Podcasts about valley fever

What happens when we commodify nature? The natural world is not doing well, and is not put here to do with as we want. How can we learn to appreciate nature, and environment, without jumping to conclusions about what is happening, or picking sides in an ideological battle that has nothing to do with actual wild nature? Also: how are DOGE cuts affecting scientists? Four people profiled in Science magazine reveal that some good science is being hit with chaos and uncertainty—but also that a lot of “science” funding that has been cut was suspect, at best.*****Our sponsors:Manukora: the most flavorful, delicious, and nutritious honey you'll ever have. Get $25 off your starter kit at http://www.Manukora.com/DarkHorseFresh Pressed Olive Oil Club: Scrumptious & freshly harvested. Go to http://www.GetFreshDarkHorse.com to get a bottle of the best olive oil you've ever had for $1 shipping.Caraway: Non-toxic & beautiful cookware. Save $150 on a cookware set over buying individual pieces, and get 10% off your order at http://Carawayhome.com/DarkHorse10.*****Join us on Locals! Get access to our Discord server, exclusive live streams, live chats for all streams, and early access to many podcasts: https://darkhorse.locals.comHeather's newsletter, Natural Selections (subscribe to get free weekly essays in your inbox): https://naturalselections.substack.comOur book, A Hunter-Gatherer's Guide to the 21st Century, is available everywhere books are sold, including from Amazon: https://amzn.to/3AGANGg (commission earned)Check out our store! Epic tabby, digital book burning, saddle up the dire wolves, and more: https://darkhorsestore.org*****Mentioned in this episode:But They Are Wild - https://naturalselections.substack.com/p/antipode-chapter-22U.S. scientists' lives and careers are being upended. Here are five of their stories:https://www.science.org/content/article/u-s-scientists-lives-and-careers-are-being-upended-here-are-five-their-storiesSpread of Valley Fever: https://www.science.org/content/article/climate-change-may-be-driving-spread-deadly-fungus-u-s-southwestSupport the show

A Cochise County wildfire has residents packing their go bags; Tucson Unified gets ready to eliminate empty positions ; NAU loses science funding, ending research into Valley Fever; and more...

Broadcast from KSQD, Santa Cruz on 2-06-2025: A live guest in the studio introduces Mom's Meals (momsmeals.com,) a program providing free meal delivery services for qualifying Medicare Advantage and Medi-Cal recipients with various dietary needs. During a lengthy live call, Dr. Dawn provides comprehensive guidance for a patient experiencing recurring COVID infections, discussing treatment options, long-haul symptoms, and recovery strategies. She announces FDA approval of Suzetrigine (Journavx), a novel non-opiate pain medication that works by blocking pain signals in the spinal cord, potentially marking a significant advancement in pain management. Responding to an email, Dr. Dawn provides detailed advice for treating a chronically splitting fingernail, recommending silk wrap treatment as a long-term solution. The show examines research showing omega-3 fatty acids, vitamin D, and exercise can slow biological aging, with participants aging 4 months slower over a 3-year study period. Dr. Dawn discusses concerning new research showing microplastics accumulating in mouse brains, kidneys and liver. She explores the emergence of valley fever (coccidiomycosis) as a climate change-related health threat, explaining how drones and genetic analysis are helping track its spread in California where 97% of cases originate The show explores promising research on oyster hemolymph proteins that may help combat antibiotic-resistant bacteria. A live caller follows up with a question about microplastic exposure from CPAP machines, with Dr. Dawn recommending inline bacterial paper-based filters to help capture microplastics and suggesting consultation with doctors about adjusting pressure settings to accommodate the filters.

In this podcast, Karen Tynan (shareholder, Sacramento) and Kevin Piercy (shareholder, Fresno) discuss Valley fever, also known as coccidioidomycosis, a lung infection caused by inhaling fungus spores commonly found in the soil of California's Central Valley and parts of the southwestern United States. Karen, who is the West Coast chair of the firm's Workplace Safety and Health Practice Group, and Kevin delve into the symptoms, causes, and the occupations most at risk, such as construction and agricultural jobs that disturb the soil. They also review relevant Cal/OSHA regulations, including sections 3203, 5141, 5144, and 14300, providing critical guidance on how employers can protect their workers and respond if Valley fever is suspected.

It is on the rise in the desert.  Valley Fever is a fungal infection found in desert soil.  And while the desert is magnificent place to hike and recreate, people need to be aware of this under diagnosed disease. Listen and learn about the desert dust that causes Valley Fever. 

Valley Fever explained - An Airline pilot delivers pizzas to his flight - Get ready for the Dock Strike - Impact Plastic company BOSS killed 6 people - Floor walkers defined - US playing the long game on Japanese airfields - We are all guilty of 'Mulch Volcano' and much much more !

Eastern Equine Encephalitis, Sloth Fever, and West Nile Virus, It's a mosquito apocalypse! On this episode of the N&H podcast special guest Jason Tetro "The Science Guy" joins us to talk about vector born diseases going 'viral' in the media as well as Monkey Pox, and Valley Fever. Jason also shares his insights regarding the 2024 Olympics and the toxic Seine river. Jason Tetro has been involved in health-related microbiology and immunology for the last 30 years. He has worked in various fields including bloodborne, food and water pathogens; environmental microbiology; disinfection and antisepsis; and emerging pathogens such as Zika virus. In the public, he is better known as The Germ Guy. He has written two books, The Germ Code, which was shortlisted as Science Book of The Year in 2014, and The Germ Files, which spent several weeks on the national bestseller list. He has also co-edited, The Human Microbiome Handbook, which provides an academic perspective on the impact of microbes in human health. He is the host of the Super Awesome Science Show, which explores how science fits into our everyday lives. He lives in Edmonton, Alberta, Canada.Jason "The Germ Guy" TetroHost of the Super Awesome Science ShowAuthor of “The Germ Code” and “The Germ Files”Email: thegermguy@gmail.comTwitter: @JATetro Nurses get 1.0 CE's go to https://www.surveymonkey.com/r/R5Y9X6L This episode was brought to you by Rogue Nurse Media. Throw us some bucks, and help support our cause! Venmo: @Nurses-Hypo or PayPal paypal.me/eproguenursemedia Need consulting or have questions: nursesandhypochondriacs@gmail.com Give us a 5 star rating on apple podcasts For The Well Written Nurse Writing and Storytelling classes go to: https://www.eventbrite.com/e/whats-your-story-part-1-detox-intro-to-writing-and-storytelling-tickets-94768506153 Join our email newsletter http://mailchi.mp/f134561374e9/rogue-nurse-media-501c3-newsletter-empowering-nurses-and-patients-to-tell-their-stories

California's bad Valley fever season this year. Capital Stage's season kicks off with “Fairview.” The Hot Jazz Jubilee returns over Labor Day weekend. Finally, Insight host Vicki Gonzalez shares an update on her breast cancer treatment. Valley Fever Season in CA Earlier this year, five people at a music festival in Kern County contracted a fungal infection known as Valley fever. Cases of the disease have tripled in California over the last decade, and more than 5,300 cases have been reported this year through June - 63% higher than last year. Dr. George Thompson, co-director of the Center for Valley Fever at UC Davis Health joins Insight to discuss the risks associated with this infection, and the role climate change plays in spreading Valley fever to more areas. UC Davis Health is a financial supporter of CapRadio. ‘Fairview' Premieres at CapStage   Capital Stage is presenting the Sacramento premiere of Pulitzer Prize winning play “Fairview.” Directed by Sacramento's Anthony D'Juan, “Fairview” used the standard family dramedy for a sharp examination of race in America. Anthony, actor Kathryn Smith-McGlynn (who plays Beverly Fraiser) and Managing Director Keith Riedell talk about bringing this thought-provoking production to life. Capital Stage is a financial supporter of CapRadio.   Hot Jazz Jubilee Sacramento's long-running love affair with Jazz music continues this weekend with the Hot Jazz Jubilee. Patti Jones is the festival's director and she joins Insight to talk about the history of the jubilee and why Sacramento audiences can't seem to get enough. We'll also learn more about its dedication to teaching young musicians. Vicki Gonzalez Update For the past several months, Insight host Vicki Gonzalez has been updating listeners on her ongoing treatment after being diagnosed with breast cancer. Vicki rejoins Insight with the latest step in her journey, what the next several months of treatment and recovery will look like, and how she hopes to continue being a presence on CapRadio during this time.

