Podcasts about varicella

Welcome to another episode of Impact Theory with Tom Bilyeu! In today's compelling conversation, we're joined by the outspoken and influential Candace Owens. Known for her critical stance on social policies and extensive research into controversial issues, Candace dives deep into the idea of freedom in America, revealing why she believes the nation is drifting from its founding ideals towards socialism. Throughout the episode, Candace critiques welfare systems, forced vaccinations, and educational standards, passionately advocating for self-sufficiency and practical skills like homeschooling and food growing. She also brings a personal dimension to the discussion, sharing her own experiences with vaccine injuries and why she distrusts the medical industry. Together with Tom, Candace navigates complex issues, touching upon everything from government manipulation and economic motives to cultural empowerment and the erosion of public trust. If you're ready for a thought-provoking discussion that challenges conventional wisdom and encourages critical thinking, then this is an episode you won't want to miss. So, settle in and let's explore what true freedom means in today's world with Candace Owens on Impact Theory. SHOWNOTES 00:00 America is an illusion of freedom, weak leadership. 10:30 Beliefs' utility matters more than appearances. 12:43 Homelessness and filth contrast with America's greatness. 21:27 Homeschooling promotes freedom and educational excellence. 24:12 People lack memory of past hard times. 28:01 I provided study access, encouraging informed decisions. 37:15 Trust in experts erodes, prompting skepticism and uncertainty. 42:26 Parents claim vaccines harmed their children; gaslighting. 49:13 Rhetorically gifted, logical arguments, offer life shortcuts. 50:38 Beliefs inform how we interpret data. 56:00 Varicella fear unfounded; statistics show minimal risk. 01:03:26 Matrix of lies shapes education and narratives. 01:08:45 Value intuition, family, faith; they're unshakable blessings. CHECK OUT OUR SPONSORS ButcherBox: Get your choice of a free protein in every box for a year, plus that $20 off your first order with code IMPACT at https://butcherbox.com/impact. Tonal: Go to https://tonal.com and get $200 off with promo code IMPACT. Huel: Try Huel with 15% OFF today using code IMPACT at https://huel.com/impact. Miro: Bring your teams to Miro's revolutionary Innovation Workspace and be faster from idea to outcome at https://miro.com. Design.com: Ready to transform your brand? Head to https://design.com/impacttheory and get up to 88% off. FOLLOW TOM: Instagram: https://www.instagram.com/tombilyeu/ Tik Tok: https://www.tiktok.com/@tombilyeu?lang=en Twitter: https://twitter.com/tombilyeu YouTube: https://www.youtube.com/@TomBilyeu What's up, everybody? It's Tom Bilyeu here. If you're serious about leveling up your life, I urge you to check out my new podcast, Tom Bilyeu's Mindset Playbook —a goldmine of my most impactful episodes on mindset, business, and health. Trust me, your future self will thank you. LISTEN AD FREE + BONUS EPISODES on APPLE PODCASTS: apple.co/impacttheory Learn more about your ad choices. Visit megaphone.fm/adchoices

Fulvio Risuleo"La tenda"Fandango Libriwww.fandangolibri.itMartino e Mati si sono finalmente decisi per la loro prima vacanza in tenda ma, quando sono in un negozio di campeggio per decidere che modello acquistare, scoppia un litigio che li porta a una vera e propria rottura.Rimasto solo tra picchetti e sacchi a pelo ma desideroso di proseguire nei loro piani, Martino decide comunque di acquistare la tenda dei loro sogni. Solo che nella casa che condivide con Mati non può tornare e l'amica a cui chiede ospitalità per una sera non ha un letto in più per lui: da lì è un attimo passare la notte nella sua nuova tenda nel salotto di lei.Inizia così per Martino un esperimento folle quanto affascinante tra collezioni di piante preistoriche e di pappagalli e antichi affetti ritrovati, tra persone che, come in ogni buon viaggio che si rispetti, gli daranno una nuova prospettiva su quella che lui considera “la normalità”.Un'educazione sentimentale tenera, esilarante, un gioco dell'oca tra oggetti parlanti e nevrosi che in un incredibile viaggio da fermi ci insegna tutto della natura dell'amore. Una commedia romantica e picaresca per tutti coloro che hanno sofferto per un cuore spezzato.Fulvio Risuleo (Roma, 1991), si è diplomato in regia al Centro Sperimentale di Cinematografia nel 2013. Dopo avere scritto e diretto una serie di cortometraggi, tra cui Varicella, vincitore della Semaine de la Critique di Cannes nel 2015, esordisce al cinema nel 2017 con Guarda in alto, presentato alla Festa del cinema di Roma. Nel 2019 dirige la serie interattiva Il caso Ziqqurat e il suo secondo lungometraggio, Il colpo del cane, in anteprima al Festival di Rotterdam. Nel 2022 presenta alla Mostra del cinema di Venezia il suo terzo film, Notte fantasma. Autore di vari libri a fumetti, ha pubblicato con Antonio Pronostico Sniff (2019), con cui ha vinto nel 2020 il premio Micheluzzi alla miglior sceneggiatura al Napoli Comicon e il premio Boscarato come miglior sceneggiatore al Treviso Comic Book Festival, Tango (2021), candidato come miglior fumetto al Napoli Comicon 2022 e il più recente L'Eletto (2023). La tenda è il suo primo romanzo.IL POSTO DELLE PAROLEascoltare fa pensarewww.ilpostodelleparole.itDiventa un supporter di questo podcast: https://www.spreaker.com/podcast/il-posto-delle-parole--1487855/support.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-390 Overview: In 1995, the US launched a varicella vaccination program, leading to a significant drop in cases. However, breakthrough infections still occur, and clinical diagnosis has become less reliable as the virus has evolved. Join us to hear current recommendations for what to consider in the differential diagnosis and how emerging evidence may impact public health and your practice. Episode resource links: Marin, M, Leung, J, Anderson, TC, Lopez, AS. Monitoring Varicella Vaccine Impact on Varicella Incidence in the United States: Surveillance Challenges and Changing Epidemiology, 1995–2019, The Journal of Infectious Diseases, Volume 226, Issue Supplement_4, 1 November 2022, Pages S392–S399, https://doi.org/10.1093/infdis/jiac221 Qiu L, Liu S, Zhang M, et al. The epidemiology of varicella and effectiveness of varicella vaccine in Ganyu, China: a long-term community surveillance study. BMC Public Health. 2023;23(1):1875. Published 2023 Sep 28. doi:10.1186/s12889-023-16304-4 Ruprecht A, Marin M, Strain AK, Harry K, Kenyon C. Notes from the Field: Expanded Laboratory Testing for Varicella — Minnesota, 2016–2023. MMWR Morb Mortal Wkly Rep 2024;73:245–246. DOI: http://dx.doi.org/10.15585/mmwr.mm7311a3 DynaMed – Chicken pox – Varicella (https://www-dynamed-com.umassmed.idm.oclc.org/condition/chickenpox#GUID-DFBFAA99-31E8-4553-AFDB-AA1988B1967A): Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-390 Overview: In 1995, the US launched a varicella vaccination program, leading to a significant drop in cases. However, breakthrough infections still occur, and clinical diagnosis has become less reliable as the virus has evolved. Join us to hear current recommendations for what to consider in the differential diagnosis and how emerging evidence may impact public health and your practice. Episode resource links: Marin, M, Leung, J, Anderson, TC, Lopez, AS. Monitoring Varicella Vaccine Impact on Varicella Incidence in the United States: Surveillance Challenges and Changing Epidemiology, 1995–2019, The Journal of Infectious Diseases, Volume 226, Issue Supplement_4, 1 November 2022, Pages S392–S399, https://doi.org/10.1093/infdis/jiac221 Qiu L, Liu S, Zhang M, et al. The epidemiology of varicella and effectiveness of varicella vaccine in Ganyu, China: a long-term community surveillance study. BMC Public Health. 2023;23(1):1875. Published 2023 Sep 28. doi:10.1186/s12889-023-16304-4 Ruprecht A, Marin M, Strain AK, Harry K, Kenyon C. Notes from the Field: Expanded Laboratory Testing for Varicella — Minnesota, 2016–2023. MMWR Morb Mortal Wkly Rep 2024;73:245–246. DOI: http://dx.doi.org/10.15585/mmwr.mm7311a3 DynaMed – Chicken pox – Varicella (https://www-dynamed-com.umassmed.idm.oclc.org/condition/chickenpox#GUID-DFBFAA99-31E8-4553-AFDB-AA1988B1967A): Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato

Remember chicken pox also known as the Varicella zoster virus?If that virus getting reactivated in old age Shingles is what happens.According to the medical science these chicken pox virus stays sleeping or dormant in the nerve cells and during episodes of immune suppression weakness gets reactivated and starts giving you trouble.They characteristically have a burning sensation associated with skin lesions along the area of distribution of that nerve and make life difficult .It causes a dermatomal rash The regular painkillers don't work and prevention is the best policy . https://healthwealthbridge.com/shingles-prevention/ --- Send in a voice message: https://podcasters.spotify.com/pod/show/healthwealthbridge/message

