Heme Review

Chubbyemu

The official podcast of Chubbyemu. Heme Review is a podcast about case reports in medicine. Each episode will tell a patient’s story, while teaching about the pathogenesis of disease, the treatment modalities and the dilemmas that arise during their care.

  1. The Physiology of RFK Jr.'s Blue Dye

    08/01/2025

    The Physiology of RFK Jr.'s Blue Dye

    Collaborator: Dr Katherine JohnsIf you don't need to put it in your body, don't put it in your body.These cases are patients who I, or my colleagues have seen. They are de-identified and many instances have been presented in more depth in an academic setting. These videos are not individual medical advice and are for general educational purposes only. I do not give medical advice over the internet.References:A family cluster of nitrite poisoning, Suzhou City, 2013. Western Pac Surveill Response J. 2013 Jul 30;4(3):33-6. https://pmc.ncbi.nlm.nih.gov/articles/PMC3854094/Human safety controversies surrounding nitrate and nitrite in the diet. https://pubmed.ncbi.nlm.nih.gov/22487433/A mitochondrial superoxide theory for oxidative stress diseases and aging. https://pmc.ncbi.nlm.nih.gov/articles/PMC4306659/Proposed mechanism of nitrite-induced methemoglobinemia. https://pubmed.ncbi.nlm.nih.gov/15892615/Methylene Blue. https://www.ncbi.nlm.nih.gov/books/NBK557593/Methemoglobinemia. https://www.ncbi.nlm.nih.gov/books/NBK537317/Methylene Blue in Goldfrank's ToxicologyPriapism. https://www.ncbi.nlm.nih.gov/books/NBK459178/Methylene blue as a means of treatment for priapism caused by intracavernous injection to combat erectile dysfunction. https://pubmed.ncbi.nlm.nih.gov/15198160/Pharmacologically-induced Recreational Priapism: Case Report and Review. https://pmc.ncbi.nlm.nih.gov/articles/PMC7676772/PharmGKB summary very important pharmacogene information for G6PD. https://journals.lww.com/jpharmacogenetics/citation/2012/03000/pharmgkb_summary__very_important_pharmacogene.8.aspxThe Methylene Blue Baby. N Engl J Med 1989;320:1756-1757. Methylene blue as an antidote for poisoning. J Lab Clin Med. 1933;19:166–71.Methylene blue for distributive shock: a potential new use of an old antidote. J Med Toxicol. 2013;9:242–9.A review of methylene blue treatment for cardiovascular collapse. J Emerg Med. 2014;46:670–9.The role of monoamine oxidase inhibitors in depression treatment guidelines. https://pubmed.ncbi.nlm.nih.gov/22951237/FDA to Revoke Authorization for the Use of Red No. 3 in Food and Ingested Drugs. https://www.fda.gov/food/hfp-constituent-updates/fda-revoke-authorization-use-red-no-3-food-and-ingested-drugsMethylene Blue in the Treatment of Poisonings Associated with Methemoglobinemia. https://www.nejm.org/doi/abs/10.1056/NEJM193306012082205Lawmakers Press Amazon on Sales of Chemical. https://www.nytimes.com/2022/02/04/technology/amazon-suicide-poison-preservative.html

    25 min
  2. 05/16/2023

    The More Data You Have, The Further You Are From The Truth- Big Data Paradox in Medicine

