Podcasts about while cap

A Murmur On The Strange Mole Express - S03E09 - #NotMyKing Coronation Weekend 2023   13 years of a Tory Government. So many abject failures, so much corruption, lies and so much hatred of anyone who lives in the UK, or anyone who wants to come to the UK. Unless they are Russians with money. Brexit is the word that must never be spoken. Conservative must never be seen in a Tory bio. Now they are rigging elections by voter suppression. We need a Detective who can dig out the crimes and serve them up on a platter. It's time to take the Fascist Tories Out with the Trash. Who will be the one to do it? The great detective, or the people? (My Money is on the People, if the lack of ID didn't prevent them from voting... Trial run for the next GE)   Oh and this weekend, the homeless have been dragged off the streets of London for the #NotMyKing Coronation of the Head of Britain's own crime syndicate. Where Peaceful Protesters are being arrested for walking down the street. While Cap doffing serfs and subserviants hope to catch the eye of Old Sausage Fingers in his Solid Gold Carriage, while children starve and Nurses use foodbanks to survive.   We make this show for You and as Therapy for ourselves.   Enjoy the Show, it's All We Have.   PLEASE Share, Comment, Spread the Love.    ------ PLEASE CAN YOU HELP? We really enjoy making this show, we do it on Zero budget and there's things we need to help make our lives easier. Holy Mole writes, Edits and Performs on a Laptop that wouldn't look out of place in a 90s Museum and He really needs a New One with some processing power. Do you have a Spare Laptop, PC or even a MAC spare that will do the job? We would be very grateful. Sorry to ask but we are still struggling to make ends meet. Augusta really needs a Mic for her singing and a mic/pickup for her piano. Chrissie wants a nice young stud who's loaded. Chris Doc Strange just needs some sunshine and a back rub. If you fancy buying us a Coffee, you can do that here https://ko-fi.com/strangemoleshow   Oh and if you would like to Advertise with us for a Great Package of extras, get in touch with us on Twitter (Yes, still using it)   Enjoy the show, it's all we have.   Please tell your friends about us.   www.StrangeMole.co.uk        @StrangeMoleShow Written by Holy Mole Performed by  Chrissie Grech    Holy Mole   Chris Doc Strange & @AugustaLees

Today on C4 we have the story of Captain America and the Thing running into a cult who worships entropy. These jerks have gotten the Cosmic Cube and have created a living embodiment of the concept of entropy, who in direct opposition to the very concept of a cult, just disintegrates any potential recruits. While Cap fights a cult member who also is full of Super Soldier serum, Man-Thing bubbles up from the goop, snags the Cosmic Cube, and hijinks ensue. 

“While Cap and Lutiga meet with the Matriarch, Medic, Valzin, and Cesa get to know each other.” **The transcript and trigger warnings can be found at the bottom of this episode description** - - Cast and Crew of Today's Episode: Cap was voiced by Jona Lune Cesa was voiced by Lanessa Tremblett Lutiga was voiced by Nicole Tuttle Medic was voiced by Brad Valzin was voiced by Tal Minear Two Backstories for the Price of One was written by Sterling Rae and Jude Reid Sound Editing was by Xander Music was composed and performed by Benny James Novitero is a Goose Thunder Network Produced Podcast - Follow us: Tumblr/Twitter/Instagram: @noviteropodcast Website: http://bit.ly/SRpods Fan Discord: https://discord.gg/VMyk58r - Triggers: -References to cutting off various body parts -References to torture - Transcript: http://bit.ly/NOVIep6