If there's one person you'd want to talk to about immunology, the immune system and Covid, holes in our knowledge base about the complex immune system, and where the field is headed, it would be Professor Iwasaki. And add to that the topic of Women in Science. Here's our wide-ranging conversation.A snippet of the video, Full length Ground Truths videos are posted here and you can subscribe. Ground Truths is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Transcript with many external link and links to the audio, recorded 30 April 2024 Eric Topol (00:06):Hello, it's Eric Topol and I'm really thrilled to have my friend Akiko Iwasaki from Yale, and before I start talking with Akiko, I just want to mention there aren't too many silver linings of the pandemic, but one for me was getting to know Professor Iwasaki. She is my go-to immunologist. I've learned so much from her over the last four years and she's amazing. She just, as you may know, she was just recently named one of the most influential people in the world by TIME100. [and also recognized this week in TIME 100 Health]. And besides that, she's been elected to the National Academy of Medicine, National Academy of Sciences. She's the president of the American Association of Immunologists and she's a Howard Hughes principal investigator. So Akiko, it's wonderful to have you to join into an extended discussion of things that we have of mutual interest.Akiko Iwasaki (01:04):Thank you so much, Eric, for having me. I equally appreciate all of what you do, and I follow your blog and tweets and everything. So thank you Eric.Eric Topol (01:14):Well, you are a phenom. I mean just, that's all I can say because I think it was so appropriate that TIME recognize your contributions, not just over the pandemic, but of course throughout your career, a brilliant career in immunology. I thought we'd start out with our topic of great interest on Long Covid. You've done seminal work here and this is an evolving topic obviously. I wonder what your latest thoughts are on the pathogenesis and where things are headed.Long CovidAkiko Iwasaki (01:55):Yeah, so as I have been saying throughout the pandemic, I think that Long Covid is not one disease. It's a collection of multiple diseases and that are sort of ending up in similar sets of symptoms. Obviously, there are over 200 symptoms and not everyone has the same set of symptoms, but what we are going for is trying to understand the disease drivers, so persistent viral infection is one of them. There are overwhelming evidence for that theory now, all the way from autopsy and biopsy studies to looking at peripheral blood RNA signatures as well as circulating spike protein and nucleocapsid proteins that are detected in people with Long Covid. Now whether that persistent virus or remnants of virus is driving the disease itself is unclear still. And that's why trials like the one that we are engaging with Harlan Krumholz on Paxlovid should tell us what percentage of the people are suffering from that type of driver and whether antivirals like Paxlovid might be able to mitigate those. If I may, I'd like to talk about three other hypotheses.Eric Topol (03:15):Yeah, I'd love for you to do that.Akiko Iwasaki (03:18):Okay, great. So the second hypothesis that we've been working on is autoimmune disease. And so, this is clearly happening in a subset of people, again, it's a heterogeneous disease, but we can actually not only look at reactogenicity of antibodies from people with Long Covid where we can transfer IgG from patients with Long Covid into an animal, a healthy animal, and really measure outcomes of a pathogenesis. So that's a functional evidence that antibodies in some people with Long Covid is really actually causing some of the damages that are occurring in vivo. And the third hypothesis is the reactivation of herpes viruses. So many of us adults have multiple latent herpes virus family members that are just dormant and are not really causing any pathologies. But in people with Long Covid, we're seeing elevated reactivation of viruses like Epstein-Barr virus (EBV) or Varicella-zoster virus (VZV) and that may again be just a signature of Long Covid, but it may also be driving some of the symptoms that people are suffering from.(04:32):So that's again, we see the signature over and over, not just our group, but multiple other groups, Michael Peluso's group, Jim Heath, and many others. So that's also an emerging evidence from multiple groups showing that. And finally, we think that inflammation that occurs during the acute phase can sort of chronically change some tissue tone. For instance, in the brain with Michelle Monje's team, we developed a sort of localized mild Covid model of infection and showed that changes in microglia can be seen seven weeks post infection even though the virus is completely gone. So that means that inflammation that's established as a result of this initial infection can have prolonged sequence and sequela within the person and that may also be driving disease. And Eric, the reason we need to understand these diseases separately is because not only for diagnostic purposes, but for therapeutic purposes because to target a persistent virus is very different approach from targeting autoantibodies, for example.Eric Topol (05:49):Well, that's great. There's a lot to unpack there as you laid out four distinct paths that could result in the clinical syndrome and sequelae. I think you know I had the chance to have a really fun conversation with Michelle about their joint work that you've done, and she reminded me how she made a cold call to you to start as a collaboration, which I thought was fantastic. Look what that yielded. But yeah, this is fascinating because as I think you're getting at is that it may not be the same pathogenesis in any given individual so that all these, and even others might be operative. I guess maybe I first delve into the antibody story as you're well aware, we see after people get Covid a higher rate of autoimmune diseases crop up, which is really interesting because it seems to rev up self-directed immune response. And this I think many people haven't really noted yet, although obviously you're well aware of this, it's across all the different autoimmune diseases, connective tissue disease, not just one in particular. And it's, as you say, the idea that you could take the blood from a person suffering from Long Covid and give it to an experimental animal model and be able to recapitulate some of the abnormalities, it's really pretty striking. So the question I guess is if you were to do plasmapheresis and try to basically expunge these autoantibodies, wouldn't you expect people to have some symptomatic benefit pretty rapidly or is it just that the process is already far from the initiating step?Akiko Iwasaki (07:54):That's a great question. Plasmapheresis may be able to transiently improve the person if they're suffering from these autoantibody mediated diseases. People have reported, for example, IVIG treatment has dramatically improved their symptoms, but not in everybody. So it's really critical to understand who's suffering from this particular driver and appropriately treat those people. And there are many other very effective therapies in autoimmune disease field that can be repurposed for treating these patients as well.Eric Topol (08:34):The only clinical trial that has clicked so far, interestingly, came out of Hong Kong with different types of ways to manipulate the gut microbiome, which again, you know better than me is a major modulator of our immune system response. What are your thoughts about taking advantage of that way to somehow modulate this untoward immune response in people with this condition?Akiko Iwasaki (09:07):Yeah, so that is an exciting sort of development, and I don't mean to discount the importance of microbiome at all. It's just the drivers that are mentioning are something that can be directly linked to disease, but certainly dysbiosis and translocation of metabolites and microbiome itself could trigger Long Covid as well. So it's something that we're definitely keeping our eyes on. And as you say, Eric, the immune system is in intimate contact with the gut microbiome and also the gut is intimate contact with the brain. So there's a lot of connections that we really need to be paying attention to. So yeah, absolutely. This is a very exciting development.Eric Topol (09:57):And it is intriguing of course, the reactivation of viruses. I mean, we've learned in recent years how important EBV is in multiple sclerosis (MS). The question I have for you on that pathway, is this just an epiphenomena or do you actually think that could be a driving force in some people?Akiko Iwasaki (10:19):Yeah, so that's really hard to untangle in people. I mean, David Putrino and my team we're planning a clinical trial using Truvada. Truvada obviously is an HIV drug, but it has reported antiviral activity to Epstein-Barr virus (EBV) and others. So potentially we can try to interrogate that in people, but we're also developing mouse models that can sort of recapitulate EBV like viral reactivation and to see whether there's any sort of causal link between the reactivation and disease process.Eric Topol (10:57):Right now, recently there's been a bunch of anecdotes of people who get the glucagon-like peptide one (GLP-1) drugs which have a potent anti-inflammatory, both systemic and in the brain. I'd love to test these drugs, but of course these companies that make them or have other interests outside of Long Covid, do you think there's potential for a drug like that?Akiko Iwasaki (11:23):Yeah, so those drugs seem to have a lot of miraculous effects on every disease. So obviously it has to be used carefully because many people with Long Covid have issues with liver functions and other existing conditions that may or may not be conducive to taking those types of GLP-1 agonists. But in subset of people, maybe this can be tried, especially due to the anti-inflammatory properties, it may benefit again, a subset of people. I don't expect a single drug to cure everyone. That would be pretty amazing, but unlikely.Eric Topol (12:09):Absolutely. And it's unfortunate we are not further along in this whole story of clinical trials, testing treatments and applauding your efforts with my friend Harlan there to get into the testing which we had hoped RECOVER was going to do with their more than billion dollars or allocation, which didn't get us too far in that. Now before we leave Long Covid, which we could speak about for hours, I mean it's so darn important because so many people are really out there disabled or suffering on a daily basis or periodically they get better and then get worse again. There's been this whole idea that, oh, it's going away and that reinfections don't pose a threat. Maybe you could straighten that story out because I think there seems to be some miscues about the risk of Long Covid even as we go along with the continued circulating virus.Akiko Iwasaki (13:11):Right, so when you look at the epidemiological evidence of Long Covid, clearly in the beginning when we had no vaccines, no antivirals, no real good measure against Covid, the incident of developing Long Covid per infection was higher than a current date where we do have vaccines and Omicron may have changed its property significantly. So if you compare, let's say the Delta period versus Omicron period, there seems to be a reduced risk per infection of Long Covid. However, Omicron is super infectious. It's infected millions of people, and if you look at the total number of people suffering from Long Covid, we're not seeing a huge decline there at all because of the transmissibility of Omicron. So I think it's too early for us to say, okay, the rates are declining, we don't need to worry about it. Not at all, I think we still have to be vigilant.(14:14):We need to be up to date on vaccines and boosters because those seem to reduce the risk for Long Covid and whether Paxlovid can reduce the rate of Long Covid at the acute phase for the high risk individual, it seems to be yes, but for people who are not at high risk may or may not be very effective. So again, we just need to be very cautious. It's difficult obviously, to be completely avoiding virus at this time point, but I think masking and anything you can do, vaccination boosters is going to be helpful. And a reinfection does carry risk for developing Long Covid. So that prior infection is not going to prevent Long Covid altogether, even though the risk may be slightly reduced in the first infection. So when you think about these risks, again we need to be cognizant that reinfection and some people have multiple infections and then eventually get Long Covid, so we're just not safe from Long Covid yet.Nasal Vaccines and Mucosal ImmunityEric Topol (15:24):Right. No, I think that's the problem is that people have not acknowledged that there's an ongoing risk and that we should continue to keep our guard up. I want to applaud you and your colleagues. You recently put out [Yale School of Public Health] this multi-panel about Covid, which we'll post with this podcast that gave a lot of the facts straight and simple diagrams, and I think this is what you need is this is kind of like all your threads on Twitter. . They're always such great educational ways to get across important information. So now let's go onto a second topic of great mutual interest where you've also been a leader and that's in the mucosal nasal vaccine story. I had the privilege of writing with you a nice article in Science Immunology back in 2022 about Operation Nasal Vaccine, and unfortunately we don't have a nasal vaccine. We need a nasal vaccine against Covid. Where do we stand with this now?Akiko Iwasaki (16:31):Yeah, so you're right. I mean nasal vaccines, I don't really know what the barrier is because I think the preclinical models all support the effectiveness against transmission and infection and obviously disease. And there is a White House initiative to support rapid development of next generation vaccine, which includes mucosal vaccine, so perhaps that's sort of pushing some of these vaccine candidates forward. You're probably more familiar than me about those kinds of events that are happening. But yeah, it's unfortunate that we don't have an approved mucosal booster vaccine yet, and our research has shown that as simple as a spray of recombinant spike protein without any adjuvants are able to restimulate immune response and then establish mucosal immunity in the nasal cavity, which goes a long way in preventing infection as well as transmission. So yeah, I mean I'm equally frustrated that things like that don't exist yet.The Neomycin and Neosporin SurpriseEric Topol (17:52):Well, I mean the work that you and many other groups around the world have published on this is so compelling and this is the main thing that we don't have now, which is a way to prevent infection. And I think most of us would be very happy to have a spray that every three or four months and gave us much higher levels of protection than we're ever going to get from shots. And your whole concept of prime and spike, I mean this is something that we could have had years ago if there was a priority, and unfortunately there never has been. Now, the other day you came with a surprise in a paper on Neomycin as an alternate or Neosporin ointment. Can you tell us about that? Because that one wasn't expected. This was to use an antibiotic in a way to reduce Covid and other respiratory virus.Akiko Iwasaki (18:50):Right. So yeah, that's a little known fact. I mean, of course widespread use of antibiotics has caused some significant issues with resistance and so on. However, when you look at the literature of different types of antibiotics, we have reported in 2018 that certain types of antibiotics known as aminoglycoside, which includes Neosporin or neomycin, has this sort of unintended antiviral property by triggering Toll-like receptor 3 in specialized cell types known as conventional dendritic cell type 1. And we published that for a genital herpes model that we were working on at the time. But because it's acting on the host, the Toll-like receptor 3 on the host cell to induce interferon and interferon stimulated genes to prevent the replication of the virus, we knew that it could be pan-viral. It doesn't really matter what the virus is. So we basically leverage that discovery that was made by a postdoc Smita Gopinath when she was in the lab to see if we can use that in the nasal cavity.(20:07):And that's what Tianyang Mao, a former graduate student did, in fact. And yeah, little spray of neomycin in the nose of the mice reduce this infection as well as disease and can even be used to treat shortly after the infection disease progress and using hamster models we also showed that hamsters that are pretreated with neomycin when they were caged with infected hamsters, the transmission rate was much reduced. And we also did with Dr. Charles Dela Cruz, a small clinical trial, randomized though into placebo and Neosporin arms of healthy volunteers. We asked them to put in a pea size amount of Neosporin on a cotton swab into the nose, and they were doing that twice a day for seven days. We measured the RNA from the nose of these people and indeed see that more than half the participants in the Neosporin group had elevated interferon stimulated genes, whereas the control group, which were given Vaseline had no response. So this sort of shows the promise of using something as generic and cheap as Neosporin to trigger antiviral state in the nose. Now it does require a much larger trial making sure that the safety profiles there and effectiveness against viral infection, but it's just a beginning of a story that could develop into something useful.New Frontiers in Immunology and Tx CellsEric Topol (21:51):Yeah, I thought it was fascinating, and it does bring up, which I think has also been underdeveloped, is our approaches for interferon a frontline defense where augmenting that, just getting that exploiting the nasal mucosa, the entry site, whether it be through that means or of course through even more potent a nasal vaccine, it's like a missing, it's a hole in our whole defense of against this virus that's led to millions of people not just dying, but of course also sick and also with Long Covid around the world. So I hope that we'll see some progress, but I thought that was a really fascinating hint of something to come that could be very helpful in the meantime while we're waiting for specific nasal vaccines. Now added to all these things recently, like last week you published a paper in Cell with your husband who's in the same department, I think at Yale. Is that right? Can you tell us about that and this paper about the whole new perspectives in immunology?Akiko Iwasaki (23:05):Yeah, so my husband Ruslan Medzhitov is a very famous immunologist who's in the same department, and we've written four or five review and opinion pieces together over the years. This new one is in Cell and it's really exploring new perspectives in immunology. We were asked by the editors to celebrate the 50th anniversary of the Cell journal with a perspective on the immune system. And the immune response is just a beautiful system that is triggered in response to specific pathogens and can really provide long-term or even sometimes lifelong immunity and resistance against pathogens and it really saves our lives. Much has been learned throughout the last 20, 30 years about the innate and adaptive immune system and how they're linked. In this new perspective, we are trying to raise some issues that the current paradigm cannot explain properly, some of the mysteries that are still remaining in the immune system.(24:22):And we try to come up with new concepts about even the role of the immune system in general. For instance, is the immune system only good for fighting pathogens or can it be repurposed for conducting normal physiology in the host? And we came up with a new subset of T-cells known as, or we call it Tx cells, which basically is an interoceptive type of T-cells that monitor homeostasis in different tissues and are helping with the normal process of biology as opposed to fighting viruses or bacteria or fungi. But these cells, when they are not appropriately regulated, they are also the source of autoimmune diseases because they are by design reactive against auto antigens. And so, this is a whole new framework to think about, a different arm of the immune function, which is really looking inside of our body and not really fighting against pathogens, but we believe these cells exist, and we know that the counterpart of Tx cells, which is the T regulatory cells, are indeed well known for its physiological functions. So we're hoping that this new perspective will trigger a new set of approaches in the field to try to understand this interceptive property of T-cells.Eric Topol (25:59):Yeah, well, I thought it was fascinating, of course, and I wanted to get into that more because I think what we're learning is this immune system not only obviously is for cancer whole. We're only starting to get warmed up with immunotherapy where checkpoint inhibitors were just the beginning and now obviously with vaccines and all these different ways that we can take the CAR-T cells, engineered T-cells, take the immune system to fight cancer and potentially to even use it as a way to prevent cancer. If you have these, whether it's Tx or Tregs or whatever T-cells can do this. But even bigger than that is the idea that it's tied in with the aging process. So as you know, again, much more than I do, our senescent immune cells are not good for us. And the whole idea is that we could build immune resilience if we could somehow figure out these mysteries that you're getting at, whereby we get vulnerable just as we were with Covid. And as we get older, we get vulnerable to not just infections, but everything going wrong, whether it's the walls of our arteries or whether it's the cancer or the immunity that's going on in our brain for Alzheimer's and neurodegenerative diseases. How can we fix the immune system so that we age more healthilyThe Immune System and Healthy Aging Akiko Iwasaki (27:37):Oh yeah. A lot of billionaires are also interested in that question and are pouring money into this question. It's interesting, but when you think about the sort of evolutionary perspective, we humans are only living so long. In the very recent decades, our life expectancy used to be much shorter and all we had to survive was to reproduce and generate the next progeny. But nowadays, because of this amazing wealth and health interventions and food and everything else, we're just living so much longer than even our grandparents. The immune system didn't evolve to deal with such one to begin with. So we were doing fine living up to 30 years of age or whatever. But now that we're living up to a hundred years, the immune system isn't really designed to keep up with this kind of stressors. But I think you're getting at a very important kind of more engineering questions of how do we manipulate the immune system or rejuvenate it so that we can remain healthy into the later decades? And it is well known that the immune system itself ages and that our ability to produce new lymphocytes, for example, decline over time and thymus that is important for T-cell development shrinks over time. And so anatomically it's impossible to help stop that process. However, is there a way of, for example, transferring some factors or engineering the immune cells to remain healthy and even like hematopoiesis itself can be manipulated to perhaps rejuvenate the whole immune system in their recent papers showing that. So this is a new frontier.Eric Topol (29:50):Do you think that some point in the future, we'll ex vivo inject Yamanaka factors into these cell lines and instead of this idea that you know get young plasma to old folks, and I mean since we don't know what's in there and it doesn't specifically have an effect on immune cells, who knows how it's working, but do you foresee that that might be a potential avenue going forward or even an in vivo delivery of this?Akiko Iwasaki (30:22):Yeah, it's not impossible, right? There are really rapidly evolving technologies and gene therapies that are becoming online. So it's not impossible to think about engineering in situ as you're suggesting, but we also have to be certain that we are living longer, but also healthy. So we do have to not only just deal with the aging immune system, but preventing neurodegenerative diseases and so on. And the immune system may have a role to play there as well. So there's a lot of, I mean, I can't think of a non-genetically mediated disease that doesn't involve the immune system.Eric Topol (31:03):Sure. No, I mean, it's just, when I think about this, people keep talking about the digital era of digital biology, but I actually think of it more as digital immunobiology, which is driving this because it's center stage and in more and more over time. And the idea that I'm concerned about is that we could rejuvenate the relevant immune cells or the whole immune response, but then it's such a delicate balance that we could actually wind up with untoward, whether it's autoimmune or overly stimulated immune system. It's not such a simple matter, as I'm sure you would agree. Now, this gets me to a broader thing which you've done, which is a profound contribution in life science and medicine, which is being an advocate for women in science. And I wonder if you could speak to that because you have been such a phenomenal force propelling the importance of women in science and not just doing that passively, but also standing up for women, which is being an activist is how you get things to change. So can you tell us about your thoughts there?An Activist for Women in ScienceAkiko Iwasaki (32:22):Yeah, so I grew up in Japan, and part of the reason I left Japan at the age of 16 was that I felt very stifled because of the societal norm and expectation of what a woman should be. And I felt like I didn't have the opportunity to develop my skills as a scientist remaining in Japan. And maybe things have changed over the years, but at the time when I was growing up, that's how I felt. And so, I was very cognizant of biases in society. And so, in the US and in Canada where I also trained, there's a lot less barrier to success, and we are able to do pretty much anything we want, which is wonderful, and that's why I think I'm here. But at the same time, the inequity still exists, even in pay gaps and things like that that are easy to fix but are still kind of insidious and it's there.(33:32):And Yale School of Medicine has done a great job partly because of the efforts of women who spoke up and who actually started to collect evidence for pay gap. And now there's very little pay gap because there's active sort of involvement of the dean and everyone else to ensure equity in the medical school. But it's just a small segment of the society. We really need to expand this to other schools and making sure that women are getting paid equally as men in the same ranks. And also, I see still some sexual harassment or more just toxic environment for people in general in academia. Some PIs get away with a lot of behavior that's not conducive to a healthy environment, so I have written about that as well and how we can have antidotes for such toxic environments. And it really does require the whole village to act on it. It's not just one person speaking up. And there should be measures placed to make sure that those people who does have this tendency of abusive behavior that they can get training and just being aware of these situations and corrective behavior. So I think there's still a lot of work left in academia, but things have obviously improved dramatically over the last few decades, and we are in a very, very good place, but we just have to keep working to achieve true equity.Why Don't We Have Immunome Check-Ups?Eric Topol (35:25):Well applauding your efforts for that, and I'm still in touch with that. We got a ways to go, and I hope that we'll see steady and even more accelerated and improvement to get to parity, which is what it should be. And I really think you've been a model for doing this. It isn't like you aren't busy with everything else, so to fit that in is wonderful. In closing up, one of the things that I wonder about is our ability to assess back to the immune system for a moment isn't what it should be. That is we do a CBC and we have how many lymphocytes, how many this, why don't we have an immunome, why doesn't everybody serially have an immune system checkup? Because that would tell us if we're starting to go haywire and then maybe hunt for reactivated viruses or what's going on. Do you foresee that we could ever get to a practical immunome as we go forward? Because it seems like it's a big missing link right now.Akiko Iwasaki (36:33):Yeah, I think that's a great idea. I mean, I'll be the first one to sign up for the immunome.Eric Topol (36:40):But I'm depending on you to make it happen.Akiko Iwasaki (36:44):Well, interestingly, Eric, there are lots of amazing technologies that are developed even during the pandemic, which is monitoring everything from antibody reactivity to reactivated viruses to the cytokines to every cell marker you can imagine. So the technologies out there, it's just I think a matter of having the right set of panels that are relatively affordable because some of these things are thousands of dollars per sample to analyze, and then of course clinical validation, something that's CLIA approved, and then we can start to, I guess the insurance company needs to also cover this, right? So we need to demonstrate the benefit to health in the long run to be able to afford this kind of immunome analysis. But I think that very wealthy people can already get this done.Eric Topol (37:43):Yeah, well, we want to make it so it's a health equity story, not of course, only for the crazy ones that are out there that are taking 112 supplements a day and whatnot. But it's intriguing because I think we might be able to get ahead of things if we had such an easy means. And as you said during the pandemic, for example, my friends here in La Jolla at La Jolla Immunology did all kinds of T-cell studies that were really insightful and of course done with you and others around the country and elsewhere to give us insights that you didn't get just from neutralizing antibodies. But it isn't something that you can get done easily. Now, I think this immunome hopefully will get us to another level in the future. One of the most striking things I've seen in our space clinically before wrapping up is to take the CD19 CAR T therapies to deplete the B cells of people with lupus, systemic sclerosis and other conditions, and completely stop their autoimmune condition. And when the B cells come back, they're not fighting themselves. They're not self-directed anymore. Would you have predicted this? This seems really striking and it may be a clue to the kind of mastering approaches to autoimmune diseases in the future.Akiko Iwasaki (39:19):Yeah, absolutely. So for multiple sclerosis, for example, where B cells weren't thought to be a key player by doing anti-CD20 depletion, there's this remarkable clinical effects. So I think we can only find the answer experimentally in people when they do these clinical trials and show this remarkable effects. That's when we say, aha, we don't really understand immunology. You know what I mean? That's when we have to be humble about what we think we understand. We really don't know until we try it. So that's a really good lesson learned. And these may be also applicable to people with autoimmune phenotype in Long Covid, right? We may be able to benefit from similar kinds of depletion therapy. So I think we have a lot to learn still.Eric Topol (40:14):Yeah, that's why, again, going back to the paper you just had in Cell about the mysteries and about some new ideas and challenging the dogma is so important. I still consider the immune system most complex one in the body by far, and I'm depending on you Akiko to unravel it, not to put any weight on your shoulders. Anyway, this has been so much fun. You are such a gem and always learning from you, and I can't thank you enough for all the work. And the fact is that you've got decades ahead of you to keep building on this. You've already done enough for many people, many scientists in your career, and I know you'll keep going. So we're all going to be following you with great interest in learning from you on a frequent basis. And I hope we'll build on some of the things we've talked about like a Long Covid treatment, treatments that are effective nasal vaccines, maybe even some dab of Neosporin, and keep on the momentum we've had with the understanding of the immune system, and finally, someday achieving the true parity of gender and science. And so, thank you for all that you do.Akiko Iwasaki (41:35):Thank you so much, Eric.************************CreditsHeadshot photo credits by Robert Lisak, Yale School of MedicineMy producer for Ground Truths is Jessica Nguyen, Scripps Research and our technical support for audio/video is by SInjun Balabanoff at Scripps Research.I hope you found the spot informative. Please share itThe Ground Truths newsletters and podcasts are all free, open-access, without ads.Voluntary paid subscriptions all go to support Scripps Research. Many thanks for that—they greatly helped fund our summer internship programs for 2023 and 2024.Note: you can select preferences to receive emails about newsletters, podcasts, or all I don't want to bother you with an email for content that you're not interested in.Comments are welcome from all subscribers. Get full access to Ground Truths at erictopol.substack.com/subscribe

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: July 18, 2017 Trauma and hypertension account for the overwhelming majority of cases of intracerebral hemorrhage. Today, we address the minority. In this week's episode, Dr. Steven Messe discusses the atypical causes of intracerebral hemorrhage and how they are managed. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. REFERENCES Biffi A, Greenberg SM. Cerebral amyloid angiopathy: a systematic review. J Clin Neurol 2011;7(1):1-9. PMID 21519520Gilden D, Cohrs RJ, Mahalingam R, Nagel MA. Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory features, pathogenesis, and treatment. Lancet Neurol 2009;8(8):731-40. PMID 19608099Mast H, Young WL, Koennecke HC, et al. Risk of spontaneous haemorrhage after diagnosis of cerebral arteriovenous malformation. Lancet 1997;350(9084):1065-8. PMID 10213548Ruíz-Sandoval JL, Cantú C, Barinagarrementeria F. Intracerebral hemorrhage in young people: analysis of risk factors, location, causes, and prognosis. Stroke 1999;30(3):537-41. PMID 10066848Siegler JE, Ichord RN. Teaching neuroimages: multicompartmental intracranial hemorrhage in a pediatric patient. Neurology 2016;87(23):e284. PMID 27920292  We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

Dr Steve and the office staff discuss: depression in teenagers covid vaccine 2 props to tacie traveller's diarrhea shingles (varicella) and more! featured guest: PA Lydia! Please visit: stuff.doctorsteve.com (for all your online shopping needs!) ed.doctorsteve.com (for your discount on the Phoenix device for erectile dysfunction) simplyherbals.net/cbd-sinus-rinse (the best he's ever made. Seriously.) RIGHT NOW GET A NEW DISCOUNT ON THE ROADIE 3 ROBOTIC TUNER! roadie.doctorsteve.com (the greatest gift for a guitarist or bassist! The robotic tuner!) see it here: stuff.doctorsteve.com/#roadie Also don't forget: Cameo.com/weirdmedicine (Book your old pal right now because he's cheap! "FLUID!") Most importantly! CHECK US OUT ON PATREON!  ALL NEW CONTENT! Robert Kelly, Mark Normand, the O&A Troika, Joe DeRosa, Pete Davidson, Geno Bisconte. Stuff you will never hear on the main show ;-) Learn more about your ad choices. Visit podcastchoices.com/adchoices

Join us for a relaxed round up of this month's Red Whale primary care Pearls of wisdom. This month, Nik and Caroline discuss: Fetal alcohol spectrum disorder: one child in every class at school is potentially affected and unsupported. What can we do about this, and why is discussing alcohol in pregnancy a taboo?Varicella zoster (chicken pox) and NSAIDs: why we shouldn't be recommending ibuprofen for chicken pox or children with shingles, and why a request for it could be considered a red flag…Heat-related illness: identifying those at greatest risk. How to prevent it, spot it and treat it.Measles: might we see an epidemic? Would we spot a case? How can we support and promote MMR vaccination in our specific local populations?And hear how a wedding day best intention went horribly wrong, knocking things sideways!Beat the heat: staying safe in hot weatherEffective Approaches to Combat Vaccine HesitancyMeasles on black and brown skin websiteWe'd love to hear your feedback by email - podcast@redwhale.co.uk or leave us a voice message - Send a voice message to RedWhalePrimaryCarePod (speakpipe.com) If you don't already receive our weekly Pearls email then you can sign up to these herePearls are available to read for 3 months from the date they are first published. After this time, you can get access to any Pearls - along with ALL of the rest of our online written resources - either when you buy a one-day online course from Red Whale OR if you purchase a membership to GPCPD.com here: https://gpcpd.com/subscribe-to-gpcpd Follow us on:TwitterFacebookInstagramLinkedInDisclaimerWe make every effort to ensure the information in this podcast is accurate and/ correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as...

