POPULARITY
13 episodes with venous
7 episodes with venous
6 episodes with venous
13 episodes with venous
4 episodes with venous
3 episodes with venous
3 episodes with venous
4 episodes with venous
4 episodes with venous
3 episodes with venous
16 episodes with venous
5 episodes with venous
3 episodes with venous
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4 episodes with venous
6 episodes with venous
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Resources: Rutherford Chapters (10th ed.): 174, 175, 177, 178 Prior Holding Pressure episode on AV access creation: https://www.audiblebleeding.com/vsite-hd-access/ The Society for Vascular Surgery: Clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access: https://www.jvascsurg.org/article/S0741-5214%2808%2901399-2/fulltext KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update: https://pubmed.ncbi.nlm.nih.gov/32778223/ Venous Hypertension Definition A functioning AV circuit delivers high volume arterial flow towards a stenotic venous segment, causing buildup in pressure and venous hypertension. If there are few or no branching veins between the access and stenosis, thrombosis could occur Etiology The most common etiology is venous stenosis caused by a history of vessel wall trauma by centrally-inserted venous devices such as tunneled and non-tunneled dialysis catheters, central lines, pacemakers, or defibrillator. In a study performed at a large academic medical center1, new hemodynamically significant central venous stenosis was associated with the duration of catheter dependence (26% in patients with CVCs for more than 6 months, versus 11% in patients with CVCs for less than 6 months). PICC lines can directly damage cephalic and basilic veins Venous stenosis can often go undetected until AV access creation occurs Patient Presentation Symptoms of venous insufficiency will be present– most commonly regional edema, in the area of venous stenosis. If there are patent venous branches between the AV anastomosis and the stenotic area, swelling can occur throughout the arm. Pigmentation, induration, dermatosclerosis, and ulceration may also be observed. An extensive collateral network of veins may be visible throughout anterior chest, shoulder, or flank SVC obstruction can result in swelling of the head, neck and shoulders, as well as a feeling of head and neck fullness, airway compromise, and visual problems Normal palpable thrill can be replaced by a strong pulse Dialysis can be complicated by difficulty with needle access, recirculation syndrome, and arm swelling after dialysis sessions. Workup Central vein thrombosis can be hard to detect on ultrasound because clavicle and sternum can block transmission Venography is essential to determine the presence and severity of venous stenosis or occlusion. Prevention The ideal scenario is to avoid central dialysis catheters completely, and this involves evaluating CKD patients and placing AVF or AVG before the need for dialysis arises. If a patient presents placement of an AVF/AVG, it is important to perform venography if a patient has a history of a central venous catheter or clinical signs of venous hypertension. A history of SVC obstruction from any cause can preclude permanent AV access creation in both upper extremities Treatment Endovascular approaches to venous outflow stenosis can be first-line treatment options, due to their minimal risk. They can also be performed at the same time as a diagnostic venogram. Angioplasty alone or with stenting are the endovascular options. In a study by Bakken et al2 that compared primary high-pressure balloon angioplasty versus stenting, primary patency was equivalent between groups, with 30-day rates of 76% for both groups and 12-month rates of 29% for angioplasty and 21% for stenting. Assisted primary patency was also equivalent with a 30-day patency rate of 81% and 12-month rate of 73% for the angioplasty group, 84% at 30 days, and 46% at 12 months for the stenting group. This study, along with others, shows that the major downside of endovascular interventions, whether angioplasty or stenting, often require repeat intervention and have poor long-term patency. For subclavian vein stenosis, angioplasty alone is appropriate due to its anatomical location that can put a stent at risk for extrinsic compression from the first rib and clavicle. Surgical bypass can be performed Possible bypasses include axillary-axillary, axillary-jugular, axillary-right atrial, and axillary-femoral. In these bypasses, the preferred conduits are autogenous saphenous or femoral veins. In cases where the proximal subclavian vein is obstructed, a jugular vein turndown can be performed. In this procedure the distal jugular vein is transected, sewed end-to-side at the distal subclavian vein, effectively acting as a bypass route for that obstructed segment. The Hemoaccess Reliable Outflow (HeRO) Vascular Access Device can be used as a hybrid approach, combining endovascular and open surgical techniques to bypass a central venous occlusion and provide a reliable outflow for dialysis. This device has a PTFE inflow limb that is sewn end-to-side onto the brachial artery. This limb is tunneled subcutaneously and connected to a silicone-coated nitinol outflow catheter that is inserted into a central vein and tracked directly into the right atrium. This effectively bypasses central venous stenoses. In the largest study to date on HeRO access grafts placed in 167 patients,3 HeRO primary and secondary patency was 48.8% and 90.8%, respectively, at 12 months. Interventions to maintain or re-establish patency were required in 71.3% of patients resulting in an intervention rate of 1.5/year. Access-related infections were reported in 4.3% patients. The authors concluded that HeRO device had performed comparably to standard AVGs and had proven superior to tunneled dialysis catheters in terms of patency, intervention, and infection rates. If no treatment options for venous hypertension or outflow obstruction are available, an alternate AV access site can be created, either in the contralateral arm if the SVC is uninvolved, or through placement of femoral AV access or a peritoneal dialysis catheter. Bleeding Access Site Etiology and Risk Factors Bleeding can be caused by high venous pressure after dialysis, pseudoaneurysm rupture, or trauma. Patients with end stage renal disease (ESRD) have a baseline elevated risk of bleeding due to uremia-induced platelet dysfunction and use of systemic anticoagulation within the hemodialysis circuit. Additional risk factors include dialysis through an AV graft, hypertension, longer duration of access use, and compromised integrity of the vascular access due to complications (clotting, infection) or invasive procedures. Dual antiplatelet therapy is also associated with overall bleeding events in ESRD patients. Dialysis patients could be on antiplatelet therapy for management of comorbid cardiovascular risk and/or patency of AV graft Patients with bleeding fistulas often present from their dialysis unit when standard digital pressure at the cannulation site fails to stop the bleeding. This is a very serious condition since most mature fistulas have high blood flow and the patients are at risk for hemorrhagic shock and death. Initial Management The first step of management is to obtain hemostasis. Elevate the limb above the level of the heart and apply firm and directed pressure at the site of bleeding using gauze for at least 30-40 minutes Milosevic et al4 reviewed non-operative management of bleeding fistulas and grafts and found that compared to standard dressings, the use of specialized hemostatic dressings decreased bleeding time at arterial and venous cannulation sites. These hemostatic materials included the IRIS compression bandage and cellulose-based, chitosan-based, poly-N-acetyl glucosamine-based, and thrombin-soaked dressings. There has been a “bottlecap method” described where the hollow side of a bottlecap is pressed on top of the puncture site. Maintaining pressure on the cap will cause the cap to fill with blood and clot, which tamponades the bleeding. The provider can also place a shallow figure-of-8 or purse string stitch just below the skin surface to aid in hemostasis. It is important to avoid placing the suture too deep as this can cause inadvertent fistula ligation. During this process, an assistant applies pressure just proximal and distal to the bleeding site to stop blood flow so the sutures can be placed. If these methods fail to achieve hemostasis, apply a tourniquet proximal to the fistula and tighten it until bleeding stops and the radial pulse is lost. This signifies complete occlusion of arterial inflow to the fistula. Tourniquet use should be limited to 3 hours or less, since limb ischemia beyond this timepoint is associated with permanent neuromuscular damage. Regardless of the method used for initial hemostasis, the patient is at risk for repeat hemorrhage, hematoma formation, vessel stenosis, and thrombosis. They should be evaluated by a vascular surgeon as soon as possible. Definitive Management Definitive management depends on etiology of each case, and there are a variety of interventions that can be pursued (i.e. aneurysmorrhaphy for aneurysmal bleeding) If skin erosion over the conduit is present, it should be assumed that the AV access is infected and emergency intervention should be pursued. A jump graft can be placed through with healthy tissue. A covered stent could be introduced through a separate percutaneous puncture site Finally, coagulopathy can be addressed by administering cryoprecipitate, DDAVP, erythropoietin, estrogen, tranexamic acid. Aneurysms and Pseudoaneurysms Definition and Etiology Aneurysms involve all three layers of the vessel wall and they develop due to hemodynamic changes causing remodeling of the vein wall in an AV fistula. This is necessary for vein maturation, but becomes problematic if the post-anastomotic vein continues to dilate and becomes aneurysmal. Aneurysms can also occur at anastomosis sites due to technical aspects of the surgery. Pseudoaneurysms only involve some layers of the vessel wall caused by repeated puncture for hemodialysis. Both aneurysms and pseudoaneurysms can enlarge due to venous outflow stenosis causing increased intraluminal pressures. Both true aneurysms and pseudoaneurysms can lead to overlying skin erosion and subsequent hemorrhage, pain, AV access dysfunction, and cannulation difficulties. Dialysis cannulation should be avoided at the aneurysmal sites to prevent bleeding complications. Diagnosis They can be diagnosed on ultrasound, which also provide information on flow rates, presence inflow/outflow/stenoses, and vessel diameters. Indications for Treatment Treatment is indicated for aneurysms that are rapidly expanding or ulcerating through the skin surface. These are at high risk for rupture and hemorrhage, which is life-threatening. Treatment is also indicated when the aneurysm occurs at the anastomotic site of the AV fistula, the patient has a cosmetic concern, cannulation becomes difficult, there is concern for infection, or the patient has high-output heart failure that could be exacerbated by high flow through the fistula. Treatment is not indicated in asymptomatic aneurysms, regardless of their size. True aneurysms and pseudoaneurysms are not prone to spontaneous rupture. Treatment Options Aneurysmorrhaphy is the most common treatment. It involves the resection of the aneurysmal vein wall to restore a normal diameter and removal of excess skin. Anastomosis is performed along the lateral wall to prevent issues with cannulation along the suture line. Aneurysm resection with interposition grafting is also possible. If multiple aneurysmal segments require treatment, staging their repairs can allow for continuation of dialysis without needing to place a temporary dialysis catheter. AV access ligation is an appropriate alternative to AV access salvage in certain situations but usually requires excision of the aneurysm/pseudoaneurysm due to the potential to develop thrombophlebitis and the cosmetic appearance of the thrombosed segment. If there is concern for an infected pseudoaneurysm or aneurysm, surgery should include removal of all infected material. References 1. Al-Balas A, Almehmi A, Varma R, Al-Balas H, Allon M. De Novo Central Vein Stenosis in Hemodialysis Patients Following Initial Tunneled Central Vein Catheter Placement. Kidney360. 2022;3(1):99-102. doi:10.34067/KID.0005202021 2. Bakken AM, Protack CD, Saad WE, Lee DE, Waldman DL, Davies MG. Long-term outcomes of primary angioplasty and primary stenting of central venous stenosis in hemodialysis patients. J Vasc Surg. 2007;45(4):776-783. doi:10.1016/j.jvs.2006.12.046 3. Gage SM, Katzman HE, Ross JR, et al. Multi-center Experience of 164 Consecutive Hemodialysis Reliable Outflow [HeRO] Graft Implants for Hemodialysis Treatment. Eur J Vasc Endovasc Surg. 2012;44(1):93-99. doi:10.1016/j.ejvs.2012.04.011 4. Milosevic E, Forster A, Moist L, Rehman F, Thomson B. Non-surgical interventions to control bleeding from arteriovenous fistulas and grafts inside and outside the hemodialysis unit: a scoping review. Clin Kidney J. 2024;17(5):sfae089. doi:10.1093/ckj/sfae089
