Episode 24-Shoulder Instability with Special Guest Dr. Stephen Thompson
29 min

This is a must listen to episode!  If you are a PT, OT, PA, NP, Family Physician and/or Athletic Trainer! I chat with Orthopedic and Sports Specialist Dr. Stephen Thompson about Shoulder instability. We talk about special tests, “Red Flags”, when to refer to ortho and when and how to manage conservatively. Also get a…

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The Resus Room
The Resus Room
Simon Laing, Rob Fenwick & James Yates
Anaphylaxis; Roadside to Resus
Welcome back to the podcast! In this episode of Roadside to Resus we're going to take a look Anaphylaxis, which has been highlighted on a national level of concern as NICE state ‘many people do not receive optimal management following their acute anaphylactic reaction’. Much of the problem lies within a lack of understanding of what actually constitutes an anaphylactic reaction and the knock on effect this has to the treatment provided. In this episode we'll explore the definition of anaphylaxis and the significant differences that can be seen in the presentation. We have a a think about the pathophysiology and reasons behind the variance in presentations and how this affects the importance of treatments available and their relative importance. Anaphylaxis is known to have a a number of patients who have a biphasic reaction, it predicates the need to convey patients to hospital and a period of observation; however the frequency and severity of these biphasic reactions can help to inform this further and for that reason we take a look at the literature on it. We've covered angioedema before in a separate episode, but we briefly cover the similarities and differences and how this affects management. Lastly we cover the follow up and management that these patients require. We'd love to hear any comments or feedback you have and make sure to take a look at the references and resources below. Enjoy! Simon, Rob & James
1 hr
Stimulus.
Stimulus.
Rob Orman, MD
30. COVID-19: Why a negative test doesn't clear you to see Grandma, Vax updates
We review the false negative rates of different COVID tests (PCR and rapid antigen), the known knowns and known unknowns of the Moderna vaccine. Listen on: * iTunes * Spotify * Stitcher We discuss: * Why the lack of a legitimate gold standard is a challenge when comparing different tests for COVID-19 [01:45]; * RT-PCR: why we shouldn't be reassured by a negative test result [03:45]; * How your pretest probability of disease affects your interpretation of test results [07:00]; * The COVID antigen test: faster and more widely available, but less accurate [08:10]; * A NYT report of a rapid antigen test study showing suboptimal test sensitivity when applied to asymptomatic people [10:15]; * Why you can’t rely on a negative test to make your decision to travel or spend time with family/friends for the holidays [12:05]; * Whether you need to quarantine if you’ve been in close contact with someone who themselves was exposed to a known COVID patient [13:30]; * The Moderna vaccine which has a reported efficacy of 94.5% [14:00]; * 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
18 min
Emergency Medical Minute
Emergency Medical Minute
Emergency Medical Minute
Pharmacy Phriday #4: mRNA Vaccines
Contributor: Rachael Duncan, PharmD Educational Pearls: * ED visits nationwide declined by 42% in April 2020 compared to the same time in 2019 largely due to the fear of the COVID-19 pandemic. The biggest decline was seen in pediatrics less than 14, women and emerging COVID hotspots like the Northeast. * In recent weeks, this trend has reversed, showing a record-breaking number of COVID cases, hospitalizations, and deaths. As hospitals reach capacity, critically ill COVID patients are being held in the ED until an inpatient bed becomes available. * A new mRNA vaccine has promising preliminary trial results to help end the COVID-19 pandemic. * While traditional vaccines contain purified proteins or weakened viruses, the mRNA vaccine is genetic material that is coded within the human body to make the viral protein. * The mRNA vaccine codes for the critical fragment of the viral protein without causing disease and leads to the production of powerful antibodies. * Although synthetic mRNA is genetic material, it cannot be passed on to further generations. * mRNA vaccines are much faster to develop and could potentially provide a more efficient process for developing future vaccines * Cold temperatures are currently needed to maintain the stability of the mRNA which has posed a challenge to the viability of the vaccines. However, developments are underway to overcome this hurdle. References: A Trial Investigating the Safety and Effects of Four BNT162 Vaccines Against COVID-2019 in Healthy Adults - Full Text View - ClinicalTrials.gov. Clinicaltrials.gov. https://clinicaltrials.gov/ct2/show/NCT04380701. Published 2020. Accessed November 25, 2020. Karikó K, Buckstein M, Ni H, Weissman D. Suppression of RNA recognition by Toll-like receptors: the impact of nucleoside modification and the evolutionary origin of RNA. Immunity. 2005;23(2):165-175. doi:10.1016/j.immuni.2005.06.008 Safety and Immunogenicity Study of 2019-nCoV Vaccine (mRNA-1273) for Prophylaxis of SARS-CoV-2 Infection (COVID-19) - Full Text View - ClinicalTrials.gov. Clinicaltrials.gov. https://clinicaltrials.gov/ct2/show/NCT04283461. Published 2020. Accessed November 25, 2020. Schlake T, Thess A, Fotin-Mleczek M, Kallen KJ. Developing mRNA-vaccine technologies. RNA Biol. 2012;9(11):1319-1330. doi:10.4161/rna.22269 Wolff JA, Malone RW, Williams P, et al. Direct gene transfer into mouse muscle in vivo. Science. 1990;247(4949 Pt 1):1465-1468. doi:10.1126/science.1690918 Summarized by Emily Mack OMSIII | Edited by Mason Tuttle
17 min
BrainWaves: A Neurology Podcast
BrainWaves: A Neurology Podcast
Jim Siegler, MD | Neurologist | Father | Friend of dogs
#174 The mental status
The mental status exam is a keystone of the neurologic assessment. Dr. Andrea Casher (Cooper University Hospital) builds upon this metaphor in our program this week. Making a special appearance is US President Donald Trump, who underwent a mental status exam and recounts his experience. Produced by James E. Siegler and Andrea Casher. Music courtesy of Unheard Music Concepts, Purple Planet Music, Lee Rosevere, and Scott Holmes. 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 * Tombaugh TN and McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc. 1992;40:922-35. * Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL and Chertkow H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695-9. * Dong Y, Sharma VK, Chan BP, Venketasubramanian N, Teoh HL, Seet RC, Tanicala S, Chan YH and Chen C. The Montreal Cognitive Assessment (MoCA) is superior to the Mini-Mental State Examination (MMSE) for the detection of vascular cognitive impairment after acute stroke. Journal of the neurological sciences. 2010;299:15-8. * Gorno-Tempini ML, Hillis AE, Weintraub S, Kertesz A, Mendez M, Cappa SF, Ogar JM, Rohrer JD, Black S, Boeve BF, Manes F, Dronkers NF, Vandenberghe R, Rascovsky K, Patterson K, Miller BL, Knopman DS, Hodges JR, Mesulam MM and Grossman M. Classification of primary progressive aphasia and its variants. Neurology. 2011;76:1006-14. * Ng KP, Chiew HJ, Lim L, Rosa-Neto P, Kandiah N and Gauthier S. The influence of language and culture on cognitive assessment tools in the diagnosis of early cognitive impairment and dementia. Expert review of neurotherapeutics. 2018;18:859-869. * Rabinovitz B, Jaywant A and Fridman CB. Neuropsychological functioning in severe acute respiratory disorders caused by the coronavirus: implications for the current COVID-19 pandemic. Clin Neuropsychol. 2020:1-27.
30 min
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