Broadcast from KSQD, Santa Cruz on 8-08-2024: Dr. Dawn compares conventional medicine with functional medicine, explaining their different approaches to diagnosis and treatment. The show addresses a listener's question about nutrition and supplementation for breastfeeding mothers, offering specific advice on omega-3 fatty acids, calcium, vitamin K2, and dietary recommendations. A new study using gut flora analysis and AI to potentially detect autism in children at an early stage is discussed, highlighting the potential for earlier interventions. Recent research using epigenetic markers to identify prenatal exposures allows early diagnosis of subtle, hard to identify congenital defects and start early treatments The show explores other new uses of AI in medical research, particularly in the development of new antibiotics and antibodies for various diseases including cancer. The potential of AI in protein folding prediction and its application in designing more effective antibodies for diseases like Ebola and COVID-19 is explained. Development of new antibiotics and antifungals using AI and nonprofit partnerships is discussed as a way to address antibiotic resistance where no market incentives exist to drive industry investment. Health warnings are given about Valley Fever (coccidiosis) risks at outdoor music festivals in California and dangers of freshwater algae blooms during summer. The potential of repurposing older, off-patent drugs for cancer treatment is explored, using the example of pyrvinium for colon cancer. The rising costs of new cancer drugs and biological treatments are addressed, with suggestions for alternative development models. A concerning increase in congenital syphilis cases is noted, with a call for more widespread testing, especially in pregnant women.

Valley Fever talk, then: a serious question about relationships and handling (major) crisis together as partners. Or not.

In this episode of Your Natural Dog with Angela Ardolino, we're joined by Halle Stene, Owner of Lonestar Pet Treats, specializing in single-ingredient pet treats and natural nutrition for pets. Halle and Angela delve into various topics, including the effects of Valley Fever, the benefits of mushrooms for respiratory distress, and the importance of gut health for a strong immune system. They also explore the differences between dehydrated and freeze-dried treats, the benefits of quail eggs for dogs, and the need for transparency in the pet industry. Tune in to hear Angela and Halle's insightful discussion on the journey of crafting superior treats tailored for our pet's health.Episode Recap: What is Valley Fever?Mushrooms for respiratory distressGut health for a strong immune systemCreating better treats for dogsDehydrated vs Freeze Dried TreatsQuail eggs for dogsFreeze-drying quail eggsNutritional content & cost effectiveness of freeze-dried treats & foodFinding the best CBD & Mushrooms for her storeThe need for transparency in the pet industryBenefits of quail eggs for petsDehydrated quail feet for petsFeed Real SummitVisit Lonestar Pet Treats in AZUse code RADIO for 15% off your first order at https://cbddoghealth.comUse code MYCO10 for 10% off your order of https://mycodog.comNote: Like all discount codes, they don't last furever!If you have a question about your pet you'd like answered on the podcast, email us at kenzie@hisocialgroup.com.Episode Resources:Lonestar Pet TreatsFollow Lonestar Pet Treats on Instagram, Facebook, and TiktokFeed Real SummitHave a question about your pet that you want answered on the podcast? Email us at Carter@yournaturaldog.com Angela ArdolinoCBD Dog HealthFollow Your Natural Dog on Facebook and Instagram and if you want to see what Angie (our founder) is up to, follow her on Facebook 

A longtime political consultant just released a new book examining the country's largest voting bloc: Latinos. We'll hear about how he says both parties are failing them. And, an entire lab in Arizona studies this phenomenon of social insects, who, this researcher says, are genetically engineered against self-preservation. That and more on The Show.

More than half of U.S. households include pets, but there has been a lack of medical treatments developed specifically for small animals. Biotech companies are working to change that with new treatment options that both borrow from and, potentially, advance human health discoveries.Follow us on LinkedIn, X, Facebook and Instagram. Visit us at https://www.bio.org/