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Send us a textIn this episode, host Dr. Pâmela Valelongo welcomes Dr. Rafael Hortêncio Melo, intensivist at HCor and Hospital Vila Santa Catarina (part of Hospital Israelita Albert Einstein), for a deep dive into VEXUS, a technique that is rapidly transforming how we assess venous congestion in critical care, from the ICU to the post-op setting.This episode is a high-yield summary generated with the help of artificial intelligence, based on a full conversation originally recorded in Portuguese.You'll learn:What VEXUS is and how it worksHow to apply it in daily clinical decision-makingPitfalls to avoid when interpreting the scoreWhy POCUS should be part of every residency curriculum in intensive care, emergency medicine, and cardiologyBut here's something important: every piece of content you'll hear today was curated, reviewed, and approved by our medical team at Clube da Cardio because clinical excellence always comes first.
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Dana thinks it's time we talk about cousin Dennis, Dan has a shredded tankini, Gaye is feeling lucky and Adam wishes Derek Huffman well. If you're a fan of False Positive, you'll love Banned Camp—a comedy podcast about why books are banned. Blue Sky @False-Positive Instagram @False_Positive
Dr. Jeffrey Kopin, Chief Medical Officer for Northwestern Medicine Lake Forest Hospital, joins John Williams to talk about what happens if you miss a day of your prescribed medications, President Trump being diagnosed with chronic venous insufficiency, a genetic test that could predict the odds of obesity, and what happens when people stop using weight loss drugs.
Dr. Jeffrey Kopin, Chief Medical Officer for Northwestern Medicine Lake Forest Hospital, joins John Williams to talk about what happens if you miss a day of your prescribed medications, President Trump being diagnosed with chronic venous insufficiency, a genetic test that could predict the odds of obesity, and what happens when people stop using weight loss drugs.
Dr. Matthew J Blecha, Vascular Surgery at Loyola Medicine, joins Lisa Dent to discuss what chronic venous insufficiency is. President Donald Trump was seen with swollen ankles. The White House later announced that the president had chronic venous insufficiency. Dr. Blecha shares some information about the condition and what may cause it.
Dr. Jeffrey Kopin, Chief Medical Officer for Northwestern Medicine Lake Forest Hospital, joins John Williams to talk about what happens if you miss a day of your prescribed medications, President Trump being diagnosed with chronic venous insufficiency, a genetic test that could predict the odds of obesity, and what happens when people stop using weight loss drugs.
It's Monday, July 21st, A.D. 2025. This is The Worldview in 5 Minutes heard on 140 radio stations and at www.TheWorldview.com. I'm Adam McManus. (Adam@TheWorldview.com) By Adam McManus Nigerian Muslims slaughtered 27 Christians including 3-year-old girl At 3:00 a.m. on July 15th, the Christian village of Bindi near Jos in the Plateau State in Nigeria, was plunged into a nightmare. Twenty-seven Christians were slaughtered, including a 3-year-old girl and nine members of Pastor Davou Musa's family, burned alive in their home, reports TruthNigeria.com. These attacks are not isolated incidents. They are part of a coordinated, radical Islamic campaign carried out by Fulani terrorists, with a mission to eradicate Christians from Nigeria and establish a Muslim caliphate. The perpetrators shouted “Allahu Akbar” as they hacked, shot, and burned families alive. One pastor shed light on what that Arabic phrase means. PASTOR: “Allah Akbar. Some will translate that as ‘God is great.' ‘ Perhaps a better translation of that Arabic phrase is, ‘Our God is greater.' This is a declaration that the demon and demons working through these people consider themselves to be greater than Jesus Christ, the God of Abraham Isaac and Jacob. “Ephesians 6:[12] says that our war is not just ‘against flesh and blood, but powers, principalities and spirits.' Practically, what this means is, when you see conflict in the seen realm, there is far greater conflict in the unseen realm. And when you hear, ‘Our God is greater,' that is a declaration of spiritual warfare from a demon against Jesus Christ, the God of Abraham Isaac and Jacob.” And where was the military? Just two miles away, but they arrived two hours late, a disturbing pattern of complicity that Christians have endured over and over again. Equipping The Persecuted is mobilizing immediately to assist survivors, providing emergency aid, trauma care, food, and security. But they urgently need your help. They are the only organization on the ground whose mission is to stop the persecution, not just clean up after it. This is not just a humanitarian crisis. It is genocide. And the world is ignoring it. Make a donation to Equipping the Persecuted through a special link in our transcript today at www.TheWorldview.com. Huckabee rebukes attackers of Christian church in Palestinian town U.S. Ambassador to Israel Mike Huckabee condemned recent attacks on a Christian village and its historic church in the West Bank, calling them “a crime against humanity and God,” reports The Christian Post. His statement came after visiting the site of the arson and ongoing harassment. Huckabee travelled Saturday to Taybeh, a Christian Palestinian town that residents say has endured a wave of assaults by Israeli settlers in recent weeks, according to The Times of Israel. The attacks include a fire set near the ruins of the Church of St. George, which church leaders described as among the most severe incidents to date. Huckabee, a longtime Evangelical supporter of Israel, said during his visit that the desecration of religious sites represented “an act of terror” and that such actions should carry “harsh consequences.” Trump diagnosed with chronic venous insufficiency after leg swelling Last Thursday, White House Press Secretary Karoline Leavitt gave the press an update on President Donald Trump's health. She told reporters that he has experienced mild swelling in his lower legs, according to a memo from Dr. Sean Barbarella, the physician to the president. LEAVITT: “The president underwent a comprehensive examination, including diagnostic vascular studies. Bilateral lower extremity veinous doppler ultrasounds were performed and revealed chronic venous insufficiency, a benign, common condition, particularly in individuals over the age of 70.” Leavitt also talked about photos showing some minor bruising on the back of the President's hand. She explained the bruising is a minor soft tissue irritation from frequent handshaking and the use of aspirin, reports CBN News. Intercessors for America featured this prayer. Pray with me now, if you would. “Father, we lift President Trump before You. We ask You would heal him and strengthen his body as he continues to serve our great nation. Amen.” Why Republicans defunded NPR and PBS The U.S. Congress voted to defund the Public Broadcasting Corporation by $1.1 billion, reports The Epoch Times. Republican Congressman Brandon Gill of Texas spoke from the floor of the House. GILL: “Tonight is the culmination of months of work from House Republicans to defund left wing state sponsored media outlets like NPR. “During that process, we got to bring in leadership from these outlets, like the CEO of NPR, Katherine Maher to testify before the House Oversight Committee she's written extensively about every single major woke buzz word that you could think of, including, ‘the ravages of late stage capitalism,' ‘structural privilege,' her own ‘cis white mobility privilege.' Most Americans, including myself, didn't know what that meant until reading this. “She's written about how ‘I do wish Hillary, [meaning Hillary Clinton], wouldn't use the language of ‘boy and girl.' It's erasing language for non-binary people. “This is the person running the outlet the other side of the aisle wants our tax dollars to subsidize non-partisan news outlets are not run by lunatics like this. Republicans are done using the power that voters give us to fund Democrat media machines. We're playing to win now.” Chip and Joanna Gaines promote homosexuality on new TV show And finally, Christians across America are objecting to the moral compromise of self-proclaimed Christians Chip and Joanna Gaines known for their home renovation show Fixer Upper and the Magnolia Network, reports the New York Post. As producers of a new reality show “Back to the Frontier” which premiered on July 10th, they sparked backlash for casting a homosexual male couple. A source close to Chip and Joanna – who cast a faux-married couple Jason Hanna and Joe Riggs and their 10-year-old twin sons through surrogacy – says they have long affirmed perversion. Conservative Christian leaders like Reverend Franklin Graham and podcaster Allie Beth Stuckey both slammed their decision, with Graham calling the casting “very disappointing.” Graham was clear in his stance, writing: “His Word is absolute truth. God loves us, and His design for marriage is between one man and one woman.” This prompted Chip to pour gasoline on the controversy by tweeting: “The way of ‘modern American Christian culture' is ‘Judge 1st, understand later/never.' ” Christian author Matt Walsh replied, “Maybe you should endeavor to understand the basic moral teachings of your own alleged religion before you give lectures to other people about their lack of understanding.” And Robby Starbuck, another Christian influencer, said, “Promoting this show means cash is greater than Christianity. When you reduce it to that simple truth, it's eye opening. I hope you correct course Chip. ‘For what profit is it to a man if he gains the whole world, and loses his own soul? Or what will a man give in exchange for his soul?'” (Matthew 16:26) The TV couple – parents to five children ranging between 20 and seven in age – are active members of the traditionally conservative Antioch Community Church of Waco, Texas. On its website, the church proclaims, “God commissions each of us to go into our spheres of influence and represent Jesus so that His Kingdom would come and His will would be done.” Close And that's The Worldview on this Monday, July 21st, in the year of our Lord 2025. Follow us on X or subscribe for free by Spotify, Amazon Music, or by iTunes or email to our unique Christian newscast at www.TheWorldview.com. Plus, you can get the Generations app through Google Play or The App Store. I'm Adam McManus (Adam@TheWorldview.com). Seize the day for Jesus Christ.
