Shows
The Danbury Medical FilesPOCUS in the outpatient clinic, my first impressions.In this ad-lib podcast, I explore my first impression of my experience in teaching and using POCUS in the outpatient world.I will try to tell you how this happened, how I feel the program is going, and whether I believe it is useful. Also, some of my experiences, feats, challenges, and hopes.Hope you like the episode. Soon, I will have an email for you to give me feedback. Right now, I do not follow Twitter or X; I do not follow Facebook or Instagram. I am trying to l...2025-05-1321 minThe Danbury Medical FilesThe data breach of the century. How and why your health information is not secure anymore.In our medical career, one of the things that we are thought since we start is importance of privacy in to keep the patience, privacy safe. We even have laws that penalize anyone who shares private information from patients.This is not true when large companies are irresponsible with the way that they treat our medical information.It is also important to have awareness of this problem and many other problems that the healthcare oligopoly is creating to patients, pharmacies and physicians, as well as the taxpayers.In this podcast we explore the data...2024-05-2029 minThe Danbury Medical FilesHospital MergersIn this episode I am discussing the effects of hospital and healthcare systems mergers. I have tried to place a vast amount of information in a few minutes. I hope this will be of your interest and will be good information. Lastly, a call for action from all the physician community. We need to participate more, sadly participating more can be risky, however, in the current times not participating will be more detrimental for our profession. Here some links:https://www.kff.org/health-costs/issue-brief/ten-things-to-know-about-consolidation-in-health-care-provider-markets/https://www.aha.org/aha-search?search_api_fullt...2024-05-0136 minThe Danbury Medical FilesThree cases in outpatient POCUSIn this episode of the Danbury Medial Files, I talk about three patients where POCUS was used successfully in the outpatient clinic. I also talk about lidocaine side effects, anxiety as a common side effect of procedures. A second case of abdominal pain and a two minutes diagnosis with POCUS. A third case in avoiding a readmission. Hopefully you find this interesting and entertaining. Hit us on X if you want to hear about other topics. Follow the channel in youtube #IMPOCUShttps://www.youtube.com/channel/UCpzYai7ngGjZ00NOnU...2024-04-1925 minThe Danbury Medical FilesThoughts about the volume status assessmentErratum: I called VExUS volume excess ultrasound, and is venous excess ultrasound. Also I said the flow of the portal vein should be 20 to 30 mmHg, however is 20 to 30 cm/sec. Happy new year! This is the first episode of the Danbury Medical Files in the 2024. I talked about volume status, volume status is complex and deserves at least a book chapter, however, I tried to summarize the most important parts and make the case to use point of care ultrasound and learn more about the different option that POCUS has for us. Hope you have a...2024-01-0832 minThe Danbury Medical FilesLung Congestion and POCUSI stopped podcasting early this year because of personal problems. I will try to keep up the next year, however, I wanted to do a final episode in 2023. Thank you to my residents for always bringing to my attention topics that could be of benefit. How do we know if POCUS B lines are pulmonary edema?What are the forces that are responsible for pulmonary edema?What are the factors that protect the lungs from pulmonary edema?Why we should do POCUS in patients with CHF?What are stress B lines?Hope th...2023-12-1325 minThe Danbury Medical FilesIs it safe to perform and teach lung ultrasound?Hey everyone. This is a follow-up chapter from the prior one, exploring how safe it is to auscultate a patient. Also, how useful.This time I try to make the case that it is safe and also useful. Follow me in this POCUS journey in the second season of the Danbury Medical Files. Below I leave some interesting articles if you feel like checking. Picano E, Scali MC, Ciampi Q, Lichtenstein D. Lung Ultrasound for the Cardiologist. JACC Cardiovasc Imaging. 2018 Nov;11(11):1692-1705. doi: 10.1016/j.jcmg.2018.06.023. PMID: 30409330.Mumoli N, Vitale J, Giorgi-Pierfranceschi M, Cresc...2023-02-2224 minThe Danbury Medical FilesBlack History Month Special. An Interview with Dr. Brenda Ayers MD and her fascinating work towards equity.Inequality in healthcare is a recognized problem. I had the privilege of interviewing Brenda Ayers, MD. The head of a task force to decrease and eliminate inequality in NUVANCE-HEALTH. I met Dr. Ayers as the Chief Hospitalist at Vassar Brothers Hospital in Poughkeepsie, New York. Her work in the Nuvance Health Network (Danbury Hospital, which is my employer, is part of this network) is already changing structures and effectively trying to deal with racial disparity. I interviewed her at Vassar in the Hospitalist's office, so some noises were not completely filtered. However, the interview was well worth...2023-02-1531 minThe Danbury Medical FilesIs auscultation safe?This time I am exploring what is written about the efficacy of lung auscultation. I found this interesting meta-analysis and saw the difficulties that the authors went thru to find literature about lung auscultation. Is it safe? We have auscultation for so long right now, however is it really giving results?The article used is below: Arts, L., Lim, E.H.T., van de Ven, P.M. et al. The diagnostic accuracy of lung auscultation in adult patients with acute pulmonary pathologies: a meta-analysis. Sci Rep 10, 7347 (2020). https://doi.org/10.1038/s41598-020-64405-62023-02-0826 