Episode 164: More Than Just A HeadacheDr. Song presents a case of a subacute headache that required an extensive workup and multiple visits to the hospital and clinic to get a diagnosis. Dr. Arreaza added comments about common causes of subacute headaches.    Written by Zheng (David) Song, MD. Editing and comments 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.Introduction to the episode: We are happy to announce the class of 2027 of the Rio Bravo / Clinica Sierra Vista Family Medicine Residency Program. Our new group will be (in alphabetical order): Ahamed El Azzih Mohamad, Basiru Omisore, Kenechukwu Nweke, Mariano Rubio, Nariman Almnini, Patrick De Luna, Sheila Toro, and Syed Hasan. We welcome all of you. We hope you can enjoy 3 enriching and fulfilling years. During this episode, you will hear a conversation between Dr. Arreaza and Dr. Song. Some elements of the case have been modified or omitted to protect the patient's confidentiality. 1. Introduction to the case: Headache. A 40-year-old male with no significant PMH presents to the ED in a local hospital due to over a month history of headaches. Per the patient, headaches usually start from the bilateral temporal side as a tingling sensation, and it goes to the frontal part of the head and then moves up to the top of the head. 8 out of 10 severities were the worst. Pt reports sometimes hypersensitivity to outdoor sunlight but not indoor light. OTC ibuprofen was helpful for the headache, but the headache always came back after a few hours. The patient states that if he gets up too quickly, he feels slightly dizzy sometimes, but it is only for a short period of time. There was only one episode of double vision lasting a few seconds about 2 weeks ago but otherwise, the patient denies any other neurological symptom. He does not know the cause of the headache and denies any similar history of headaches in the past. The patient denies any vomiting, chest pain, shortness of breath, cough, abdominal pain, or joint pain. The patient further denies any recent traveling or sick contact. He does not take any chronic medication. The patient denies any previous surgical history. He does not smoke, drink, or use illicit drugs. What are your differential diagnoses at this moment? Primary care: Tension headache, migraines, chronic sinusitis, and more.2. Continuation of the case: Fever and immigrant.Upon further inquiries, the patient endorses frequent “low-grade fever” but he did not check his temperature. He denies any significant fatigue, night sweats, or weight loss. He migrated from Bolivia to the U.S. 12 years ago and has been working as a farm worker in California for the past 10 years. He is married. His wife and daughter are at home in Bolivia. He is currently living with friends. He is not sexually active at this moment and denies having any sexual partners. Differential diagnoses at this moment?  Tension headache, migraine, infections, autoimmune disease, neurocysticercosis. 3. Continuation of the case: Antibiotics and eosinophilia. As we kept asking for more information, the patient remembered he visited a clinic about four months ago for a dry cough and was told he had bronchitis and was given antibiotics and the cough got better after that. He went to another local hospital ED one month after that because the cough came back, now with occasional phlegm and at that time he also noticed two “bumps” on his face but nothing significant. After a CXR at the ED, the patient was diagnosed with community-acquired pneumonia and sent home with cough medication and another course of antibiotics. His cough improved after the second round of antibiotics. We later found on the medical record that the CXR showed “mild coarse perihilar interstitial infiltrates of unknown acuity”. His blood works at the ED showed WBC 15.2, with lymphocyte 21.2%, monocyte 10.1%, neutrophil 61.7%, eosinophil 5.9% (normally 1-4%), normal kidney, liver functions, and electrolytes, and prescribed with benzonatate 100mg TID and doxycycline 100mg bid for 10 days. He went to the same ED one month before he saw us for headache and fever (we reviewed his EMR, and temp was 99.8F at the ED). After normal CBC, CMP and chest x-ray. The patient was diagnosed with a viral illness and discharged home with ibuprofen 400mg q8h.Due to the ongoing symptoms of headache and fever, the patient went back to the same clinic he went to four months ago for a dry cough and requested a complete physical and blood work. The patient was told he had a viral condition and was sent home with oseltamivir (Tamiflu®) for five days. However, the provider did order some blood work for him. Differential diagnoses at this moment?  Patients with subacute meningitis typically have an unrelenting headache, stiff neck, low-grade fever, and lethargy for days to several weeks before they present for evaluation. Cranial nerve abnormalities and night sweats may be present. Common causative organisms include M. tuberculosis, C. neoformans, H. capsulatum, C. immitis, and T. pallidum. At his physical exam visit, the patient actually asked the provider specifically to check him for coccidiomycosis because of his job as a farm worker and he heard from his friends that the infection rate is pretty high in the Central Valley of California. His serum cocci serology panel showed positive IGG and IGM with CF titer of 1:128. His HIV, syphilis, HCV, HBV are all negative. The patient was told by that clinic to come to ED due to his history of headache, fever, and very high serum coccidiomycosis titer.  The senior and resident intern were on the night shift that night and we were contacted by the ED provider at around 9:30 pm for this patient. When reviewing his ED record, his vitals were totally normal at the ED, the preliminary ED non-contrast head CT showed no acute intracranial abnormality. A lumbar puncture was performed by the ED provider, which showed WBCs (505 - 71%N, 20%L, 7%M), RBC (1), glucose (19), and protein (200). CSF: High Leukocytes, low glucose, and high protein.On the physical exam, the patient was pleasant and cooperative, he was A&O x 4, he had a normal examination except for two brown healing small nodules on his forehead and left cheek and slight neck stiffness. At that point, we knew the patient most likely had fungal meningitis by cocci except for the predominant WBC in his CSF fluid was neutrophil not the more typical picture of lymphocyte dominant. And because of his very benign presentation and subacute history, we were not 100% sure if we had a strong reason to admit this patient. We thought this patient could be managed as an outpatient with oral fluconazole and referred to infectious disease and neurology. 4. Continuation of case: Admission to the hospital.Looking back, one thing that was overlooked while checking this patient in the ED was the LP opening pressure. Later, the open pressure was reported as 340mm H2O (very high). The good thing was, after speaking to the ED attending and our attending, the patient was admitted to the hospital and started on oral fluconazole.  Three hours after the admission, a rapid response was called on him. While the floor nurses were doing their check-in physical examination, the patient had a 5-minute episode of seizure-like activity which included bilateral tonic arm/hand movements, eye deviation to the left, LOC unresponsive to sternal rub, and the patient desaturated to 77%. He eventually regained consciousness after the seizure and pulse oximetry increased to 100% on room air. The patient was started on Keppra and seen by a neurologist the following day. His 12-hour EEG was normal, but his head MRI showed “diffuse thickening and nodularity of the basal meninges are seen demonstrating enhancement, suggesting chronic meningitis, possibly related to cocci. Other etiologies including sarcoidosis and TB meningitis and/or infiltration by metastatic process/lymphoma are not excluded. The ventricles are slightly prominent in size”. MRI of the cervical, thoracic, and lumbar spines also showed extensive diffuse leptomeningeal thickening, extensive meningitis, and nodular dural thickening. Also, his chest x-ray showed “some heterogeneity and remodeling of the distal half of the left clavicle. Metabolic bone disease, infectious etiology and/old trauma considered”. This could also be due to disseminated cocci infection. The infectious disease doctor saw this patient and recommended continuing with fluconazole, serial LPs until opening pressure is less than 250 mmH2O and neurosurgery consultation for possible VP shunt placement. The neurologist recommended the patient continue with Keppra indefinitely in the context of structural brain damage secondary to cocci meningitis.Take home points: Suspect cocci meningitis in patients with subacute headache associated with respiratory symptoms, new skin lesions, photophobia, neck stiffness, nausea, vomiting, eosinophilia, erythema nodosum (painful nodules on the anterior aspect of legs). Other symptoms to look for include arthralgias, particularly of the ankles, knees, and wrists.____________________Brief summary of coccidiomycosis. Etiology Coccidioidomycosis, commonly known as Valley fever, is caused by dimorphic soil-dwelling fungi of the genus Coccidioides (C. immitis and C. posadasii). They are indistinguishable in clinical presentation and routine laboratory test results.1, 2, 3, 5Epidemiology In the United States, endemic areas include the southern portion of the San Joaquin Valley of California and the south-central region of Arizona. However, infection may be acquired in other areas of the southwestern United States, including the southern coastal counties in California, southern Nevada, southwestern Utah, southern New Mexico, and western Texas (including the Rio Grande Valley). There are also cases in eastern Washington state and in northeastern Utah. Outside the United States, coccidioidomycosis is endemic to northern Mexico as well as to localized regions of Central and South America.1, 2Overall, the incidence within the United States increased substantially over the 1998-2019, most of that increase occurred in south-central Arizona and in the southern San Joaquin Valley of California. From 1998 to2019, reported cases in California increased from 719 to 9004.1, 6The risk of infection is increased by direct exposure to soil harboring Coccidioides. Past outbreaks have occurred in military trainees, archaeologists, construction or agricultural workers, people exposed to earthquakes or dust storms. However, in endemic areas, many cases of Coccidioides infection occur without obvious soil or dust exposure and are not associated with outbreaks. Change in population, climate change, urbanization