vehicles and of those, there are only about three to four cases where we can trace back to the root causes. So, we don't even know where the foodborne illness is coming from, even if we have a rough estimate of how much there is. It's also hard to know what caused the illness because we don't have root cause analysis or it's very rare. We don't know whether or not a particular intervention fell short or really made the difference. It's very difficult to figure out what the different levels of illness connected with a particular food are. We can make a food safety change but we don't have any way to measure on the public health side whether or not illness has been reduced as a result of that. When illness rates go up or down, we don't really have a way of tracing that back to where the failure's occurring in the system. We can't connect particular interventions to improve food safety with particular public health outcomes in terms of reducing illness.   You know, it's amazing how complicated this is, because when you're a consumer and you go to the store, you go to a restaurant and you buy something, you just assume it's going to be safe. And there are a whole bunch of people that are paying attention to that and making sure that that is so, but it's way more complicated than that. So interesting to hear you lay that out. So let's talk about what you think effective reforms would be. I'd like to ask about one thing in particular, in this context, where some people have called for reorganizing federal food safety regulation under a single federal agency which kind of makes sense instinctually, wouldn't it make sense instead of having destroyed the things going on, that all take place under one umbrella? I know you have some reservations about that. Could you explain?   Sure, I'll just start with this idea of a single food safety agency. This is a proposal that has been put forward in every single presidential administration, Democratic and Republicans, since the Truman Administration. It's basically the idea that if we can rearrange the bureaucratic structure of food safety, we can reap efficiencies and do a better job. I think there are a number of reasons to be skeptical of this particular approach to fixing the food safety system. First of all, there's very widespread lack of support from Congressional oversight committees. Congressional oversight committees and industry are basically connected with particular agencies. There are about 15 federal agencies currently that deal with food safety and each one has its own oversight committee in Congress. If you were to consolidate that, you would reduce the power of each of those congressional representatives to actually serve the interests of their constituents. It would make it harder for industry to sort of exercise influence in government. As a result, there's really not much support in Congress for this sort of consolidation. Second, it would require a massive and complex statutory overhaul. The food safety laws of this country go back to the late 19th century. They're involved in many difficult and complex and large statutory laws and they all are put together in a complex system. And I can't imagine the Congress getting involved in that level or scale of a statutory overhaul what it would take to consolidate this all in one agency. Furthermore, the agencies have different expertise and culture. So USDA is populated largely by people who do animal veterinary science and they look at beef production and poultry production. FDA's populated by microbiologists and they look at a lot of things related to water quality and safety and food production. These are just different technical skills and so reorganization would be very difficult. And finally, I would say that there's no evidence from other countries that have done this and a number of countries have done this, that they have reaped any public health benefits from this. We do know it would cost an enormous amount of money at the front end, but we don't have any indication that it would actually save us any money or be more effective at the back end. I think we would do a better job, rather than consolidating and rearranging the bureaucracy, to do a better job of knitting it together and creating cooperative task forces and more interaction between agencies. There's actually a lot of this already. There are joint task courses that have membership from USDA and FDA and the CDC and the other agencies involved. And I think that that growing coordination is probably a better approach to the food safety system than trying to consolidate. When we move away from that, I think there are probably three things I would focus on in terms of advances that would be good reforms for us. The first is to focus more government investment on outbreak investigation, to put more money into the CDC's surveillance systems for foodborne illness and the inter-agency cooperation that goes into investigating outbreaks. We need more information in order to know whether what we're doing is working and one way to generate that is better surveillance at the public health side and better investigation. Second thing I would do is I would rely more on private resources for oversight of that system. That is to rely more on private auditors and on liability insurance and the liability system to try and put pressure in order to have food producers more compliant with food safety regulations as opposed to spending a lot of government money on what's really become quite an inadequate inspection system. And the last thing I would stress is that we want to look for opportunities for feedback and learning. We want to be more experimental in the way that we think about food safety, try something out and then build into that a way to evaluate whether we think it works and whether or not we think it's an efficient way to go about advancing food safety in that way. Only if we generate more information, we'll be able to do things that we have greater confidence are safeguarding consumers as opposed to what we're doing now, which is largely just shooting in the dark.   Those things make a great deal of sense. So let me close by asking you kind of a broad summary question. You're really on top of this, of course, as you see trends like in public opinion on these issues, on actions that are being taken by the administrative and legislative branches of government, what industry is doing, is there a reason to be hopeful that things are moving in a good direction?   I think there are two sources of hope at least. One is that we are seeing steady technological advances in the ability to fingerprint DNA of foodborne pathogens. Those technological advances are sort of moving along and as they move along, they are spinning off better ways to spot foodborne illness outbreaks when they occur, more effective and efficient ways to investigate the root causes of it. And they are also creating new ways of thinking about how we can intervene in food production to try and create opportunities to reduce microbial contamination after it occurs or before it occurs. So technological events I think is a great source of hope. There are really a lot of very smart minds working very hard in a number of fields to try and improve food safety. The second thing I think that's a source of hope is the maturation of liability insurance. This is not something that most people think about very much. But when you think about big public health problems of the last century - things like urban fires in the 19th century and things like car accidents in the 20th century - liability insurance became a major driver for safety reforms in those two areas. Liability insurers basically collect premiums to ensure when those accidents happen and then they try and figure out ways not to have to pay out when the accidents happen on the insurance policies. So they get into the safety business. Many of our safety features associated, for example, with fire safety measures in our houses, in public buildings, as well as the type of things that our cars have in terms of safety equipment are driven by the liability industry trying to look for ways to reduce risks so that they cannot have to pay out when there are accidents. I think those types of markets are emerging in food safety. Increasingly we see food safety liability insurers getting into the business of trying to help companies figure out how to comply with the state-of-the-art in food safety.   Bio   Timothy D. Lytton is Distinguished University Professor and Professor of Law and currently serves as Associate Dean for Research and Faculty Development at Georgia State University College of Law. He teaches courses in torts, administrative law, and legislation. His research focuses on tort litigation and the regulation of health and safety. Lytton is the author of several books, including Outbreak: Foodborne Illness and the Struggle for Food Safety (University of Chicago Press 2019), which was a finalist for the 2020 ABA Silver Gavel Award, Kosher: Private Regulation in the Age of Industrial Food (Harvard University Press 2013), Holding Bishops Accountable: How Lawsuits Helped the Catholic Church Confront Clergy Sexual Abuse (Harvard University Press 2008), and the editor of Suing the Gun Industry: A Battle at the Crossroads of Gun Control and Mass Torts (University of Michigan Press 2005). Lytton has B.A. and J.D. degrees from Yale University. He is licensed to practice law in New York, Ohio, and Georgia, and in 2018 was elected to membership in the American Law Institute.