Chief Medical Officer at Central DuPage Hospital Dr. Thomas Moran joins Bob Sirott to explain what chronic venous insufficiency is, a study on a possible link between a virus and Parkinson’s, and why there is an increase in gastrointestinal cancer in people under fifty. He also talks about the link between oral health and your […]
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This episode we go into strictly politics. We got the 3 LA County Sheriff's Department deputies killed in an explosion, we also go into Trump Chronic Venous Insufficiency diagnosis and Trump rolling back $9B in public media funding and foreign aid. Hosted by your Pastor Michael Smith and co-hosted by your Brotha Lamick IsraelIf you would like tune in and join Brotha Lamick Young Disciples Discord the link is https://discord.gg/SVQygUP2 If you would like to sign up for the Monthly newsletter/ have a special request/report you would like done email Brotha Lamick Israel at Lamick19@outlook.com
Plus 4 dead and 16 hospitalized following an awful bus accident operated by company out of Fort Worth, Keller police and the city jail could soon become the first in Tarrant County to enter into a formal partnership with federal immigration authorities, Chiefs wide receiver Rashee Rice is sentenced to 30 days in jail and five years deferred probation, and more!
President Trump was diagnosed with chronic venous insufficiency, a “benign and common” condition. We talk about what it is, what to watch for, and whether it can be a sign of something more serious in some cases with Dr. Jose Wiley, Professor of Medicine and Chief of the Section of Cardiology at the Tulane School of Medicine
July 18, 2025 ~ Dr. Joel Kahn, Integrative Cadiologist at the Kahn Center for Cardiac Longevity discusses Donald Trump being diagnosed with Chronic Venous Insufficiency.
America Out Loud PULSE with Dr. Vaughn & Dr. Tankersley – As Dr. Jordan Vaughn has identified and treated in many patients, the large veins in the pelvis can cause a myriad of problems. He has been working closely with one of the world's preeminent radiologists for over a year on this issue, and Dr. Brooke Spencer, a renowned expert, has now published her initial findings on the...
America Out Loud PULSE with Dr. Vaughn & Dr. Tankersley – As Dr. Jordan Vaughn has identified and treated in many patients, the large veins in the pelvis can cause a myriad of problems. He has been working closely with one of the world's preeminent radiologists for over a year on this issue, and Dr. Brooke Spencer, a renowned expert, has now published her initial findings on the...
On this episode of the PTA Elevation Podcast, host Dr. Briana Drapp, PT, DPT, PTA, CSCS goes over the important things to know about arterial vs. venous insufficiency ulcers when studying for the NPTE. At the end of this episode, Briana provides and reviews a sample question that helps students get a feel for how this subject will be asked on the NPTE - PTA. Tune in to learn more!Come to the review session on June 22nd and 29th! https://ptaelevation.com/last-minute-reviewCheck out our FREE stuff!: https://ptaelevation.com/freebiesWebsite: https://www.ptaelevation.com/Join our FB group for FREE resources to help you study for the exam! https://www.facebook.com/groups/382310196801103/If you're interested in our prep course, check it out here: https://ptaelevation.com/the-600-plus-systemFollow us on our other platforms! https://www.ptaelevation.com/linktree
Send us a textLaktat und SvO2 als Transfusionstrigger? Dies besprechen wir diese Woche im Journal Club:Noitz M, Brooks R, Schlömmer C, et al. Central/mixed venous oxygen saturation and lactate levels might be of limited use as physiologic transfusion triggers in cardiac surgery: Results of a retrospective analysis. Eur J Anaesthesiol. 2025;42(6):536-542. doi:10.1097/EJA.0000000000002149Im Studie wieder dabei: Konstantin Urbach, wissenschaftlicher Mitarbeiter der Klinik für Anästhesiologie am UKHD.
Welcome to the final episode of our ESVS Vascular Fundamentals podcasts. In the last episode, we looked at some basic venous physiology. In this podcast, we will be looking at the haemodynamics of specific venous disorders such as acute venous thrombosis, primary varicose veins and chronic venous insufficiency. Ever wondered why exactly a DVT causes limb swelling? What happens to the venous physiology in phlegmasia? Why do people get varicose veins? What are the haemodynamic consequences of chronic venous insufficiency? Lots more burning questions that we will answer! Stay tuned!With Justin Woolgar and Joanna Halman.
Welcome to Part 3 of our ESVS Vascular Fundamentals series of podcasts. In the last two podcasts we concentrated on arterial haemodynamics; now it's the turn of the venous system.In this episode we look at what constitutes venous pressure and flow. How does blood flow in this low pressure system with what are effectively collapsible tubes. We explain what happens to venous pressure on standing and during exercise. What is ambulatory venous pressure? How does the cardiac cycle affect venous pressure? We will also explain how important the calf muscle pump is in reducing venous pressure and returning blood to the heart. What role do venous valves play? All basic principles in understanding venous patho-physiology.With Justin Woolgar and Joanna Halman.
CardioNerds Critical Care Cardiology Council members Dr. Gurleen Kaur and Dr. Katie Vanchiere meet with Dr. Yash Patel, Dr. Akanksha, and Dr. Mohammed El Nayir from Trinity Health Ann Arbor. They discuss a case of pulmonary air embolism, RV failure, and cardiac arrest secondary to an ocular venous air embolism. Expert insights provided by Dr. Tanmay Swadia. Audio editing by CardioNerds Academy intern, Grace Qiu. A 36-year-old man with a history of multiple ocular surgeries, including a complex retinal detachment repair, suffered a post-vitrectomy collapse at home. He was found hypoxic, tachycardic, and hypotensive, later diagnosed with a pulmonary embolism from ocular venous air embolism leading to severe right heart failure. Despite a mild embolic burden, the cardiovascular response was profound, requiring advanced hemodynamic support, including an Impella RP device (Abiomed, Inc.). Multidisciplinary management, including fluid optimization, vasopressors and mechanical support to facilitate recovery. This case underscores the need for early recognition and individualized intervention in cases of ocular venous air embolism. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls- Clear Vision, Clouded Heart: Ocular Venous Air Embolism with Pulmonary Air Embolism, RV Failure, and Cardiac Arrest Hypoxia, hypotension and tachycardia in a patient following ocular instrumentation are classic findings suggestive of pulmonary embolism from possible air embolism. The diagnosis of RV failure is based on clinical presentation, echocardiographic findings (such as McConnell's sign), and invasive hemodynamic assessment via right heart catheterization. Mechanical circulatory support can be considered as a temporary measure for patients with refractory RV failure. Central Figure: Approach to Pulmonary Embolism with Acute RV Failure Notes - Clear Vision, Clouded Heart: Ocular Venous Air Embolism with Pulmonary Air Embolism, RV Failure, and Cardiac Arrest 1. What is an Ocular Venous Air Embolism (VAE), and how can it be managed in critically ill patients? An Ocular Venous Air Embolism is defined as the entry of air into the systemic venous circulation through the ocular venous circulation, often during vitrectomy procedures. Early diagnosis is key to preventing cardiovascular collapse in cases of Ocular Venous Air Embolism (VAE). The goal is to stop further air entry. This can be done by covering the surgical site with saline-soaked dressings and checking for air entry points. Adjusting the operating table can help, especially with a reverse Trendelenburg position for lower-body procedures. The moment VAE is suspected, discontinue nitrous oxide and switch to 100% oxygen. This helps with oxygenation, speeds up nitrogen elimination, and shrinks air bubbles. Hyperbaric Oxygen Therapy can reduce bubble size and improve oxygenation, especially in cases of cerebral air embolism, when administered within 6 hours of the incident. Though delayed hyperbaric oxygen therapy can still offer benefits, the evidence is mixed. VAE increases right heart strain, so inotropic agents like dobutamine can help boost cardiac output, while norepinephrine supports ventricular function and systemic vascular resistance, but this may also worsen pulmonary resistance. Aspiration of air via multi-orifice or Swan-Ganz catheters has limited success, with success rates ranging from 6% to 16%. In contrast, the Bunegin-Albin catheter has shown more promise, with a 30-60% success rate. Catheterization for acute VAE-induced hemodynamic compromise is controversial, and there's insufficient evidence to support its ...