and construction activities, and increased awareness and reporting, are possible contributing factors.1, 2, 5 Pathology In the soil, Coccidioides organisms exist as filamentous molds. Small structures called arthroconidia from the hyphae may become airborne for extended periods. Arthroconidia are usually 3-5 μm—small enough to evade bronchial tree mucosal mechanical defenses and reach deep into the lungs.1, 3Once inhaled by a susceptible host into the lung, the arthroconidia develop into spherules (theparasitic existence in a host), which are unique to Coccidioides. Endospores from ruptured spherules can themselves develop into spherules, thus propagating infection locally.1, 3, 5Although rare cases of solid organ donor-derived or fomite transmitted infections have been reported, coccidioidomycosis does not occur in person-to-person or zoonotic contagion, and transplacental infection in humans has never been documented.2, 5Cellular immunity plays a crucial role in the host's control of coccidioidomycosis. Among individuals with decreased cellular immunity, Coccidioides may spread locally or hematogenously after an initial symptomatic or asymptomatic pulmonary infection to extrathoracic organs.1, 3, 7Clinical manifestationThe majority of infected individuals (about 60%) are completely asymptomatic. Symptomatic persons (40% of cases) have symptoms that are related principally to pulmonary infection, including cough, dyspnea, and pleuritic chest pain. Some patients may also experience fever, headache (common finding in early-stage infection and does not represent meningitis), fatigue, night sweats, rash, myalgia.1, 2, 3, 5In most patients, primary pulmonary coccidioidomycosis usually resolves in weeks without sequelae and lifelong immunity to reinfection. However, some patients may develop chronic pulmonary complications, such as nodules or pulmonary cavities, or chronic fibrocavitary pneumonia. Some individuals with intense environmental exposure or profoundly suppressed cellular immunity (e.g., in patients with AIDS) may develop a primary pneumonia with diffuse reticulonodular pulmonary process in association with dyspnea and fever.1, 3, 5Fewer than 1% of infected individuals develop extrathoracic disseminated coccidioidal infection. Common sites for dissemination include joints and bones, skin and soft tissues, and meninges. One site or multiple anatomic foci may be affected. 1, 2, 3, 7It is estimated that coccidioidal meningitis, the most lethal complication of coccidioidomycosis, affects only 0.1% of all exposed individuals. Patients with coccidioidal meningitis usually present with a persistent headache (rather than a self-limited headache in some patients with primary pulmonary infection), with nausea and vomiting, and sometimes vision change. Some may also develop altered mental status and confusion. Meningismus such as nuchal rigidity, if present, is not severe.Hydrocephalus and cerebral infarction may develop in some cases. Papilledema is more commonly observed in pediatric patients.1, 3, 4, 5, 7When meningitis develops, most patients may not have any respiratory symptoms nor radiographic manifestation of pulmonary infection. However, a large number of these individuals also present with other extrathoracic lesions.7DiagnosisAlthough early diagnosis carries obvious benefits for patients and the health care systems as a whole (e.g., decreases patient anxiety, reduces the cost of expensive and invasive tests, removes the temptation for empirical antibacterial or antiviral treatments, and allows for early detection of complications), considerable diagnostic delays up to several weeks to months are common in both endemic areas and non-endemic areas.3, 7 Most symptomatic persons with coccidioidal infection present with primarily pulmonary symptoms and are often misdiagnosed as community-acquired bacterial pneumonia and treated with antibiotics. In endemic areas like south-central Arizona, previous studies found up to 29% of community-acquired pneumonia is caused by coccidioidomycosis. Healthcare providers thus should maintain a high clinical suspicion for coccidioidomycosis when evaluating persons with pneumonia who live in or have traveled to endemic areas recently. Elevated peripheral-blood eosinophilia of over 5%, hilar or mediastinal adenopathy on chest radiography, marked fatigue, and failure to improve with antibiotic therapy should prompt suspicion and testing for infection with coccidioidomycosis in endemic areas.1, 3, 5Serological testing plays an important role in establishing a diagnosis of coccidioidomycosis. Enzyme immunoassay (EIA) to detect IgM and IgG antibodies is highly sensitive and therefore commonly used as the screening tool. Immunodiffusion is more specific but less sensitive than enzyme immunoassay. It is used to confirm the diagnosis of positive EIA test results. Complement fixing (CF) test, which indirectly detects the presence of coccidioidal antibodies by testing the consumption of serum complement, are expressed as titers. Serial measurements of titers are of not only diagnostic but also prognostic value.1, 2, 3, 5Other methods, including culture, microscopic, or polymerase chain reaction (PCR) exam on tissue or respiratory specimens, are limited by their availability, sample obtaining and handling, or lack of sufficient evaluation.1, 2, 3, 5Cerebrospinal fluid (CSF) examination in coccidioidal meningitis usually demonstrates lymphocyte dominated elevation of leukocytes, although polymorphonuclear leukocyte dominance can also be seen in the early stage of the infection. Profound hypoglycorrhachia and elevated protein levels in CSF examination are also very common in coccidioidal meningitis.1, 7Although isolating Coccidioides from CSF or other CNS specimens are diagnostic for coccidioidal meningitis, in practice, diagnoses are often made based on the combination of clinical presentation, CSF examination that suggesting fungal infection, and positive Coccidioides antibodies found in CSF.7Imaging, especially enhanced magnetic resonance imaging (MRI), can help in diagnosing coccidioidal meningitis. Basilar leptomeningeal enhancement is a more common finding even though hydrocephalus, cerebral infarction, and vertebral artery aneurysm can also be seen.7TreatmentMost patients with focal primary pulmonary coccidioidomycosis do not require antifungal therapy. According to 2016 Infectious Diseases Society of America (IDSA) Clinical Practice Guideline, antifungal therapy should be considered in patients with concurrent immunosuppression that adversely affect cellular immunity (e.g., organ transplant patients, AIDS in HIV-infected patients, and patients receiving anti–tumor necrosis factor therapy) and those with significantly debilitating illness, extensive pulmonary involvement, with concurrent diabetes, pregnant women, or who are otherwise frail because of age or comorbidities. Some experts would also include African or Filipino ancestry as indications for treatment. Conversely, humoral immunity comprise splenectomy, hypocomplementemia, or neutrophil dysfunction syndromes are not major risk factors for this disease.1, 2, 3, 4, 5Triazole antifungals (fluconazole or itraconazole) are currently considered as the first-line medications used to treat most cases of coccidioidomycosis. Amphotericin B is reserved for only the most severe cases of dissemination and patients with coccidioidal meningitis in whom triazole antifungal therapy has failed. It is also the choice of therapy for coccidioidomycosis in pregnant women during the first trimester because of the possible teratogenic effect of high-dose triazole therapy during this period of time.1, 3, 4, 5Treating coccidioidal meningitis (CM) poses a special challenge because untreated meningitis is nearly always fatal. Lifelong therapy is recommended for CM because the majority 80% patients with CM experience relapse when therapy is stopped despite initial response to antifungal treatment. Shunting of CSF is required in cases of meningitis complicated by hydrocephalus.1, 3, 4, 5, 7Prevention Avoidance of direct contact with contaminated soil in endemic areas (e.g., respirator use by construction workers) may reduce disease risk, although clear evidence of its benefit is lacking.1, 5Some special population groups may benefit from prophylactic use of antifungals, such as those about to undergo allogeneic solid-organ transplantation or patients with a history of active coccidioidomycosis or a positive coccidioidal serology in whom therapy with tumor necrosis factor α antagonists is being initiated. The administration of prophylactic antifungals is not recommended for HIV-1-infected patients even if they live in an endemic region.1, 5Conclusion: Now we conclude episode number 164, “More than just a headache.” Dr. Song explained that a headache with an indolent course, accompanied by subacute respiratory symptoms, nausea, vomiting, photophobia, neck stiffness, and skin lesions can be secondary to Valley Fever. The Central Valley of California, as well as other areas with dry climate, are endemic and we need to keep this disease in our differential diagnosis.This week we thank Hector Arreaza and Zheng (David) Song. 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:Roos KL, Tyler KL. Acute Meningitis. McGraw Hill Medical. Published 2023. Accessed August 18, 2023. https://accessmedicine.mhmedical.com/content.aspx?bookid=2129§ionid=192020493Information for Healthcare Professionals. Published 2023. Accessed August 18, 2023. https://www.cdc.gov/fungal/diseases/coccidioidomycosis/health-professionals.html#printValley Fever (Coccidioidomycosis) a Training Manual for Primary Care Professionals. Accessed August 18, 2023. https://vfce.arizona.edu/sites/default/files/valleyfever_training_manual_2019_mar_final-references_different_colors.pdfAmpel NM. Coccidioidomycosis. Idsociety.org. Published July 27, 2016. Accessed August 18, 2023. https://www.idsociety.org/practice-guideline/coccidioidomycosis/Herrick KR, Trondle ME, Febles TT. Coccidioidomycosis (Valley Fever) in Primary Care. American Family Physician. 2020;101(4):221-228. Accessed August 18, 2023. https://www.aafp.org/pubs/afp/issues/2020/0215/p221.htmlValley Fever Statistics. Published 2023. Accessed August 18, 2023. https://www.cdc.gov/fungal/diseases/coccidioidomycosis/statistics.htmlUpToDate. Uptodate.com. Published 2023. Accessed August 18, 2023. https://www.uptodate.com/contents/coccidioidal-meningitis?search=7%20Coccidioidal%20meningitis&source=search_result&selectedTitle=1~10&usage_type=default&display_rank=1Royalty-free music used for this episode: Tropicality by Gushito, downloaded on July 20, 2023, from  https://www.videvo.net/