A 1978 UMKC School of Medicine graduate, Dr. Jackson completed a pediatric residency at Cincinnati Children's and an infectious diseases fellowship at the University of Texas Southwestern before joining Children's Mercy Kansas City faculty in 1984. Acknowledged locally, regionally, and nationally as an educator on pediatrics and pediatric infectious diseases topics, she is recognized for developing one of the most robust pediatric infectious diseases programs in the country and for educating thousands of students, residents, fellows, and faculty in pediatrics throughout her nearly 40-year career. In 2019, she was recognized with the American Academy of Pediatrics award for Lifetime Contribution to Infectious Diseases Education. A fellow of the American Academy of Pediatrics, the Infectious Diseases Society of America, and the Pediatric Infectious Disease Society, she served as a National Vaccine Advisory Committee member from 2017-2021. She has also been elected to the Alpha Omega Alpha Honor Society, the American Pediatric Society, the Society of Pediatric Research, and the Academic Pediatric Association.  She is a national thought leader in pediatric infectious disease topics. In 2014 with her colleagues at Children's Mercy, she identified the first cases of enterovirus D68 infection, leading to a CDC investigation that alerted pediatric providers around the country to the largest outbreak ever of this unique virus that led to respiratory failure and a polio-like syndrome that followed infection. Her research efforts have focused on the characterization of Kawasaki disease, prevention of antibiotic resistance, judicious use of antibiotics, emerging viruses, and optimal use of vaccines. During the COVID-19 pandemic, she has served on University, state, and national advisory committees. For the last five years, Dr. Jackson has been the Dean of the UMKC School of Medicine, working to promote recruitment and retention of a diverse student body and faculty, inspire changes in an already innovative curriculum, and promote a vibrant discovery enterprise for their MD degree programs, the Masters in Science Physician Assistant, the Masters in Science Anesthesia Assistant and Graduate Health Education programs.This show was made possible by a generous corporate contribution from PBG. Physician Buying Group, helping pediatricians vaccinate children. Support the showPlease subscribe to our podcast on Apple or Amazon and give us a 5-star review. The Pediatric Lounge - A Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between. The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.

May 26: Saint Philip Neri, Priest 1515–1595 Memorial; Liturgical Color: White Patron Saint of Rome, humor and joy Everyone saw the halo Saint Philip Neri often begged alms from his wealthy friends and acquaintances to redistribute to needy children. On one occasion, he approached a friend, held out his hand, and asked him, once again, for a few coins: “How about some help for the children.” The man slapped him hard across the face. Saint Philip quickly recovered from the shock, extended his cupped hand again, and said, “That was for me, now how about something for the children?” Saint Philip was born into a well-educated, Catholic, middle-class home. He carried himself all his life with the bearing of an amiable, well-read, finely dressed, shrewd individual who knew no enemies. After growing up in Florence, he moved to Rome and spent many years as a layman studying theology and helping the poor in practical ways. While still a layman, Philip founded a group to care for the many impoverished pilgrims who came to Rome. He befriended the great reformer Saint Ignatius of Loyola, who wanted Philip to become a Jesuit. But after encouragement from his confessor, Philip was ordained a secular priest in 1551. Soon afterward, he had to formalize the large following he generated that wanted to live more fully the life he preached and modeled. Saint Philip was so well loved and so well known in Rome that he is sometimes called its “Third Apostle” after Saints Peter and Paul. His personality radiated a natural warmth and cordiality. His priestly ministry could be fairly characterized as “evangelization by walking around.” He walked the streets of Rome from end to end continually throughout his long life. His life was a long conversation with a thousand characters on street corners, in shops, factories, churches, parks—wherever. He reached out to the destitute, prostitutes, poor children, and the uneducated. Saint Philip would often gather a group to visit seven churches in a row. As they went from one church to another, the group would picnic and listen to the musicians whom Saint Philip brought along for entertainment. These outings, understandably, became hugely popular. Leaders, intellectuals, musicians, and scholars were also drawn to him, in addition to common folk, and formed the impressive circle of committed Catholics who first joined his apostolic efforts. Saint Philip and his companions were given charge of a parish where they held evening sessions filled with song, readings from the lives of the martyrs, the praying of the psalms, and rich conversation. Saint Philip called these gatherings the “oratory,” in part because the participants also listened to musical pieces called “oratorios.” So when it came time to formalize his newly founded community in Church law, the name “Oratory” was chosen. The Congregation of the Oratory, which is still thriving today, was recognized by the Holy Father in 1575 and given the magnificent, new parish of Santa Maria in Varicella, known as Chiesa Nuova (The New Church), in the heart of Rome. Oratorians are mostly diocesan priests and some laymen who live together in a loose brotherhood, taking no vows, while pursuing various individual ministries. The many dozens of oratories around the world are joined in an informal confederation, whereas canonical bonds tie the many houses of a religious order together in a far tighter union. Saint Philip is one of the bright lights of the Counter-Reformation. He blazed a new path, like other reformers. But the new path he blazed was really just the old path, walked differently. Saint Philip was the silent observer, the cheerful listener, the priest always there, who spoke hard truths but always bent on the non-essentials. He mortified himself but never talked about it. He was poor but wore nice clothes. He looked like everyone else, yet…there was that intangible something: the sparkle in his eye, his polish, his lively concern, his clever wit, his courtesy, his wide education, his humor, and his constant turning of the conversation back to God. He was like everyone else, but he wasn't, really. He radiated what twentieth-century psychologists would call the “halo effect.” Everyone saw the invisible halo casting a glow over Saint Philip, and people crowded around to stand in his mellow light. Saint Philip did not start a university, reform an institution, write a classic, or formulate a new rule. He changed the world the only way it can truly be changed—one soul at a time. This army of one was canonized in 1622. His body rests in a glass coffin in Chiesa Nuova, the sumptuous Mother Church of the Oratory, where pilgrims come in faith, kneel before him, and seek his powerful intercession. Saint Philip Neri, your good nature and charm, united with your theological orthodoxy and life of deep prayer, made you a powerful apostle for the people of Rome. May all evangelists, especially priests, see in your openness to others a pathway of changing the world.

In this episode, we review the high-yield topic of Chicken Pox (Varicella)⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Pediatrics section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets

TESTO DELL'ARTICOLO ➜ www.bastabugie.it/it/articoli.php?id=4559LA DITTATURA IMPONE VACCINI OBBLIGATORI PER TUTTI di Paolo GulisanoNelle ultime settimane, abbiamo assistito al diffondersi di una psicosi generalizzata riguardo le Meningiti. Un caso costruito sul nulla. La NBQ ne ha già parlato [leggi nota alla fine dell'ariticolo, N.d.BB], i massimi esperti di Epidemiologia sono più volte intervenuti a rassicurare attraverso i media che non c'è alcun aumento di casi, ma non c'è niente da fare: è partito il passa parola tra la gente, specialmente tra le mamme, e non si ferma più. "Ma come? Con tutto quello che si sente? Tuo figlio non l'hai ancora vaccinato?" e la povera mamma che teme di essere degenere si affretta a intasare le linee telefoniche dei Servizi Vaccinazioni per prenotare il vaccino. "Quale?" Ma sì, mi faccia quello che "copre contro tutto". Magari.Ancora una volta, dunque, le vaccinazioni diventano uno degli argomenti di maggiore discussione in ambito sanitario - più di tanti argomenti di salute pubblica altrettanto se non molto più importanti - e si scatenano anche le faide politiche. Come la NBQ aveva già annunciato, la Regione Emilia-Romagna ha approvato prima di Natale una legge regionale che prevede l'esclusione dalle scuole dei bambini che non hanno fatto le vaccinazioni dell'obbligo. Immediatamente questo esempio è stato seguito da regioni con analoghe amministrazioni di Sinistra, a cominciare dal Lazio e dalla Toscana.Il Ministro Beatrice Lorenzin ha dato già il suo consenso a queste misure legislative, e non ha escluso che lo stesso Governo centrale possa prendere un simile provvedimento.CONTROVENTODi fronte a questa prospettiva, ha preso posizione il sindaco Cinquestelle di Livorno, Filippo Nogarin, un ingegnere, che ha dichiarato che rendere obbligatori i vaccini per i bimbi che vogliono frequentare l'asilo è una forzatura insopportabile.Il sindaco ha peraltro precisato di non essere un fanatico anti-vaccinale, di credere nella vaccinazione come mezzo per debellare le malattie più gravi, ma la scelta - ha puntualizzato - deve essere individuale. "Se si trasforma in un'imposizione, si viola la libertà del singolo individuo da un lato e si finisce per dare ossigeno a complottisti e sostenitori di teorie pseudoscientifiche pericolose. Se vogliamo raggiungere un risultato serio, dobbiamo lavorare sulla prevenzione, l'informazione e la comunicazione. Altrimenti si deresponsabilizza l'individuo e questo è molto pericoloso". Parole equilibrate e sensate. Ma contro di lui si sono scatenati i social e i paladini delle vaccinazioni ad oltranza. Il sindaco, che appena eletto aveva riscosso i consensi del mondo radicalchic e politicamente corretto per essere stato uno dei primi ad accettare la trascrizione dei "matrimoni" tra persone dello stesso sesso avvenuti in altri Paesi, si è reso conto a sue spese di cosa succede quando su altre questioni si prova ad andare controcorrente e a toccare determinati interessi. Il quotidiano l'Unità, dal suo stato preagonico, ha levato un grido trionfante: per Nogarin una Caporetto. Così scrive il giornale diretto da Staino.La cosa che più fa sorridere, in questa polemica tra "obbligazionisti" e difensori delle libertà individuali, è che in realtà in Italia l'obbligo delle vaccinazioni esiste già. Riguarda quattro vaccinazioni: Difterite, Tetano, Poliomielite ed Epatite B. Si tratta di obblighi "storici", esistenti da molti anni. L'ultima obbligatorietà riguarda l'Epatite B, introdotta nel 1991, quando i drammatici (e mai divulgati) dati epidemiologici dicevano che in Italia c'era più di un milione di sieropositivi per l'Epatite B, un virus che si diffonde coi rapporti sessuali e con il contatto con sangue infetto.SOLO ITALIA E FRANCIA HANNO L'OBBLIGO DI VACCINAZIONESarebbe stata necessaria anche una riflessione sugli stili di vita che portano alla diffusione di questo virus, ma si preferì puntare esclusivamente a tutelare le generazioni future, vaccinando tutti i nuovi nati. Dunque, l'obbligo esiste già. Un tempo ai genitori "inadempienti" questo obbligo venivano mandati a casa i Carabinieri, e i giudici dei Tribunali dei Minori potevano sospendere temporaneamente la patria potestà affinché si potesse effettuare le vaccinazioni. Misure francamente sgradevoli. In tempi più recenti, i giudici si limitano a verificare che le vaccinazioni non siano state evitate per trascuratezza dei genitori o stato di abbandono dei minori.Aggiungiamo che solo due Paesi in Europa hanno l'obbligo di vaccinazione: Italia e Francia. Due Stati, non a caso, con trascorsi giacobini. I Paesi più evoluti, dalla Scandinavia alla Gran Bretagna, alla Germania, non impongono, ma propongono. Il provvedimento legislativo adottato dall'Emilia-Romagna e che la Lorenzin vorrebbe fosse esteso a tutte le Regioni, è un grosso passo indietro, e bene ha fatto dunque il Sindaco di Livorno a prendere posizione, una facoltà che gli è concessa dalla Carta costituzionale che individua nel Sindaco il responsabile della salute pubblica nella propria comunità di competenza.Ma perché si invoca un provvedimento così draconiano come l'esclusione dei bambini non vaccinati dalle scuole? Per tutelare la salute degli altri bambini? No. Questi bambini non hanno nulla da temere - visto che sono vaccinati - dai piccoli inadempienti, che rischiano di essere tacciati di essere degli "untorelli". Semmai sono proprio loro ad essere a rischio, un rischio che evidentemente i loro genitori hanno deciso di assumersi.TERRORISMO PSICOLOGICOQuello che è in gioco, un gioco dove la tattica adottata è quella della paura, è l'introduzione di molti altri nuovi vaccini, che la Lorenzin ha annunciato trionfalmente per il 2017, insieme ai nuovi livelli essenziali di assistenza (Lea). E' il Piano Nazionale Vaccini, di cui si discuteva da molto tempo, e che è stato approvato sull'onda emotiva della fantomatica e inesistente epidemia di meningite. Non a caso prevede l'introduzione di diversi tipi di vaccini anti-meningite.Il numero di vaccinazioni che un bambino dovrebbe effettuare a partire dai 3 mesi fino ai quindici anni di età viene ad essere più che raddoppiato. Inoltre, ci vorrebbe un surplus di spesa di circa 100 milioni di euro, ma questo non sembra preoccupare il Governo. Potrebbe preoccupare - e molto - i cittadini. Ma - qualcuno afferma - tutto questo serve a salvare vite umane. Sulla letalità di malattie come la Varicella (è uno dei vaccini che verrebbero introdotti) ci sarebbe molto da discutere. Per non parlare del vaccino contro l'HPV, il Papilloma Virus, nei maschi.Questa vaccinazione è stata introdotta da pochi anni, non senza polemiche, e con numerosi Paesi che non l'hanno adottata, dubitando della sua efficacia e del rapporto costi-benefici. Si tratta di un vaccino contro alcuni agenti causali di infezioni dell'apparato genitale, che possono - col passare degli anni - portare a tumori. Il vaccino infatti - a livello popolare - è stato presentato come "il vaccino contro il tumore all'utero". Ora lo si vorrebbe proporre anche ai maschi, ed è facile immaginarsi la perplessità di molti genitori.Certo, le malattie a trasmissione sessuale sono in aumento, nonostante l'ormai capillare uso del preservativo, che doveva essere la salvezza da ogni infezione di questo tipo, e che evidentemente (ma questo gli esperti intellettualmente onesti lo sapevano e lo dicevano da molto tempo) ha un notevole tasso di fallibilità.Ma questo giustifica l'introduzione di tale vaccinazione? E' un dubbio che avranno tanti genitori. E allora una soluzione inquietante a quella che potrebbe essere una scarsa risposta alle offerte di tali vaccini sta nella coercizione. L'obbligo, dalle quattro vaccinazioni sopra citate, potrebbe essere esteso a tutte le proposte del Piano Vaccini. Un obbligo garantito dalle misure sanzionatorie come la non ammissione a scuola per i bambini o la radiazione dall'Ordine dei Medici per i sanitari che non vaccinano. Alla faccia della libertà e della democrazia. L'alternativa? Fare come in tutti gli altri Paesi europei: documentare, informare, educare alla salute. Senza diktat sgradevoli.Nota di BastaBugie: Paolo Gulisano nell'articolo sottostante dal titolo "Il tribunale del popolo ha deciso: è meningitefobia" riflette sul fatto che non sia più la scienza che detta l'agenda dell'organizzazione sanitaria, ma la spinta emotiva del momento. Poco importa che l'evidenza scientifica ci dica che non c'è alcuna epidemia di meningite. Nel 2015 i casi segnalati in tutta Italia sono stati circa 120. Ma con un meccanismo strano di lettura emotiva e paranoica dei dati reali, si sta diffondendo questa paura. E improvvisamente il vaccino diventa la panacea.Ecco dunque l'articolo completo pubblicato su La Nuova Bussola Quotidiana il 6 gennaio 2017:Negli scorsi giorni due fenomeni - tra loro collegati - hanno caratterizzato il panorama sanitario. Da una parte un sovraffollamento spaventoso dei reparti di pronto soccorso degli ospedali, dall'altra parte un enorme richiesta rivolta ai servizi vaccinazioni delle aziende sanitarie di vaccini anti-meningite.Dicevamo che si tratta di fenomeni correlati perché una grande percentuale delle affluenze al pronto soccorso era motivata, sia per bambini che adulti, da sintomi di febbre alta. Il lettore si chiederà: che c'è di strano? Siamo in inverno, e siamo in piena stagione influenzale. Già, ma molta gente, di fronte alla presenza di febbre, va a pensare alla Meningite, che è decisamente la malattia del momento. Le notizie di casi di questa malattia verificatisi negli ultimi mesi hanno scatenato una vera fobia collettiva, e come si diceva sopra, oltre a pensare al peggio di fronte a banali influenze, si è scatenata una vera e propria caccia al vaccino, che per certi aspetti ha del paradossale.

In questo episodio parleremo di varicella. Con l'aiuto degli specialisti dell'Ospedale Pediatrico Bambino Gesù, capiremo cos'è, quali sono i sintomi e come si cura.Episodio registrato giovedì 19 maggio 2022.

Ainara's first feature was feature film See You Tomorrow, God Willing about a group of Franciscan nuns which she wrote, shot, directed and edited. She has collaborated with Russian filmmaker Victor Kossakovsky  as First Assistant Director  on several of his acclaimed films like: Varicella,  Aquarela, and more recently Gunda. Ainara's most recent directorial project is her acclaimed documentary feature, Polaris.