    Dr Pavlos Msaouel: https://faculty.mdanderson.org/profiles/pavlos_msaouel.html 0:00 Pretext and context MD Anderson Cancer Center 1:42 The Early Experiences That Shaped Dr Msaouel 3:39 The System of Cancer Research In the United States 5:25 FDA Drug Approvals and Special Designations For Oncology 11:09 A trade-off in our current system 12:35 Whoops 😞 I misspoke 14:35 Randomized trials are not supposed to be representative of a population 18:10 Inference for the treatment of Katie Coleman (metastatic oncocytoma) 25:12 It is much more valuable to refute hypotheses than to confirm them 28:05 All Models Are Wrong, But Some Are Useful 30:05 Recasting the Bias-Variance Trade-off as the Patient Relevance-Robustness Trade-off 33:38 High Relevance, Low Robustness: Subjective Bayes 34:46 High Robustness, Low Relevance: Pure Randomization 41:47 Signal To Noise Ratio 45:49 The Big Data Paradox 53:41 How the Big Data Paradox fits in with Katie Coleman's case 54:33 How the Big Data Paradox fits in with other branches of medicine 57:54 How do we rectify subjectivity in The Truth? 01:00:43 How do we address the problems introduced by the Big Data Paradox? 01:04:21 Duality in nature and a Twitter argument re: the Evidence-Based Deep Medicine Iceberg 01:07:03 Why the ideas coming from MD Anderson are coming from MD Anderson 01:09:39 Where you can find Dr Msaouel Dr Msaouel: https://twitter.com/PavlosMsaouel Heme Review: https://twitter.com/HemeReview Produced by ⁠ @chubbyemu ⁠ Production Assistant: Nick Brown Secret channel:  @BigEmus  Cancer Patient Speaks With Her Oncologist ► https://youtu.be/Nddft_nc3Yc A Woman Had A Headache Lasting 3 Days (Katie's case) ► https://www.youtu.be/i9fLEvgZzRE References: Stephen Senn. Statistical Issues in Drug Development. Why representativeness should be avoided. https://academic.oup.com/ije/article/42/4/1012/656034 Commentary: Representativeness is usually not necessary and often should be avoided. https://academic.oup.com/ije/article/42/4/1018/658638 Impervious to Randomness: Confounding and Selection Biases in Randomized Clinical Trials. https://www.tandfonline.com/doi/full/10.1080/07357907.2021.1974030 A Causal Framework for Making Individualized Treatment Decisions in Oncology. https://www.mdpi.com/2072-6694/14/16/3923 Causal Diagram Techniques for Urologic Oncology Research. https://www.sciencedirect.com/science/article/pii/S1558767320301932 Causal inference and the data-fusion problem. https://www.pnas.org/doi/10.1073/pnas.1510507113 Causal Inference: What If. Miguel A Hernán and James M. Robins. https://www.hsph.harvard.edu/miguel-hernan/wp-content/uploads/sites/1268/2023/04/hernanrobins_WhatIf_31mar23.pdf There is Individualized Treatment. Why Not Individualized Inference? https://arxiv.org/abs/1510.08539 Unrepresentative big surveys significantly overestimated US vaccine uptake. https://www.nature.com/articles/s41586-021-04198-4 Unrepresentative Big Surveys Significantly Overestimate US Uptake https://arxiv.org/pdf/2106.05818.pdf Statistical Modeling: The Three Cultures. https://hdsr.mitpress.mit.edu/pub/uo4hjcx6/release/1 How “centaur AI” will radically reshape the future of healthcare. https://bigthink.com/health/how-centaur-ai-will-radically-reshape-the-future-of-healthcare/

    1h 10m
  3. 12/26/2022

    Venomous Spider Bite

    ​ @chubbyemu  video: https://youtu.be/xtVvtsPgfew Heme Review Podcast: https://anchor.fm/chubbyemu Behind the scenes channel:  @BigEmus  Music by  @Lifeformed  ► https://lifeformed.bandcamp.com All Heme Review videos (playlist) ► https://www.youtube.com/playlist?list=PLAHeV2H_YiGUYhHOF4wRMCuqBIJvrnWqS Daddy Longlegs by Vengolis Loxosceles gaucho by Halies Some images by Getty Images References: CMS Malaque, RS Vetter, M Entres. Loxosceles spiders. Critical Care toxicology. https://link.springer.com/referenceworkentry/10.1007/978-3-319-17900-1_119 Myth: Idiopathic wounds are often due to brown recluse or other spider bites throughout the United States https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071166/ Correspondance: Bites of the Brown Recluse Spider. https://www.nejm.org/doi/full/10.1056/nejm200505123521922 Spider Bites: Part 1. https://lacerationrepair.com/wound-blog/spider-bites/ Brown Recluse Pest Management Tips for The Spider That's Not As Common As You Think. https://entomologytoday.org/2018/01/29/brown-recluse-pest-management-tips-for-the-spider-thats-not-as-common-as-you-think/brown-recluse-range-map/ The Chilean Recluse. https://www.fdacs.gov/content/download/68159/file/Pest_Alert_-_Loxosceles_laeta,_The_Chilean_Recluse.pdf Brown recluse spider (Loxosceles reclusa) envenomation leading to acute hemolytic anemia in six adolescents. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4902007/ Acute kidney injury and dermonecrosis after Loxosceles reclusa envenomation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119339/ Bites of Brown Recluse Spiders and Suspected Necrotic Arachnidism. https://www.nejm.org/doi/full/10.1056/NEJMra041184

    11 min
5
out of 5
246 Ratings

About

The official podcast of Chubbyemu. Heme Review is a podcast about case reports in medicine. Each episode will tell a patient’s story, while teaching about the pathogenesis of disease, the treatment modalities and the dilemmas that arise during their care.

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