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Episode 19 Allergic Rhinitis

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Intro: Rock Christmas/ Christmas Music by tramp963

Outro: Tokyo Café by TVARI

Courtesy of Pixabay for non-commercial educational use

Produced by: Todd Fredricks DO MSS

Edited by: Todd Fredricks DO MSS

Questions and Answers from Episode 18  

Question 1

A 35-year-old male patient presents with newly diagnosed pulmonary tuberculosis (TB) confirmed to be drug-susceptible (DS-TB). The patient has non-cavitary disease and a low bacillary burden. Based on recent clinical trial evidence and World Health Organization (WHO) guidelines, which of the following treatment regimens is most appropriate for this patient?

 B. 4 months of rifapentine, moxifloxacin, isoniazid, and pyrazinamide
 
 Question 2

A 42-year-old female patient is diagnosed with multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) without fluoroquinolone resistance. The patient has no contraindications to new TB drugs. Based on the most recent WHO recommendations and clinical trial data, which regimen is the preferred treatment option for this patient?

 B. 6 months of bedaquiline, pretomanid, linezolid, and moxifloxacin (BPaLM)

Question 3

A 50-year-old male patient with pre-extensively drug-resistant tuberculosis (pre-XDR TB, defined as MDR/RR-TB with fluoroquinolone resistance) is being considered for a new treatment regimen. The patient has no baseline resistance to bedaquiline or linezolid. Which of the following regimens, supported by recent clinical trial evidence, is most appropriate, and what is a key consideration for its use?

A. 6–9 months of bedaquiline, linezolid, clofazimine, and delamanid; monitor for linezolid-associated toxicity

Paper for next week

Yerem Yeghiazarians, Hani Jneid, Jeremy R. Tietjens, Susan Redline, Devin L. Brown, Nabil El-Sherif, Reena Mehra, Biykem Bozkurt, Chiadi Ericson Ndumele, Virend K. Somers, Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association, July 20, 2021 Circulation. 2021;144:

Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS.

Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency.

Listeners interested in specifics from the paper authors should contact them directly through their respective institutions.

Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

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Episode 18.1  Thoughts on TB

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Intro/Outro: Night Detective by Amaksi

 Courtesy of Pixabay under Creative Commons for non-Commercial Educational use only.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

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Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS

Rotations is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency.

 Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

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Episode 18 Tuberculosis

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Intro: Rock Christmas/ Christmas Music by tramp963

Outro: Piano Inspiring by Paul Yudin

Courtesy of Pixabay for non-commercial educational use

Produced by: Todd Fredricks DO MSS

Edited by: Todd Fredricks DO MSS

Questions and Answers from Episode 17 

Question 1: Antiviral Treatment for Elderly Patient

A 65-year-old man with chronic obstructive pulmonary disease (COPD) presents with a 2-day history of fever, cough, and myalgia. He has been diagnosed with influenza A. Which of the following antivirals is most appropriate for this patient?

 Correct Answer: B. Oseltamivir 

 Question 2: Diagnostic Test for High-Risk Child

A 3-year-old child with asthma has been exposed to influenza and presents with fever, runny nose, and cough. Which diagnostic test is most appropriate for this patient?

Correct Answer: C. RT-PCR 

Question 3: Vaccination Recommendation for Pregnant Patient

A 30-year-old woman at 28 weeks gestation has not received the influenza vaccine. What is the most appropriate recommendation regarding influenza vaccination for this patient?

Correct Answer: C. Administer the inactivated influenza vaccine (IIV) 

Paper for next week

Lana Rosenfield, Paul K. Keith, Jaclyn Quirt, Peter Small, and Anne K. Ellis,

Allergic rhinitis, Allergy, Asthma & Clinical Immunology (2024) 20:74

Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS.

Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency.

Listeners interested in specifics from the paper authors should contact them directly through their respective institutions.

Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

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Episode 17 Influenza

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 Intro: Rock Christmas/ Christmas Music by tramp963

Outro: Main Title Blockbuster by Mint Music

 Courtesy of Pixabay for non-commercial educational use

Produced by: Todd Fredricks DO MSS

Edited by: Todd Fredricks DO MSS

Questions and Answers from Episode 16 

Question 1: Diagnosis of Bacterial Acute Rhinosinusitis

A 25-year-old male presents with a 7-day history of nasal congestion, rhinorrhea, and facial pressure. Initially, his symptoms improved after 3 days but then worsened, and he now has a fever of 38.2°C, maxillary sinus tenderness, and purulent nasal discharge. Based on the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2020 guidelines, what is the most likely diagnosis for this patient?

