Episode 545: In high-risk older patients with atrial fibrillation, rhythm control reduces cardiovascular death and stroke, but at a price
Play • 9 min
Dr. Ebell and Dr. Wilkes discuss the POEM titled ' In high-risk older patients with atrial fibrillation, rhythm control reduces cardiovascular death and stroke, but at a price '
Stimulus.
Stimulus.
Rob Orman, MD
41. Cognitive Reframing
We have a choice in how we perceive and act on any situation. Using that knowledge in an intentional way to shift perspective is at the core of cognitive reframing. Epictetus, the great Stoic philosopher, said it best, "It is our attitude toward events, not events themselves, which we can control." Listen on: * iTunes * Spotify * Stitcher Guest Bio: Jaime Hope, MD is an attending emergency physician at Beaumont hospital in Detroit, Michigan. She is the author of Habit That!: How You Can Health Up in Just 5 Minutes a Day, leads the Better Health Habits online course, and teaches the Behavior Change and Motivational Interviewing Courses to future physicians at Oakland University William Beaumont School of Medicine. Essentials of Emergency Medicine, the conference I host each year, is happening May 25-27, 2021. Early bird discount ends April 3. For an additional $100 off registration, use the code 'orman' at the bottom of the checkout page. We discuss: * Reframing, a psychological technique which involves thinking about something from a different perspective [04:30]; * How reframing can be used in the ED when you’re engaging with a patient or a patient’s family member who is hostile and upset [07:50]; * Discussing comfort measures with the family of a dying patient [12:12]; * 'Status dramaticus' -- the loud, demonstrative patient who catastrophizes their (often relatively minor) symptoms, triggering irritation for many providers [14:30]; * Reframing when treating patients who suffer from addiction [16:30]; * Ways to reframe yourself and your job to offset burnout [20:00]; * Advice to first year medical students [25:40]; * And more. For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/ If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob: Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx
27 min
Cardionerds: A Cardiology Podcast
Cardionerds: A Cardiology Podcast
CardioNerds
103. Case Report: A Rare Cause of Postpartum Angina and Arrest – University of Maryland
CardioNerds (Amit Goyal & Daniel Ambinder) join University of Maryland cardiology fellows (Manu Mysore, Adam Zviman, and Scott Butler) for some cardiology and an Orioles game in Baltimore! They discuss a rare cause of postpartum angina and cardiac arrest due to coronary vasculitis. Program director Dr. Mukta Srivastava provides the E-CPR expert segment and a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Rick Ferraro with mentorship from University of Maryland cardiology fellow Karan Desai. This case has been published in JACC Case Reports! Collect free CME/MOC credit just for enjoying this episode! Jump to: Patient summary - Case media - Case teaching - References Episode graphic by Dr. Carine Hamo Support our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza 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! Patient Summary A woman in her early 30s with a past medical history of Hashimoto's thyroiditis and one prior miscarriage at <8 weeks presented with chest pain about 6 weeks postpartum from the birth of her third child. In the ED, she continued to report intermittent sharp chest discomfort and found to have a diastolic decrescendo murmur at the left upper sternal border and labs demonstrating a troponin-I of 0.07 ng/dL. Join the UMD Cardionerds for the incredible course and story of this young patient as we go through the differentia and approach to postpartum chest pain and ultimately arrive in a very rare diagnosis!   For a detailed course, enjoy the JACC case report. Case Media Visit the JACC Case Reports to review the case media! Episode Schematics & Teaching The CardioNerds 5! – 5 major takeaways from the #CNCR case 1. How Do We Evaluate Chest Pain in Younger Patients  Start with the same things as everyone else!  Think broadly about the big three concerning etiologies of chest pain: Cardiac, Gastric, and Pulmonary (The excellent Clinical Problems Solvers 4+2+2 construct here is always a great resource. Find them at: https://clinicalproblemsolving.com/dx-schema-chest-pain/).   Of course it is important to think about non-life threatening etiologies as well – esophageal spasm, gastric ulcer, rib fracture, skin lesion, among many others - given that high-risk chest pain is less likely in younger adults.  While less common, acute coronary syndrome is not uncommon in young patients, as 23% of patients with MI present at age <55 years.   2. What About Chest Pain in Women?   