The government's rollout of what was supposed to be a new and improved college financial aid form has been full of glitches. One local high school counselor worries it could keep students out of college. And, what new data tell us about Valley fever, and how it spreads. That and more on The Show.

Valley fever - a combo of fever, cough, and fatigue - is on the rise in CA. LA City Council approves new steps to stop copper wire thefts that have blacked out lots of city streetlights. How did you celebrate Valentine's Day? We speak to some newlyweds. Plus, more. Support The L.A. Report by donating at LAist.com/join and by visiting https://laist.com.   Support the show: https://laist.com

Highlights this week. Interviews may be abbreviated. For the date and hour podcast to hear more, see the note 0:00 Bonus Track: Katie Hobbs promised to secure the border and make Arizona safe when she ran for Governor

Bruce Ash, host of Inside Track, joins Chris today to celebrate Hanukkah with latkes prepared by his wife! Inside Track airs every Saturday right here on 1030 The Voice from 1-3PM. Chris, Bruce, and Esq enjoy latke's and Bruce lights the menorah. US Representative David Schweikert. What do Rob Gronkowski and progress on a Valley Fever vaccine have in common? Federal indictments on retaliation against FBI whistleblowers mirror David's committee work that the media criticized. Harvard imploding at the top.

Despite the many advances in diagnostic testing for infectious diseases, detection of Coccidoides infections continues to rely on serologic assessment for anti-fungal antibodies, and what is perhaps more astonishing is that the serologic methods we use today, such as complement fixation and immunodiffusion, were first developed about a century ago. These assays are technically challenging to maintain and perform, and as a result few labs offer this testing, and even if performed on-site, testing can take up to 3 days complete, so there is definitely room for improvement. So today, we are talking about a study that aimed to modernize and improve our current options and diagnostic approach for Valley Fever, using a simpler and definitely faster lateral flow immunoassay. And as an added bonus, the study was not homo sapien-centric. Guests: Dr. Francisca Grill, Chief Scientific Officer at Cactus Bio Dr. Tom Grys, Associate Professor of Laboratory Medicine and Pathology, and co-Director of the Clinical Microbiology laboratory at Mayo Clinic in Arizona Links: Development of a rapid lateral flow assay for detection of anti-coccidioidal antibodies This episode of Editors in Conversation is brought to you by the Journal of Clinical Microbiology and hosted by JCM Editor in Chief, Alex McAdam and Dr. Elli Theel. JCM is available at https://jcm.asm.org and on https://twitter.com/JClinMicro. Visit journals.asm.org/journal/jcm to read articles and/or submit a manuscript. Follow JCM on Twitter via @JClinMicro

We love our animals, small and large. So do those professionals who help us care for them. Christine Staten, DVM is a large animal veterinarian and owner of Adobe Veterinary Center, specializing in small and large animals. She also mentors those new to the profession. During more than thirty years of practice, she has seen many changes both in the science side and business side. She chats with Russell and Alan about those changes and her concerns about the future of veterinary medicine.

New episode! Kath thought she was a talker, but she met her match in our lively and joyous guest, Frederick Johnson, who regales Kath and Jan with tales of growing up in a family where everyone had multiple names and ate macrobiotic food! Frederick talks about his battle with Valley Fever and how in recovery, he left the healthy stuff behind and craved the bad (good) stuff, like tacos and cereal. We discuss the fact that at one point he lost 30 pounds and didn't even realize it. Frederick also talks about his first job working alone in a snack bar from morning till night under the watchful eye of a future corrections officer. He then reveals that he can make killer greens with smoked turkey as well as pecan pie, which assures him an instant spot at Kath's Thanksgiving table. We could have talked for hours! Listen in!

A Biden Administration program to monitor asylum-seeking families and subject them to a curfew is set to expand to several California cities next week. It's part of an effort by the Biden Administration to signal a tough but humane approach to border enforcement. Reporter: Tyche Hendricks, KQED  Following the state's record-breaking rainfall in the winter, and now its dry heat, public health officials are worried about an uptick in Valley fever infections.  Reporter: Izzy Bloom, The California Report In the early 1900s, many young Americans of Japanese descent left the United States to escape discrimination and seek opportunity back in Japan. When war broke out, they experienced the violence of the U.S. offensive while trying to navigate complex, often contradictory feelings about identity and belonging. Reporter Kori Suzuki explores this period through a very personal story — that of his grandmother. Reporter: Kori Suzuki, KQED

KFI Investigative Reporter Steve Gregory joins the show to talk about the man found in barrel at Malibu Lagoon, plane crash at Van Nuys Airport, and previews an all-new episode of 'Unsolved', airing tomorrow night right here on KFI. Dr. Jim Keany, Co-Director of the Emergency Room at Mission Hospital in Mission Viejo, joins The Bill Handel Show for a fresh edition of 'Medical News'! The two talk about infant peanut butter exposure and how it could prevent allergies are ‘peanut parties', health officials warn “Valley Fever” infections rising in SoCal, pot addiction is real but no one is taking it seriously, and Central Florida is a hotspot for Leprosy.

Dr. Jim Keany, Co-Director of the Emergency Room at Mission Hospital in Mission Viejo, joins The Bill Handel Show for a fresh edition of 'Medical News'! The two talk about infant peanut butter exposure and how it could prevent allergies are ‘peanut parties', health officials warn “Valley Fever” infections rising in SoCal, pot addiction is real but no one is taking it seriously, and Central Florida is a hotspot for Leprosy.

In this episode, I Interview George Thompson from UC Davis. Join us as we talk all about Coccidioidomycosis and more.

Another indictment of former President Trump. We go In Depth into how this one might be the most damning.  We also look into a potential breakthrough for one of the Hollywood strikes.  If you're sick it might be something other than a cold or COVID. We explain. 

We went to SoFi Stadium to check out the madness in the line for merch. Also, could there be a breakthrough this week in the Hollywood strikes? And if you've been sick lately, could it have been Valley Fever? Health officials have a warning. Plus, and update on the murder mystery in Malibu. 

About 20,000 cases were reported to the CDC in 2019, up sevenfold from 1999. Learn more at https://www.yaleclimateconnections.org/

Episode 143: Pulmonary Cocci BasicsDr. Lovedip Kooner explains the history, diagnosis, and treatment of pulmonary coccidioidomycosis (cocci for short.) Disseminated cocci infection was also discussed. Dr. Arreaza added some anecdotes of patients seen with this infection.  Written by Lovedip Kooner, MD. Comments 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.Definition:Coccidioidomycosis, also known as Valley Fever, is an infection caused by the fungi Coccidioides immitis and Coccidioides posadasii. Coccidioides is also referred to as cocci. Generally speaking, C. immitis is found in California and C. posadasii is found in Arizona, and Central and South America. More recently Cocci has also been found as far north as Washington and British Columbia. History:The fungal infection was first reported by Wernicke and Posadas in Argentina in 1892 where they described a case where a man had cutaneous cocci of the head, arm, and trunk. To this day, the head is preserved in Argentina. 4 For many years, only disseminated cases were recognized and described as “coccidioidal granulomas.” The work of Dixon and Gifford in 1935 elucidated that a pneumonic disease of unknown cause termed “San Joaquin Valley Fever” was, in fact, the primary coccidioidal infection and the port of entry of almost all coccidioidal disease. Initial infection occurs predominantly by inhalation of aerosolized arthroconidia and rarely by direct cutaneous inoculation.1,2Coccidioides spp. survive best in areas with low rainfall (12–50 cm per year), limited winter freezes, and alkaline soils. With climate change models, predicting the geographical range expansion.These dimorphic fungi exist in a mycelial form in the soil. Coccidioides species have been found in animal burrows near the Kern River and in Armadillo burrows in South American countries like Brazil. The mycelia produce arthroconidia (spores) that are ultimately airborne and inhaled.The inoculum required for infection is low and in animal models as few as a single arthroconidium may cause infection.3 Infection:Once arthroconidia are inhaled into the lung, there is typically a 1-3-week incubation period. The arthroconidia undergo morphologic changes into spherules, which are large structures that contain endospores.4 As spherules mature, they rupture and release endospores. Endospores can be spread hematogenous or through lymphatics to essentially any organ, leading to the development of new spherules and potentially disseminated disease.5 Not everyone who inhales the arthroconidia gets the infection. Clinical Manifestations.About 60% of patients who inhale arthroconidia are asymptomatic. 30% have a mild respiratory illness, like the flu. 10% have a more serious disease course and are diagnosed. Other symptoms may include fever, drenching night sweats, and weight loss. Extreme fatigue that limits baseline activity may also raise concerns. Symptom onset up to 2 months after endemic exposure should lead to coccidioidomycosis on the differential. Coccidioidomycosis cases have been documented in Michigan, Europe, and China. These cases were of people who traveled to endemic areas for as little as a few days and then were later diagnosed. 1-3% of all coccidioidomycosis cases are disseminated, severe, or chronic pulmonary infections. If undiagnosed, coccidioidomycosis may lead to significant morbidity and mortality. Dissemination sites include the skin, lymph nodes, bones, and Central Nervous System (CNS) which is the most severe. Any organ can be infected, including documented cases of the prostate and adrenal gland. Arreaza: Recap: 60% are subclinical, 30% are mild, 10% serious, 1-3% are disseminated. What are some risk factors for severe infection? Should I stop biking?Risk factors for severe infection:Severe pulmonary infections can happen in anyone but occur more commonly in diabetics, tobacco users, and people older than 65 years of age.Oceanic or Filipino ethnicity and black or African American have a higher rate of dissemination. Immunosuppression, including HIV, transplant patients, and immunosuppressive medications like corticosteroids or TNF-alpha inhibitors have been shown to be risk factors for dissemination. Pregnant patients, particularly in the third trimester have higher rates of severe infection as well.Arreaza: How do we diagnose the disease?Diagnosis:Diagnosis is commonly made serologically. EIA (enzyme immunoassay) is used more often. There are more false positives than false negatives and varies by manufacturer. Kern County Health Department uses Immunodiffusion IgG and IgM and Complement Fixation are used. Immunodiffusion IgG and IgM are scaled by non-reactive, weakly reactive, reactive and strongly reactive. Compliment fixations are scaled by a ratio/dilution. Serum Compliment fixations