Answer Choices:
C. Bacterial ARS
 
Question 2: Treatment for Viral Acute Rhinosinusitis

A 30-year-old female with a history of allergic rhinitis presents with a 5-day history of nasal congestion and clear rhinorrhea. She has no fever, no facial pain, and her symptoms have not worsened. What is the most appropriate initial treatment for this patient?

C. Saline nasal irrigation

Question 3: Indication for Antibiotics in Acute Rhinosinusitis

Which of the following scenarios indicates the most appropriate use of antibiotics in acute rhinosinusitis (ARS)?

 B. A 10-day history of facial pain, purulent nasal discharge, and fever of 38.5°C
 
 Paper for next week

 Ilaria Motta, Martin Boeree, Dumitru Chesov, Keertan Dheda, Gunar Günther, Charles Robert Horsburgh Jr., Yousra Kherabi, Christoph Lange, Christian Lienhardt, Helen M. McIlleron, Nicholas I. Paton, Helen R. Stagg, Guy Thwaites, Zarir Udwadia, Reinout Van Crevel, Gustavo E. Vel asquez, Robert J. Wilkinson, Lorenzo Guglielmetti, Clinical Microbiology and Infection, 30 (2024) 1107-1114

Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS.

Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency.

Listeners interested in specifics from the paper authors should contact them directly through their respective institutions.

Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

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Episode 16 Common Cold

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Intro: Rock Christmas/ Christmas Music by tramp963

Outro: Rainbow by Mood Mode

Courtesy of Pixabay for non-commercial educational use

Produced by: Todd Fredricks DO MSS

Edited by: Todd Fredricks DO MSS

“Who Moved my Cheese,” Spencer Johnson, 1998

https://en.wikipedia.org/wiki/Who_Moved_My_Cheese%3F

Questions and Answers from Episode 15 

Question 1: 

 A 32-year-old healthy female presents to your clinic with a 5-day history of cough that started as dry but has become productive of yellow sputum over the past 2 days. She denies fever or shortness of breath. Her vital signs are normal  and her chest examination reveals no crackles or wheezing. There are no current outbreaks of influenza or COVID-19 in the area. What is the most appropriate management for this patient? 

 D. Reassure the patient that antibiotics are not necessary and provide symptomatic relief 

Question 2: 

 A 68-year-old male with a history of COPD and heart failure presents with cough productive of purulent sputum, fever (38.5°C), shortness of breath on exertion, and pleuritic chest pain for 3 days. His vital signs include a heart rate of 102/min, respiratory rate of 24/min, blood pressure of 110/70 mmHg, and oxygen saturation of 92% on room air. Chest examination reveals crackles in the right lower lobe. After evaluation using clinical prediction tools (CURB-65 score of 1), it is determined that he can be managed as an outpatient. What is the most appropriate antibiotic regimen for this patient? 

 D. Amoxicillin-clavulanate plus azithromycin 

Question 3: 

 A 70-year-old male with hypertension and type 2 diabetes presents to your clinic with a 3-day history of fatigue, cough, headache, and loss of smell (anosmia). He has no shortness of breath or chest pain. His vital signs are stable (temperature 37.2°C, heart rate 88/min), and his oxygen saturation is 96% on room air. A rapid antigen test for SARS-CoV-2 is positive. What is the most appropriate treatment for this patient as an outpatient? 

 B. Ritonavir-boosted nirmatrelvir (Paxlovid)
 

Correct Answer: B 

Paper for next week

Timothy M Uyeki, David S Hui, Maria Zambon, David E Wentworth, Arnold S Monto, Influenza, the lancet, Vol 400 August 27, 2022

Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS.

Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency.

Listeners interested in specifics from the paper authors should contact them directly through their respective institutions.

Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0. 