Before you dive into learning all about the arteries and veins I would suggest you take a look at some of the key terms associated with the systems. It will be super helpful if you have a good understanding of the bones and muscles of facial expression before you tackle the arteries, veins, and lymphatic system. Additional resources: Check out my free scorecard for students - you can rank yourself on how you are doing to take action on the steps toward being a successful college student. Sign up on the Google doc HERE - I will send along your scorecard to use the entire time you are enrolled in school. Study Sheets: https://thehappyflosserrdh.etsy.com/ Specialized Course: How to be successful in Dental Hygiene Schoolhttps://billie-lunt-s-school.teachable.com/p/how-to-be-successful-in-dental-hygiene-schoolOther Podcasts: blog.feedspot.com/dental_hygiene_podcasts/ Take a look at a recent product I have tried and recommend. bit.ly/thehappyflosser promo code: HAPPYFLOSSER Tooth fairy escape room Here Email Me: HappyflosserRDH@gmail.com
The "River" stent is a novel stent designed specifically to account for the anatomical and procedural requirements of venous sinus stenosis. A multicentre study of the device's safety and efficacy is underway, comprising 39 subjects across 5 US centres. The 1-year results have been recently published in JNIS. Editor-in-Chief of JNIS, Dr. Felipe C. Albuquerque, interviews Dr. Athos Patsalides¹, author of the paper: The River study: the first prospective multicenter trial of a novel venous sinus stent for the treatment of idiopathic intracranial hypertension 1. Department of Neurological Surgery, North Shore University Hospital, Manhasset, New York, USA Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.
Jamil Matthews, MD, vascular and endovascular surgeon, discusses Peripheral Artery Disease and Venous Disease, signs symptoms, prevention and treatment options.
In this episode of Spot Diagnosis, we explore two frequently coexisting conditions: venous eczema and tinea pedis. How should a patient with both be managed? This episode provides insight into the causes and treatment of these common yet challenging clinical presentations.See omnystudio.com/listener for privacy information.
Germline melanoma mutations -Treating venous insufficiency -Dermasphere clip show: Episodes 141-150! -To sign up for Luke's atopic dermatitis CME activity, go to:impactedu.gathered.com/invite/4QbYEVpbzqWant to donate to the cause? Do so here! Donate to the podcast: uofuhealth.org/dermasphere Check out our video content on YouTube: www.youtube.com/@dermaspherepodcast and VuMedi!: www.vumedi.com/channel/dermasphere/ The University of Utah's Dermatology ECHO: physicians.utah.edu/echo/dermatology-primarycare - Connect with us! - Web: dermaspherepodcast.com/ - Twitter: @DermaspherePC - Instagram: dermaspherepodcast - Facebook: www.facebook.com/DermaspherePodcast/ - Check out Luke and Michelle's other podcast, SkinCast! healthcare.utah.edu/dermatology/skincast/ Luke and Michelle report no significant conflicts of interest… BUT check out our friends at: - Kikoxp.com (a social platform for doctors to share knowledge) - www.levelex.com/games/top-derm (A free dermatology game to learn more dermatology!
In this episode, Ihsan Kaadan, MD, MS, discusses how he and Rush clinicians provide tailored, wraparound care for patients with peripheral artery disease (PAD) and chronic venous insufficiency. We also profile Dr. Kaadan's unique role in guiding Rush's multidisciplinary approach to treat these conditions, where he works with cardiologists, vascular surgeons and interventional radiologists to deliver optimal patient care. Dr Kaadan is a vascular medicine specialist in the Rush University System for Health; he evaluates and treats patients with complex arterial and vein disorders. “It's a one-stop shop at Rush, which sets us apart. A patient can come to the vascular medicine clinic, get evaluated for their disease, then start treatment either with me or one of my colleagues in cardiology or interventional radiology. Patients can also receive cardiac rehab and occupational and physician therapy, so they're supported throughout their entire experience
Dr. Jasmine Sukumar and Dr. Dionisia Quiroga discuss advances in adjuvant therapy for patients with early breast cancer and BRCA1/2 mutations, including how to identify patients who should receive genetic testing and the significant survival benefits of olaparib that emerged from the OlympiA trial. TRANSCRIPT Dr. Jasmine Sukumar: Hello, I'm Dr. Jasmine Sukumar, your guest host of the ASCO Daily News Podcast today. I'm an assistant professor and breast medical oncologist at the University of Texas MD Anderson Cancer Center. On today's episode, we'll be exploring advances in adjuvant therapy for high-risk early breast cancer in people with BRCA1/2 germline mutations. Joining me for this discussion is Dr. Dionisa Quiroga, an assistant professor and breast medical oncologist at the Ohio State University Comprehensive Cancer Center. Our full disclosures are available in the transcript of this episode. Dr. Quiroga, it's great to have you on the podcast. Thanks for being here. Dr. Dionisia Quiroga: Thank you. Looking forward to discussing this important topic. Dr. Jasmine Sukumar: Let's start by going over who should be tested for BRCA1/2 genetic mutations. How do you identify patients with breast cancer in your clinic who should be offered BRCA1/2 genetic testing? Dr. Dionisia Quiroga: So, guidelines on who to offer testing to somewhat differ between organizations at this point. I would say, generally, I do follow our current ASCO-Society of Surgical Oncology (SSO) Guidelines, though. Those guidelines recommend that BRCA1/2 mutation testing be offered to all patients who are diagnosed with breast cancer and are 65 years old or younger. For those that are older than 65 years old, there are additional factors to really take into account to decide on who to recommend testing for. Some of this has to do with personal and family history as well as ancestry. The NCCN also has their own specific guidelines for who to offer testing to. For example, people assigned male at birth; those who are found to have a second breast primary; those who are diagnosed at a young age; and those with significant family history should also be offered BRCA1/2 testing. I think, very important for our discussion today, ASCO and SSO also made a very important point that all patients who may be eligible for PARP inhibitor therapy should be offered testing. So clearly this includes a large amount of our patient population. In my practice, we often refer to our Cancer Genetics Program. We're fortunate to have many experienced genetic counselors who can complete pre-test and post-test counseling with our patients. However, in settings where this may not be accessible to patients, it can also be appropriate for oncology providers to order the testing and ideally perform some of this counseling as well. Dr. Jasmine Sukumar: Thank you Dr. Quiroga. Let's next review where we are in current clinical practice guidelines. What current options do we have for adjuvant therapy specific to people with high-risk early breast cancer and BRCA1/2 genetic mutations? Dr. Dionisia Quiroga: Our current guidelines recommend adjuvant olaparib for one year for individuals with HER2-negative high risk breast cancer. This approval largely came from the data and the results of the OlympiA trial. This was a prospective phase 3, double blind, randomized clinical trial. It enrolled patients who had been diagnosed with HER2-negative early-stage breast cancer who also carried germline pathogenic or likely pathogenic variants of either the BRCA1 and/or BRCA2 genes. The disease also had to be considered high-risk and there were several criteria that had to be evaluated to deem whether or not these patients were high-risk. For example, those who are treated with neoadjuvant chemotherapy, if they had disease that was triple-negative, they needed to have some level of invasive residual disease at time of surgery. Alternatively, if the disease was hormone receptor-positive, they needed to have residual disease and a calculated CPS + EG score of 3 or higher. This scoring system is something that estimates relapse probability on the basis of clinical and pathologic stage, ER status, and histologic grade, and this will give you a score ranging from 0 to 6. In general, the higher the score, the worse the prognosis. This calculator though is available to the public online to allow providers to calculate this risk. For the subset of patients who received adjuvant chemotherapy, for them to qualify for the OlympiA trial, if they had triple-negative disease, they needed to have a tumor of at least 2 cm or greater and/or have positive lymph nodes for disease. For hormone receptor-positive disease that was treated with adjuvant chemotherapy, they were required to have four or more pathologically confirmed positive lymph nodes at time of surgery. From this specified pool, patients were then randomized 1:1 to get either adjuvant olaparib starting at 300 mg twice a day or a matching placebo twice a day after they had completed surgery, chemotherapy and radiation treatment if needed. Dr. Jasmine Sukumar: And what were the outcomes of this study? Dr. Dionisia Quiroga: The study ended up enrolling over 1,800 patients and from these 1,800 patients, 70% had a BRCA1 mutation while 30% had a BRCA2 mutation. About 80% of the patients had triple-negative disease compared to hormone receptor-positive disease. Interestingly, about half of all patients enrolled had received neoadjuvant chemotherapy while the other half received adjuvant chemotherapy. Looking at the outcomes, this was overall a very positive study. We actually now have outcomes data from a median of about 6 years out. This was just reported in December at the 2024 San Antonio Breast Cancer Symposium. There was found to be a 9.4% absolute difference in six-year invasive disease-free survival favoring the olaparib arm over the placebo arm. What was also interesting is that this was consistent across multiple subgroups of patients and the benefit was really seen whether or not they had hormone receptor-positive or triple-negative disease. The absolute difference in distant disease-free survival was also high at 7.8% and additionally favored olaparib. Most importantly, there was found to be a significant overall survival benefit. The six-year overall survival was 87.5% in the olaparib group compared to 83.2% in the placebo group. This translates to about a 4.4% difference and a relative 28% overall survival benefit in using olaparib. Now, future follow up is going to be very important. Follow up for this study is actually planned to continue out until June 2029 so we can continue to observe if these survival curves will continue to branch apart as they have so far at each follow up. And I think this is especially important for those patients diagnosed with hormone receptor-positive cancers because we know those patients are at particular risk for later recurrences. As an additional side note, the researchers also noted that there were fewer primary malignancies in the olaparib group, not just of the breast but also primary ovarian or fallopian tube cancers as well, which is not