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

Celebrities such as athletes, movie actors/actresses and even tv personalities have raised awareness of diseases or procedures that would otherwise go unnoticed in society today. It also destigmatizes the public perception of the disease/procedure. In doing so, it raises funding for research to help find a cure for those diseases. Join Dr. Niket Sonpal as he sheds light on the Ramsay Hunt Syndrome also known as Varicella zoster. - We've been in the business of helping students and clinicians learn better medicine, get ahead, and ultimately live more fulfilled lives they're proud of for nearly 10 years. Because of this, we've undoubtedly have a resource to help you. Because you're a podcast listener, we also want to give you access at no cost! Click here to get your hands on your free training [https://www.medgeeks.co/training] - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach.  Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help.   We've worked with thousands of physician assistants and nurse practitioners working in Primary Care since 2013 and we're confident we can help take your career and life to the next level. If you're working in primary care, you can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/application - Learn more about who we are here: https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks 

May 26: Saint Philip Neri, Priest1515–1595Memorial; Liturgical Color: WhitePatron Saint of Rome, humor and joyEveryone saw the haloSaint Philip Neri often begged alms from his wealthy friends and acquaintances to redistribute to needy children. On one occasion, he approached a friend, held out his hand, and asked him, once again, for a few coins: “How about some help for the children.” The man slapped him hard across the face. Saint Philip quickly recovered from the shock, extended his cupped hand again, and said, “That was for me, now how about something for the children?”Saint Philip was born into a well-educated, Catholic, middle-class home. He carried himself all his life with the bearing of an amiable, well-read, finely dressed, shrewd individual who knew no enemies. After growing up in Florence, he moved to Rome and spent many years as a layman studying theology and helping the poor in practical ways. While still a layman, Philip founded a group to care for the many impoverished pilgrims who came to Rome. He befriended the great reformer Saint Ignatius of Loyola, who wanted Philip to become a Jesuit. But after encouragement from his confessor, Philip was ordained a secular priest in 1551. Soon afterward, he had to formalize the large following he generated that wanted to live more fully the life he preached and modeled.Saint Philip was so well loved and so well known in Rome that he is sometimes called its “Third Apostle” after Saints Peter and Paul. His personality radiated a natural warmth and cordiality. His priestly ministry could be fairly characterized as “evangelization by walking around.” He walked the streets of Rome from end to end continually throughout his long life. His life was a long conversation with a thousand characters on street corners, in shops, factories, churches, parks—wherever. He reached out to the destitute, prostitutes, poor children, and the uneducated. Saint Philip would often gather a group to visit seven churches in a row. As they went from one church to another, the group would picnic and listen to the musicians whom Saint Philip brought along for entertainment. These outings, understandably, became hugely popular.Leaders, intellectuals, musicians, and scholars were also drawn to him, in addition to common folk, and formed the impressive circle of committed Catholics who first joined his apostolic efforts. Saint Philip and his companions were given charge of a parish where they held evening sessions filled with song, readings from the lives of the martyrs, the praying of the psalms, and rich conversation. Saint Philip called these gatherings the “oratory,” in part because the participants also listened to musical pieces called “oratorios.” So when it came time to formalize his newly founded community in Church law, the name “Oratory” was chosen. The Congregation of the Oratory, which is still thriving today, was recognized by the Holy Father in 1575 and given the magnificent, new parish of Santa Maria in Varicella, known as Chiesa Nuova (The New Church), in the heart of Rome. Oratorians are mostly diocesan priests and some laymen who live together in a loose brotherhood, taking no vows, while pursuing various individual ministries. The many dozens of oratories around the world are joined in an informal confederation, whereas canonical bonds tie the many houses of a religious order together in a far tighter union.Saint Philip is one of the bright lights of the Counter-Reformation. He blazed a new path, like other reformers. But the new path he blazed was really just the old path, walked differently. Saint Philip was the silent observer, the cheerful listener, the priest always there, who spoke hard truths but always bent on the non-essentials. He mortified himself but never talked about it. He was poor but wore nice clothes. He looked like everyone else, yet…there was that intangible something: the sparkle in his eye, his polish, his lively concern, his clever wit, his courtesy, his wide education, his humor, and his constant turning of the conversation back to God. He was like everyone else, but he wasn't, really. He radiated what twentieth-century psychologists would call the “halo effect.” Everyone saw the invisible halo casting a glow over Saint Philip, and people crowded around to stand in his mellow light.Saint Philip did not start a university, reform an institution, write a classic, or formulate a new rule. He changed the world the only way it can truly be changed—one soul at a time. This army of one was canonized in 1622. His body rests in a glass coffin in Chiesa Nuova, the sumptuous Mother Church of the Oratory, where pilgrims come in faith, kneel before him, and seek his powerful intercession.Saint Philip Neri, your good nature and charm, united with your theological orthodoxy and life of deep prayer, made you a powerful apostle for the people of Rome. May all evangelists, especially priests, see in your openness to others a pathway of changing the world.

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

On December 17, 2021, the CDC changed its guidance for students in schools who have been “close contacts” to persons that have tested positive for COVID-19. In this episode, Doc analyzes the new guidance, compares it to previous guidance, unpacks how contact tracing works in schools, and also takes a macro-look at overall immunization compliance in schools for students K-12 for mumps, measles, rubella, polio, and other required (non-COVID) vaccinations. Doc studied schools' data and assembled a graphic with alarming information. Thanks to all of you for helping Doc surpass 1000 subscribers to his “The Safety Doc” YouTube channel. CDC TEST-TO-STAY. From the CDC: “Test to Stay combines contact tracing and serial testing (testing that is repeated at least twice during a seven-day period post-exposure) to allow asymptomatic school-associated close contacts who are not fully vaccinated and do not test positive for SARS-CoV-2 to continue in-person learning. Because fully vaccinated close contacts are not required to quarantine following exposure, they would not be included in Test to Stay. Students who participate in Test to Stay should consistently and correctly wear masks while in school and should stay home and isolate if they develop symptoms or test positive for SARS-CoV-2. In the studies done in Illinois and California, both the person with COVID-19 and the close contact had to be properly masked at the time of exposure to qualify for Test to Stay. If schools are considering implementing Test to Stay, they should also have robust contact tracing in place and access to testing resources (for example, testing supplies and personnel to conduct testing, or access to an existing community testing site), among other layered prevention strategies. Testing frequency can vary (for example, from twice in a seven-day period to daily), but more frequent testing can more quickly identify students who become infected with SARS-CoV-2 and need to isolate.” CONTACT TRACING IN SCHOOLS. Dr. Perrodin shares that most school districts in his state have fewer than 1000 students and do not employ a designated “contact tracer.” Close Contacts are determined by settings in the school's schedule software. For example, identifying which students were in a 7th hour geometry course attended by a student who tested positive for COVID. Doc is skeptical of the test-to-stay guidance due to shorthanded schools and lack of tests. WISCONSIN STUDENT IMMUNIZATION COMPLIANCE CHECK. Wisconsin Immunization Law (State Statute 252.04)requires that each of the state's 421 school districts annually submit a report of immunization compliance for students. The 2020-2021 compliance requirements are found at (https://www.dhs.wisconsin.gov/publications/p44021.pdf). Here are the requirements: K-5: 4 doses polio, 3 doses hepatitis B, 2 doses MMR, and 2 doses Varicella. Per Wisconsin DHS, students are compliant with the immunization law if they meet all of the minimum immunization requirements, are considered “in process”, or have a waiver on file. The percent of Students Compliant with Immunization Law in 2020-2021 in Wisconsin is publicly available at https://www.dhs.wisconsin.gov/publications/p02388a.pdf  : Here are reports from 12 of Wisconsin's 421 school districts: Blair Taylor 628 students total enrolled in district = no reports received; Beloit 5426 students with 389 students not in compliance = 92.82%; Baraboo = 100%; Ashland 1863 students with 95 students not in compliance = 94.87%; Butternut = no reports received; Columbus 1242 students with 30 students not in compliance = 97.52%; Fall River 492 students with 3 students not in compliance = 99.38%; Portage = 100%; Potosi = no reports give; Madison 25,503 students with 438 students not in compliance = 98.28%; Milwaukee 66,977 students with 6429 students not in compliance = 90.40%; and Montello (614 students with 29 students not in compliance = 95.22%. 32/421 (8%) school districts did not submit reports! This is abysmal, yet there are no statements from the DPI or DHS indicating efforts to complete the data sets. A diagram of this information is included in the corresponding blog post for episode 163 at safetyphd.com. FOLLOW DR. PERRODIN: Twitter @SafetyPhD and subscribe to The Safety Doc YouTube channel & Apple Podcasts. SAFETY DOC WEBSITE, BLOG & BOOKS: www.safetyphd.com. The Safety Doc Podcast is hosted & produced by David P. Perrodin, PhD. ENDORSEMENTS. This is episode 163 of The Safety Doc Podcast published on 12-22-2021. Purchase Dr. Perrodin's Books: School of Errors – Rethinking School Safety in America. www.schooloferrors.com Velocity of Information - Human Thinking During Chaotic Times. www.velocityofinformation.com 

In this episode, Tracy Zivin-Tutela, MD, discusses expert guidance on vaccination against shingles.Tracy Zivin-Tutela, MDInfectious Diseases SpecialistDepartment of Infectious DiseasesFountain Valley Regional HospitalLos Alamitos Medical CenterFountain Valley, CaliforniaUsing a case study and the latest expert guidance, this podcast covers topics such as: Counseling patients on benefits and efficacy of vaccination against shinglesVaccine safetyVaccination guidelines for adults with or without previous vaccination with zoster vaccine live or recalled childhood chickenpoxAdministration of vaccination with consideration for other routine vaccines for flu, pneumonia, COVID-19Content based on a CME program supported by an educational grant from GlaxoSmithKlineFollow along with the downloadable slides at: https://bit.ly/3kunxJrLink to full program: https://bit.ly/3o4PB8N

  Imagine yourself in California at a clearing in a large forest. And it's on fire. There are three groups of people standing before you. A large group is screaming and running around pointing at the fire. They're yelling that we need to do something, anything we can to stop the fire. Meanwhile, there is another group (not as large) with their backs to the fire. They are mocking and ridiculing the group running around panicking. They tell them to calm down and to stop ordering people around. They insist there isn't anything wrong at all. Of course, the largest group of people are standing between these groups and looking behind those panicking at an intact forest and behind the ones who don't notice the giant flames licking at the backs of the those ridiculing the screamers. These people aren't sure what to do but in the interest of safety feel that getting away from the flames is probably the right decision. They tend to stand with the group that's worried. Obviously, this analogy describes our current situation with COVID in America. Most are not in one of the extreme camps. But we either identify with one or are left standing unsure of what to do or think. What needs to be done, and what I did with my friend Dr. David Graham in April of 2020, is to try and be reflective and better understand what it is that we are dealing with. What are the biological, historical, and medical facts or suppositions that we can make to understand this pandemic? If we return to our analogy of the forest fire, it would be best if we could somehow hop up in a hot air balloon and look down at the situation to assess what would be the best individual actions and true scope of the problem. History and biology could be used to understand the nature of fires, how they spread, what do you do to stop them, and what they are likely to do in their course. Contrary to popular opinion, we have some rough ideas about what happens in pandemics and where we will end up. And THAT is the critical fact that we have to accept - those in all camps and in between. Because if we get THAT wrong, then we get everything else wrong. The critical question we must ask is what is the endpoint for this pandemic? What is the biological consequence for SARS-CoV-2 (the virus that causes COVID-19) and its effect on humans. We have to agree on the ultimate end point in order to get our policies and strategies right for surviving the pandemic. What became obvious to us in April of last year was that this virus, despite some government efforts at the time, would become endemic. It would join the other four coronaviruses that currently cause the common cold as a virus that will circulate forever throughout the human population. It will not get eradicated. It will infect everyone probably multiple times throughout your life. This is the biological history of endemic coronaviruses. It really is the way all these common respiratory viruses operate. Rhinovirus, adenovirus, parainfluenza virus - they infect your upper respiratory tract (nose, sinus, mouth) and cause a cold because although you don't have enough antibodies to prevent infection (because they've waned over time or it's a new variant that looks different enough to evade your antibody response) you have memory T and B cells that mount a quick response after infection to prevent a systemic or lower respiratory infection (pneumonia). We know you get this immunity as a child and anyone who has kids knows small children are always sick with runny noses as they are constantly exposed to these different cold viruses which builds up their long term immunity to them when exposed later in life. The mRNA vaccines are a medical miracle and trick your body into generating an immune response. It's not magical (except the technology) and an elegant way to get your body to do the work so when it sees the real virus in the wild, it will seek it out and destroy it. But respiratory viruses often infect us before we can mount a complete immune response so you get sick and can transmit the virus. This isn't a failure - your body has done what it needs to do - and so has the virus which just wants to reproduce and move to the next host. We live in an equilibrium with these viruses, we develop immunity when we're young so if we are exposed when we're older we can prevent really bad outcomes. But we get sick and the virus continues to circulate in the world's population with different viruses coming and going. It's a sort of dance. So what does this all have to do with our wild fire? Well, we know this thing will burn until there isn't any fuel. And fuel is considered people without immunity to the virus. There are only two ways to get immunity - a vaccine or infection. Until the virus has burnt all the fuel, it will continue to burn - there is nothing we can do to stop it. We might slow it down, we might find ways of treating the fuel on fire (although most treatments for viruses are not very good), but ultimately, everyone is going to get it. What does history tell us about coronaviruses? Well, until SARS-CoV-2, we had four endemic coronaviruses that cause colds. The youngest is OC43 which researchers believe jumped from cows to humans in the late1800s. This was at the same time as the “Russian Flu” worked its way around the world so perhaps that flu was actually a coronavirus. If so, OC43 caused a lot more problems to humans back then who were older and naive to the virus according to the news reports from all over the world. But by now, we have all had multiple infections with OC43 and its variants from when we were kids to today where we usually feel terrible for a few days or maybe a week. Over time, the virus does ‘mutate' towards becoming more benign and infectious but that usually takes a long time. Anyway, it serves as a useful road map for what might happen to us in our biological dance with this new unwelcome visitor. We also know, that immunity to these respiratory viruses wanes over time. Either with natural infections or vaccines. The only way you can develop better immunity is through booster shots or infections. But what we really care about - ending up in the hospital - is focused almost entirely on the non-immune. This is a nasty bug, it affects the obese and elderly the most and it isn't going anywhere. It has definitely killed hundreds of thousands of Americans. So this gets us to the important policy considerations - if we know that it is endemic (which was obvious over a year ago) then how should we approach our public health? Obviously, the only point to slowing the spread at this time is if you could get those without any immunity (no infection and no vaccine) vaccinated to minimize the number of people clogging our hospitals. But you can't get to any vaccination rate that will stop the spread of the virus. There is no herd immunity threshold - no number of vaccinated and immune to perfectly prevent its spread. Besides the fact that our ability to slow the spread is questionable anyway, it just doesn't make a difference in the end. We are all going to get this virus. Somewhere, there's a date with you and you and you and me with this virus. Whether you've been vaccinated or not you will almost assuredly get infected. If you have some immunity through a vaccine or previous natural infection, you are much less likely to get very sick. So mandating vaccines - if we agreed that it was wise and just - wouldn't matter much to those who are vaccinated. It may slow the spread and delay the next time they're exposed but they will still get it when their immunity wanes. And again and again. If your mitigation measures worked, all you would do right now is extend the time it takes for everyone to get immunity unless you believe you can convince those who won't get immunized to get the vaccine. Even so, that only really benefits those who have chosen to not protect themselves while inconveniencing everyone else and taking away a lot of rights and simple joys of life. It's easy to see how we got here. Mission creep is not just something that happens with the military - it happens in public policy too. By believing that we could prevent people from getting infected, we have embarked on a strategy that is unwindable and with no clear end point. There is a preponderance of evidence that people can get reinfected multiple times with COVID and after vaccination. Both through research and observational data we know that infections with SARS-CoV-2 will continue to happen forever whether you are vaccinated or not, whether you have had it before and recovered, and no matter where in the world you are living. Fundamentally, we have been chasing a zero-COVID strategy in almost every aspect of our society. Obviously, vaccines are a great idea for those who are at risk. I like to point out to how getting chicken pox (Varicella) as an adult is a completely different experience for an adult than it is a child. Adults can die from chicken pox whereas kids almost never do. Also, an infection of varicella puts you at risk of getting shingles later in life which can cause pain and a host of other problems. This is one reason why we vaccinate children for chicken pox. But clearly, vaccination (since we know it won't stop transmission in its tracks no matter how high the rate is) is a strategy to keep people out of the hospital and free up hospital resources for other things like heart attacks, strokes, cancer, etc. Masks, lockdowns, testing and quarantining and any other mitigation efforts are Zero-COVID policies which are of dubious efficacy and ultimately, make no difference since we will all get infected eventually. The most sensible reason to resist vaccine mandates, masking rules, and various lockdown measures in the US at this point is because they are attempting to stop what cannot be stopped. Even 60% of the deer in Michigan have had COVID and serve as a reservoir for the virus along with mice. SARS-CoV-2 is not going anywhere so acting like you can keep it out is akin to wrapping yourself with a towel when you go swimming to stay dry. Perhaps you could argue that you are waiting until there is a childhood vaccine but that might take months or years until you get large enough numbers of kids' parents to get their kids vaccinated. What target are you looking at? It is exceedingly rare for kids to get really sick with this virus. Do these measures justify affecting their socialization and education and all the other aspects of life we take for granted? Is it worth having every child see other people as disease vectors rather than unique individuals to whom they can get to know, collaborate, play, love, and innovate? Some might argue that the infirm or immunocompromised (like those with solid organ transplants) are at risk and we should encourage vaccination to protect them. Again, the vaccinated can still spread the virus and the only thing vaccination does is frees up hospital resources (which is important). However, once people have had an infection once or maybe twice, they are much less likely to clog the hospitals. Either way, all you're doing is maybe buying some time with these extreme measures but not significantly altering the course of the pandemic in any significant way. The effect of all these mitigation measures falls hardest on our youth. They are the ones who need socialization the most. They are the ones who need interactions for learning the most. I'd argue that right now our greatest generation is our youth, (gen Z and gen alpha) as they have given up the unique experiences of high school sports, graduation, dances, gatherings, the arts - in order to protect the elderly in our society. They have given up so much and we must recognize that and always ask ourselves how much more do we need them to sacrifice to slow the spread of an inevitable disease. We have become so locked in to thinking that we need a zero-COVID strategy to slow the spread that we have forgotten that that was only supposed to last as long as it took to protect those who wanted protection. We've gotten there and now it's time to allow those who want to isolate go do it and let everyone else go about their lives. Dr. Eric Larson is the host of the Paradocs Podcast and an anesthesiologist in private practice. show notes Episode 146: Today's show Surgery Center of Oklahoma: Dr. Smith's 100% price transparent surgery center in Oklahoma City, OK. Episode 143: We were so, so, so, so right about COVID Episode 134: Dr. Jay Bhattacharya on how science is now broken Episode 132: Dr. Monica Gandhi on T cells and long term immunity Episode 128: Dr. Noorchashm on immunity from prior infections to SARS-CoV-2 Episode 127: Independence Day from COVID Locum Story: Today's sponsor who helps you find locum work as a doc. Doctor Podcast Network: The home for the Paradocs and a number of other physician based podcasts. Top 20 Physicians Podcasts Made Simply Web Site Creations: This is the great, affordable website service that built my wife's podcast site. I cannot recommend this company more to someone looking for creating a website. Always Andy's Mom: Home of my wife, Marcy's, podcast for parents grieving or those looking to help them. YouTube for Paradocs: Here you can watch the video of my late son singing his solo on the Paradocs YouTube page. Patreon - Become a show supporter today and visit my Patreon page for extra bonus material. Every dollar raised goes towards the production and promotion of the show.    