Most of us had a summer job when we were in high school or college, and if we were lucky, we had one that helped us make meaningful decisions about college or a career. 
  At TGen, summer interns in the Helios Scholars at TGen program work alongside researchers on projects that are much more than “just” eight weeks of full-time hours inside a lab. Many Scholars choose a field of research they will pursue for an entire career.
   On this episode of the TGen Talks, we connect with Heather Mead, Ph.D., a research assistant professor in TGen's Pathogen and Microbiome Division. A former Helios Scholar who describes the eight-week internship as life changing and encouraged her to begin a second career in research, one that has seen her come full circle as today she mentors Helios Scholars, helping them find and follow their passion … all while conducting research and coordinating projects around Tuberculosis, Valley Fever, COVID and more.

Episode 141: Adrenal Insufficiency BasicsFuture doctor Wilson explains how to recognize an acute adrenal insufficiency and explains how to treat it. Also, chronic adrenal insufficiency is explained. Dr. Arreaza adds comments about congenital adrenal hyperplasia.Written by Candace Wilson, MSIV, American University of the Caribbean. Comments by Hector Arreaza, MD.June 2, 2023.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.Introduction: After having seen patients with adrenal insufficiency when I did a rotation in ICU, I saw how important it is to be able to recognize it quickly to ensure that patients receive appropriate treatment as quickly as possible. Arreaza: AI is adrenal insufficiency but also AI stands for Artificial intelligence, so we had the idea to ask Chat GPT what are the adrenal glands and this is what we got: “The adrenal glands are small endocrine glands located on top of each kidney. They are small in size, but they play a vital role in producing and secreting essential hormones.” (end of quote)Glucocorticoids play an important role in the mobilization of energy reserves by increasing gluconeogenesis, glycogen synthesis, protein catabolism, lipolysis, appetite, and insulin resistance. Each adrenal gland is composed of two main parts: the outer region called the adrenal cortex and the inner region called the adrenal medulla. These two regions have distinct structures and functions.” The adrenal cortex has three zones, Zona glomerulosa (mineralocorticoids, mainly aldosterone), Zona fasciculata (cortisol), and Zona reticularis (androgens). Mineralocorticoids are a class of steroid hormones produced by the Zona glomerulosa of the adrenal gland that influence electrolyte and water balance through modifying renal absorption of sodium and potassium.Definition of AI: AI is “inadequate functioning of the adrenal glands”. Adrenal gland hormones: glucocorticoids, mineralocorticoids, and sex hormones.Primary vs. secondary adrenal insufficiency.Candace: Primary adrenal insufficiency is caused either by the abrupt destruction of the adrenal gland or by progressive destruction/atrophy, whereas secondary adrenal insufficiency is due to conditions that impair the hypothalamic-pituitary-adrenal axis leading to decreased ACTH production. Causes of primary adrenal insufficiency includes autoimmune adrenalitis (which is the most common cause in the US); infectious adrenalitis (tuberculosis being the most common cause worldwide); adrenal hemorrhage; infiltration of the adrenal gland by tumors, amyloidosis, or hemochromatosis; adrenalectomy; cortisol synthesis inhibitors (such as rifampin, fluconazole, phenytoin, ketoconazole); 21B-hydroxylase deficiency; and vitamin B5 deficiency. Fluconazole is commonly used to treat pulmonary cocci (Valley Fever in our community). What about secondary causes?Causes of secondary adrenal insufficiency include sudden discontinuation of chronic glucocorticoid therapy; stress (such as infection, trauma, or surgery) during prolonged glucocorticoid therapy; and hypopituitarism. Clinical presentation of adrenal crisis.Adrenal insufficiency can present acutely or chronically with more insidious symptoms. We will first discuss the acutemanifestation of adrenal insufficiency, also known as adrenal crisis. In any patient who demonstrates vasodilatory shock, unexplained severe hypoglycemia, or unexplained hyponatremia whether or not the patient is known to have adrenal insufficiency, adrenal crisis should be considered a possibility. Adrenal crisis is a life-threatening emergency that requires immediate medical treatment and can occur in either primary or secondary adrenal insufficiency, though it is most common in patients with primary adrenal insufficiency. The main feature of adrenal crisis is shock, but patients may also have vague symptoms such as anorexia, nausea, vomiting, abdominal pain, weakness, fatigue, lethargy, fever, confusion, or coma. In patients with adrenal crisis from primary adrenal insufficiency, volume depletion and hypotension are the major clinical features, resulting from mineralocorticoid deficiency. In contrast, the patients with adrenal crisis from secondary adrenal insufficiency (which is an isolated glucocorticoid deficiency) will have hypotension secondary to decreased vascular tone without volume depletion.Treatment of adrenal crisis.Signs of an adrenal crisis should be recognized quickly, and management should be started as quickly as possible. When adrenal crisis is suspected, do not wait for laboratory results before initiating treatment as this is a life-threatening medical emergency. After all necessary laboratory tests have been collected (including serum electrolytes, glucose, routine measurement of plasma cortisol and ACTH) and IV access has been established, infuse 2-3L of isotonic saline or 5% dextrose in isotonic saline as quickly as possible and give bolus of hydrocortisone 100mg IV followed by 50mg IV every 6 hours or 200mg/24 hours as a continuous IV infusion for the first 24hrs. The answer to many endocrine emergencies is IV fluids, in this case, you also add hydrocortisone and mineralocorticoids.Alternative glucocorticoids if hydrocortisone is unavailable include methylprednisolone and dexamethasone. While patient is hemodynamically unstable, it is important to frequently monitor vital signs and serum electrolytes to avoid iatrogenic fluid overload. When the patient has stabilized, continue IV isotonic saline at a slower rate for 24-48 hours, and for patients with primary adrenal insufficiency, begin mineralocorticoid replacement with fludrocortisone 0.1mg orally daily when saline infusion is stopped. If there is concern for infectious precipitating cause of the adrenal crisis, perform an extensive infectious workup. Addison's disease.Early symptoms of chronic adrenal insufficiency can be vague and nonspecific (such as fatigue, weight loss, and GI complaints), making the clinical diagnosis more difficult than acute adrenal insufficiency. Diagnosis must be confirmed with a thorough endocrine evaluation to determine the type and cause of the adrenal insufficiency, but treatment should be started before the diagnosis is established in acutely ill patients. Primary and secondary adrenal insufficiency shares some common clinical manifestations, such as fatigue, weight loss, anorexia, nausea, vomiting, abdominal pain, amenorrhea, diffuse myalgia, arthralgia, confusion, delirium, stupor, depression, psychosis, mania, anxiety, disorientation, and hallucinations.Clinical manifestations of indicative of primary adrenal insufficiency include orthostatic hypotension, salt craving, hyperpigmentation especially of areas not typically exposed to sunlight (such as palmar creases, mucous membrane of the mouth), vitiligo (though hyperpigmentation is more common), hypotension, and auricular calcifications. Lab findings.Laboratory results will show electrolyte disturbances (such as hyponatremia, hyperkalemia, and hypercalcemia), azotemia, normocytic anemia, eosinophilia, increased renin, normal anion gap metabolic acidosis, hypoglycemia, increased ACTH, low cortisol, low aldosterone, increased cortisol releasing hormone, and decreased DHEA-S.Clinical manifestations of secondary adrenal insufficiency is similar to those in primary adrenal insufficiency with the notable exceptions of: hypotension (which is less prominent than in primary AI), absence of dehydration, pale skin as opposed to hyperpigmentation. Laboratory results in secondary adrenal insufficiency will show normal aldosterone, sodium, potassium, and renin; decreased ACTH and cortisol; and increased cortisol-releasing hormone.Treatment of chronic adrenal insufficiency. Treatment of primary adrenal insufficiency focuses on replacing hypocortisolism with glucocorticoids and hypoaldosteronism with mineralocorticoids. In contrast, the treatment of secondary adrenal insufficiency focuses on the replacement of hypocortisolism with glucocorticoids without the need to supplement aldosterone. Short-acting glucocorticoids (such as hydrocortisone) are the preferred medication for treatment since they roughly mimic the normal diurnal rhythm. Intermediate-acting (such as prednisone or prednisolone) and long-acting glucocorticoids (such as dexamethasone) are acceptable alternatives, especially in patients who are non-compliant with multiple-day dose schedules or those with severe late-evening or early-morning symptoms, but due to variable inter-individual metabolism of dexamethasone, be cautious of over-treating patients. Whether the patient is receiving short-acting, intermediate-acting, or long-acting, ensure that patients receive the lowest glucocorticoid dose that relieves symptoms while avoiding signs and symptoms of glucocorticoid excess (such as weight gain, facial plethora, truncal obesity, osteoporosis, etc.).Summary: Primary = Glucocorticoids and mineralocorticoids. Secondary = Glucocorticoids. Glucocorticoids can be short, intermediate, and long-acting. What about mineralocorticoids?Fludrocortisone 0.1mg/day is the preferred agent for mineralocorticoid replacement in patients with primary adrenal insufficiency, though patients who are receiving hydrocortisone therapy in conjunction may require a lower dose of 0.05mg/day. Mineralocorticoid therapy may need to be increased during the summer due to salt loss in perspiration. As a reminder, aldosterone works by controlling the reabsorption of sodium and excretion of potassium. It influences water reabsorption. It is part of the renin-angiotensin-aldosterone system (RAAS) to maintain blood pressure. In addition, it is important that patients receive adequate education about their medical condition and causes, whether it is primary or secondary adrenal insufficiency, especially the maintenance of medication, adjustment during minor illnesses, and when to consult a clinician.Bottom line: Adrenal insufficiency can be acute or chronic, primary or secondary. In primary adrenal insufficiency, laboratory results will show electrolyte abnormalities, such as hyponatremia and hyperkalemia, with increased ACTH. Whereas in secondary adrenal insufficiency, electrolytes will be normal, and ACTH will be decreased. Both primary and secondary adrenal insufficiency require treatment with glucocorticoid, but a mineralocorticoid should be added in the setting of primary adrenal insufficiency. _________________________Conclusion: Now we conclude episode number 141, “Adrenal Insufficiency Basics.” We encourage you to recognize acute adrenal insufficiency promptly and start IV fluids and glucocorticoid stat. Candace reminded us that chronic adrenal insufficiency presents with vague and insidious symptoms, including hypotension, fatigue, weight loss, anorexia, hyperpigmentation of the skin, and even vitiligo. Make sure to include our colleagues from endocrinology if you have concerns.   This week we thank Hector Arreaza and Candace Wilson. 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:Nieman, L. K. (n.d.). Diagnosis of adrenal insufficiency in adults. UpToDate. https://www.uptodate.com/contents/diagnosis-of-adrenal-insufficiency-in-adults. Accessed June 2, 2023.Nieman, L. K. (2022, October 25). Clinical manifestations of adrenal insufficiency in adults. UpToDate. https://www.uptodate.com/contents/clinical-manifestations-of-adrenal-insufficiency-in-adults . Accessed June 2, 2023.Nieman, L. K. (2022a, October 19). Treatment of adrenal insufficiency in adults. UpToDate. Treatment of adrenal insufficiency in adults - UpToDate. Accessed June 2, 2023.Royalty-free music used for this episode: "Latina Havana Boulevard." Downloaded on October 13, 2022, from https://www.videvo.net/ 