This podcast presents an interesting internal medicine case of a patient who initially presented to themselves to the clinic with a chief complaint of a cough, and the chain of events that occurred with this particular case.  Joining Dr. John Peitersen, (Internal Medicine) in the case discussion today include: Dr. Barrett Larson, (Pulmonary Medicine), Dr. James Currie (Lakeview Clinic-Infectious Disease), Dr. Matthew Herold (Emergency Medicine), Dr. David Gross (Radiology), Dr. Susan Bowers (Pathology), Dr. Kevin White (Hospitalist), along with various other providers and Allied Health staff.  Enjoy the podcast. Objectives: Upon completion of this CME event, program participants should be able to: Perform a differential diagnosis on cases presented. Identify limitations of certain tests. Discuss the interpretation of lab results on the cases presented. CME credit is only offered to Ridgeview Providers for this podcast activity. Complete and submit the online evaluation form, after viewing the activity.  Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within 2 weeks.  You may contact the accredited provider with questions regarding this program at rmccredentialing@ridgeviewmedical.org. Click on the following link for your CME credit:  CME Evaluation: 2019 Internal Medicine Case Conference (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.)  The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition.” FACULTY DISCLOSURE ANNOUNCEMENT  It is our intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented. Planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event.   Show Notes:      This is the case of a 44 year old woman who initially presents for a cough for about a week. She is obese and has OSA. She is on flonase. She had a low grade fever. Exam doesn’t reveal much besides a serous OM and some mild anterior cervical lymphadenopathy. Conservative care was advised, as well as follow-up in the next couple weeks if not improving. Dr. Peiterson now will tell us the chain of events in this peculiar case. Joining Dr. John Peitersen in the discussion today are: Dr. Barrett Larson from Ridgeview pulmonary medicine, Dr. James Currie, Lakeview Clinic infectious disease, Dr. Matthew Herold, Ridgeview emergency medicine, Dr. David Gross, Radiologist with Consulting Radiologists, Ltd, Dr. Susan Bowers, Pathology, Dr. Kevin White, Ridgeview hospitalist, and various others from the provider and allied health audience.      The initial small segment of this discussion had recording difficulty, so our conversation picks up immediately after the initial presentation of the patient.   CHAPTER 1 REVIEW:      So... let’s recap up to this point. So far we have heard input from Dr. Peiterson, Dr. Larson the pulmonologist, Dr. Gross the radiologist and Dr. Bowers the pathologist. So, initially she was seen for what sounds like a viral URI, and was told to f/u if not improving. Well, we all see this kind of case every day, right? She was then treated by phone with Azithromycin; seen by different providers; Reports “crackling in the lungs’, malaise and subjective fever. She has a Son who had strep 9-days ago. Ears look better today. Cryptic tonsils. VSS. Negative strep test. This was felt to be Viral bronchitis.  CXR offered, patient declined due to $.      Five months later, the patient sees a sleep doctor. Continued cough noted. Pulmonary function tests are likely now indicated. Is there mild asthma? PFTs are able to give us a lot of information. Is the FEV1-FVC ratio acceptable.  Yes, it’s above 80 -  in her case. Chance of asthma markedly low. However the diffusion capacity is low at 83. For some reason, she is not absorbing O2. Nothing really going on with her expiratory loop, or any other major issues with this test. Is the patient’s obesity contributing to her poor lung perfusion? Interestingly, her weight has decreased by 15 lbs since her last visit.       Pulmonary physician recommended a CXR, a 4 week post nasal drip protocol. Additionally is a metacholine challenge needed here? Often a pre- and post-neb peak flow will first be done first. Then the metacholine challenge is done if the clinical picture fits. Is it time to rule-in or out asthma and spare someone years of MDI use. Diffusion capacity should be normal in asthma.       Dr. Peitersen reflects on an often asked board question. When to get a chest xray for the complaint of persistent cough. Barring other obvious reasons such as new chest pain, high fever/shaking chills or focal exam findings, The American College of Chest Physicians recommends that if a cough is present for greater than 8 weeks, a CXR is indicated. This patient’s CXR reveals interstitial changes that bring up a broad list of possibilities on the differential. These include CHF, infection, autoimmune disease.      Chest CT non-contrast was now ordered and shows reticulonodular areas and some regions of consolidation that are almost mass like. Other patchy areas noted throughout. No endobronchial findings. Lymphadenopathy is also noted in various areas of the intra- and extra-thoracic regions. CT with contrast is important to see vascular issues, but also to see small hilar lymph nodes. Sometimes contrast can falsely increase the density of a nodule leading you to call it a granuloma. Hi Resolution chest CT is an older term, but current modern CT scans accomplish this . This involves 1 mm cuts vs. 3 mm cuts. Essentially thinner cuts to see nodules better.      The patient is now seeing a new pulmonologist and has normal vital signs, unremarkable lung exam, which is not totally unusual despite a very abnormal looking xray or CT. A PET CT scan is advised and will show hypermetabolic lesions. Essentially it will help find other areas of concerning activity that would be less risky to biopsy. Radiologist generally avoid biopsy of central lesions that are near important organs and structures. Insurance declines the PET CT, but a node was biopsied in the thigh. Dr. Bowers comments that this biopsy could be a low grade lymphoma, although at this point it would need further assessment, but this is a send-out, looking for B and T cell rearrangement. A hematopathologist would also be good to consult with in this case. For now, this is benign specimen.       Another lymph node specimen was obtained, now axillary. This one shows really no other concerning findings. Tiny granulomas are noted. A variety of staining procedures were performed and all were negative. For Dr. Bowers, Toxoplasmosis may need to be considered.   