It is not uncommon for many modern readers to question the real reason(s) behind keeping Kashrut (dietary laws known as Kosher) today - and not just Jews, as I know many Gentiles who shop the Kosher food section. Often, many opt for the logic of a health-based rationale, such as; the avoidance of Trichinosis, limiting the amount of chemicals and hormones from processing plants, and many other modern [important] points of focus. In this episode, we explore a perhaps hidden dimension to the prohibition of avoiding blood.Subscribe to our website:http://www.thehiddenorchard.comFor a written version:http://www.thehiddenorchard.com/the-blood-and-the-life-force

Lexman Artificial interviews Erik Brynjolfsson, professor of economics at MIT and director of the Initiative on the Digital Economy. They discuss Erik's new book, paging: Reflections on the Future of Attention, which examines what will happen to our time-starved world when people start demanding more from the overwhelming world of digital distractions.

Just the two of us this week so hold onto your butts.... wait, why do you have multiple butts? Thanks for supporting the show! Check out our store... https://www.designbyhumans.com/shop/PotatoThumbsPodcast/  OMG we have a Discord! https://discord.gg/SYvh5jvsSH  Email Us PotatoThumbsPodcast@Gmail.com  Twitter https://twitter.com/PotatoThumbs https://twitter.com/FluffyFingersMD  https://twitter.com/AdmiralNips  IG https://www.instagram.com/fluffyfingersmd  Spotify Playlists Day 1 Playlist https://open.spotify.com/playlist/3u37PzeFv04b3z6Uq5voCO?si=3c52ad41c94348a1  Day 2 Playlist https://open.spotify.com/playlist/65jrMS8NSxNW5I9IG27drM?si=500a009043b74a17  Day 3 Playlist https://open.spotify.com/playlist/2B3PydCdAhKvhdKfqssRIK?si=6d9adeba01d946eb 

In this Podcast, Tanner and Nelson discuss parasites in wild game like Trichinosis, Rice Breast and Ticks. Get prepared for hunting season isn't just about getting the shot, but preparing for after the shot.  https://www.themeateater.com/listen/meateater/podcastepisode027   Follow us on IG: @theoutdoortalkpodcast Subscribe on YouTube: https://www.youtube.com/channel/UCRO6kaHA577r8wBrXWyrehQ Nelson's YouTube Channel: https://www.youtube.com/nelsoncobb