In this episode, Tracy Zivin-Tutela, MD, discusses factors that put your patients at risk for shingles and its complications.Tracy Zivin-Tutela, MDInfectious Diseases SpecialistDepartment of Infectious DiseasesFountain Valley Regional HospitalLos Alamitos Medical CenterFountain Valley, CaliforniaUsing a case study and the latest data, this podcast covers topics such as: Pathophysiology and epidemiologyDisease burden and potential complications in older patients, including postherpetic neuralgiaRisk factors, including age, immunosenescence, chronic diseases, unvaccinated statusContent based on a CME program supported by an educational grant from GlaxoSmithKlineFollow along with the downloadable slides at:https://bit.ly/3ENbcbPLink to full program:https://bit.ly/3o4PB8N

In this episode, we review the high-yield topic of Varicella-Zoster Virus from the Microbiology section. --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

Episode 38: Menopause Tips. Asthma treatment update, menopause tips, MMR associated fever and seizures.Today is January 25, 2021.Updates on asthma: As you know asthma is a significant burden for our healthcare system, and for the most part it is not preventable nor curable, but advances in management have changed many patient’s lives over the last 40 years. On our episode 27, we mentioned the updated practice guidelines by the Global Initiative of Asthma (GINA). Today we will give you the updated recommendations by the National Asthma Education and Prevention Program (NAEPP) posted on December 3, 2020. It contains recommendations for the treatment of asthma in children, adolescents, and adults[1]. This is an update from the NAEPP 2007 guidelines and are slightly different than GINA regarding step 1 and step 2 management.-Step 1 (intermittent asthma): NAEPP did not make any changes from 2007. They continue to recommend short-acting β2-agonists [SABAs] for rescue therapy. Remember that GINA recommends against use of SABA as a sole therapy for step 1. -Step 2 (mild persistent asthma): Either daily low-dose ICS plus as-needed SABA therapy or as-needed concomitant ICS and SABA. -Step 3 and step 4 (moderate persistent asthma): formoterol combined with an inhaled corticosteroid in a single inhaler (also known as single maintenance and reliever therapy – SMART) is recommended as the preferred therapy. For step 3 a LOW-dose ICS-formoterol therapy is recommended, and for step 4 a MEDIUM-dose ICS-formoterol therapy is recommended for both daily and as-needed therapy. A short-term increase in the ICS dose alone for worsening of asthma symptoms is not recommended. -Step 5 (severe persistent), adding a long-acting muscarinic antagonist (LAMA) is recommended in patients whose asthma is not controlled by ICS-formoterol therapy. -Fractional exhaled nitric oxide testing (FeNO) is recommended to ASSIST in diagnosis and monitoring of symptoms, but is should not be used ALONE for the diagnosis and monitoring of asthma, and do NOT use in younger than 5 yo patients. Another recommendation is to control allergens in patients with relevant sensitivity. This may not sound so new, but there are several strategies for allergen mitigation, for example, use of impermeable pillow and mattress covers only as part of a multicomponent allergen mitigation intervention. Subcutaneous immunotherapy is recommended as an adjunct to standard pharmacotherapy for individuals with symptoms and sensitization to specific allergens. Sublingual immunotherapy is not recommended specifically for asthma. Bronchial thermoplasty is not recommended as part of standard care; if used, it should be part of an ongoing research effort. If you are still confused about these 2020 NAEPP guidelines updates, I recommend you go online and review them, it is easier to read them than listening to them. Find the link in our posted script.This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it’s sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. ____________________________Menopause Tipsby Valerie, That's me, Dr. Civelli w/ a C!and your friendly medical student neighbor Patrick De LunaTIP #1: Hot Flashes. Hot flashes, aka vasomotor symptoms occur in 70% of women in menopause. Hot flashes can last 1-5 minutes; can be characterized by perspiration, flushing, chills, clamminess, anxiety, and on occasion, heart palpitations; and can cause sleep disturbances. Hot flashes are the most common indication for hormone replacement therapy (HRT). Contraindications for HRT include undiagnosed vaginal bleeding, a history of breast cancer, VTE, or Severe liver disease.Dr Wonderly, how do you treat hot flashes? [Listen to her answer in Episode 38]TIP #2: Hormonal replacement therapy for hot flashes.Estrogen or estrogen/progesterone combo is the most effective therapy for menopausal hot flashes. It’s FDA-approved and has a grade A research according to AAFP and ACOG. Topical methods are preferable as they have fewer adverse effects. But how do you choose? There’s Estrogen? Or estrogen/Progesterone combo? And what is the cancer risk? Remember if using hormones: Dose, duration and risk factors are key! Combined estrogen/progestogen therapy is recommended over estrogen alone, but still increases the risk of breast cancer after three to five years of use. There is no evidence that using low-dose local estrogen increases the risk of breast cancer recurrence. Combined formulation of estrogen and the selective estrogen receptor modulator bazedoxifene may also be used, especially when the patient still has a uterus. The decision to start HRT or to continue for more than three to five years should be made after reviewing all risks, benefits, and symptoms with each patient. Dr Wonderly, when do you decide to continue HRT for longer than 3-5 years? [Listen to her answer in Episode 38]TIP #3: Nonhormonal options to treat hot flashes.Vasomotor symptoms are best managed with systemic HT, but FDA approved, nonhormonal treatment options are available which are SSRIs, SNRIs, and clonidine. All have been shown to be effective. Antidepressants for nonhormonal treatment of vasomotor symptoms specifically include: citalopram, escitalopram, clonidine, desvenlafaxine, venlafaxine, gabapentin, pregabalin, and paroxetine. TIP #4: Natural remedies for menopause. There is no high-quality, consistent evidence that all-natural herbal alternatives are effective. This includes black cohosh, botanical products, omega-3 fatty acid supplements, or lifestyle modifications.  AAFP and ACOG do not endorse any of these as appropriate alternatives. For effective, evidenced based, proven therapies to alleviate hot flashes, think estrogen, estrogen/progesterone combo or antidepressants. TIP #5: The “timing hypothesis” in HRT? It is possible that a patient may ask you about your opinion regarding the timing hypothesis. This hypothesis suggests that starting hormone therapy early in menopause (compared with starting it 10 years or more after the onset of menopause) may be cardioprotective because of estrogen's apparent ability to slow the progression of atherosclerosis in younger women.  Although the evidence suggests that beginning hormone therapy near the start of menopause decreases the risk of cardiac disease, further study is needed. Current guidelines recommend against using hormone therapy to prevent or treat cardiac disease. Further, the American Academy of Family Physicians recommends against using hormone therapy for the prevention of chronic conditions. Dr Wonderly, when is the ideal time to start HRT? [Listen to her answer in Episode 38]TIP # 6: Genitourinary syndrome in menopause (GSM). In 2014, a consensus conference endorsed new terminology: the term genitourinary syndrome of menopause is now recommended to use and replaces the terms vulvovaginal atrophy, atrophic vaginitis, or urogenital atrophy. Keep in mind this change is because new terminology accounts for the genital tract symptoms that commonly occur in women with menopause.Genitourinary Syndrome of Menopause (GSM) is a chronic, progressive, vulvovaginal, sexual, and lower urinary tract condition characterized by a broad spectrum of signs and symptoms due to the lack of estrogen that characterizes menopause. Even though the condition mainly affects postmenopausal women, it is seen in many premenopausal women as well. The low estrogen level causes structural changes such as vaginal dryness, dyspareunia, and reduced lubrication. These can have a great impact on patients’ quality of life.Treatment: Women with GU syndrome in menopause may benefit from vaginal estrogen, nonhormonal vaginal moisturizers, or ospemifene (the only nonhormonal treatment approved for dyspareunia due to menopausal atrophy). Dr Wonderly, do you think UTIs are commonly misdiagnosed in menopause when the GU symptoms are actually being caused by low estrogen? [Listen to her answer in Episode 38]TIP #7: The MenoPro® app.This app has several unique features, including the ability to calculate your 10-year risk of heart disease and stroke, which is important in deciding whether a treatment option is safe for you. It also has links to online tools that assess your risk of breast cancer and osteoporosis and fracture[7].Dr Wonderly, do you know any comprehensive app to be used in menopause? [Listen to her answer in Episode 38]Conclusion: Menopause is likely undertreated because patients suffer in silence and do not disclose their symptoms to the doctor because these symptoms are seeing as “normal part of life” and lack of treatment is not fatal, but treatment can improve quality of life significantly. So, be aware of these symptoms and be prepared to treat them appropriately. Estrogen Medications for the Treatment of Vasomotor SymptomsMEDICATIONAVAILABLE DOSAGES (MG)BIOIDENTICAL?COST*OralEnjuvia (conjugated estrogen)0.3, 0.45, 0.625, 0.9, 1.25 (per day)No$87Estrace (estradiol)0.5, 1.0, 2.0 (per day)Yes$131Menest (esterified estrogen)0.3, 0.625, 1.25, 2.5 (per day)No$48Premarin (conjugated estrogen)0.3, 0.45, 0.625, 0.9, 1.25 (per day)No$143Transdermal patch (estradiol)Alora0.025, 0.05, 0.075, 0.1 (twice per week)Yes$90Climara0.025, 0.0375, 0.05, 0.06, 0.075, 0.1 (once per week)Yes$50Minivelle0.025, 0.0375, 0.05, 0.075, 0.1 (twice per week)Yes$137Vivelle Dot0.025, 0.0375, 0.05, 0.075, 0.1 (twice per week)Yes$84Transdermal gel (estradiol)Divigel0.25, 0.5, 1.0 (per day)Yes$118Elestrin0.52 (per day; adjust dosage based on response)Yes$109Estrogel0.75 (per day)Yes$126Transdermal spray (estradiol)Evamist1.53 per spray (start with 1 spray per day, adjust up to 3 sprays per day based on response)Yes$118Vaginal (estradiol)Femring0.05, 0.10 (for 90 days)Yes$355*—Estimated retail price of one month's treatment based on information obtained at http://www.goodrx.com(accessed June 13, 2016).   ____________________________Speaking Medical: MMR by Heather Langner, MS4MMR is a vaccine against measles, mumps, and rubella which contains live attenuated viruses. In the US, children should get two doses of MMR vaccine, starting with the first dose at 12 to 15 months of age, and the second dose at 4 through 6 years of age (usually before starting preschool or kindergarten).  MMRV (MMR combined with varicella, brand name ProQuad) has been proposed as a way to simplify administration. Let’s listen to what our future doctor has to say about it[8].According to the CDC there are 2 adverse events that occur most often during the 42 days after the first dose of the MMR/MMRV vaccine: Fever of 102F or higher and rash. The highest rates happening between 5-12 days after vaccination. Risk of fever: When the MMR vaccine and the Varicella vaccine are given separately the risk of fever (above 102F) is slightly higher than when given the combined MMRV vaccine (1 in 7 vs 1 in 5 children). Risk of seizures: A study published in Pediatrics explored the risk of febrile seizures in the MMR vs MMRV vaccine. The study included over 83,000 MMRV vaccine recipients and over 376,000 MMR+V vaccine recipients. The study found that the fever and seizures were clustered around day 7-10. The MMR+V vaccine had a febrile seizure risk of 4 in 10,000 doses and the MMRV vaccine had 5 in 10,000 doses. So, the risk of seizures is slightly higher when MMR and varicella are given combined (MMRV).After first dose: Data suggests febrile seizure post MMR vaccination are primarily seen after the first dose in children aged 12-47 months. The second dose of the vaccine is less likely to cause fever than the first dose. This means that having a febrile seizure after the first vaccination is not a contraindication for receiving subsequent doses. Something to consider: if there is a personal or family history (parent or sibling) of febrile seizures, the child should receive the separate MMR and Varicella vaccine. As children get older the risks for the MMR vs MMRV vaccine are the same.Contraindications: Per the AAP the only absolute contraindications for the MMR or MMRV vaccine: anaphylactic reaction to MMR vaccine or its components (neomycin or gelatin), pregnancy, and immunosuppression. Relative contraindications include: history of thrombocytopenia (small risk for thrombocytopenia post vaccination, but no hemorrhagic complications have been reported), recent receipt of blood products (may interfere with seroconversion), patients receiving high-dose steroid therapy (immunosuppression), and severe acute illness (precaution intended to prevent complicating management with vaccine reactions). Egg allergy reactions to the MMR vaccine are now considered extremely rare and is therefore no longer a contraindication. Breastfeeding and fevers are also not contraindications for MMR vaccine administration.__________________________Question of the month: Diabetes managementby Steven Saito, MD This is a reminder of our question for this month. Please answer before Feb 8, 2021. The best answer will receive a prize.Question: What is the first treatment approach for type 2 DM? For example, for a patient who had polydipsia, polyuria for a few weeks and at your office had a random BG of 210.Send your answer to RBresidency@clinicasierravista.org. Don’t miss this chance to win.____________________________For your Sanity: Random Jokesby Katherine Schlaerth, Manuel Tu, and Cassandra Levitske-If those who can’t hear are deaf, and those who can’t see are blind, what do you call those who can’t smell or taste?-Covid positive-What does a gynecologist and a deaf person have in common? They're pretty good at reading lips.-Why did Tigger stick his head in the toilet?-He was looking for Pooh.-Why is pea soup more special than mashed potatoes?-Because anyone can mash potatoes.Conclusion: Now we conclude our episode number 38 “Menopause Tips”, we started with some updates on asthma management, then Dr Civelli and our “future doctor” De Luna gave us some tips about the treatment of menopause symptoms. Our wonderful Dr Wonderly also answered a few questions about the management of this unavoidable, “period-free” period in a woman’s life. Then doctor-to-be Heather explained her findings on risks associated with MMR, specifically fever and seizure risks. Don’t forget our question for this month. Send us a brief, original, and relevant answer to our email before Feb 8, 2021. We hope you enjoyed this episode.  Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Valerie Civelli, Patrick De Luna, Sally Wonderly, Cassandra Levitske, Manuel Tu, Katherine Schlaerth, Tana Parker, and Steven Saito. Audio edition: Suraj Amrutia. See you next week! _____________________References:Cloutier MM, Dixon AE, Krishnan JA, Lemanske RF, Pace W, Schatz M. Managing Asthma in Adolescents and Adults: 2020 Asthma Guideline Update From the National Asthma Education and Prevention Program. JAMA. 2020;324(22):2301–2317. doi:10.1001/jama.2020.21974 (https://jamanetwork.com/journals/jama/article-abstract/2773482)2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group, https://www.nhlbi.nih.gov/health-topics/all-publications-and-resources/2020-focused-updates-asthma-management-guidelines. Asthma: Updated Diagnosis and Management Recommendations from GINA, Am Fam Physician. 2020 Jun 15;101(12): 762-763. https://www.aafp.org/afp/2020/0615/p762.html.  Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention, 2020. Available from: www.ginasthma.orgACOG Releases Clinical Guidelines on Management of Menopausal Symptoms, Am Fam Physician. 2014 Sep 1;90(5):338-340. https://www.aafp.org/afp/2014/0901/p338.htmlHormone Therapy and Other Treatments for Symptoms of Menopause. Am Fam Physician. 2016 Dec 1;94(11):884-889. https://www.aafp.org/afp/2016/1201/p884.htmlHabib, Jamie, NAMS Launches Free Mobile Menopause App, Contemporary OB/GYN, October 16, 2014, https://www.contemporaryobgyn.net/view/nams-launches-free-mobile-menopause-appDavid W. Kimberlin, ACIP, AAP support choice of MMRV or separate MMR, varicella vaccines, AAP News January 2010, 31 (1) 10; DOI: https://doi.org/10.1542/aapnews.2010311-10. https://www.aappublications.org/content/31/1/10.1Meissner, H. Cody, MD, FAAP, What are the indications, precautions, contraindications for MMR vaccination?AAP News, May 14, 2019, https://www.aappublications.org/news/2019/05/14/idsnapshot051419.  Febrile Seizures and Childhood Vaccines, Questions and Concerns, Centers for Disease Control and Prevention, last reviewed on August 14, 2020, https://www.cdc.gov/vaccinesafety/concerns/febrile-seizures.html.MMRV Vaccine and Febrile Seizures, Centers for Disease Control and Prevention, last reviewed on June 4, 2020, https://www.cdc.gov/vaccinesafety/vaccines/mmrv/mmrv-febrile-seizures.html.VSD MMRV Safety Study, Centers for Disease Control and Prevention, last reviewed on June 29, 2020, https://www.cdc.gov/vaccinesafety/vaccines/mmrv/vsd-mmrv-safety-study.html.Klein Nicola P., Bruce Fireman, W. Katherine Yih et al, Measles-Mumps-Rubella-Varicella Combination Vaccine and the Risk of Febrile Seizures, Pediatrics, July 2010, 126 (1) e1-e8; DOI: https://doi.org/10.1542/peds.2010-0665. https://pediatrics.aappublications.org/content/126/1/e1.

This episode covers varicella zoster virus!