CHAPTER 2:      Toxoplasmosis seems unlikely because this patient is apparently not immunocompromised. The differential dx does include various other infectious etiologies, such as bartonella, brucellosis and Q-fever. Melioidosis as well. Therefore, a travel history such as to SE Asia should be obtained. So, what now? There are about 20 possible infectious etiologies for this presentation...we need to do more tests. But, the patient was lost to follup for some time.       Now it is 16-months later, and she returns to urgent care with cough, fever, increased respiratory rate, O2 sats are marginal and an abnormal lung exam. Mild leukocytosis noted, and anemia which is new. Dr. White interjects with the following questions: 1. Has she ever been treated with a steroid? 2. Did anyone perform laryngoscopy? In the setting of normal chest imaging, these things should be considered. But of course, since her last CT scan was abnormal, a pulmonary etiology is of highest concern. And indeed a repeat CXR shows worsening overall interstitial change along with increase in the density of the azygoesophageal fissure which was noted on previous CT. The UC provider feels this looks like pneumonia. She was treated for pneumonia and a potpourri of other remedies were tried. Unfortunately, she did not follow-up with her medical doctor. She did see her naturopathologist who resumed drops for bartonella and Lyme disease. As Dr. Currie said, though, Lyme Disease does not present with granulomatous lymph lesions.       She now presents to the Emergency department 18 months after the UC visit. She is SOB, coughing, and states she has “chronic lyme disease”. She is 85% on RA. She has SIRS. Leukocytosis, and a respiratory alkalosis is noted. Her CXR shows Left upper lobe infiltrate that is quite dense. This must be followed to ensure resolution. Lactate and influenza were normal. The commentary from Dr. Herold in the audience was that this patient is not quite meeting sepsis criteria, but quite ill all the same. The decision to initiate broad spectrum antibiotics was made. Further history demonstrates that she was diagnosed with Lyme disease at age 10 and has struggled with health issues ever since. The patient had ongoing frustrations about cost of care and so she continued to see her naturopathologist.       Regarding another good exchange between Dr. Gross and Dr. Herold, involved the discussion of using CT to differentiate this very abnormal CXR for infiltrate vs. empyema. Ultrasound can also be employed for thoracentesis if indeed it is empyema.       Dr. Currie also makes the point that "chronic lyme disease" is not a known condition, so that when patients present with this issue or concern, other underlying disease states must be considered.      While CAP is the leading dx, other considerations in the differential still exist. Dr. Curry also states that azithromycin/Ceftriaxone is a reasonable inpatient treatment regimen going forward. She is feeling better on hospital day 2, but her blood cx come back positive in all 4-bottles. Strep pneumonia is the culprit, and is the current, but certainly not chronic reason for her symptoms. TTE was recommended to rule out endocarditis, especially given her chronic issues. Echo showed high right sided pressures, and a CT PE study was done showing no PE. Dr. Gross discusses the CT reading and notes bilateral signifcant hilar and subcarinal lymphadenopathy. Dense alveolar consolidation around the bronchi and layering left sided pleural effusion. Also noted is a large spleen and some prominent retroperitoneal nodes. Hospital day 3 she has left sided chest pain and had an unchanged repeat chest CT.       Dr. Bowers, the pathologist, discussed the blood cell differential and comments that she is anemic and that is the primary issue. All other counts are normal. Mild rouleaux (stacking of cells) is noted on the morphology and prompts you to think about increased proteins, such as monoclonal and fibrinogen. On hospital day 3, the patient was to go home on levaquin. She is supposed to f/u with pulmonary, but then develops another fever and requires O2 once again. Fever after 40-hours of antibiotics is not entirely unexpected in this patient, especially due to her past history and the likelihood of some underlying etiology that has yet to be discovered.   CHAPTER 3:      Okay, so her immunoglobulins are low. What does that mean? Well, this looks like Chronic Variable Immunodefincy disorder. Does she need IVIG? Yes, it is worth a try per the immunologist. Especially since she is having fevers, rigors and need for increased oxygen. Repeat CXR shows some mild improvement in infiltrate, but a bit more of a CHF pattern, perhaps. ID is involved now and they feel that CVID made sense as a diagnosis. Her symptoms improved and no further IVIG is given. In terms of follow-up, the patient has done quite well. No further hospitalizations to date. There were some barriers in her care involving cost and insurance issues. A repeat CT in 2018 was reviewed by Dr. Gross and she still has some reticulonodular infiltrates. No further dense consolidation in the lung. Lymphadenopathy has improved in general. And the spleen is still enlarged. The patient apparently then was referred to another facility and had another node biopsy after she had yet another scan that showed once again some worsenening. IVIG is helpful for these patients and unfortunately is also very expensive. Many of these patients succomb to cancers of various types, as opposed to infection as they once did many years ago.       According to UpToDate, Common variable immunodeficiency is the most common form of severe antibody deficiency in adults and kids. It is somewhat complex, but in general is due to severe antibody deficiency due to impaired B cell differentiation with defective immunoglobulin production. Recurrent infections, chronic lung disease, GI disease and increased susceptibility to lymphoma are common. Besides having very low IgG, IgA and IgM levels, there is also a poor or absent response to vaccinations.      Feel free to comb through the literature on this one, and while it is not ultra common, it is not unreasonable to consider this in your patients who just can’t seem to avoid getting sick on a regular basis, or who happen to have significantly waned immunity to pathogens they were once immunized for.   Thanks to Dr. Peiterson for bringing this baffling diagnosis to our attention, and to everyone else involved in presenting this case.