Heidi Kyser joined Desert Companion, the premier city magazine that celebrates the pursuits, passions, and aspirations of Southern Nevadans, as a staff writer in January 2014. In 2018, she was promoted to senior writer and producer, working for both DC and State of Nevada. She produced KNPR's first podcast, the Regional Murrow Award-winning Native Nevada, in 2020. The following year, she returned her focus full-time to Desert Companion, becoming Deputy Editor, and became interim editor, replacing Andrew Kiraly, in July 2022. In her 20 years as a print and on-air journalist, Heidi's done it all, from news writing for a weekly business publication, to producing multimedia stories for an alternative weekly, winning a handful of Eddie, Maggie, and Nevada Press Association awards along the way. When she's not camping, hiking, riding her bike, or doing some other outdoor activity with her husband Peter, Heidi is most likely to be found on a yoga mat, being spotted by her 90-pound American Bulldog Buster. During episode 510 on how to make healthcare work better for all, Heidi discusses her experiences reporting on healthcare for Desert Companion. Plus, she shares how a diagnosis of Valley Fever, a fungal infection that can attack a person's nervous system, their most vital organs, and lead to cerebral meningitis (and, in extreme cases, death) “brought home the healthcare system shortcomings [she's] reported on for years.” More specifically, Heidi shares: Key changes in the healthcare system that could help medical providers AND patients How her personal experiences navigating her own healthcare motivated her reporting with Desert Companion Why self-advocacy is a vital patient competency Her hopes for how healthcare will evolve by 2033 Resources Mentioned in This Episode:   Learn more about Heidi Kyser and her work at Desert Companion Read 5 Big Ideas for Better Healthcare in Desert Companion Learn more about Desert Companion Connect with Heidi on Twitter Please leave a review and subscribe to Moxielicious® via Apple Podcasts, Stitcher, Google Play, or Spotify so you never miss an episode!

https://www.yahoo.com/news/eye-infections-tainted-eyedrops-may-030317250.html https://www.yahoo.com/news/dax-tejera-surprising-cause-death-160523318.html https://www.insider.com/man-us-prostate-cancer-irish-accent-2023-2#:~:text=A%20man%20in%20the%20US%20developed%20an%20uncontrollable,as%20foreign%20accent%20syndrome%2C%20according%20to%20a%20report. https://www.yahoo.com/finance/news/cancer-vaccines-already-reality-doctor-110000530.htmlhttps://www.yahoo.com/news/20-old-thought-she-had-111825286.html https://www.yahoo.com/news/valley-fever-historically-found-only-003211130.htmlhttps://www.yahoo.com/news/last-us-loosely-based-real-234532202.htmlEMAIL: hypoalmapodcast@gmail.comSOCIAL MEDIA: @podcast.addict

talk about a fungus that is spreading due to climate change

We don't talk much about valley fever here in Connecticut but now we are. The issue which typically plagues people in the southwest is now reportedly spreading and is expected to reach the east by the end of the century. Dr. Browne shares why it's spreading and everything we need to know about it.  He also touched on mpox and fake cures being sold online to beware of.  IMAGE CREDIT:  iStock / Getty Images Plus 

Dr. Aileen Marty, Infectious Disease Specialist and Professor at Florida International University, joins Bob Sirott to talk about the latest health news. Dr. Marty explains what valley fever is and discusses a new Omicron subvariant, CH.1.1, or Orthrus.