Jodee Dixon joins Artemis this week to talk about bear hunting in southeast Alaska. We talk about spring versus fall bear fat, pie crust, trichinosis (sp?- no one species, see note below), skinning a hide for preservation, scouting tactics, and more. Plus, what does hunting do for our sense of self? It's kind of a forced meditation, which is a powerful experience -- both as it's happening, and months later when we enjoy our harvest at the table. 2:00 Cold-season gardening, y'all 5:00 How does hunting change our relationship to the natural world? (Hiking feels extremely anticlimactic, for one) 9:00 How bear hunting differs from other quarries, and predator vs. prey dynamics 15:00 Bear meat, spring vs. fall 17:00 Predator hunting... it's an intimate decision for some hunters 18:00 Trichinosis  23:00 Freeze in chunks for grinding later (even MUCH later) 25:00 Catch our 'What About the Hide?' episode (or the blog post) it inspired a bear-hide tanning project. Want to TRY a hide? Roadkill can be a good starting point 30:00 Ticks... or mosquitos? (Or devil's club?)  33:00 The zen of hunting for a distilled/strengthened self... a "forced meditation" 40:00 Boat-assisted bear hunting in Alaska (with a side of grouse) 42:00 Predator hunting: bears, wolves, cougars... it's different 43:00 Black bear kidney fat for pie crusts 47:00 Mind-blowing bear biology... body temperatures, the quick transition out of torpor, floating eggs, etc. 51:00 "A bear without its hide looks a lot like a person." 55:00 Skinning paws/nose/head for a hide destined for the taxidermist (and OTHER languishing hides) 56:00 Sleeping on the boat, dragging anchor, custom-sewn sheets for the v-berth 59:00 2021 Artemis Ambassador squad... assembly in process!

This episode I share the story of my first Bear harvest. I talk about how the season was leading up to Mondays kill, the kill itself, and reflect on how the whole process makes me feel more connected to the world. I didn't mention it in the episode so I'll say it here. Eating the meat gives me B.D.B.E. (Big Dick Bear Energy); It makes me feel strong, alert, energized. *Note- Bear meat is the leading cause of Trichinosis in the USA, Make sure you cook any Bear meat well. "Well" is a cause for debate some say 145 others say 160. I can say I go for caution and cook to internal temp of 160 and it's still delicious, savory, and (everyones favorite word) MOIST. I am so appreciative of that Bear, I cannot say that enough.  

Today Larry sits down with Luke Clayton from Luke Clayton Outdoors on Catfish Radio, and Jeff Rice from the Buck and Bass Ranch out in Lake Fork Texas.  The guys talk about the history and origin of wild hogs, hunting hogs, and even preparing and cooking the pork without fear of Trichinosis.  The group also … Continue reading 052 – Wild Hogs with Luke Clayton and Jeff Rice →

Mike presents Trichinella Spiralis (the nematode that causes Trichinosis), Meredith presents a the Tree Pangolin. Our 14th Meeting!Follow us on Instagram @AnimalFanClubPod .Send your Listener Feedbag Questions to: AnimalFanClubPod@gmail.com .Tell your friends!

A Conversation with a First Time Fall Turkey Hunter This week, Cameron Weddington joins us to share a story of his recent fall turkey hunt - his first fall turkey hunt.  Cameron describes the action that took place during his hunt along with his first experience with coyote backstraps. Listen in as we discuss Trichinosis, wild turkeys, coyotes, shotguns, and crossbows. 

A Conversation with a First Time Fall Turkey Hunter This week, Cameron Weddington joins us to share a story of his recent fall turkey hunt - his first fall turkey hunt.  Cameron describes the action that took place during his hunt along with his first experience with coyote backstraps. Listen in as we discuss Trichinosis, wild turkeys, coyotes, shotguns, and crossbows. 

We all know it's probably smart not to eat raw pork, but this week on Sawbones, we'll meet the inspiring people brave enough to ask "Why?" (Note: We're publishing this week's episode a little early because we're headed out on tour!) Music: "Medicines" by The Taxpayers

In this episode of HDTGB comedian Evan Pittfield returns to huddle up with Zane & Jake and score a touchdown with the RAW Bowl. FOOTBALL PUNS!!! DEAL WITH IT!!! This hour long episode of Monday Night RAW almost rekindled Jake & Zane’s childhood love affair with professional wrestling while Evan remains unmoved by pro wrestling. But those Football Puns tho. This episodes does raise a serious question, Does Vince McMahon know the differences between the NCAA & NAACP? One thing is for sure we are lucky to have the Raw Bowl on the network and in our lives in general. As we see in this episode we are also lucky that Triple H didn’t die from Trichinosis. Make sure you take a time out and listen to this week’s episodes of How Did This Get Booked on the RAW Bowl. FOOTBALL PUNS!!!This episode is sponsored by Evan’s Country Clean. And as a added bonus listeners of HDTGB get 15% of their purchases at EvansCountryClean.com when they use the promo code: booked15As always for corrections tweet at Jake @manscoutmanning or email him at Jake@SSLShow.com. Make sure you checkout HowDidThisGetBooked.com for more information on the next episode.Available on iTunes, Stitcher, Google Play, SoundCloud, YouTube & HowDidThisGetBooked.com