This episode is CHOCK (love that word!) full of content. The Spirit Machines make their debut on KWR! Chemlab creeps their way towards us, again. Talking Dutch author Michael Faber's book Under the Skin and the film with Scarlet Johansson. Machine Man records represents with Haxon's new thrash epic "Periphery." Varicella gets love (more to come). Horror movies, The Wretched and #CarousHell2 by Steve Rudzinski, @MachinesSpirit #machinemanrecords @JarodLouche #ticktokcontroversy #thrashmetal #spiritmachinesband #chemlabindustrialmusic #atticusross #trentreznor #kettlewhistleradio #drpeelordemonpsychiatrist #zober #spiritmachinesband

TESTO DELL'ARTICOLO ➜http://www.bastabugie.it/it/articoli.php?id=6274L'ARCIVESCOVO DI SYDNEY CRITICA IL VACCINO CONTRO IL CORONAVIRUSIl vaccino in fase di sviluppo all'Università di Oxford fa uso di una linea cellulare coltivata da un bambino abortito e quindi è eticamente inaccettabileda Sito del TimoneAnthony Fisher, arcivescovo di Sydney, ha utilizzato i social media per criticare il vaccino in fase di sviluppo all'Università di Oxford, dicendo che «fa uso di una linea cellulare coltivata da un feto umano abortito elettivamente». Il vaccino, considerato tra i primi nella corsa globale per combattere il COVID-19, è stato sviluppato da una linea cellulare renale (HEK-293) prelevata da un feto abortito, una pratica comune nella ricerca medica. La scorsa settimana il governo australiano ha firmato un accordo con la società farmaceutica britannica AstraZeneca per garantire 25 milioni di dosi del potenziale vaccino COVID-19 se questo supererà i test.«Che questo vaccino abbia successo o meno, è importante che il governo non crei un dilemma etico per le persone», ha scritto su Facebook l'arcivescovo Fisher. Poi ha aggiunto di aver scritto al primo ministro, Scott Morrison, esortandolo a perseguire vaccini alternativi che «non utilizzino cellule fetali nel loro sviluppo». Morrison ha precedentemente affermato che il governo non stava limitando la sua ricerca di un vaccino solo all'Università di Oxford.Il vice direttore della sanità, Nick Coatsworth, ha rassicurato riguardo eventuali preoccupazioni morali. «Penso che possiamo avere piena fiducia che il modo in cui hanno prodotto il vaccino sia stato con i più alti standard etici a livello internazionale», ha affermato. Il tesoriere federale Jim Chalmers ha detto che le persone «stanno scaldando gli animi senza motivo», poiché il vaccino era ancora in fase di prova. «La mia opinione personale è che se e quando un vaccino è disponibile e viene immesso nel mercato, allora quante più persone possibile dovrebbero essere vaccinate», ha detto all'ABC. «Lo dico da cattolico che questo è il miglior risultato per l'Australia perché il vaccino è davvero ciò che ci porterà in salvo».Il premio Nobel e immunologo professor Peter Doherty ha detto che a suo avviso, il processo è stato etico. «È una linea cellulare consolidata utilizzata in molte applicazioni», ha detto. «Se l'Arcivescovo lo trova discutibile, è suo perfetto diritto dirlo ed è nostro diritto perfetto non prenderlo assolutamente in considerazione», ha detto. Il professor Colin Pouton, del Monash Institute of Pharmaceutical Sciences, ha affermato che la cellula HEK-293 è stata regolarmente utilizzata nella ricerca medica «per creare prodotti vettoriali virali» perché ci sono vantaggi nell'utilizzo di cellule di mammifero, aggiungendo che questa linea cellulare è stata sviluppata decenni fa ed è stata ampiamente utilizzata in tutto il mondo. «Non è che la gente stia usando una nuova linea cellulare. È già lì, quindi per molti aspetti la questione etica è cosa passata».Altri vaccini in Australia utilizzano le «linee cellulari diploidi umane» di WI-38 e MRC-5, che sono originariamente derivate da tessuto fetale umano. Questi includono i vaccini contro la rosolia, l'epatite A e la rabbia, tra gli altri.Questa è la prassi ed è giusto che tutti sappiano che i feti umani vengono sacrificati. Il «dilemma etico», come rilevato dall'arcivescovo di Sidney, è evidente. [...]Nota di BastaBugie: per quanto riguarda in generale l'argomento dei vaccini si possono leggere gli articoli che abbiamo pubblicato in questi anni al seguente link:http://www.bastabugie.it/it/contenuti.php?pagina=utility&nome=_vacciniInvece per quanto riguarda lo specifico tema dei vaccini prodotti attraverso feti abortiti, l'autore del precedente articolo, Paolo Gulisano, in un articolo dal titolo "Vaccini prodotti attraverso feti abortiti" ricorda la posizione della Pontificia Accademia per la Vita che nel 2005 si pronunciò sui vaccini ricavati da cellule fetali con un documento con il quale concludeva che è eticamente inammissibile utilizzare tali vaccini.Ecco un estratto significativo dell'articolo pubblicato su La Nuova Bussola Quotidiana il 5 marzo 2019:Se ne discute da molto tempo, ma molti continuano a non sapere: è la questione dei vaccini prodotti attraverso feti abortiti. Una questione che potrebbe e dovrebbe interrogare le coscienze dei cattolici, e non solo loro. Una realtà a volte negata, ora semplicemente minimizzata. In fondo - dice qualcuno - per ottenere le linee cellulari necessarie per produrre vaccini come quello contro Morbillo, Parotite, Rosolia e Varicella o contro l'Epatite A sono stati sufficienti due feti abortiti, due feti sani, ovviamente, e quindi esito di interruzioni volontarie di gravidanza.Due bambini mai nati. Una femmina svedese abortita nel 1962 e un maschietto inglese nel 1966. Dai loro polmoni sono stati estratti fibroblasti (cellule del tessuto connettivo) che hanno composto le linee cellulari WI-38 e MRC-5, tuttora utilizzate. Sono i terreni di coltura che rendono i virus adatti a essere inseriti nei vaccini. Solo due, dicono i giustificazionisti, anche se a detta degli stessi ricercatori dedicati ai vaccini sono servite decine di altre piccole vittime per arrivare a queste due linee cellulari, vite umane sacrificate in nome di un imperativo tecnologico, giustificato dal fatto che questi vaccini possano salvare altre vite. Ma il fine non giustifica mai i mezzi.La gran parte delle persone ignora questa realtà, tra cui i genitori che portano i bambini a vaccinare, e anche molti operatori. La ignora anche il mondo cattolico, che tace.Eppure, non trattandosi di evidenze recenti, ma ormai consolidate, la Chiesa ebbe modo già anni fa di pronunciarsi autorevolmente. La Pontificia Accademia per la vita, istituita da san Giovanni Paolo II nel 1994, si pronunciò sui vaccini ricavati da cellule fetali con un documento del 2005. Il documento illustrava correttamente e in modo documentato come fossero state prodotte quelle linee cellulari, stigmatizzandone l'uso. Il documento dell'Accademia per la Vita parlava "di vera e illecita cooperazione al male", e invitava i cittadini ad opporsi con l'obiezione di coscienza, e a fare pressioni sulle aziende perché progettassero linee cellulari alternative e chiedendo "un controllo legale rigoroso".

Cyberage Radio 07.25.2020 : ANGSTSYSTEM, RAGE SERMON, SPANKTHENUN, DAWN OF ASHES, ALIEN:NATION, SIN D.N.A., TOXIKK DECEPTION, BINARY DIVISION, BRIGADIER, FORMATO NEGATIVO, AMORPHOUS, VARICELLA, RED LOKUST, IN ABSENTIA, PRO PATRIA, PSYCHO CIRCUS, TOOTHPINCH, SYNAPSCAPE, BELLHEAD, CHMCL STR8JCKT SPEED INJEKTION,WHITE NOISE TV, FRONT LINE ASSEMBLY, SKINNY PUPPY

New Tunesday: new releases from the last week! Give the bands a listen and if you like what you hear then support the bands! Buy their music! Like their social media pages! Watch their live streams! Today's episode features new releases by Provision, Sister Electra, Negant, Slow Danse With The Dead, Ultra Sunn, SynthAttack, ALEX, Kasper Hate, Pegasus Asteroid, Dimitri Berzerk, Camlann, Varicella, Let Em Riot, Alexandria's Dream, Das Klaus, Crystalline Stricture, The Sea At Midnight, New Neon, Areal Kollen, The Alpha Video, Andy Fox, and previous releases by Thrillsville, Petrol Bastard, Bedless Bones, Purple Grid, Egotragik, Гласность, Hammershøi, XelaM, and Traumship!

New Tunesday: new releases from the last week! Give the bands a listen and if you like what you hear then support the bands! Buy their music! Like their social media pages! Watch their live streams! Today's episode features new releases by Provision, Sister Electra, Negant, Slow Danse With The Dead, Ultra Sunn, SynthAttack, ALEX, Kasper Hate, Pegasus Asteroid, Dimitri Berzerk, Camlann, Varicella, Let Em Riot, Alexandria's Dream, Das Klaus, Crystalline Stricture, The Sea At Midnight, New Neon, Areal Kollen, The Alpha Video, Andy Fox, and previous releases by Thrillsville, Petrol Bastard, Bedless Bones, Purple Grid, Egotragik, Гласность, Hammershøi, XelaM, and Traumship!

New Tunesday: new releases from the last week! Give the bands a listen and if you like what you hear then support the bands! Buy their music! Like their social media pages! Watch their live streams! Today's episode features new releases by Provision, Sister Electra, Negant, Slow Danse With The Dead, Ultra Sunn, SynthAttack, ALEX, Kasper Hate, Pegasus Asteroid, Dimitri Berzerk, Camlann, Varicella, Let Em Riot, Alexandria's Dream, Das Klaus, Crystalline Stricture, The Sea At Midnight, New Neon, Areal Kollen, The Alpha Video, Andy Fox, and previous releases by Thrillsville, Petrol Bastard, Bedless Bones, Purple Grid, Egotragik, Гласность, Hammershøi, XelaM, and Traumship!

Dr. Toney reviews the epidemiology and management of Varicella Zoster infections. He first discusses the prevalence and clinical presentation of this herpesvirus family infection. He points out the importance of recognizing the prodrome in patients before the complete outbreak occurs. He goes on to discuss the clinical complications of VZV disease, including ophthalmologic, multi-dermatomal, and disseminated infections. He next discusses the treatment options available to manage Zoster infections. The subject of available Zoster vaccines is then discussed, with a focus on the newer Recombinant Zoster Vaccine (RZV). Lastly, Dr. Toney presents a couple of photo case-studies.

New Tunesday: new releases from the last week! Give the bands a listen and if you like what you hear then support the bands! Today's episode features new releases by ManMindMachine, Fermion, Lucy In Disguise, Menschdefekt, Plike, Kinex Kinex, Civil Hate, Rayne Reznor & Samtar, 808 DOT POP, Fiction8, Werner Karloff, Tiltshifted, Deflexity, Bara Hari, El Ojo Y La Navaja, Varicella, Take The Night, Ethseq, Wiegand, The Violent Youth, Dandroid, Demon Machine, Blood Handsome, Paranormales, The Less Dead & Dark Smoke Signal, Lazerpunk!, Alexandria's Dream, This Is The Bridge, Chris Keya, Sólveig Matthildur, Psychic Guilt, Keep Shelly In Athens, A Transition, Jessie Frye, Faderhead, daddybear, Marva Von Theo, Moenia, CZARINA & Future Enemies, Patenbrigade: Wolff, Enzo Kreft, Projekt Ich & Stereo In Solo, Plastic Estate, Apoptygma Berzerk, YORU 夜, unitcode:machine, Fatigue, White Cauldron, The Foreign Resort, and Dharmata 101!

New Tunesday: new releases from the last week! Give the bands a listen and if you like what you hear then support the bands! Today's episode features new releases by ManMindMachine, Fermion, Lucy In Disguise, Menschdefekt, Plike, Kinex Kinex, Civil Hate, Rayne Reznor & Samtar, 808 DOT POP, Fiction8, Werner Karloff, Tiltshifted, Deflexity, Bara Hari, El Ojo Y La Navaja, Varicella, Take The Night, Ethseq, Wiegand, The Violent Youth, Dandroid, Demon Machine, Blood Handsome, Paranormales, The Less Dead & Dark Smoke Signal, Lazerpunk!, Alexandria's Dream, This Is The Bridge, Chris Keya, Sólveig Matthildur, Psychic Guilt, Keep Shelly In Athens, A Transition, Jessie Frye, Faderhead, daddybear, Marva Von Theo, Moenia, CZARINA & Future Enemies, Patenbrigade: Wolff, Enzo Kreft, Projekt Ich & Stereo In Solo, Plastic Estate, Apoptygma Berzerk, YORU 夜, unitcode:machine, Fatigue, White Cauldron, The Foreign Resort, and Dharmata 101!

New Tunesday: new releases from the last week! Give the bands a listen and if you like what you hear then support the bands! Today's episode features new releases by ManMindMachine, Fermion, Lucy In Disguise, Menschdefekt, Plike, Kinex Kinex, Civil Hate, Rayne Reznor & Samtar, 808 DOT POP, Fiction8, Werner Karloff, Tiltshifted, Deflexity, Bara Hari, El Ojo Y La Navaja, Varicella, Take The Night, Ethseq, Wiegand, The Violent Youth, Dandroid, Demon Machine, Blood Handsome, Paranormales, The Less Dead & Dark Smoke Signal, Lazerpunk!, Alexandria's Dream, This Is The Bridge, Chris Keya, Sólveig Matthildur, Psychic Guilt, Keep Shelly In Athens, A Transition, Jessie Frye, Faderhead, daddybear, Marva Von Theo, Moenia, CZARINA & Future Enemies, Patenbrigade: Wolff, Enzo Kreft, Projekt Ich & Stereo In Solo, Plastic Estate, Apoptygma Berzerk, YORU 夜, unitcode:machine, Fatigue, White Cauldron, The Foreign Resort, and Dharmata 101!

New Tunesday: new releases from the last week! Futurepop, Synthpop, EBM, Industrial, Post-Punk, Darkwave, Dark Electro, Synthwave, and more! Give the bands a listen and if you like what you hear then support the bands! Buy their music! Like their social media pages! Go see them on tour! Today's episode features new releases by Beyond Border, PreCog, Logan Ryuk, Youth Code, Death Loves Veronica, Soul Extract, ORAX, Radio Wolf & Parallels, Varicella, Neuvision, Kitka, Sixth June, Volkor X, Tokyo Rose & Pylot & Essenger, Probe, Negant, Goldparalax, Magnavolt, Sukabura, Vyrtual Zociety, Psychic Guilt, LAZERLVST, Armageddon Dildos, Neurobash, SØTUL, Beat Noir Deluxe, Glenn Love, and Nius X!

New Tunesday: new releases from the last week! Futurepop, Synthpop, EBM, Industrial, Post-Punk, Darkwave, Dark Electro, Synthwave, and more! Give the bands a listen and if you like what you hear then support the bands! Buy their music! Like their social media pages! Go see them on tour! Today's episode features new releases by Beyond Border, PreCog, Logan Ryuk, Youth Code, Death Loves Veronica, Soul Extract, ORAX, Radio Wolf & Parallels, Varicella, Neuvision, Kitka, Sixth June, Volkor X, Tokyo Rose & Pylot & Essenger, Probe, Negant, Goldparalax, Magnavolt, Sukabura, Vyrtual Zociety, Psychic Guilt, LAZERLVST, Armageddon Dildos, Neurobash, SØTUL, Beat Noir Deluxe, Glenn Love, and Nius X!

New Tunesday: new releases from the last week! Futurepop, Synthpop, EBM, Industrial, Post-Punk, Darkwave, Dark Electro, Synthwave, and more! Give the bands a listen and if you like what you hear then support the bands! Buy their music! Like their social media pages! Go see them on tour! Today's episode features new releases by Beyond Border, PreCog, Logan Ryuk, Youth Code, Death Loves Veronica, Soul Extract, ORAX, Radio Wolf & Parallels, Varicella, Neuvision, Kitka, Sixth June, Volkor X, Tokyo Rose & Pylot & Essenger, Probe, Negant, Goldparalax, Magnavolt, Sukabura, Vyrtual Zociety, Psychic Guilt, LAZERLVST, Armageddon Dildos, Neurobash, SØTUL, Beat Noir Deluxe, Glenn Love, and Nius X!

Ainara's early work includes her short documentary, Sertres and Demonstration, working with 32 students under the direction of Russian filmmaker Victor Kossakovsky. Ainara's first feature was film See You Tomorrow, God Willing about a group of Franciscan nuns which she wrote, shot, directed and edited. Her relationship with Victor Kossakovsky continued by working as First Assistant Director on his films Sports Kids: Varicella, and Aquarela, for which she also worked on Second Unit Camera and and as Editor, and the upcoming, Gunda. Ainara is also developing her second feature film called Polaris.

Il titolo riprende una frase scritta per anni sulla carreggiata sull'Autostrada A1, pressappoco dopo Civitavecchia in direzione Genova, e serve a riassumere il sentore popolare sul decreto legge che permette di fare attività fisica all'aperto ai tempi del COVID-19. I commenti, i messaggi e le email arrivate dagli utenti negli ultimi giorni mi hanno convinto a dire qualcosa su questo argomento, sempre partendo dall'idea di non giudicare né offendere né generalizzare. In mezzo: la mia varicella, il Dell XPS 13... Continua a leggere su https://riccardo.im/podcast/il-mordente-57/ Potete inviare messaggi vocali su Telegram o Whatsapp al numero 351 8516089, oppure usare il modulo contatti su riccardo.im per scrivere una e-mail. Ciao.

Tappava isorokko on maailmasta hävitetty kattavilla rokotusohjelmilla, mutta miten on muiden kulkutautien laita? Mitä eroa sillä on sairastaako lastentaudit vai suojautuuko taudeilta rokotteilla? Sekä tuhka- ja vesirokon sairastamalla että rokotteella ihmisen puolustussysteemi oppii torjumaan uuden tartunnan loppuiäksi. Mutta erojakin on, terhakkaat tautivirukset aiheuttavat pitkäaikaisia tai pysyviä jälkiseuraamuksia. Tuhkarokon poteminen aiheuttaa potilaalle immunologisen muistinmenetyksen, joka altistaa kaikille tyrkyllä oleville tartuntataudeille. Vesirokon sairastaminen jättää ikuiseksi riesaksi Varicella zoster-viruksen väijymään ihmispolon selkäytimen hermojuureen. Sieltä tämä herpesviruksiin kuuluva virus pomppaa esiin stressin, ikääntymisen tai puolustuskyvyn heikkenemisen myötä ja aiheuttaa vyöruusun. Rokotteissa käytetyt heikennetyt virukset eivät moiseen pysty. Miten immuuniteetti kehittyy sairastamalla tai rokottamalla ja miten laumasuoja toimii entä miksi meillä on paikallisia epidemioita rokotuskattavuudesta huolimatta. Professorit Mikael Knip ja Anu Kantele puhuvat tarttuvista taudeista ja rokotteista Tiedeykkösessä. Toimittaja on Leena Mattila. Kuva: All Over Press / Mauricio Jordan / Alamy

WHRO Public Media hosted the 13th Annual Virginia Media Spelling Bee, and we have the winner. Twelve-year-old Andrew Hoehn walked away with the first place trophy--and now he's headed to the Scripps National Spelling Bee in Washington, D.C.

In this NB Hot Topics Podcast, Dr Neal Tucker takes an in depth look at coronavirus, the data that scientists need to predict whether it becomes a pandemic, and how this affects UK general practice. He also reviews new research on isolated diastolic hypertension and whether treating this improves outcomes, and on the booster theory for adult exposure to children with chickenpox. As well we look at the latest news in cluding Ian Paterson and the new GP Contract.