While Cap and Alex are away, Steve is joined by Anna Bonilla, Matt Daigle (Deadlock NCHC), and John Hayes (former owner of Tremont Music Hall), discussing performing, controversy in music, and awkward celebrity encounters. Music: Looking Back: Deadlock NCHC Alcohol: Deadlock NCHC featuring John Hayes Follow Fithman Radio @FithmanRadioPod @HateEnergyDrink @alexstiff1945 @NewPodWorldOrdr

What’s an episode of Nerdy Show like without its captain? You’re about to find out! While Cap is on shore leave, the rest of the bridge crew venture out into deep pop culture space, and become voyagers in search of nerdy discoveries and beyond. It ain't’ mutiny if there’s no captain aboard! Join boR, Nicky, Brandon, and Doug as they discuss new VR technology, Norway’s secret apocalyptic “seed vault,” Star Trek’s newest sci-fi television series Discovery, Seth MacFarlane’s new sci-fi series The Orville, Netflix’s new fantasy series based on The Witcher, Netflix’s new fantasy series based on The Dark Crystal, and a little more on Guardians of the Galaxy 2. http://nerdyshow.com/2017/05/nerdy-show-289-seed-vault-discovery/Learn more about your ad choices. Visit megaphone.fm/adchoices See acast.com/privacy for privacy and opt-out information.

Put on your safety glasses, 'cause Nerdy Show is soldering up some science and technology! This is a Microsode 2-pack! Microsodes are where fans choose the topics we discuss, and this is two of them mashed together. Cap and our resident sci-tech experts Jessica and Jon team up with hosts from across The Nerdy Show Network to provide expert infotainment. First up, Trench88 wants to know about cybernetics - and it turns out most of us don't really know what the word means. Brandon, along with a special guest appearance by the Fleming Bros. of Wicked Anime, do their damnedest to make pop culture comparisons. We come up with our own definition of "cybernetics" as well as put some tasteful new spins on "cybering". Next, Nerdy Show fan Viral Demon asks: "The Internet: How Does It Work?" We're joined by boR of Derpy Show and Doug, but things are not what they seem. While Cap professes his secrets of the REAL Internet, boR serves as a very un-derpy font of knowledge; dropping some raw truths and squeezing fresh Internet juice. All that plus visions of the virtual net to come, quantum computing, and the joys of holographic chat roulette. For links and more info, head to the main episode page: http://nerdyshow.com/2015/05/nerdy-show-221-journey-into-the-cyber-netLearn more about your ad choices. Visit megaphone.fm/adchoices See acast.com/privacy for privacy and opt-out information.

In the premier episode of THE MAD CAP HOUR on Toadhop, Cap and crew talk virginity. When did you lose yours? And what is the best age to do so? While Cap learns that women have more holes than he realized. "The Weekly Dumbass Report" includes lots of laughs about swimming with sharks and black market tampons.