completely surprising knowing that this drug is also heavily used and beneficial in different types of gynecologic cancers. Ultimately, the amount of adverse events reported have been low with only about 9.9% of patients receiving olaparib needing to discontinue drug due to adverse events, and this is compared to 4.2% reported in the placebo group. Dr. Jasmine Sukumar: You mentioned that the OlympiA trial showed an overall survival benefit, but interestingly the OlympiAD trial looking at olaparib versus chemotherapy in patients with advanced metastatic HER2-negative breast cancer did not show a significant overall survival benefit. Could you discuss those differences? Dr. Dionisia Quiroga: I agree, that's a very good point. So OlympiA's comparator arm was, of course, a placebo. So while this isn't the same as comparing to chemotherapy, it does still potentially suggest that there is a degree of benefit that olaparib can provide when it's introduced in the early local disease setting compared to advanced metastatic disease. I think we need more future trials looking at potential other combinations to see if we can improve the efficacy of PARP inhibitors in the metastatic setting. Dr. Jasmine Sukumar: For patients who do choose to proceed with use of adjuvant olaparib due to the promising efficacy, what side effects should oncologists counsel their patients about? Dr. Dionisia Quiroga: The most common notable side effects, I would say with olaparib and other PARP inhibitors are really cytopenias. Gastrointestinal side effects such as nausea and vomiting can occur as well as fatigue. There are some less common but potentially more serious side effects that we should counsel our patients on. This includes pneumonitis. So counseling patients on if they're short of breath or experiencing cough to let their provider know. Venous thromboembolism can also be increased rates of occurrence. And then of course myelodysplastic syndromes or acute myeloid leukemia is something that we often are concerned about. That being said, I think it should be noted that interestingly in the OlympiA trial so far, there have been less new cases of MDS and AML in the olaparib group than actually what's been reported in the placebo group at this median follow up of over six years out. So we'll need to continue to monitor this endpoint over time, but I do think this provides some reassurance. Dr. Jasmine Sukumar: Since the initiation of the OlympiA trial, other adjuvant treatments have also been studied and FDA approved for non-metastatic HER2-negative breast cancer. So for example, the CREATE-X trial established adjuvant capecitabine as an FDA approved treatment option in patients with triple-negative breast cancer who had residual disease following neoadjuvant chemotherapy. So if a patient with triple-negative breast cancer with residual disease is eligible for both adjuvant olaparib and adjuvant capecitabine treatments, how do you decide amongst the two? Dr. Dionisia Quiroga: If a patient's eligible for both, I honestly often favor olaparib, and I do this because I find the data for adjuvant olaparib a little bit more compelling. There are also differences in toxicity profile and treatment duration between the two that I think we should discuss with patients. For example, olaparib is supposed to be taken for a year total, whereas with capecitabine we typically treat for six to eight cycles with each cycle taking three weeks. There are some who may also sequence the two drugs in very high-risk disease. However, this is very much a data free zone. We don't have any current clinical trials really comparing these two or if sequencing of these agents is appropriate. So I don't currently do this in my own clinical practice. Dr. Jasmine Sukumar: Nowadays, almost all patients with stage 2 to 3 triple-negative breast cancer will be offered neoadjuvant chemotherapy plus immune checkpoint inhibitor therapy pembrolizumab per our KEYNOTE-522 trial data. With our current approach, pembrolizumab is continued into the adjuvant setting regardless of surgical outcome, so that patients receive a year total of immunotherapy. So in patients with residual disease and a BRCA germline mutation, do you suggest using adjuvant olaparib concurrently with pembrolizumab? Do we have any data to support that approach? Dr. Dionisia Quiroga: I do. I do use them concurrently. If a patient is eligible for adjuvant olaparib, I would use it the same way as if they were not on pembrolizumab. That being said, there are no large studies currently that have shown what the benefit or the toxicity of pembrolizumab plus olaparib are for early-stage disease. However, we do have some safety data of this combinatorial approach from other studies. For example, the phase 2/3 KEYLYNK-009 study showed that patients with advanced metastatic triple-negative breast cancer who were receiving concurrent pembrolizumab and olaparib had a manageable safety profile, particularly as the toxicities of these drugs alone don't tend to overlap. Dr. Jasmine Sukumar: And what about endocrine therapy for those that also have hormone receptor-positive disease? Dr. Dionisia Quiroga: Adjuvant endocrine therapy should definitely be continued while patients are on olaparib if they're hormone receptor-positive. An important component of this will also likely be ovarian suppression, which should include recommendation of risk reducing bilateral salpingo oophorectomy due to the risk of ovarian cancer development in patients who carry BRCA1/2 gene mutations. In most cases, this should happen at age 40 or before for those that carry a BRCA1 mutation, and at age 45 or prior for those with BRCA2 mutations. Dr. Jasmine Sukumar: And do you also consider adjuvant bisphosphonates in this context? Dr. Dionisia Quiroga: Yes. Like adjuvant endocrine therapy, adjuvant bisphosphonates were also instructed to be given according to standard guidelines in the OlympiA trial, so I would recommend use of bisphosphonates when indicated. You can refer to the ASCO Ontario Health Guidelines on Adjuvant Bone-Modifying Therapy Breast Cancer to guide that decision in order to utilize this due to multiple clinical benefits. It doesn't just help in terms of adjuvant breast cancer treatment but also reduction of fracture rate and down the line, improved breast cancer mortality. Dr. Jasmine Sukumar: Particularly in hormone receptor-positive breast cancer, another adjuvant therapy option that was not available when the OlympiA trial started are the CDK4/6 inhibitors, ribociclib and abemaciclib, based on the NATALEE and monarchE studies. So how do you consider the use of these adjuvant therapy drugs in the context of olaparib and BRCA mutations? Dr. Dionisia Quiroga: Yeah, so we are definitely in a data-free zone here. And that's in part because the NATALEE and the monarchE studies are still ongoing and reporting data out at the same time that we're getting updated OlympiA data. So unlike some of our other adjuvant treatments that we discussed, where olaparib could be safely given concurrently, the risk of myelosuppression and using both a CDK4/6 inhibitor and a PARP inhibitor at the same time would be too high. In some cases, even if a patient has a BRCA1/2 mutation, they may not meet that specified inclusion criteria that OlympiA set for what they consider to be high-risk disease. And we know from the NATALEE and the monarchE trial there are also different markers that they use to denote high-risk disease. So it's possible, for example, in the NATALEE trial that looks specifically at adjuvant ribociclib, they included a much larger pool of hormone receptor-positive early-stage breast cancers, including a subset that did not have positive axillary lymph nodes. In cases where patients would qualify for both olaparib and a CDK4/6 inhibitor, I think this is worth a nuanced discussion with our patients about the potential benefits, risks and administration of these drugs. I think another point to bring up is the cost associated with these drugs and the length of time patients will be on for, because financial toxicity is always something that we should bring up with patients as well. When sequencing these in high-risk disease, my practice is to generally favor olaparib first due to the overall survival data. There is also some data to support that patients with BRCA1/2 germline mutations may not respond quite as well to CDK4/6 inhibitors compared to those without. But again, this is still outside of the purview of current guidelines. Fortunately, we have more potential choices for patients, and that's a good thing, but shared decision making also needs to be key. Dr. Jasmine Sukumar: And while our focus today is on adjuvant treatment for people who carry germline BRCA mutations, what about other related gene mutations such as PALB2 pathogenic variant? Dr. Dionisia Quiroga: That's a great question. Clinical trials in the advanced metastatic setting have shown that there is efficacy of olaparib in the setting for PALB2 mutations. This is largely based on the TBCRC 048 phase 2 trial and that provided a Category 2B NCCN recommendation for patients with these PALB2 gene mutations. However, we're really still lacking enough clinical data for use in early-stage disease, so I don't currently use adjuvant olaparib in this case. I am definitely eager for more data in this area as the efficacy of PARP inhibitors in PALB2 gene mutations is very compelling. I think also, in the same line, there's been some data for somatic BRCA1/2 mutations in the metastatic setting, but we still have a lack of data for the early stage setting here as well. Dr. Jasmine Sukumar: Thank you Dr. Quiroga, for sharing your valuable insights with us today on the ASCO Daily News Podcast. Dr. Dionisia Quiroga: Thank you, Dr. Sukumar. Dr. Jasmine Sukumar: And thank you to our listeners for your time today. You'll find links to the studies discussed today in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review and subscribe wherever you get your podcasts. Thank you. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers: Dr. Dionisa Quiroga @quirogad @quirogad.bsky.social Dr. Jasmine Sukumar @JasmineSukumar @jasmine.sukumar.bsky.social Follow ASCO on social media: @ASCO on X @ASCO on Bluesky ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. Dionisia Quiroga: No relationships to disclose Dr. Jasmine Sukumar: Honoraria: Sanofi (Immediate Family Member)
Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is responsible for 9–30% of pregnancy-related mortality in high resource countries and remains a significant, increasing cause of severe maternal morbidity. Peripartum, 50% of VTE events occur in the postpartum interval, which has a 6-fold higher risk compared to antepartum. There is wide variation in LMWH pharmacological postpartum prophylaxis guidance. The RCOG, for example, recommends 10 days of LMWH for all postop CS patients unless it was elective, and additional risk factors exist. The ACOG uses a more selective approach. However, on Jan 16, 2025, a new multicenter retrospective study from the US is raising questions about the efficacy of postpartum VTE pharmacologic therapy. Is there really no need for pp VTE pharmacologic therapy? Or does the answer lie in the reality of VTE as a “low frequency, high acuity” event? Listen in for details!
