Ep 149 Liver Emergencies: Thrombosis and Bleeding, Portal Vein Thrombosis, SBP, Paracentesis Tips and Tricks
Play • 57 min

In this part 2 of our 2 part series on Liver Emergencies we clear up the confusing balance between thrombosis and bleeding in liver patients, the elusive diagnosis of portal vein thrombosis, spontaneous bacterial peritonitis diagnosis and treatment and some tips and tricks on paracentesis with Walter Himmel and Brian Steinhart....

The post Ep 149 Liver Emergencies: Thrombosis and Bleeding, Portal Vein Thrombosis, SBP, Paracentesis Tips and Tricks appeared first on Emergency Medicine Cases.

Bedside Rounds
Bedside Rounds
Adam Rodman, MD, MPH, FACP
60 - Santa's Salmonella
For a special holiday treat, we’re going to explore two tales of salmonella disease detectives -- the first about Mary Mallon (“Typhoid Mary”) and the birth of the genre; and the second about a mysterious salmonella outbreak at Massachusetts General Hospital solved with the assistance of a very jolly patient. Along the way, we’ll talk about clinical epidemiology, the long-lasting influence of Berton Roueché, and the joys of being an internist! You can sign up for the Digital Education conference at cmeregistration.hms.harvard.edu/digitaleducation. Sources: * Buckle GC, Fischer Walker CL, and Black RE, Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010.J Glob Health. 2012 Jun; 2(1): 010401. * Marineli F et al, Mary Mallon (1869-1938) and the history of typhoid fever.Ann Gastroenterol. 2013; 26(2): 132–134. * Soper GA, The Curious Career of Typhoid Mary, read on May 10, 1939 before the Section of Historical and Cultural Medicine. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1911442/pdf/bullnyacadmed00595-0063.pdf * Norrington B, Cochineal: A Little Insect Goes a Long Way, UCSB Geography. * Roueche B, The Santa Claus Culture, The New Yorker, Aug 27, 1971. * Lang DJ et al, Carmine as a Source of Nosocomial Salmonellosis, NEJM. Apr 13, 1967. * You can buy Medical Detectives here: https://www.amazon.com/Medical-Detectives-Collection-Award-Winning-Investigative/dp/0452265886
38 min
Medgeeks Clinical Review Podcast
Medgeeks Clinical Review Podcast
Medgeeks
Psilocybin assisted therapy, mental health, and how we doubled the size of our company
It’s been a very long time since I have jumped on the Medgeeks podcast. But, every year I share and reflect everything I have learned with the community...and this year is no different! This episode is heavily focused on mental health and the pandemic. Much of what I discuss today is based off my personal experience, which is what shaped the growth of our company. Today, I’ll be discussing: * The Pandemic * My experience with psilocybin * Why I started therapy and how it’s helped shape Medgeeks * How our company doubled in size and brought on many full time employees in a time when many businesses were laying people off. * The #1 mistake PAs and NPs make after graduation * The secret to being the absolute best clinician you can be * 4 main takeaways I learned in 2020 that changed my life It’s my hopes that I can do my small part to help squash the stigma behind mental health. After all, my fiance is a marriage and family therapist :). At the end of the episode, I ask to see if anyone is interested in discussing business and/or personal growth. If that’s you, just click the link below to sign up. If there’s enough interest, I'll hold a free virtual session, where we can work together to help you get ahead. I have nothing to sell. This is just my way of giving back: https://medgeeks.co/business-talk Talk soon! - Andrew p.s. The future podcast episodes will not be like this. We’ll continue to focus on evidence based medicine to help you master medicine. But, it’s my podcast and I wanted to share haha. Happy New Year!
38 min
Cardionerds: A Cardiology Podcast
Cardionerds: A Cardiology Podcast
CardioNerds
97. Hypertension part 2 with Dr. Luke Laffin
CardioNerds (Amit Goyal and Daniel Ambinder) are joined by Cleveland Clinic cardiology fellow Dr. Gregory Ogunnowo to discuss hypertension with Dr. Luke Laffin, cardiology faculty in the division of Preventive Cardiology and Rehabilitation and Medical Director of Cardiac Rehabilitation at the Cleveland Clinic. Part 2 of this discussion covers the evaluation for secondary causes of HTN, approach to resistant HTN, interventional anti-hypertensive procedures, and a note on cardiac rehabilitation. Part 1 covered the definition of hypertension, correct measurement of blood pressure, nonpharmacologic HTN management, initial choice of BP agents, and hypertensive disorders of pregnancy. Episode graphic by Dr. Carine Hamo CardioNerds Cardiovascular Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll Subscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Show notes Coming soon! Cardionerds Cardiovascular Prevention Series The Cardionerds CV prevention series  includes in-depth deep dives on so many prevention topics including the ABCs of prevention, approach to obesity, hypertension, diabetes mellitus and anti-diabetes agents, personalized risk and genetic risk assessments, hyperlipidemia, women’s cardiovascular prevention, coronary calcium scoring and so much more! We are truly honored to be producing the Cardionerds CVD Prevention Series in collaboration with the American Society for Preventive Cardiology! The ASPC is an incredible resource for learning, networking, and promoting the ideals of cardiovascular prevention! This series is kicked off by a message from Dr. Amit Khera, President of the American Society for Preventive