A lot of soon-to-be moms aren't sure what vaccinations they should (or shouldn't) get during pregnancy, if any. I know there are a lot of questions and misconceptions about immunization generally, so I thought this would be a good opportunity to do a deep dive into vaccines and pregnancy. There is a key difference between inactive and live vaccines, and the live kind are never recommended during pregnancy. In fact, there are only two immunizations that are definitely recommended during pregnancy; otherwise, you should try to be up to date before you get pregnant, or wait until after you've given birth to get vaccinated. Today I'll tell you what immunizations you should get before getting pregnant, which ones you should not get while pregnant, and some of the effects that these preventable diseases can have on mom and her developing baby if she doesn't get vaccinated. Don't forget about your flu shot, either - I did a whole episode on why you should get your flu shot during pregnancy, too! And if you  have any questions, come join us in the All About Pregnancy and Birth Facebook Group. In this Episode, You’ll Learn About: Why immunizations are such an important part of a healthy pregnancy How safe vaccinations are and what to keep in mind before getting any new immunizations How the body produces antibodies and passes them along to your baby Why it's such a good idea to get your MMR and Varicella (chicken pox) vaccines before you get pregnant Some of the effects that measles, mumps, rubella, and varicella can have on mom and baby during pregnancy Why moms should get the TDAP (tetanus, diphtheria, and acellular pertussis) during pregnancy Links Mentioned In The Episode How To Make A Birth Plan That Works - Free Online Class! The Birth Preparation Course Ep #43: What You Need to Know About Flu and Pregnancy Join my email list here!

Cyberage Radio 11.30.2019 : DIE KRUPPS, PRE EMPTIVE STRIKE 0.1, INTENT:OUTTAKE, CENTHRON, FRACTAL AGE, SYNTHATTACK,INJUSTRIAL, AGONOIZE, HOCICO, KMFDM , VARICELLA,UNIDAD OBSCURA, PRO PATRIA, DIE ROBOT, WOLFCHILD, SPANKTHENUN

Cyberage Radio 11.23.2019 : INTENT:OUTTAKE, CENTHRON, FRACTAL AGE, DIE KRUPPS, INJUSTRIAL, FORMATO NEGATIVO, AGONOIZE, HOCICO, VARICELLA, DIVERJE, UNIDAD OBSCURA, PRO PATRIA, WOLFCHILD

We put the trivia podcast in trivia podcast! Time to challenge yourself with an all new episode of Quiz Quiz Bang Bang. We have everything from "Amman the capital of which country?" to " In the bible, who was visited by the Queen of Sheba?" to "Varicella is the medical term for which disease?" Find out in this episode! If you like this one, check out Episode 9 for more fun trivia! Music Hot Swing, Fast Talkin, Bass Walker, Dances and Dames, Ambush by Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/ Don't forget to follow our trivia podcast on social media: Patreon - patreon.com/quizbang - Please consider supporting us on Patreon. Check out our fun extras for patrons and help us keep this podcast going. We appreciate any level of support! Website - quizbangpod.com Check out our website, it will have all the links for social media that you need and while you're there, why not go to the contact us page and submit a question! Facebook - @quizbangpodcast - we post episode links and silly lego pictures to go with our trivia questions. Enjoy the silly picture and give your best guess, we will respond to your answer the next day to give everyone a chance to guess. Instagram - Quiz Quiz Bang Bang (quizquizbangbang), we post silly lego pictures to go with our trivia questions. Enjoy the silly picture and give your best guess, we will respond to your answer the next day to give everyone a chance to guess. Twitter - @quizbangpod We want to start a fun community for our fellow trivia lovers. If you hear/think of a fun or challenging trivia question, post it to our twitter feed and we will repost it so everyone can take a stab it. Come for the trivia - stay for the trivia. Ko-Fi - ko-fi.com/quizbangpod - Keep that sweet caffeine running through our body with a Ko-Fi, power us through a late night of fact checking and editing!

> Influenza Influenza is an orthomyxovirus Most commonly seen during the fall and winter Incubation period of 18-72 hours Secondary diseases are a major concern Pneumonia Reye’s syndrome Children under 18 Biggest risk factors are having the Flu or Varicella […] The post S2 E058 Pulm Infections part 2 appeared first on Physician Assistant Exam Review.

Cyberage Radio 11.02.2019 : HELLOWEEN 2 : AGONOIZE, PRE EMPTIVE STRIKE 0.1, WOLFCHILD, VELVET ACID CHRIST, PRO PATRIA, NOHYCIT, DIVERJE, VARICELLA , LARVA, BLACKPILL, DIE ROBOT, CYGNOSIC, MORDACIOUS, DISTORTION SIX

If you don’t have herpes then hearing that everyone has  herpes virus probably just freaked you out! Well, it’s true that everyone has a herpes virus and it’s nothing to be worried about. You’re going to be just fine. Promise.  We’ve been living with these dang herpes viruses for as long as humans have been walking on this earth. The herpes virus want to survive as much as we do and they’ve done a pretty good job at it.  Let me explain.   There are more than 100 known herpes viruses out there! Yep 100! The good news is that there are really only 8 that infects us as humans. Here’s the list and I’d bet you have more than one of them: herpes simplex virus type 1 (HSV) or commonly known as cold sores or fever blisters herpes simplex virus type  2 (HSV) commonly known as genital herpes Varicella-zoster virus (VZV) or commonly known as chickenpox or shingles cytomegalovirus is very common and doesn’t really have any symptoms Epstein-Barr virus or commonly known as mononucleosis or mono and the Symptoms include fatigue, fever, rash, and swollen glands.  human herpesvirus 6 or commonly known as HHV and infects nearly 100% of human beings, typically before the age of three and often results in fever, diarrhea, sometimes with a rash known as roseola. human herpesvirus 7 or commonly known as HHV has symptoms including acute febrile respiratory disease, fever, rash, vomiting, diarrhea, low lymphocyte counts, and febrile seizures, though most often no symptoms present at all. Kaposi's sarcoma virus or human herpesvirus 8 include symptoms that are lesions on the skin: flat, painless spots that are red or purple on white skin and bluish, brownish, or black on dark skin.    Ok so heres the deal. You have 1 or 2 or 3 or many of the herpes virus that are living with us humans. The only one that causes us to freak out or make us believe that we did something wrong is herpes or HSV 1 or 2. So why is it that getting chicken pox or mono doesn’t make us feel like we’re a leper? My guess it’s all a marketing stunt that was put into place to sell the antiviral, valtrex. The pharma companies need a compelling story to convince people that then needed this antiviral in order to continue to live a normal life. And yes, it’s 100% BS. You don’t need the antiviral to live a normal life, yes it helps heal the outbreaks faster but thats really it.    But back to the 8 herpes viruses and how we all have many of them and we all freak out about getting genital herpes or oral herpes.  It really does get me going when you hear people cringe or have an eww attitude towards people with herpes when I know that they have herpes viruses too. Oh and 80% of the people with HSV don’t even know they have it.    The reason why this is important to you, someone living with either oral or genital herpes, is that you can educate the person who stereotypes you or calls you names. Ask them if they have ever had mono or the chicken pox or cold sores. I can guarantee you they’ve had one or all of them.    The truth is you have herpes viruses and that’s just fine. Chickenpox or mono doesn’t define you’re life so why should you let HSV 1 or 2 define your life. What? It’s because you feel like nobody else has it or nobody will date you? It’s total BS and all that it is is a stupid virus that gives you some blisters here and there. That’s it! Life With Herpes Details: Join the Secret Society  HerpAlert (use promo code: lifewithherpes and get 10% off) Shop the LWH Essentials Shop the Secret Society CBD Lip Balm  Oh yea, remember to subscribe to the Life With Herpes newsletter and get The 5 things  I wished she knew before I was diagnosed with herpes sent directly to your inbox + weekly updates.    Xoxo, Alexandra Just in case… Learn about the Herpes Outbreak Toolkit: Need to talk confidentially about herpes?  Oh Yea and in case you need Herpes Outbreak Essentials   Are you social?  Instagram Facebook  

Cyberage Radio 10.19.2019 : AGONOIZE, WOLFCHILD, UNIDAD OBSCURA, VELVET ACID CHRIST, PRO PATRIA, ANGELS OF SUICIDE (DVR REMIX),NOHYCIT, NECROTOXICOZ, ALIEN:NATION, VDEVIL, VARICELLA (CHMCL STR8JCKT REMIX), LARVA, CRUEL, AVERSION THEORY, DEATH OF SELF, XOTOX

Cyberage Radio 10.05.2019 : UNIDAD OBSCURA, DIVERJE, BLACKPILL, VELVET ACID CHRIST, PRE EMPTIVE STRIKE 0.1, HOCICO, PRO PATRIA, LARVA, VARICELLA, WOLFCHILD, NUMB, STAHLSCHLAG, DISTORTION SIX, W.A.S.T.E.

This podcast presents an approach to varicella (commonly known as chickenpox). The clinical presentation, pathogenesis, prevention, and treatment of varicella will be covered. The podcast was developed by Dr. Gauri Shah, a pediatrician who completed a fellowship in Pediatric Infectious Diseases at the University of Alberta, and Dr. Joan Robinson, a Pediatric Infectious Disease specialist at the Stollery Children's Hospital in Edmonton, Canada.

This video presents an approach to varicella (commonly known as chickenpox). The clinical presentation, pathogenesis, prevention, and treatment of varicella will be covered. The video was developed by Dr. Gauri Shah, a pediatrician who completed a fellowship in Pediatric Infectious Diseases at the University of Alberta, and Dr. Joan Robinson, a Pediatric Infectious Disease specialist at the Stollery Children's Hospital in Edmonton, Canada.

  Session 18 As always, I'm joined by Dr. Karen Shackelford from Board Vitals. If you haven't yet, check out Board Vitals and use the promo code BOARDROUNDS to save 15%. They have a huge database and question bank to help you get the practice you need to get the score that you need. [01:35] Question of the Week An older patient comes in with a painful rash. We have a 64-year-old female who presents complaining of a severe painful rash that is localized to the left side of her upper back and neck. She knows that the area of the rash feels hot and burning and extremely painful. She is otherwise healthy with no significant past medical history. On exam, her vital signs were within normal limits. And her exam is significant, primarily, because she has a large, red vesicular rash running along her left shoulder in confluent patches. She remarks that the lesions were smaller a few days ago and they quickly start to bubble over into larger 02:39. The physician performed a Tzanck smear to confirm her suspicions. She found the test to be positive for multinucleated giant cells. The patient will have which of the following characteristics? (A) Gram-positive, catalase-positive, beta-hemolytic and arranged in clusters (B) Branching pseudohyphae with budding yeast cells (C) Enveloped-virus with double-stranded DNA (D) Enveloped-virus with positive-strand RNA virus [04:30] Thought Process The correct answer is C. Varicella zoster virus would probably come to mind as well as shingles as the Tzanck smear showed multinucleated giant cells – herpes simplex virus 1 and 2 (HSV 1 and 2) as well as pemphigus vulgaris. Other findings you would probably see on the Tzanck smear would include acantholytic cell and keratinocyte ballooning. This test is not typically performed usually as a clinical diagnosis. But it can be performed in the office. The patient can be immunocompromised with atypical looking lesion or atypical presentation. So we'd think of herpes and varicella zoster. For the other answer choices, Choice A is Staphylococcus aureus, which isn't a choice for a skin infection. Choice B is a fungus. A fungal disease like Candida can cause a really nasty rash. But it won't be the vesicular nor the dermatomal, which this question suggests. Varicella zoster virus is latent in the sensory ganglion so it tends to erupt on one or two contiguous dermatomes, although it can erupt outside of the dermatome. But it's not going to be a big eruption and just one or two vesicles scattered somewhere else from reactivation of the viral particles. Option D is Rubella. It causes a rash and it's usually tested for IgM antibodies. If a test is needed, it's not the Tzanck smear. [07:45] Possible Question Points About the Herpes Virus About 30% of Americans will have it at some point in their lives coming from reactivation of the virus. It causes two clinically distinct diseases including chicken pox. Chicken pox would be characterized by vesicular lesions but they're on different stages of development. They're concentrated on the face and the trunk. It's an airborne virus that invades the lymphoid tissue in the nose or nasopharynx. The virus overcomes local host defenses. The epidermal cells usually react by making alpha-interferons. That's the incubation period. When the virus can overcome the local host defenses, then you've got a viremia. Then the virus downregulates your immune response through a variety of mechanisms, such as the inhibition of the expression of interferon response genes. When the virus remains latent for years in most cases, you're more at risk of reactivation as you get older because you have a diminished T-cell response. This is the same reason that people with immuno-compromise are more likely to erupt with shingles. It's a unilateral vesicular eruption, usually in the dermatome. The reactivated varicella can travel either way. It can travel peripherally through the sensory ganglion and go down the sensory nerve. This results in a skin infection or the characteristic rash. It can also reactivate and move centrally from the ganglion. This is seen in those who are severely immuno-compromised. But this results in some of the complications associated with herpes zoster like meningitis-encephalitis. Some of the syndromes include the Ramsay Hunt syndrome but it's a random thing. It occurs whenever the virus replicates in the geniculate ganglion. It travels down the 8th nerve and you have vesicles on the auricle or in the ear canal – ipsilateral facial paralysis. Herpes 11:12 is a pretty significant complication. You have to recognize it really early on because it can cause blindness. You can get herpes keratitis and acute retinal nephrosis. The treatment is going to be an antiviral ganciclovir or acyclovir. Postherpetic neuralgia is another big complication with severe significant pain (3 out of 10 and higher for about 90 days or more). Some people can have sensory changes. It can be intensely pruritic. If you get vesicular lesions on the nose then the nerve distribution is pretty worrisome so you have to be aware of that. [12:50] Board Vitals Check out Board Vitals and use the promo code BOARDROUNDS to save 15% off your QBank purchase. Whether you're studying for the COMPLEX or USMLE, Board Vitals has the QBank you need to help prepare you the best possible way. Links: Board Vitals (use the promo code BOARDROUNDS to save 15%)

The exogenous boosting hypothesis predicted that pediatric universal varicella vaccination would fuel a rise in adult herpes zoster cases. However, in the U.S., the 20-year experience has delivered just the opposite effect. Also today, in type 2 diabetes, healthy lifestyle lowers CVD risk and mortality, antipsychotics linked to increased body fat and insulin resistance in children, and maternal use of pot and tobacco may boost birth defect risk.

Cyberage Radio 06.17.2018 : REACTOR7X, PRE EMPTIVE STRIKE 0.1, TRAKKTOR, GENIUS OF NEFARIOUS FEAT.POIZON PARTY IV + MIDIAN DITE, WINFXDINAMO, RUINIZER, ANTIBODY, ,CHMCL STR8JCKT (THE ELDRIDGE EXPERIENCE REMIX),WOLFCHILD , VARICELLA, DEMISE AND DOMINATION, HARMIZE, BIOHACKER, BLOOD CONNEK7ION, SYNTHATTACK , GEN-ZX, PHILIPP MUNCH, SKINNY PUPPY BLOCK! FRONT LINE ASSEMBLY, TO MEGA THERION,MRS DINK, EFF DST

Cyberage Radio 06.10.2018 : N3VOA FEAT. LEATHER STRIP,GENIUS OF NEFARIOUS FEAT. LARVA, WINFXDINAMO, RUINIZER, ANTIBODY, 11GRAMS,CHMCL STR8JCKT (SKIN CONTACT REMIX),WOLFCHILD , VARICELLA, BLOOD CONNEK7ION, MURDER WEAPONS (X-FUSION REMIX), ELEKTRIFZIERER, SYNTHATTACK , EXTIZE FEAT.SHIV-R PHILIPP MUNCH, IN-FUSED, SKINNY PUPPY BLOCK! FRONT LINE ASSEMBLY, W.A.S.T.E. SIAMGDA, MNEMONIC

Cyberage Radio 05.27.2018 : SYNTHATTACK, NOHYCIT, VISCERA DRIP, GENIUS OF NEFARIOUS (REQUIEM RUST REMIX),VARICELLA, CHMCL STR8JCKT REMIXED! POIZON PARTY IV, DISSONANCE, FORMATO NEGATIVO, PHILIPP MUNCH, MICHAEL IDEHALL, IN-FUSED, SKINNY PUPPY BLOCK! FRONT LINE ASSEMBLY

Cyberage Radio 05.06.2018 : DISTOXIA, T-ERROR MACHINEZ, SICKMAN, STIGMATROZ, WINFXDINAMO, VARICELLA, ANTIBODY, N3VOA, BINARY DIVISION, AND THE SKY BLED ( FEAT.LEATHER STRIP),CHMCL STR8JCKT (VARICELLA REMIX), SEVERED SKIES, ZWAREMACHINE, KISS IS KILL, DEPOTEK, C-LEKKTOR, XENTRIFUGE, THE MERCY CAGE, PHILIPP MUNCH, MICHAEL IDEHALL, IN-FUSED, SKINNY PUPPY BLOCK

Cyberage Radio 04.29.2018 : DIE KRUPPS, DISTOXIA, RABIA SORDA, VDEVIL, T-ERROR MACHINEZ (POIZON PARTY IV REMAKE), STIGMATROZ, WINFXDINAMO, VARICELLA, AND THE SKY BLED ( FEAT.GENIUS OF NEFARIOUS), SEVERED SKIES, SN-A, W.A.S.TE., PHILIPP MUNCH, MICHAEL IDEHALL, IN-FUSED, SKINNY PUPPY BLOCK

If you are of a certain age, you remember a time when pretty much every kid got chicken pox. But those days are behind us as most of our children are vaccinated agains varicella, the virus that causes chicken pox. But for us old folks, shingles is the still around to remind of the old days when we still got chicken pox.  Today 2 docs talk about the effect of the varicella vaccine, the problem with shingles, and what you can do about it.   Be sure and subscribe in iTunes or Stitcher if you haven’t already.  And you know we’d appreciate it so much if you would tell your friends about 2 Docs Talk! Listen on iTunes Listen on Stitcher Now Available on Google Play Music!

The October 2017’s Archimedes podcast includes answers to “Have you ever wondered if it might be worth trying to do an Archi?” and “What came first, the ‘brufen or the necrotic flesh?” along with cerebrospinal fluid (CSF) analysis and musings on the nature of evidence-based medicine. Read more about varicella-zoster virus (VZV) and non-steroidal anti-inflammatories here - http://adc.bmj.com/content/102/10/988.1 - and how to interpret delayed CSF results here - http://adc.bmj.com/content/102/10/990. The ADC Archimedes podcast, home of the best evidence-paediatrics chat, is presented by Bob Phillips, the Social Media and Archimedes Editor.