This week we discuss blood clots A blood clot is a clump of blood that has changed from a liquid to a gel-like or semisolid state. Clotting is a necessary process that can help prevent excessive blood loss when you have a cut, for example. Thrombosis is when a blood clot forms and reduces blood flow. There are two types: Arterial thrombosis occurs when a blood clot forms in an artery. Venous thrombosis occurs when a blood clot forms in a vein. When a clot forms inside one of your veins, it may dissolve on its own. However, sometimes a clot doesn't dissolve on its own, or part of it breaks off and travels elsewhere in your circulatory system. When this happens, the blood clot may get stuck elsewhere and restrict blood flow, known as embolism. These situations can be very dangerous and even life threatening. According to the Centers for Disease Control and Prevention (CDC), 1 in 2 people don't experience any symptoms when they have a deep venous blood clot. When symptoms do appear, it's important to get immediate medical attention. Medical emergency A blood clot may be a medical emergency and life threatening if left untreated. Call 911 or go to the nearest emergency room immediately if you or someone you're with experiences symptoms of a serious blood clot, such as: sudden shortness of breath chest pressure difficulty breathing, seeing, or speaking Call a doctor or seek medical attention if you experience throbbing, swelling, and tenderness in one body part.
In this episode of the PFC Podcast, Dennis and Alex discuss the complexities of trauma surgery, particularly focusing on pelvic injuries and the use of pelvic binders. They explore the subjective nature of truth in medical practice, the importance of research and evidence in trauma care, and the anatomy and physiology related to pelvic injuries. The conversation delves into injury patterns, damage control surgery, and the challenges faced in operational environments. They also engage in a debate about the efficacy of pelvic binders, weighing the evidence and risks involved in their use during trauma care. In this conversation, Dennis discusses the critical importance of evidence-based practice in combat medicine, particularly regarding the use of pelvic binders. He emphasizes the need for medical professionals to understand the nuances of pelvic injuries, especially in a combat environment, and how these injuries differ from civilian cases. The discussion also covers the structured approach to prolonged field care, the management of blood transfusions, and the challenges of imaging in trauma assessment. Dennis advocates for clinical decision-making that prioritizes patient safety and effective care, while also acknowledging the emotional weight of these decisions in high-stakes environments. Takeaways Truth is subjective and varies by perception. Disagreement in medical practice can lead to better patient care. Understanding research quality is crucial in medical decisions. Venous bleeding is more common in pelvic injuries than arterial. Damage control surgery involves multiple phases of patient management. Operational environments present unique challenges for trauma care. Pelvic binders are debated in their effectiveness and necessity. Surgical decision-making requires weighing risks and benefits. Evidence-based medicine is essential but often lacking in operational settings. The role of pelvic binders in trauma care remains contentious. Evidence is crucial in medical practice to avoid misinformation. Dismounted IED blasts result in unique injury patterns. Understanding research and statistics is essential for medical professionals. Pelvic binders may not always be beneficial in every injury case. Timely blood transfusions are critical in managing trauma patients. Imaging plays a vital role in assessing pelvic injuries. Clinical decision-making should be based on patient stability and evidence. Prolonged field care requires a structured approach to patient management. Team collaboration is essential in making difficult medical decisions. Continuous education and training are vital for operational medics. Chapters 00:00 Introduction to the Podcast and Guest 02:58 Understanding Trauma Surgery and Pelvic Injuries 06:13 Research and Evidence in Trauma Care 09:06 Anatomy and Physiology of Pelvic Injuries 12:04 Injury Patterns and Their Implications 14:53 Damage Control Surgery and Patient Management 17:48 Operational Environment Challenges 21:03 The Role of Pelvic Binders in Trauma Care 23:52 Debate on Pelvic Binders and Evidence 26:51 Surgical Decision Making in Trauma 29:47 Conclusion and Final Thoughts 45:19 The Importance of Evidence in Medical Practice 52:34 Understanding Pelvic Injuries in Combat 53:59 Prolonged Field Care: A Structured Approach 01:00:03 Managing Blood Transfusions in Critical Care 01:10:06 The Role of Imaging in Trauma Assessment 01:18:00 Clinical Decision-Making in Prolonged Field Care For more content go to www.prolongedfieldcare.org Consider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
THE BALANCED MOMTALITY- Pelvic Floor/Core Rehab For The Pregnant and Postpartum Mom
Hey Friend, For those that haven't been following along, I have been struggling with symptoms of Pelvic Venous Disorder or PeVD or better known as, Pelvic Congestion Syndrome, for the last year. It all started with an ovarian cyst like pain, but I later learned that my “menstrual cramps” I was feeling on and off throughout the month, not just during my menses, was also due to these enlarged veins. The heaviness and cramping was starting to get so uncomfortable that standing or sitting for too long was painful, and even exercise started to become painful. Thankfully sex was never painful, but painful intercourse or dyspareunia, especially pain or cramping with and after arousal or orgasm, is a very common symptom of PeVD. I was not a typical presentation for this diagnosis, so it surprised me when I found out from an ultrasound. So I share my story so that others with pelvic pain, constipation, heaviness, sharp abdominal pain, low back pain or pain with sitting, standing, or exercising, can start to become aware of this diagnosis and advocate for yourself. As many gynecologists do not believe this condition is a cause of pain…. And I can tell you… it most definitely IS! After two procedures using coil embolization and sclerotherapy to close off the dysfunctional varicose veins in my pelvis, it was identified that a compression of my Iliac vein was pretty severe and needed to be treated with a stent. I am two weeks postop and recovery has been a journey. Many things I was not expecting, so again, I wanted to share with the World so that maybe you can feel more prepared and aware of the treatment options out there for you! Thanks for following along on my health journey and sending all the love and supporting messages, it has meant a lot! As always, if you are experiencing any pelvic floor/women's health issue like urinary incontinence/leaking, pelvic pain, pain with sex, urgency, heaviness/prolapse or any other back/hip/joint pain let's get you booked for a virtual coaching session or in person physical therapy session for a more individualized plan and one-on-one instructions so you can feel confident in your body and start healing today!! Make Sure to reach out to> PTDes@balancedmomtality.com AND/OR Join my FREE Facebook community for ACCOUNTABILITY and a safe and supportive place to share and support each other!> https://www.facebook.com/groups/1696216757461633/ Join my VIP Insider group and receive my Newsletter full of great tips and tricks and upcoming resources! > https://newsletter.balancedmomtality.com/ Follow and get tips/tricks on: Facebook> @thebalancedmomtality Instagram> @the_balanced_momtality Learn > www.balancedmomtality.com
Our guest Dr. Mike DeBord, the visionary Founder and President of B3 Sciences, explains how Blood Flow Restriction (BFR) bands are transforming the fitness industry. Dr. Mike shares the science behind these revolutionary exercise bands and demonstrates their use. Learn how BFR bands can: Boost Growth Hormone production Increase vascular efficiency Help combat osteoporosis and dementia Discover how B3 Sciences is making workouts more effective than ever before. Watch the full episode and see how you can elevate your fitness routine with this innovative technology! #BFRBands #FitnessTech #GrowthHormone #HealthRevolution https://yakking.b3sciences.com Timeline 01:50 What are BFR bands 02:10 Osteoporosis myths 12:00 Using BFR bands 13:50 BFR bands& cardiovascular issues 20:20 BFR & growth hormone 23:40 Venous supply & varicose veins 26:20 Safety 29:20 How to get BFR bands 31:00 Anti-ageing 34:10 Weight loss 37:00 Dr. Mike's tip 5 minutes of daily exercise 38:21 Contact Dr. Mike The Yakking Show is brought to you by Peter Wright & Kathleen Beauvais contact us to be a guest on our show. https://TheYakkingShow.com peter@theyakkingshow.com kathleen@theyakkingshow.com Join our community today so you don't miss out on advance news of our next episodes. https://bit.ly/40GdxCG Here are some of the tools we use to produce this podcast. Kit for sending emails and caring for subscribers Hostgator for website hosting. Podbean for podcast hosting Airtable for organizing our guest bookings and automations. Spikers Studio for video editing Clicking on some links on this site will let you buy products and services which may result in us receiving a commission, however, it will not affect the price you pay.