The Alan Cox Show

On today's episode, California Department of Public Health officials provide valuable information on Valley Fever, capping off August's awareness month for the fungal disease affecting ag workers. Additionally, Vicky Boyd reports on the recently released USDA report that looked at unplanted acreage in each state, including California.   Supporting the People who Support Agriculture Thank you to our sponsors who make it possible to get you your daily news. Please feel free to visit their websites. The California Walnut Board – https://walnuts.org/ PhycoTerra®  –https://phycoterra.com/

Join Yvonne Brandenburg, RVT, VTS SAIM and Jordan Porter RVT, LVT, VTS SAIM as we talk about: More fungus! We talk about Valley Fever or coccidioidomycosis; this can affect the respiratory tract, skin, ocular, bones, and even the CNS.    Question of the Week Have you seen ocular valley fever, what did it present like?  Leave a comment at https://imfpp.org/episode131   Resources We Mentioned in the Show  https://pubmed.ncbi.nlm.nih.gov/18762558/#:~:text=The%20dimorphic%20fungi%20Coccidioides%20immitis,frequently%20results%20in%20chronic%20cough. https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4952695 https://www.merckvetmanual.com/generalized-conditions/fungal-infections/coccidioidomycosis https://vcahospitals.com/know-your-pet/coccidioidomycosis-in-dogs https://health.ucdavis.edu/valley-fever/    Thanks so much for tuning in. Join us again next week for another episode!  Want to earn some RACE approved CE credits for listening to the podcast? You can earn between 0.5-1.0  hour of RACE approved CE credit for each podcast episode you listen to.    Join the Internal Medicine For Vet Techs Membership to earn and keep track of your continuing education hours as you get your learn on!   Join now! http://internalmedicineforvettechsmembership.com/   Get Access to the Membership Site for your RACE approved CE certificates Sign up at https://internalmedicineforvettechsmembership.com  Get Access to the Technician Treasure Trove  Sign up at https://imfpp.org/treasuretrove    Thanks for listening!  – Yvonne and Jordan   

In this VETgirl online veterinary continuing education podcast, we discuss the treatment of refractory coccidioidomycosis in dogs. Coccidioidomycosis, also known as Valley Fever, is a common fungal infection in the southwestern United States that is caused by the organisms Coccidioides immitis and Coccidioides posadasii. We review the study by Shubitz et al entitled "Posaconazole treatment of refractory coccidioidomycosis in dogs."

Brad Bosworth is a guy who caught the land speed racing bug and took the plunge, building a 260+ MPH, 30-foot long streamliner in his garage! If you've recently been to Speed Week, you've no doubt seen the bright red Valley Fever streamliner in action. On this episode of the Bonneville Up To Speed Podcast, Brad shares the story on how he built it in his home garage, the evolution from a Hayabusa engine to the current 2JZ powerplant, now twin turbocharged for 2022. We also learn about the car's name, strategies to respectfully break speed records, and more.

In this VETgirl online veterinary continuing education podcast, we discuss a point-of-care (POC) antibody assay for Coccidioides in dogs. Coccidioides is a systemic fungal infection also known as Valley Fever, common in the southwest United States and parts of northern Mexico (Brown). The fungal organisms live in the soil, but unfortunately can become aerosolized and inhaled, leading to disease. Affected dogs often suffer from respiratory disease, but a quarter of cases can result in more serious, disseminated infections (Davidson). In a study entitled "Clinical performance of a point-of-care Coccidioides antibody test in dogs" by Reagan et al, the authors dive into the diagnostic options available for detecting Coccidioides, and they offer a quick and helpful review of the available options. Briefly, several diagnostic options are available, though cytology, histopathology, or fungal culture represent the gold standards. An agar gel immunodiffusion (AGID) assay is used commonly in dogs to detect IgM or IgG against fungal antigens, but this test is expensive, has certain technical challenges, and varies in performance. Additionally, an enzyme immunoassay can also be performed for rapid antibody detection, but this assay still requires sending samples to a reference laboratory. Lastly, an immunochromatographic lateral flow assay (LFA) is another type of rapid detection assay that detects antibodies against two Coccidiodies antigens. This is a POC test that can be performed in approximately 30 minutes! Therefore in the current study, the authors sought to determine the agreement between this LFA and the standard AGID assay in dogs with suspected coccidioidomycosis.

Congressman David Schweikert, representing Arizona's 6th District, joins Seth to talk about the development of a vaccine for Valley Fever, and health care and technology.  Baby formula shortages.  Attorney and Navy veteran Brett Johnson of Snell and Wilmer (swlaw.com), on how the courts see cases about slandering a public figure.   See omnystudio.com/listener for privacy information.

Valley fever is a serious disease in both animals and people. And as cases…

Valley fever is a serious disease in both animals and people. And as cases increase in humans, the same is happening with dogs. The fungal organism responsible is endemic to...

Tik Tok might look like fun for your kids, especially the younger ones, as they watch short, funny videos. But it turns out that entertainment might be doing more harm than good when it comes to their brains. We go In Depth into how Tik Tok and other social media could be making it harder for kids to concentrate.  Elon Musk has bashed Twitter lately over its content policies so what is he doing now as the company's largest shareholder? We try to find out.  Russia is facing its heaviest criticism yet over the war in Ukraine. Images are coming out of Ukraine of bodies of dozens, maybe even hundreds, of civilians on the streets, apparently killed by Russian forces. President Biden now calling for a war crimes trial against Vladimir Putin.  We talk to a man in Ukraine who says he's coordinating a group of cyber warriors to go after Russia.  A new U.N. report is a buzz kill for those hopeful that we all can slow down global warming together. We go In Depth into what hope we have left before it's too late.  Valley Fever was once thought to be mostly a problem in California's Central Valley. But it's spreading across the West and climate change might be a big reason why.  Learn more about your ad choices. Visit podcastchoices.com/adchoices

Tik Tok might look like fun for your kids, especially the younger ones, as they watch short, funny videos. But it turns out that entertainment might be doing more harm than good when it comes to their brains. We go In Depth into how Tik Tok and other social media could be making it harder for kids to concentrate. Elon Musk has bashed Twitter lately over its content policies so what is he doing now as the company's largest shareholder? We try to find out. Russia is facing its heaviest criticism yet over the war in Ukraine. Images are coming out of Ukraine of bodies of dozens, maybe even hundreds, of civilians on the streets, apparently killed by Russian forces. President Biden now calling for a war crimes trial against Vladimir Putin. We talk to a man in Ukraine who says he's coordinating a group of cyber warriors to go after Russia. A new U.N. report is a buzz kill for those hopeful that we all can slow down global warming together. We go In Depth into what hope we have left before it's too late. Valley Fever was once thought to be mostly a problem in California's Central Valley. But it's spreading across the West and climate change might be a big reason why.  To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

We are back!! So sorry to have kept you waiting.  This episode has some commentary in the beginning you can skip through and jump right into the Valley Fever content if you want around the 15min mark.  Then we talk about Valley Fever and its history..  More fascinating that I first realized.  By the say, I accidentally cuss in the first 15 mins which is why i have it as explicit content, no other reason.  Enjoy!Support the show (https://www.patreon.com/Dissecting)

When common flu symptoms, such as fever, cough, chest pain and headaches, begin to last for multiple weeks or turn into something more serious, Central Valley families may start to hear the term “Valley fever” or “cocci.” California's Central Valley is a hotspot for Valley fever, but much is still being learned about this diagnosis. Hear from Dr. Fouzia Naeem and Dr. Vini Vijayan as they talk to Dr. Jolie Limon about what we see in the Central Valley about who is impacted by Valley Fever, the signs and treatments.

Charlie Beljan, PGA golfer, recounts his experience with Valley Fever and we ask the question to Dr. Galgiani - are athletes more susceptible to Valley Fever?