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Episode 15 Treating Respiratory Infections

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 Intro: Rock Christmas/ Christmas Music by tramp963

Outro: You and Me by HitsLab

Courtesy of Pixabay for non-commercial educational use

Produced by: Todd Fredricks DO MSS

Edited by: Todd Fredricks DO MSS

Questions and Answers from Episode 14 Bronchitis

Question 1: Diagnosis Scenario 

Question: A 35-year-old healthy patient presents with a two-week history of cough, mild fever (100.2°F), and normal lung auscultation. What is the most appropriate next step in management? 

C) Treat with supportive care and patient education 

Question 2: Treatment Scenario for Children

Question: A 2-year-old child with acute bronchitis has a persistent cough. The parent asks for treatment options. Which is most appropriate? 

B) Administer honey 

 Question 3: Complication and Differential Diagnosis 

Question: A patient with acute bronchitis reports persistent fever after one week of symptoms. What is the most appropriate next step? 

B) Order chest X-ray 

 Paper for next week

 Francesca Jaume, & Meritxell Valls-Mateus, & Joaquim Mullol, Common Cold and Acute Rhinosinusitis: Up-to-Date Management in 2020, Current Allergy and Asthma Reports (2020) 20:28

Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS.

Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency.

Listeners interested in specifics from the paper authors should contact them directly through their respective institutions.

Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

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Episode 14 Acute Bronchitis

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 Intro: Rock Christmas/ Christmas Music by tramp963

Outro: You Can by Grand Project

Courtesy of Pixabay for non-commericial educational use

Produced by: Todd Fredricks DO MSS

Edited by: Todd Fredricks DO MSS

Questions and Answers from Episode 13 Pneumonia

 Question 1:

 A 70-year-old man presents to your clinic with a 3-day history of cough productive of yellow sputum, fever, and shortness of breath. On examination, he appears confused, has a respiratory rate of 24 breaths per minute, blood pressure of 85/50 mm Hg, and diminished breath sounds in the right lower lobe. Chest radiography shows a right lower lobe consolidation. Which of the following is the most appropriate next step in management based on risk stratification? 

• B) Admit to the hospital for intravenous antibiotics 

Question 2:

 A 55-year-old woman with a history of chronic obstructive pulmonary disease (COPD) presents with a 2-day history of fever, productive cough, and dyspnea. Chest radiography confirms right middle lobe consolidation consistent with community-acquired pneumonia. She is hemodynamically stable, and her oxygen saturation is 92% on room air. Which of the following is the most appropriate initial antibiotic regimen? 

• C) Amoxicillin-clavulanate plus azithromycin 

Question 3:

 A 68-year-old man with type 2 diabetes mellitus presents for an annual physical examination. He has no history of pneumonia and is up to date on other vaccinations. He inquires about vaccination to prevent community-acquired pneumonia. Which of the following is the most appropriate recommendation? 

• C) Administer the 20-valent pneumococcal conjugate vaccine (PCV20) alone 

 Paper for next week

Rodrigo Cavallazzi and Julio A. Ramirez, How and when to manage respiratory infections out of hospital, Eur Respir Rev 2022; 31

Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS.

Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency.

Listeners interested in specifics from the paper authors should contact them directly through their respective institutions. 

Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

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Episode 13 Pneumonia

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Intro: Rock Christmas/ Christmas Music by tramp963

Outro: Winner Main by Gand Project

Courtesy of Pixabay for non-commercial educational use

 Produced by: Todd Fredricks DO MSS

Edited by: Todd Fredricks DO MSS

Questions and Answers from Episode 12 COPD

Question 1

A 62-year-old male with a 40-pack-year smoking history presents to the primary care clinic complaining of progressive shortness of breath during exercise and a chronic cough productive of sputum for the past 3 years. Spirometry reveals a post-bronchodilator FEV₁/FVC ratio of 0.65 and an FEV₁ of 55% predicted. He reports two episodes of acute worsening of symptoms in the past year requiring oral corticosteroids. According to the GOLD ABCD assessment tool, which group should this patient be classified into?

D. Group D 

Question 2

A 58-year-old female with a confirmed diagnosis of COPD presents for a follow-up visit. She reports persistent dyspnea despite adherence to a long-acting muscarinic antagonist (LAMA). Her blood eosinophil count is 350 cells/mm³, and she experienced one moderate exacerbation in the past 12 months treated with antibiotics. Based on current GOLD guidelines, which of the following is the most appropriate next step in her pharmacological management?