Stroke survivor Molly Buccola inspires others with her recovery from venous sinus thrombosis and her mission to bring connection and hope to others. The post Molly Buccola's Recovery from Venous Sinus Thrombosis: A Story of Resilience and Purpose appeared first on Recovery After Stroke.
Dr. Gillett, James O'Hara, & Jake Fantus MD discuss Testosterone, Sexual Function, & fertility. 00:00 Intro01:47 Secret Shopper Study06:58 Dr. Fantas TRT patients 09:16 Are podcast responsible for popularizing TRT? Subcutaneous TRT.12:38 Coming off TRT 16:22 Testicular fibrosis/fertility with long term use21:56 Varicocele 28:31 Venous leak30:34 Guidlines 34:33 Lifestyle changes to improve ED37:25 Epigenetics and Fertility 39:56 SSRIs 41:18 Clomid 45:30 Lab work overestimating free T52:40 Traverse trial 56:31 Aspirin57:03 FSH and fertility in men 01:00:37 Gonadorelin01:03:05 Male Birth Control 01:06:29 How many people have tried TRT?01:09:49 Did TRT create the Red Wave? 01:12:07 Outro Link to Health Update: https://youtu.be/Fe9_vNE2RgQLink to The Longevity Clinic Movement?: https://youtu.be/QKjMujVZLcULink to calculate your free testosterone: https://www.issam.ch/freetesto.htmFor High-quality labs:► https://gilletthealth.com/order-lab-panels/For information on the Gillett Health clinic, lab panels, and health coaching:► https://GillettHealth.comFollow Gillett Health for more content from James and Kyle► https://instagram.com/gilletthealth► https://www.tiktok.com/@gilletthealth► https://twitter.com/gilletthealth► https://www.facebook.com/gilletthealthFollow Kyle Gillett, MD► https://instagram.com/kylegillettmdFollow James O'Hara, NP► https://Instagram.com/jamesoharanpFor 10% off Gorilla Mind products including SIGMA: Use code “GH10”► https://gorillamind.com/For discounts on high-quality supplements►https://www.thorne.com/u/GillettHealth#testosteron #erectiledysfunction #hormones #podcastAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
Soft Cock Appreciation Week know that when maintaining an erection is a challenge, there may be a physiological root that unfortunately is not easily or commonly treated by traditional medicine. “Imagine pumping up a bicycle tire that has a pinhole leak, no matter how you pump it, that tire just isn't going to stay firm, so too is the way of Venous leak”. This is the wisdom of Nigel Shaw, the creative innovator and inventor of Xialla, an easy to wear, uniquely designed penis ring for men with Venous leak. Erica Leroye and Nigel delve into the world of Venous Leak and Xialla: What IS Venous leakage, understanding the frustrations that come with this particular challenge, how it's underserved in traditional medicine, and differentiating physical from the psychological roots when maintaining is the predominant concern. Some unique signs and symptoms of VL and lifestyle changes that may help Innovating a new solution and how the Xialla ring works for venous leak as well as for other sexual enhancing play The Xialla community as a resource and tips for others who want to support men's fears and vulnerability. For More Information and to Connect With Nigel Shaw Xialla.com For More Information and to Connect With Erica Leroye https://www.flowcode.com/page/creativebodyrelease.com For More Information and to Connect With Soft Cock Appreciation Week https://www.softcockweek.com/ We have MERCH! Check out our storewww.softcockweek.com/store and support both Soft Cock Week and this year's, once we make a profit, partner SELFED (getselfed.org) Chapters 00:00 Introduction to Soft Cock Appreciation Week 03:25 Understanding Intimacy and Erection Dynamics 06:20 The Invention of the Xialla Device 09:13 Personal Journey and Health Challenges 11:54 Exploring the Market for Erectile Dysfunction Solutions 15:13 The Mechanics of Venous Leak 17:53 Demonstrating the Xialla Device 19:36 demo of Xialla ring 21:06 The Magical Benefits of the Xialla Device 24:04 Understanding Venous Leak in Depth 24:22 New Chapter 26:27 The Psychological Aspects of Erection 27:53 Conclusion and Final Thoughts 34:45 Navigating Interruptions in Intimacy 35:51 The Impact of Masculinity on Mental Health 37:48 Understanding Erection Challenges 39:22 The Role of Xialla in Sexual Health 42:16 Integrating Xialla with Other Treatments 47:41 2nd demo 49:25 Creating Safe Spaces for Men to Share 52:45 The Emotional Side of Erectile Dysfunction 56:38 Exploring Alternatives to Traditional Intimacy 58:01 The Limitations of Medical Solutions 01:01:44 Benefits of Xialla Beyond E Soft Cock Appreciation Week, erectile dysfunction, venous leak, intimacy, Nigel Shaw, Xialla device, sexual health, men's health, psychological effects, innovation
THE BALANCED MOMTALITY- Pelvic Floor/Core Rehab For The Pregnant and Postpartum Mom
Hey Girl, Do you suffer from chronic pelvic pain or heaviness? Hemorrhoids? Ovarian pain or cysts? What about bloating or constipation? Is it worse with standing or exercise? Maybe sex makes it worse? It's possible you have Pelvic Venous Disorder (PeVD) or recently known as Pelvic Congestion Syndrome. This Diagnosis is so under diagnosed and missed and many times the same symptoms are attributed to things like Endometriosis, PCOS, IBS, or ovarian cysts and fibroids. PeVD is a part of my story and I have a few episodes talking more about the disorder itself and how to identify it and many holistic things you can do to help so check those out if you would like! Inside this week's episode I am diving more into my personal journey and updating my tribe on how I am doing since my embolization procedure. I share my hopes, my struggles, and my experiences with chronic pain and what my plan is moving forward. Thank you to all of my amazing listeners and friends who have reached out to check in on me and let me know that sharing my journey has been helpful for you! You all give me so much strength and support and just know, I'm here to do the same for you! As always, if you are experiencing any pelvic floor/women's health issue like urinary incontinence/leaking, pelvic pain, pain with sex, urgency, heaviness/prolapse or any other back/hip/joint pain let's get you booked for a virtual coaching session or in person physical therapy session for a more individualized plan and one-on-one instructions so you can feel confident in your body and start healing today!! Make Sure to reach out to> PTDes@balancedmomtality.com AND/OR Join my FREE Facebook community for ACCOUNTABILITY and a safe and supportive place to share and support each other!> https://www.facebook.com/groups/1696216757461633/ Join my VIP Insider group and receive my Newsletter full of great tips and tricks and upcoming resources! > https://newsletter.balancedmomtality.com/ Follow and get tips/tricks on: Facebook> @thebalancedmomtality Instagram> @the_balanced_momtality Learn > www.balancedmomtality.com
0-20: Chet Paulsen introduction and talking about the birth of Rockcuffs, understanding Blood Flow Restriction, design of BFR cuffs. Design problems are the main cause for safety issues. Truly dissecting research and understanding improper or misrepresented studies. Hormonal response to BFR, endocrine response, cause for DOMS. Using BFR for pain reduction for up to 24 hours afterwards.20-30: BFR reduces pain, improves strength and muscle size, improve adherence to use, uses for recovery. Ability to improve Vo2 Max levels. Importance of using BFR on both limbs.30-40: Targeting both sides with BFR as both limbs become affected after an injury/surgery. Average person does not know their 1 Rep max, can use BFR with minimal exercises with process of tightening and loosening to have benefits. BFR can have benefits during passive range of mobilization and joint mobilizations. BFR is not just mechanical it is endocrine, metabolic hack. Hormonal release is systemic, hypothalamus will put hormones in motion. Cells become more permeable to IGF Insulin growth factor. M Torque 1 is where it makes transition from blood stream to the muscle. BFR can have benefits for slowing diseases like Parkinson's due to angiogenesis process. Importance of using BFR post injury.40-50: Contraindications to using BFR. Safety and injury issues with BFR come from high pressure. Pressure changes when exercising, Arterial Occlusion pressure changes on muscle based on position of muscle and also from rest to exercises as blood flow increases. Venous pressure is 1/10th of arterial, veins are more compliant as they have a smaller muscle around them, hold 70% of blood volume. Venous occlusion happens between 20-70mm of pressure. Rock cuffs are rigid and equal efficiency pressure of 2 inches. Pneumatic cuffs tend to bubble and limited adequate pressure, too much pressure in the middle. Most pneumatic cuffs are shiny object tools. Understanding cuff size and efficient pressure to limb size.50-60: Pressure doubles under cuff during exercise, more pressure is not better. Time it takes for set up and ease of putting on cuffs being a factor. Understanding measuring venous pressure, difference between lean individuals and bigger individuals and use of pressure on cuff. Reinforcing again that the pressure in the cuff when the muscle is relaxed changes when the muscle is contracted. 30-15-15-15 with the rest breaks is the aerobic capacity of the muscle. The middle part of the last set, fatigue should occur. Reps should be consistent without a pause, pause means fatigue is setting in and too much pressure. Don't need fancy equipment to tell you how tight a cuff needs to be.60-70: Understanding proper placement and use of Rockcuffs, adjusting pressure, dosage of exercise. Arterial flow is never full occluded, do not need to fully occlude arterial flow. 18-20 minutes is max time of being occluded. Feedback and observation are best clues to understanding occlusion and fatigue levels. Lactate levels above normal for 10 minutes 3x week, hypothalamus will start it's process. BFR has to be consistent and used as a supplement to exercise not just one set of exercise or one time use during a week.70-80: BFR is a partnering with body system response not a punishment or trick system like most training programs. Calorie consumption is important for during use of BFR. Central aminos, hydration are key for building blocks IGF, and M Torque 1 process. Protein synthesis will be optimized with BFR, hydration and central aminos. Avoid caffeine for 90 minutes beforehand using BFR routine, Have caffeine after because it is a vasoconstrictor. Following BFR want vasodilation response after Un occluding. BFR allows to do exercise with less weight and less injury due to lower resistance and focus on form and technique. Understanding 30-15-15-15 and 30-30-30 regimens. Want to keep pressure low and regimens prescribed the proper way to ensure adherence and reduce DOMS. And more…