Cardiology and President of the SouthWest Affiliate of the American Heart Association. Guest Profiles Dr. Luke Laffin, serves as cardiology faculty in the division of Preventive Cardiology and Medical Director of Cardiac Rehabilitation at the Cleveland Clinic. Dr. Laffin attended medical school at Vanderbilt University School of Medicine. He trained in internal medicine and cardiology at the University of Chicago where he completed a dedicated fellowship in hypertensive diseases. He is a clinical specialist in hypertension designated by the American Society of Hypertension – which has now merged with the AHA. Dr. Gregory Ogunnowo is a cardiology fellow at the Cleveland Clinic. He completed medical school at the University of South Carolina School of Medicine in Columbia, South Carolina. He went on to complete internal medicine residency at Washington University School of Medicine in St. Louis where he stayed on as faculty in the Department of Hospital Medicine for a year prior to pursing fellowship. His interests include outcomes research in interventional cardiology and medical education In his spare time, Greg enjoys traveling, exercising, and experiencing new cultures through their food. When he’s not in the hospital, you can find Greg planning a trip with close friends and family. References and Links Coming soon! Luke Laffin MDGreg Ogunnowo, MDAmit Goyal, MDDaniel Ambinder, MD
32 min
BrainWaves: A Neurology Podcast
BrainWaves: A Neurology Podcast
Jim Siegler, MD | Neurologist | Father | Friend of dogs
#33 Controversies in chronic traumatic encephalopathy
Almost 5 years ago, we published a show on chronic traumatic encephalopathy and its relationship to American football. But a lot has happened since 2016. New rules in the NFL. Emerging data on how the developing human brain of a child or adolescent is even more vulnerable to pathologic changes following mild head injury. And a heightened awareness of the disingenuous campaign against contact sports among one of the most outspoken whistleblowers in the medical field. This week on the program, we have remastered and updated the 2016 program. With some additional commentary on how parenthood may yield a new perspective on contact sports. Produced by James E. Siegler. Music courtesy of Chris Haugen, Kevin McLeod, and Meydan. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES * Montenigro PH, Corp DT, Stein TD, Cantu RC and Stern RA. Chronic traumatic encephalopathy: historical origins and current perspective. Annu Rev Clin Psychol. 2015;11:309-30. * Giza CC, Kutcher JS, Ashwal S, Barth J, Getchius TS, Gioia GA, Gronseth GS, Guskiewicz K, Mandel S, Manley G, McKeag DB, Thurman DJ and Zafonte R. Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013;80:2250-7. * Guskiewicz KM, Marshall SW, Bailes J, McCrea M, Cantu RC, Randolph C and Jordan BD. Association between recurrent concussion and late-life cognitive impairment in retired professional football players. Neurosurgery. 2005;57:719-26; discussion 719-26. * Stamm JM, Bourlas AP, Baugh CM, Fritts NG, Daneshvar DH, Martin BM, McClean MD, Tripodis Y and Stern RA. Age of first exposure to football and later-life cognitive impairment in former NFL players. Neurology. 2015;84:1114-20. * Ling H, Morris HR, Neal JW, Lees AJ, Hardy J, Holton JL, Revesz T and Williams DD. Mixed pathologies including chronic traumatic encephalopathy account for dementia in retired association football (soccer) players. Acta Neuropathol. 2017;133:337-352. * Alosco ML, Mez J, Tripodis Y, Kiernan PT, Abdolmohammadi B, Murphy L, Kowall NW, Stein TD, Huber BR, Goldstein LE, Cantu RC, Katz DI, Chaisson CE, Martin B, Solomon TM, McClean MD, Daneshvar DH, Nowinski CJ, Stern RA and McKee AC. Age of first exposure to tackle football and chronic traumatic encephalopathy. Annals of neurology. 2018;83:886-901. * Hobson W. "From Scientist to Salesman". Available online at https://www.washingtonpost.com/graphics/2020/sports/cte-bennet-omalu/. Accessed 31 December 2020.
19 min
Primary Care Knowledge Boost
Primary Care Knowledge Boost
Primary Care Knowledge Boost
Remote Consultations
Lisa and Sara talk to Dr Adam Abbs about remote consulting. Dr Abbs is a GP who has written a handbook about remote consulting which has been accredited by the RCGP. Remote consulting has been in our lives for quite some time now, and this doesn’t look likely to change anytime soon so we thought it was worth getting some more hints and tips to make us all the best remote consulters that we can be. We talk about common pitfalls, how to do some examinations remotely and a couple of special situations such as care homes and patients with visual or hearing impairments. **This is an amended episode from the one originally uploaded this morning as we realised that an older edit had been uploaded in error. * Primary Care Pathways Website, Remote Consulting: https://primarycarepathways.co.uk/covid-19/clinical-assessment/resources-to-support-remote-working-for-doctors * EGP Learning: https://egplearning.co.uk/ * Remote Consultations Handbook: https://www.archealth.io/handbook * GMC Remote Consultations: https://www.gmc-uk.org/ethical-guidance/ethical-hub/remote-consultations * Healthier Together Website: https://what0-18.nhs.uk/professionals/gp-primary-care-staff/clinical-pathways-remote-assessment ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT ___ This podcast has been made with the support of Greater Manchester Health and Social Care Partnership, GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.
29 min
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