This episode covers Chapter 110 of Rosen’s Emergency Medicine (9th Ed.), Dermatologic Presentations.  Episode Overview List five broad categories of rashes Describe the primary skin lesion types  a. Bonus: What are the secondary skin lesions (show notes only) List systemic diseases that present with cutaneous signs for each of the following locations: Generalized rash Head and neck Hands Legs Palms and Soles Describe the various presentations of tinea and their treatment List 8 RFs for candida infections Describe the stepwise management of diaper dermatitis Describe the distribution of Pityriasis rosea Describe the management of atopic dermatitis Describe the management of impetigo & folliculitis List 6 RFs of C.A.-MRSA and 4 oral Abx treatments Describe the presentation and management of Staph Scalded Skin andTSS List 10 causes of EM / SJS / TEN Describe presentation of EM + SJS/TEN. Differentiate between TEN and SJS List 6 broad categorical causes of urticaria Describe the typical features for each of the following: Measles Rubella Roseola Infantum Erythema Infectiosum Scarlet Fever Describe treatment of poison ivy Describe presentation and treatment of Pediculosis + Scabies List 10 causes of Erythema Nodosum List a 6 ddx for vesicular lesions List 4 lesions with a positive Nikolsky’s sign List 4 complications of HSV infection List 5 complications of Varicella + describe the management of an exposure during pregnancy List 5 complications of Zoster + differentiate between Ophthalmicus and Oticus What is the treatment of herpes zoster? Wisecracks List 5 causes of desquamating lesions List 5 palm and sole rashes List 10 maculopapular rashes List 1 low, medium and high potency topical steroid Identify the following rashes: erythema migrans, erythema marginatum, erythema multiforme, erythema nodosum, meningococcemia

This episode covers Chapter 110 of Rosen’s Emergency Medicine (9th Ed.), Dermatologic Presentations.  Episode Overview List five broad categories of rashes Describe the primary skin lesion types  a. Bonus: What are the secondary skin lesions (show notes only) List systemic diseases that present with cutaneous signs for each of the following locations: Generalized rash Head and neck Hands Legs Palms and Soles Describe the various presentations of tinea and their treatment List 8 RFs for candida infections Describe the stepwise management of diaper dermatitis Describe the distribution of Pityriasis rosea Describe the management of atopic dermatitis Describe the management of impetigo & folliculitis List 6 RFs of C.A.-MRSA and 4 oral Abx treatments Describe the presentation and management of Staph Scalded Skin andTSS List 10 causes of EM / SJS / TEN Describe presentation of EM + SJS/TEN. Differentiate between TEN and SJS List 6 broad categorical causes of urticaria Describe the typical features for each of the following: Measles Rubella Roseola Infantum Erythema Infectiosum Scarlet Fever Describe treatment of poison ivy Describe presentation and treatment of Pediculosis + Scabies List 10 causes of Erythema Nodosum List a 6 ddx for vesicular lesions List 4 lesions with a positive Nikolsky’s sign List 4 complications of HSV infection List 5 complications of Varicella + describe the management of an exposure during pregnancy List 5 complications of Zoster + differentiate between Ophthalmicus and Oticus What is the treatment of herpes zoster? Wisecracks List 5 causes of desquamating lesions List 5 palm and sole rashes List 10 maculopapular rashes List 1 low, medium and high potency topical steroid Identify the following rashes: erythema migrans, erythema marginatum, erythema multiforme, erythema nodosum, meningococcemia

This week we discuss the presentation and management of herpes zoster. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_112_0_Final_Cut.m4a Download Leave a Comment Tags: Infectious Diseases, Varicella Show Notes Take Home Points Classically, herpes zoster will present with rash and pain in a dermatomal distribution Immunocompromised patients are at greater risk for significant complications of zoster, including visceral dissemination and zoster ophthalmicus Appropriate therapy includes antiviral therapy within 72 hours of onset of symptoms and analgesia for acute neuritis Disseminated zoster and zoster ophthalmicus threatening sight should be treated with IV antivirals Read More Emergency Medicine Ireland: Tasty Morsels of EM 073: FRCEM Varicella Life in the Fast Lane: Herpes zoster ophthalmicus Core EM: Herpes Zoster Read More

This week we discuss the presentation and management of herpes zoster. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_112_0_Final_Cut.m4a Download Leave a Comment Tags: Infectious Diseases, Varicella Show Notes Take Home Points Classically, herpes zoster will present with rash and pain in a dermatomal distribution Immunocompromised patients are at greater risk for significant complications of zoster, including visceral dissemination and zoster ophthalmicus Appropriate therapy includes antiviral therapy within 72 hours of onset of symptoms and analgesia for acute neuritis Disseminated zoster and zoster ophthalmicus threatening sight should be treated with IV antivirals Read More Emergency Medicine Ireland: Tasty Morsels of EM 073: FRCEM Varicella Life in the Fast Lane: Herpes zoster ophthalmicus Core EM: Herpes Zoster Read More

Brianne joins the TWiVMasters to explain how mutations in genes encoding RNA polymerase III predispose children to severe varicella, and detection of an RNA virus by a DNA sensor. Hosts: Vincent Racaniello and Rich Condit Guest: Brianne Barker Become a patron of TWiV! Links for this episode RNA pol III mutations underlie severe varicella (J Clin Inves) Dengue virus activates cGAS by release of mitochondrial DNA (Sci Rep) Dengue virus NS2B protein targets cGAS for degradation (Nat Micr) Image credit Letters read on TWiV 456 This episode is brought to you by the Defense Threat Reduction Agency. Part of the U.S. Department of Defense, the Agency’s Chemical and Biological Technologies Department hosts the 2017 Chemical and Biological Defense Science & Technology Conference to exchange information on the latest and most dynamic developments for countering chemical and biological weapons of mass destruction. Find out more at http://www.cbdstconference.com Weekly Science Picks Brianne - Up-Goer Five Challenge (related to Thing Explainer) Rich - The Farthest: Voyager in Space and Vipassana Momma: Science Vincent - Episode of Revisionist History: The Basement Tapes Listener Pick Jennie - What Piece of Lab Equipment Are You? Intro music is by Ronald Jenkees. Send your virology questions and comments to twiv@microbe.tv

Forsaken Generation is happy to hour Star Stevens as our guest this week on the show.. Tune in to hear her family's story.    From Star "On July 13, 2011, my healthy 16 yr old received the Varicella, MCV4, and the TDaP vaccines. 2 days after his shots, his upper left arm was swollen as if a tennis ball was cut in half & placed underneath his skin. He became extremely sluggish. He began to have trouble breathing, walking, and swallowing. His symptoms only got worse with time. His other symptoms: joint inflammation, vision problems, tingling in arms & legs, delayed motor skills, exhaustion, no appetite, extreme migraines, extreme confusion, "Foggy" brain, weight loss, lightheadedness, nausea, muscular numbness, extreme slurred speech. (He had symptoms of GBS, Guillain-Barré Syndrome, a disorder in which the immune system attacks the nerves.)  He was diagnosed with adrenal failure, leaky gut, & Celiac (plus other severe food allergies), which led to a long host of other auto immune diseases."

Hello and welcome to the Health Hits podcast. In the last episode we covered chickenpox, that common viral infection, usually caught in childhood. It can be pretty miserable but the real kicker is that it never really goes away, and comes back to life as a painful, burning, blistering rash. The condition we’re talking about is shingles. We’ll go over what is actually happening and why, and what we can do when it does strike.

Hello and welcome to the Health Hits podcast. This week we talk all about that miserable rite of passage that all children in the UK go through: Chickenpox. We’ll talk about how it affects us and why, the latest controversial evidence about managing it, as well as the available but almost unused chickenpox (varicella) vaccine.

Voice introduction I was having a discussion the other day with the mom of one of my patients. She was asking me why we vaccinate children against chickenpox; a disease that her mother told her was a benign mild childhood illness that doesn't hurt kids.  Keep in mind that almost none of the parents of my current patients have ever seen or had any experience with the disease of chickenpox.  The disease is virtually gone in the United States so everything parents know today is based on what they have heard.  This particular mom had so many questions and a few misconceptions about chickenpox. Because of this I thought many of my blog listeners probably have many of the same questions, so today were going to talk about the disease known as chickenpox: the myths and facts and the rationale behind vaccinating today's children. Why do we bother vaccinating for a harmless childhood illness? Music introduction The biology of chickenpox Let's start with the basics. Chickenpox is caused by a herpes virus that goes by few names:  Varicella, herpes zoster, and  HHV-3 or human herpes virus type three. It's very contagious, one of the most contagious diseases ever known to exist.  In fact, it can spread airborne up to 7 feet, which means that Just being in the same room with someone who has chickenpox can spread the disease to the others in the room. No touch is needed.  The rash itself looks a lot like it's deadly cousin, smallpox.  Fortunately smallpox has been eradicated from earth since the 1970's since it is a deadly infection in both adults and children.   Chickenpox however is usually a relatively mild illness for most kids so my patient's mom was correct on that point. In fact when I was a child it was common for Mom's to have a chickenpox parties when there was an active case in the neighborhood so that all the kids would go ahead and get exposed and get the disease out of the way. It was just considered a right of passage to have chickenpox.  Spring was the big season for chickenpox for some reason. So why do we go to all the expense of vaccinating children against what's usually such a mild disease. Well there are two reasons.  The first is that there were deaths from chickenpox years ago the illness was common. Usually a child got chickenpox and then got a nasty strep or staph infection on top of some of there open sores. This could be lethal. Remember the flesh eating strep?  Germs like this love all the broken skin chickenpox creates. Death from natural chickenpox happened 150 times per year in the United States before we start vaccinating in children 1995.  But 11,000 children a year ended up in the hospital secondary to complications from the chickenpox in the US alone, many with life threatening complications such as encephalitis, an often fatal liver disease called Reyes syndrome, pneumonia, or just good old dehydration. Chickenpox can be a very frightening disease. The second reason we vaccinate children today is a little more complicated to understand. You need to understand that everyone who gets infected with any chickenpox virus harbors this herpes virus for the rest of his or her life, an infectious disease time bomb so to speak. In the short run, the virus becomes dormant, hanging out silently for decades in the nervous system of anyone who has had chickenpox. But weaken that person's immune system with age, sickness, or stress, and it can spring right back out as a disease known as shingles. You've heard about that old age disease shingles. Remember, shingles and chickenpox are caused by the same virus. Chickenpox is the form of the disease that is systemic, in the blood, and everywhere. A child gets chickenpox on their initial exposure to the chickenpox virus. If the virus reactivates in a localized area we call that shingles and that's a serious health problem for older folks. You probably have heard that children can get chickenpox from touching someone shingles if they've never had chickenpox.

Trauma and hypertension account for the overwhelming majority of cases of intracerebral hemorrhage. Today, we address the minority. In this week's episode, Dr. Steven Messe discusses the atypical causes of ICH and how they are managed. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision making in routine clinical practice. REFERENCES 1. Biffi A and Greenberg SM. Cerebral amyloid angiopathy: a systematic review. J Clin Neurol. 2011;7:1-9. 2. Gilden D, Cohrs RJ, Mahalingam R and Nagel MA. Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory features, pathogenesis, and treatment. The Lancet Neurology. 2009;8:731-40. 3. Mast H, Young WL, Koennecke HC, Sciacca RR, Osipov A, Pile-Spellman J, Hacein-Bey L, Duong H, Stein BM and Mohr JP. Risk of spontaneous haemorrhage after diagnosis of cerebral arteriovenous malformation. Lancet. 1997;350:1065-8. 4. Ruiz-Sandoval JL, Cantu C and Barinagarrementeria F. Intracerebral hemorrhage in young people: analysis of risk factors, location, causes, and prognosis. Stroke; a journal of cerebral circulation. 1999;30:537-41. 5. Siegler JE and Ichord RN. Teaching NeuroImages: Multicompartmental intracranial hemorrhage in a pediatric patient. Neurology. 2016;87:e284.

Finishing up infectious disease.Influenza, Epstein-Barr, Varicella, AIDs The post Influenza, Epstein-Barr, Varicella, AIDs appeared first on Physician Assistant Exam Review.

Fulvio Risuleo, classe 1991, è l'unico italiano ad aver vinto un premio al festival di Cannes con il corto, Varicella. Fischia che ti passa! lo sapevate che c'è una scuola di fischio? L'ha frequentata Micol Montera

Interview with Jerry S. Wolinsky, MD, author of Varicella-Zoster Virus Infections in Patients Treated With Fingolimod: Risk Assessment and Consensus Recommendations for Management, and Kenneth L. Tyler, MD, author of Fingolimod and Risk of Varicella-Zoster Virus Infection: Back to the Future With an Old Infection and a New Drug

Background: In 2004, routine varicella vaccination was recommended in Germany for children 11-14 months of age with one dose, and since 2009, with a second dose at 15-23 months of age. The effects on varicella epidemiology were investigated. Methods: Data on varicella vaccinations, cases and complications were collected from annual parent surveys (2006-2011), monthly paediatric practice surveillance (Oct 2006 - Sep 2011; five varicella seasons) and paediatric hospital databases (2005-2009) in the area of Munich (about 238,000 paediatric inhabitants); annual incidences of cases and hospitalisations were estimated. Results: Varicella vaccination coverage (1st dose) in children 18-36 months of age increased in two steps (38%, 51%, 53%, 53%, 66% and 68%); second-dose coverage reached 59% in the 2011 survey. A monthly mean of 82 (62%) practices participated; they applied a total of 50,059 first-dose and 40,541 second-dose varicella vaccinations, with preferential use of combined MMR-varicella vaccine after recommendation of two doses, and reported a total of 16,054 varicella cases

Wed, 09 May 2012 14:32:35 GMT http://saveyourskin.ch/podcast/EN/2.1.2.Varizellen_Zoster.mp4 Prof. Dr. Dr. h. c. Günter Burg, MD Zürich & Prof. Dr. Walter Burgdorf, MD 2013-03-10T14:32:37Z Prof. Dr. Dr. h. c. Günter Burg, MD Zürich & Prof. Dr. Walter Burgdorf, MD no

This is the Purple Team's podcast about the virus Varicella.

The herpesviruses, like most other DNA viruses, replicate in the host cell nucleus. Subnuclear domains known as promyelocytic leukemia protein nuclear bodies (PML-NBs), or ND10 bodies, have been implicated in restricting early herpesviral gene expression. These viruses have evolved countermeasures to disperse PML-NBs, as shown in cells infected in vitro, but information about the fate of PML-NBs and their functions in herpesvirus infected cells in vivo is limited. Varicella-zoster virus (VZV) is an alphaherpesvirus with tropism for skin, lymphocytes and sensory ganglia, where it establishes latency. Here, we identify large PML-NBs that sequester newly assembled nucleocapsids (NC) in neurons and satellite cells of human dorsal root ganglia (DRG) and skin cells infected with VZV in vivo. Quantitative immuno-electron microscopy revealed that these distinctive nuclear bodies consisted of PML fibers forming spherical cages that enclosed mature and immature VZV NCs. Of six PML isoforms, only PML IV promoted the sequestration of NCs. PML IV significantly inhibited viral infection and interacted with the ORF23 capsid surface protein, which was identified as a target for PML-mediated NC sequestration. The unique PML IV C-terminal domain was required for both capsid entrapment and antiviral activity. Similar large PML-NBs, termed clastosomes, sequester aberrant polyglutamine (polyQ) proteins, such as Huntingtin (Htt), in several neurodegenerative disorders. We found that PML IV cages co-sequester HttQ72 and ORF23 protein in VZV infected cells. Our data show that PML cages contribute to the intrinsic antiviral defense by sensing and entrapping VZV nucleocapsids, thereby preventing their nuclear egress and inhibiting formation of infectious virus particles. The efficient sequestration of virion capsids in PML cages appears to be the outcome of a basic cytoprotective function of this distinctive category of PML-NBs in sensing and safely containing nuclear aggregates of aberrant proteins.

Varicella zoster virus (VZV) is a member of the alphaherpesvirus subfamily and with a genome encoding 70 proteins the smallest of all human herpesviruses. Upon primary infection it causes varicella also called chickenpox in children. As a consequence, it reaches sensory nerve ganglia where latency is established. Upon reactivation it causes a secondary disease called Herpes zoster mostly in adults. Todate, VZV is the least studied human herpesvirus due to the lack of cell-free virus in culture, of virus-specific tools and an effective animal model. Therefore, many aspects of the VZV infection cycle, of latency and reactivation are poorly characterized. Moreover, the function of many proteins specific to VZV has not been identified. The goal of this research was to generate hybridoma clones as a permanent source of VZV specific antibodies and to use the antibodies produced to study the localisation of VZV proteins in the viral context on a proteome-wide level. To this end, a VZV ORFeome entry library was constructed using the Gateway® recombinational cloning technology. For VZV protein expression in E. coli, the entry library was subcloned into four different pET derived expression vectors providing either an N-terminal His6, a C-terminal His6, an N-terminal MBP, or an N-terminal GST tag. Following purification of 64 VZV proteins, mice were immunised and subsequently used to generate antibody producing hybridoma clones. So far, our clone collection contains 218 mother clones producing antibodies to 61 (87%) VZV proteins. In this clone collection 190 clones were identified as positive in Western blotting covering 57 VZV ORFs while 123 antibodies were tested positive in immunofluorescence covering 52 VZV ORFs. Using this novel antibody collection, the localisation of 52 (74%) proteins could be determined in the context of VZV infection 22 of which were analysed for the first time. In total, 20 ORFs were localised in the nucleus, 16 ORFs were present in the cytoplasm and 16 ORFs were found in both the nucleus and cytoplasm. Comparison of 41 core proteins present in HSV-1, VZV, CMV, EBV as well as KSHV showed excellent agreement in localisation of conserved glycoproteins, capsid and tegument proteins. Several immunodominant regions on the viral glycoproteins gK, gB, gL, gI, gE and the membrane associated phosphoprotein ORF24 were identified using the pepscan technique. This precious antibody collection gives access to various experimental approaches and will allow to unveil biological secrets in the field of Herpesvirology.

Here we report the case of a 54-year old, immunocompetent German patient with primary varicella whose Varicella-Zoster Virus (VZV)-specific T-cell responses could be detected early in infection and before the onset of seroconversion. This case demonstrates that the detection of VZV-specific T-cells may under certain circumstances support the diagnosis of a primary varicella infection, as for example in cases of atypical or subclinical varicella or in the absence of detectable VZV DNA in plasma.

Host: Vincent Racaniello Special guest: Saul Silverstein Dickson Despommier is away this week at Pop!Tech. CDC pages on herpes and zoster (shingles).