This episode covers chapter 82 of Rosen's Emergency Medicine. Take a listen for all those juicy pericardial-pump-pearls!   List eight causes of pericarditis. Describe typical pain of pericarditis, expected lab work abnormalities, What is the typical sequence of ECG changes in pts with pericarditis? (the stages) Describe the treatment of pericarditis associated with: Uremia, Neoplasm, and SLE Outline the management of Dressler's syndrome. What is the pathophysiology of cardiac tamponade? Describe the mechanism of hypotension in pericardial tamponade and list 4 expected findings on physical examination. Describe the procedural steps in pericardiocentesis List 4 causes of pneumopericardium and one specific PEX finding List five causes of constrictive pericarditis. What is the pathophysiology of purulent pericarditis?  List 5 organisms responsible for infectious pericarditis? How is it managed? Describe the pathophysiology of hypertrophic cardiomyopathy Describe the clinical exam and ECG findings associated with HCM List 5 RFs for sudden death in HCM A pt with known hypertrophic cardiomyopathy presents to the ED with acute cardiogenic pulmonary edema causing mild hypoxia.  What is the general approach to management in the ED?  Explain your choices. List four causes of dilated cardiomyopathy. Describe ECG findings of dilated cardiomyopathy List 5 RFs for developing a dilated cardiomyopathy In what time frame would one expect peripartum DCM? List 5 causes of restrictive cardiomyopathy List 8 common pathogens responsible for myocarditis, and 3 non-infectious causes of myocarditis Describe the stages of viral myocarditis and the management at each stage     Wisecracks:   What are some functions of the pericardium? What are Chagas Disease and Trichinosis, list bizz-buzz features for each? What are the expected cardiac findings in Lyme disease and how is it treated? How does sarcoid affect the heart? Amyloidosis?  

This episode covers chapter 82 of Rosen's Emergency Medicine. Take a listen for all those juicy pericardial-pump-pearls!   List eight causes of pericarditis. Describe typical pain of pericarditis, expected lab work abnormalities, What is the typical sequence of ECG changes in pts with pericarditis? (the stages) Describe the treatment of pericarditis associated with: Uremia, Neoplasm, and SLE Outline the management of Dressler's syndrome. What is the pathophysiology of cardiac tamponade? Describe the mechanism of hypotension in pericardial tamponade and list 4 expected findings on physical examination. Describe the procedural steps in pericardiocentesis List 4 causes of pneumopericardium and one specific PEX finding List five causes of constrictive pericarditis. What is the pathophysiology of purulent pericarditis?  List 5 organisms responsible for infectious pericarditis? How is it managed? Describe the pathophysiology of hypertrophic cardiomyopathy Describe the clinical exam and ECG findings associated with HCM List 5 RFs for sudden death in HCM A pt with known hypertrophic cardiomyopathy presents to the ED with acute cardiogenic pulmonary edema causing mild hypoxia.  What is the general approach to management in the ED?  Explain your choices. List four causes of dilated cardiomyopathy. Describe ECG findings of dilated cardiomyopathy List 5 RFs for developing a dilated cardiomyopathy In what time frame would one expect peripartum DCM? List 5 causes of restrictive cardiomyopathy List 8 common pathogens responsible for myocarditis, and 3 non-infectious causes of myocarditis Describe the stages of viral myocarditis and the management at each stage     Wisecracks:   What are some functions of the pericardium? What are Chagas Disease and Trichinosis, list bizz-buzz features for each? What are the expected cardiac findings in Lyme disease and how is it treated? How does sarcoid affect the heart? Amyloidosis?  

Back in the 60s our parents always cooked pork to well done, to 180 degrees. They said it was to kill any Trichinosis that might be lurking in the meat. Then things started to change. in 2000 the USDA said you only needed to cook pork to 160 then it went down to 150 and now, pork only needs to be cooked to 145 degrees F. And we're talking about whole muscle cuts like roasts or chops. Not ground pork, that still needs to be cooked to 165 degrees F. So why the change? Well, better farming practices have led to almost no trichinosis being found in pork raised in the US. In fact, in 2015 only 11 cases of Trichinosis were documented in the US and those were from eating other wild meat including horse, moose, and bear.  So 145 is the safe temperature to kill any possible pathogens that might be in pork and it's good because pork comes out juicier and more tender at that temperature. But it also comes out pink and that is the most surprising and sometimes scary thing for people who grew up with well done pork. But fear not, it's safe, it's tasty, and it's delicious.