Audible Bleeding editor Wen (@WenKawaji) is joined by 1st year vascular surgery fellow Richa Kalsi (@KalsiMD), 3rd year medical student Nishi (@Nishi_Vootukuru), 4th-year general surgery resident Sasank Kalipatnapu (@ksasank) from UMass Chan Medical School, JVS editor Dr. Forbes (@TL_Forbes), JVS-VLD associate editor Dr. Arjun Jayaraj and JVS social media liaison Dr. Haurani to discuss some of our favorite articles in the JVS family of journals. This episode hosts Dr. Amy Felsted, Dr. Salvatore Scali, and Dr. Arjun Jayaraj, the authors of the following papers. Dr. Arjun Jayaraj and Dr. Haurani will also spend time discussing a virtual special issue, centered around iliofemoral venous stenting published in the Journal of Vascular Surgery, Venous and Lymphatic Disorders that includes six articles published between August 2023 and May 2024. Articles: Part 1: A patient-centered textbook outcome measure effectively discriminates contemporary elective open abdominal aortic aneurysm repair quality by Dr. Felsted, Dr. Scali and colleagues. Part 2: Virtual special issues on contemporary role of iliofemoral venous stenting Show Guests Dr. Amy Felsted (@aefelsted): Completed fellowship at Dartmouth-Hitchcock, Currently an assistant professor of surgery at Boston University School of Medicine and practicing vascular surgeon at the VA in Boston Dr. Salvatore Scali: Professor of Surgery at University of Florida Division of Vascular Surgery and Endovascular Therapy, program director of the vascular fellowship at University of Florida. Dr. Arjun Jayaraj: Vascular surgeon at the RANE Center in Jackson, Mississippi with a focus on the management of venous and lymphatic diseases, Associate Editor of JVS-VL. Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
VISIT US AT NCLEXHIGHYIELD.COM No matter where you are in the world, or what your schedule is like, access the entire course at www.NCLEXHighYieldCourse.com The NCLEX High Yield Podcast was featured on Top 15 NCLEX Podcasts! Make sure you JOIN OUR NEW VIP FACEBOOK GROUP! https://nclexhighyield.com/blogs/news/nclex-high-yield-quick-links A topic that confuses many, but listen to how Dr. Zeeshan breaks this bad boy down! Many people get overwhelmed with all the information that's out there, we keep it simple! Join us weekly for FREE Zoom Sessions and be one of the many REPEAT test takers that passed the exam by spending NO MONEY with NCLEX High Yield! NCLEX High Yield is a Prep Course and Tutoring Company started by Dr. Zeeshan in order to help people pass the NCLEX, whether it's the first time , or like the majority of our students, it's NOT their first time. We keep things simple, show you trends and tips that no one has discovered, and help you on all levels of the exam! Follow us on Instagram: @NCLEXHighYield or check out our website www.NCLEXHighYield.com Make sure you join us for our FREE Weekly Zoom Sessions! Every Wednesday 3PM PST / 6PM EST. Subscribe to our newsletter at nclexhighyield.com --- Support this podcast: https://podcasters.spotify.com/pod/show/nclexhighyield/support
Get caught up on the current best practices and guidelines in venous interventions. Dr. Adam Raskin covers this and more, with host Dr. Sabeen Dhand in this discussion of DVT and PE treatments. Dr. Raskin is an interventional cardiologist, medical director of Cardiac ICU, and Co-Director of the PERT program at Mercy Health in Cincinnati, Ohio. --- CHECK OUT OUR SPONSOR Imperative Care https://imperativecare.com/vascular/ --- SYNPOSIS Dr. Raskin shares his comprehensive approach for treating patients with DVT and PE, highlighting recent advancements in thrombectomy systems, as well as underscoring the need for more randomized trials to further build on current venous disease treatment guidelines. The doctors also touch on the significance of accurate diagnostic tools and thorough follow-up to improve patient outcomes. --- TIMESTAMPS 00:00 - Introduction 10:58 - Approaching DVT & PE Patients 19:04 - Thrombectomy Advancements 24:02 - Iliofemoral Interventions & Standard Practices 26:32 - Accessing Tibial Veins & Clearing Clots 38:59 - Follow-Up & Data Collection 41:09 - Future of Venous Interventions --- RESOURCES The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II Endorsed by the Society of Interventional Radiology and the Society for Vascular Medicine: https://www.jvsvenous.org/article/S2213-333X(23)00322-0/fulltext
Host: Darryl S. Chutka, M.D. [@chutkaMD] Guest: Ana I. Casanegra, M.D., M.S. Venous thrombosis is an under diagnosed and potentially serious health condition, yet in many cases its preventable and certainly treatable when found. Its most serious potential complication is embolization, most commonly to the lung. As a medical condition, venous thrombosis has been known for many years. In fact, the triad of contributing factors to venous thrombosis including venous stasis, vascular injury and hypercoagulability were discovered in the mid-1800's. Despite the long duration we've been diagnosing and treating the health problem, there's still much we need to learn about it. The topic for today's podcast is venous thrombosis and we'll discuss its risk factors, how to diagnose a DVT and the best management recommendations. My guest will be Ana I. Casanegra, M.D., M.S., a vascular medicine specialist at the Mayo Clinic. Connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
This week we turn back the clocks to re-review a recent research letter from the team at the Harvard Congenital Heart Program about venous insufficiency in the Fontan patient. Why do patients with Fontan circulation develop chronic venous insufficiency and what are the implications of this problem in the Fontan patient? What sort of evaluation should be performed on the Fontan patient presenting with lower extremity venous changes? How worried should the cardiologist be when presented with a Fontan patient with these changes? These are amongst the questions reviewed on this topic with this week's guest, Associate Professor at Baylor University, Dr. Tony Pastor.JACC Adv 2022 Mar, 1 (1) 100002
Superficial venous disease can pose significant management challenges, particularly after patients have exhausted conservative and invasive therapies. This week, our host, Dr. Sabeen Dhand, interviews Dr. Ali Golshan, an interventional radiologist and the founder of SOLVEIN. Dr. Golshan discusses the latest advancements in treating superficial venous disease, highlighting both the benefits and complexities of thermal and non-thermal ablation techniques. --- CHECK OUT OUR SPONSOR BD Advance Clinical Training & Education Program https://page.bd.com/Advance-Training-Program_Homepage.html --- SYNPOSIS Dr. Golshin introduces SOLVEIN, his innovative medical device designed to address these challenges. The conversation also includes practical tips for managing patients with venous insufficiencies, along with insights into the entrepreneurial journey involved in developing a new medical device. --- TIMESTAMPS 00:00 - Introduction 02:02 - Defining Superficial Venous Disease 05:43 - Diagnostic Techniques and Imaging 08:29 - Current Treatment Options for Venous Insufficiency 20:07 - Introducing SOLVEIN 29:42 - FDA Approval Pathway 33:37 - Advice for Aspiring Medical Entrepreneurs --- RESOURCES Dr. Ali Golshan's Practice: https://www.beachwellnessmd.com/
Venous closure devices, GLP1-s linked to blindness and cancer, resisting the urge to do an ECG, and transcatheter edge-to-edge repair (TEER) for secondary mitral regurgitation are the topics discussed this week. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Listener Feedback Venous vascular closure system vs. figure-of-eight suture following atrial fibrillation ablation: the STYLE-AF Study https://doi.org/10.1093/europace/euae105 II GLP1-s and Blindness Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2820255 Locke Twitter https://x.com/doc_BLocke/status/1808972226655629610 When to Start a Statin Is a Preference-Sensitive Decision https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.029808 III GLP1-s and Cancer Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients With Type 2 Diabetes https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820833 IV Screening ECG Routine Electrocardiogram Screening and Cardiovascular Disease Events in Adultshttps://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2820721 Clinical outcomes in systematic screening for atrial fibrillation (STROKESTOP) https://doi.org/10.1016/S0140-6736(21)01637-8 Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study) https://doi.org/10.1016/S0140-6736(21)01698-6 IV TEER for Secondary Mitral Regurgitation Randomized investigation of the MitraClip device in heart failure: Design and rationale of the RESHAPE-HF2 trial design https://doi.org/10.1002/ejhf.3247 Percutaneous repair of moderate-to-severe or severe functional mitral regurgitation in patients with symptomatic heart failure: Baseline characteristics of patients in the RESHAPE-HF2 trial and comparison to COAPT and MITRA-FR trials https://onlinelibrary.wiley.com/doi/full/10.1002/ejhf.3286 Jun 21, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001237 Stats Blog https://www.r-bloggers.com/2023/07/the-benjamini-hochberg-procedure-fdr-and-p-value-adjusted-explained/ You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net
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