As has been discussed on the Cardionerds podcast (Listen to episodes with Dr. Nanette Wenger, Dr Martha Gulati, and Dr. Leslie Cho), women generally present with acute coronary syndrome at a later age, with a higher burden of risk factors than men, and with greater symptom burden but are less likely to be treated with guideline-directed medical therapies, undergo cardiac catheterization and receive timely reperfusion. In one study of young patients with acute MI, women – 19% of cases overall – were less likely to undergo revascularization or receive guideline-directed therapy The construct of classifying chest pain as "typical" and "atypical" likely leads to misdiagnosis or delayed diagnosis of acute myocardial infarction in women. Rather, it is important to recognize that while symptoms may not be "typical" for angina, coronary disease can manifest in many different ways.  While many women will presents with chest pain suggestive of angina, women are more likely than men to present with dyspnea, indigestion, weakness, nausea/vomiting and/or fatigue. Note, shoulder pain and arm pain are twice as predictive of an acute myocardial infarction diagnosis in women compared with men.  Furthermore,
52 min
Ortho Eval Pal: Optimizing Orthopedic Evaluations and Management Skills
Ortho Eval Pal: Optimizing Orthopedic Evaluations and Management Skills
Paul Marquis P.T. Helping you feel confident with your orthopedic evaluation and management skills
175: Knee Arthritis- The Most Common Signs and Symptoms
Today, I talk about the signs and symptoms of knee arthritis so as to be able to streamline your knee evaluations better.  I will talk about the following: ▶Common visual signs of knee OA ▶The most common area of pain ▶Secondary effects of knee OA ▶Baker's Cyst ▶Weight bearing vs non-weight bearing pain ▶Rosenberg x-rays ▶Arthritic knee posture ▶Motion loss and so much more!! *Knee Arthritis Evaluation VIDEO* *Come visit our* *WEBSITE!!* Click *HERE* to check it out *Get our NEW downloadable 1.5 hour shoulder anatomy with cadaver dissection lecture** **Get our NEW downloadable 7.5 hour cervical and lumbar continuing ed course* *Get our NEW downloadable 6.0 hour shoulder continuing ed course* Be sure to "follow" us on our new *Facebook Page* I finally made it to *Instagram*. Stop by and check us out *Are you looking for **One on one Coaching? *We have it! Ask me your ortho evaluation questions and I will answer them on the show: *paul@orthoevalpal.com** *Be sure to check out our 380+ videos on our YouTube Channel called *Ortho Eval Pal with Paul Marquis *Follow our Podcast show on *Apple Podcasts*, *Spotify* and most all other podcasting platforms. Just search: Ortho Eval Pal Podcast and Enjoy! Interested in our Sponsor Products? Click *EZ Glider Socks** *or *EZ Slant** *Want to start your own podcast? I use *Buzzsprout*. Sooo easy to use and the customer service is outstanding!! #Arthritis #KneePain #OrthoEvalPal #Knees #KneeArthritis  #TreatKneePain Support the show (https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=6GY24EJMBHTMU&source=url)
14 min
Freely Filtered, a NephJC Podcast
Freely Filtered, a NephJC Podcast
NephJC Team
Freely Filtered 029: Belimumab for lupus nephritis
The Filtrate: Matt Sparks Jennie Lin Samira Farouk Joel Topf Swapnil Hiremath And two special guests: Dawn J. Caster, Assistant Professor at University of Louisville Alfred Kim, Assistant Professor of Medicine at Washington University (Twitter) Show Notes: NephJC coverage of the trial: The Bliss trial In the NEJM: https://www.nejm.org/doi/full/10.1056/NEJMoa2001180 Turtles all the way down: https://en.wikipedia.org/wiki/Turtles_all_the_way_down Nature previews Nephrology on BAFF: https://www.nature.com/articles/nri844 Phase III trial results with blisibimod, a selective inhibitor of B-cell activating factor, in subjects with systemic lupus erythematosus (SLE): results from a randomised, double-blind, placebo-controlled trial: https://pubmed.ncbi.nlm.nih.gov/29563108/ BRIGHT-SC: Blisibimod Response in IgA Nephropathy Following At-Home Treatment by Subcutaneous Administration: https://clinicaltrials.gov/ct2/show/NCT02062684 Guideline for naming monoclonal drugs: https://www.antibodysociety.org/wordpress/wp-content/uploads/2017/07/INN-2017-Reference-20.pdf A long-term study of hydroxychloroquine withdrawal on exacerbations in systemic lupus erythematosus. The Canadian Hydroxychloroquine Study Group: https://pubmed.ncbi.nlm.nih.gov/9541091/ Long-term follow-up of the MAINTAIN Nephritis Trial, comparing azathioprine and mycophenolate mofetil as maintenance therapy of lupus nephritis https://pubmed.ncbi.nlm.nih.gov/25757867/ A Day In The Life Of Dr. Anthony Fauci: https://www.huffpost.com/entry/anthony-fauci-fighting-covid-19_n_5fc7fed7c5b61bea2b14e3ee MC Arbatin MD FPCP FPSN @mcamd: the glomerulus tree: https://twitter.com/mcamd/status/1337744822543605760 finished product: https://twitter.com/mcamd/status/1338429211963322371
1 hr 9 min
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