minThe Danbury Medical FilesPOCUS and Portal hypertension.This is a follow-up from my prior episode; as I finished uploading and had a second look at that episode, I figured out that I was discussing the case of the patients like I was doing a small teaching, and everyone could see what I was saying. Today I will try to describe the findings of portal hypertension that are feasible to evaluate with POCUS in the medical ward, the outpatient clinic and the critical care setting. Hopefuly this is an interesting episode. Follow us up in Twitter @danburymedfiles. Follow us in almost all podcast apps ther...2023-01-3121 minThe Danbury Medical FilesPOCUS in the daily life of a Hospitalist: Two patients with liver disease.Welcome 2023! After a vacation I want to share this new Podcast with you. In todays episode I describe the decision making and the importance of POCUS in a couple of patients with liver disease. Is my conviction that POCUS needs to become the rule rather than the exception in our daily lives as internists and hospitalists. Let's get to the PODCAST number one. Please leave a review in any of the apps you use to hear the Danbury Medical FilesThank you for listening; follow us on X (Twitter) @danburymedfiles. Leave a review in yo...2023-01-2417 min
El Garaje Hermético de Máximo SantNSU Ro80: Un coche adelantado a su tiempoHay coches con un encanto especial. Otros con una tecnología adelantada a su tiempo. También los hay que marcaron un camino... y por último, modelos que, pese a ser poco conocidos, fueron claves en la historia. ¿A qué grupo pertenece este NSU Ro80? ¡A todos! Un coche verdaderamente excepcional…
Conocí este coche en una colección de cromos… ¡y me enamoré de él! Me llamó la atención su estética. Pero me intereso más cuando comencé a investigar sobre su motor, su bastidor y más tarde, sobre la compra de la marca NSU por parte de VW y lo que supuso...2023-01-1516 minThe Danbury Medical FilesCelebrating Women in Medicine, Interview with the Chief Residents.In today´s episode, I have the three Chief Residents from Danbury Hospital, a program of Internal Medicine. I have Dr. Azadeh, Gassemi, Dr. Uneza Khawaja and Dr. Wendy Perdomo. We explore the topic of women in medicine and have a very good discussion about the topic, about them, their goals, and how they view the future for women in Medicine. Women are shaping medicine and they have been shaping medicine from the beginning of history. I am very happy to share this interview with you. Follow the Danbury Medical Files in your favorite podcast app. ...2022-11-0333 minThe Danbury Medical FilesPleural effusion, the black bag of the physician, the case for POCUSThank you for listening to the Danbury Medical Files!During this episode, we dive into the history of the diagnosis of pleural effusion since the term "succussion" to POCUS. We talk briefly about the invention of percussion and how physical examination and imaging fare in diagnosing pleural effusion. We talk about POCUS and pleural effusion. Finally, we talk about the black box or bag of the physicians. The black bag used to be the signature of the physicians carrying all the paraphernalia that was needed for a physical examination and treatment. This black bag has disappeared, but, Is it...2022-10-0526 minThe Danbury Medical FilesEveryday tips.Today we don´t go to the room of the patient to greet the patients and figure out what brought them to the ED. As hospitalists, we are probably the third or fourth person they interact with. Check first the EMR. Assure the patient of all the work that is being performed behind the scenes. Do not anchor or close the box. Still, try to get as much detail as you can. When presenting, it is important to know the past medical history and what brought the patient in. Hope this episode gives your a few pearls...2022-09-2824 minThe Danbury Medical FilesWelcome to Internal Medicine ResidencyWelcome to residency, in this very short chapter, I want to welcome all of you to first year in Internal Medicine. To all the brand new second and third year, welcome again. Thank you for listening; follow us on X (Twitter) @danburymedfiles. Leave a review in your favorite app for podcasting. You can suggest topics you would like to hear about. Also I have a new youtube channel #IMPOCUShttps://www.youtube.com/channel/UCpzYai7ngGjZ00NOnUozc_w2022-07-0112 minThe Danbury Medical FilesAre gun deaths a matter of public health? Shall we have an opinion?Mass shootings are sadly way too common in America. So far, there are more mass shootings than days during this year. More than 18000 people have died from a gun-inflicted injury in 2022 alone. We have more guns than people in the country. In 2018 the NRA "advised" the physicians to stay in their lane and not have an opinion or research about gun deaths. Since 1996 there has been a "moratorium" from the Federal Government to fund any gun-related dead study. This is Christian España Schmidt MD, FACP. An welcome to the podcast, the Danbury Medical Files. ...2022-06-0925 minThe Danbury Medical FilesPulsus and pulsus paradoxusHello, this is Christian Espana Schmidt MD, POCUS associate director in Danbury Hospital. Today we explore a little bit of history of medicine, the pulsus paradoxus in cardiac tamponade with my special guest Dr. Ferdinand Visco FACC, Dr. Visco was born in Brooklyn NY, studied medicine in Padua Italy and became a cardiologist in Nasau County Hospital, he then became faculty in Bronx Lebanon Cardiology Fellowship and later on Program director of Saint Vincent´s Cardiology Fellowship, today he is the Director Emeritus of the Section of Cardiology in Metropolitan Hospital. We talk also about his book "Growing up Ital...2022-06-0923 min