  For my own well being I should mention, first, that unequivocally my mom is and always has been a good cook. For sure, there were a few experiments that went awry, but on the whole we ate exceptionally well. That is except for the pork chops. There was nothing good about a pork chop. They were dry, tough, and had as much flavour as a Jesus wafer on a Sunday morning. It didn’t matter who cooked it or whether you were eating at home or at your cousin’s wedding it tasted the same. I stayed away from pork, well, I stayed away from pork except for bacon, ham, pork sausages, and other charcuterie meats. Because there is a big difference between pork and pork that has been salted, sugared, smoked, and spiced. The later is down right delicious. However, for the lowly pork chop and I we did not reconvene our disappointing relationship until I started working in the health food industry. It was at this point that I found out that pork was parasitical. Ahhh...what?  I’ve had many a food revelation over the last few years and that was certainly one of them. For someone who grew up around pigs, who gently goaded them to “Pig Heaven” on Monday mornings, and tried to stomach them on Monday evenings I had no idea. I was also confused. We were selling humanely raised, pastured pork and yet folks were turning their nose up at the pork chops and the pork roasts, and, yet, still thoroughly enjoying their bacon. Was it because bacon was cured and delicious that you didn’t have to worry about getting parasites? And, if pork was so dangerous, why had I never heard of it before? The disease is called Trichinosis, and it would probably be a good idea to premise the following by saying, “It is rare!” At least in North America. There are currently about twenty cases of Trichinosis in the United States a year. And, due to improved pig management there is now a greater chance of getting Trichinosis through the consumption of Wild Game than pigs. The disease is caused by eating undercooked meat of animals infected with the larvae of the Trichinella worm. According to the Centers for Disease Control and Prevention, “The signs, symptoms, severity and duration of trichinellosis vary. Nausea, diarrhea, vomiting, fatigue, fever, and abdominal discomfort are often the first symptoms of trichinellosis. Headaches, fevers, chills, cough, swelling of the face and eyes, aching joints and muscle pains, itchy skin, diarrhea, or constipation may follow the first symptoms. If the infection is heavy, patients may experience difficulty coordinating movements, and have heart and breathing problems. In severe cases, death can occur. For mild to moderate infections, most symptoms subside within a few months. Fatigue, weakness, muscle pain, and diarrhea may last for months.” The Pigs success over the past ten thousand years of domesticated life is due mainly to its remarkable ability to adapt. Pigs are omnivorous and if left to their own whim will eat anything and that is the problem. The Trichinella worm is introduced into the Pig’s body through the pig eating other infected animals. Trichinosis was a consistent problem within our food chain up until the mid 1950s. Unfortunately, for those of us who are concerned about animal welfare and would like to support free-range, pastured animals it was the pork industry’s move towards the industrialized model that significantly lowered infection rates. Moving pigs from outdoors to confined spaces indoors allowed farmers to better control what the pig consumed--grains and more grains. Along with moving pigs into confined spaces the public was educated on the importance of cooking pork properly. Well, kind of! The Government of Canada, to this day, suggests that consumers cook pork to 160 degrees Fahrenheit. The USDA had the same recommendation until 2011 when it lowered it to 145 degrees. This is because 160 degrees results in dry, tough, flavourless pork. It wasn’t the pork chops fault. It was us all along.

Las Vegas, Nevada. On this SHOT Show two-part special, Steven Rinella talks with Kenton Carruth and Ryan Callaghan from First Lite, Janis Putelis and Helen Cho from MeatEater, Jason Nash from Federal, and Bill Dermody from Savage. Subjects discussed: Shot Show; First Lite receiving Outdoor Life's Open Access Award; Oregon dickshines and false patriotism; Steve and Janis's armed takeover of Yellowstone National Park; chronic wasting disease; Steve's wife's repeal of the Rinella household bear meat prohibition; Trichinosis from bears; the weird and disgusting worm in Janis's Coues deer head; out-of-the-box Savage rifles; Chuck Hawks; the AccuTrigger; ammo shortages; the break-in and cleaning process of rifles; copper vs lead; budget vs match grade loads; the best all-purpose caliber; and the fluctuating regional popularity of various rifle calibers.