C. Add a long-acting β₂-agonist (LABA) to the LAMA
 
Question 3

A 70-year-old male with severe COPD (FEV₁ 35% predicted) and a history of recurrent respiratory infections is admitted to the hospital with acute respiratory failure. Physical examination reveals cyanosis, a respiratory rate of 28 breaths per minute, and oxygen saturation of 88% on room air. Arterial blood gas analysis shows a PaO₂ of 7.5 kPa and a PaCO₂ of 7.0 kPa. According to the classification of COPD exacerbations, which of the following best describes this patient’s current condition?

C. Severe exacerbation

Paper for Next Week

SCOTT KINKADE, and NATALIE A. LONG, Acute Bronchitis, American Family Physician, October 1, 2016, 94:7 560-565

Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS.

Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency.

Listeners interested in specifics from the paper authors should contact them directly through their respective institutions.

Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

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Episode 12 COPD

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Intro: Rock Christmas/ Christmas Music by tramp963

Outro: The Ocean by Grand Project

Courtesy of Pixabay for non-commercial educational use

Produced by: Todd Fredricks DO MSS

Edited by: Todd Fredricks DO MSS

Questions and Answers from Episode 11 Asthma

Question 1: Diagnosis of Asthma in Patients on Controller Treatment 

Question: A 35-year-old woman presents to your clinic with a history of recurrent wheezing and shortness of breath. She has been using an inhaled corticosteroid (ICS) and long-acting beta-agonist (LABA) combination inhaler for the past year. To confirm the diagnosis of asthma, what is the most appropriate test to perform?

• a. Spirometry before and after bronchodilator

Question 2: Treatment for Mild Asthma

Question: A 25-year-old man with mild asthma presents to your clinic. He experiences occasional wheezing and shortness of breath, requiring his short-acting beta-agonist (SABA) inhaler a few times a month. According to the 2022 GINA guidelines, what is the recommended treatment for this patient?

• c. Start as-needed combination ICS-formoterol

Question 3: Assessing Symptom Control and Management

Question: A 40-year-old woman with asthma is on low-dose ICS-LABA as maintenance therapy and uses SABA as needed for symptom relief. She reports using her SABA inhaler on three different days each week. According to GINA guidelines, what should be the next step in her management?

• c. Review her adherence to maintenance medication and inhaler technique

Paper for Next Week

Jason Womack, MD, and Jill Kropa, MD, Community-Acquired Pneumonia in Adults: Rapid Evidence Review, American Family Physician, Vol 105,6 June 2022

Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS.

Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency.

Listeners interested in specifics from the paper authors should contact them directly through their respective institutions.

Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

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Episode 11 Asthma

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Intro: Rock Christmas/ Christmas Music by tramp963

Outro: Armageddon by Grabnd Project

Courtesy of Pixabay for non-commericial educational use

Produced by: Todd Fredricks DO MSS

Edited by: Todd Fredricks DO MSS

Questions and Answers from Episode 10 Isolated Distal Deep Vein Thrombosis

Question 1: Management for a Patient with IDDVT Post-Flight

A 45-year-old woman presents with left calf pain and swelling after a recent long-haul flight. Compression ultrasonography reveals a thrombus in the left peroneal vein, with no involvement of the popliteal or femoral veins. She has no other significant medical history and is not on any medications. Which of the following is the most appropriate management for this patient? 

• B. Start rivaroxaban for 3 months.

Question 2: Comparing Clinical Course of IDDVT and Proximal DVT

Which of the following statements is true regarding the clinical course of isolated distal deep vein thrombosis (IDDVT) compared to proximal deep vein thrombosis (DVT)

• C. Mortality rates are lower in IDDVT compared to proximal DVT.

Question 3: Management for Cancer Patient with IDDVT

A 62-year-old man with a history of stage IV lung cancer presents with right calf pain. Compression ultrasonography shows a thrombus in the right tibial vein, with no proximal extension. He is currently undergoing chemotherapy and has no other significant comorbidities. What is the most appropriate management for this patient?

• D. Prescribe extended anticoagulation with LMWH.

Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS.

Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency.

Listeners interested in specifics from the paper authors should contact them directly through their respective institutions.

Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.