Rotations 2.0

Todd Fredricks DO MSS
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A weekly discussion of medicine and science trends between people far too old to be trying something this new.

  1. 3D AGO

    Rotations 2.0 Episode 54 STI

    Send a text Episode 54 STI Shoot me any comments or questions @Rotation2ptoh  on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: Claim We Are Able by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use. Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS Not So Quiet on the Western Front- VD https://not-so-quiet.com/supporters/audio/193970?utm_medium=copy-share-link&utm_source=share-link&utm_campaign=post-share-supporter Answers for Episode 53 UTI Question 1 — Pathophysiology of CAUTI in a Post‑operative Patient A 68‑year‑old man undergoes hip arthroplasty. He receives tranexamic acid perioperatively to limit bleeding and has a Foley catheter in place for 48 hours. On day 3 he develops fever (38.4 °C), suprapubic discomfort, and leukocyturia. Urine culture is negative, but catheter tip culture later shows E. faecalis, UPEC, and Candida albicans in a mixed biofilm. Which mechanism best explains his severe catheter‑associated UTI (CAUTI) presentation and the negative urine culture? C. Antifibrinolytic therapy causes fibrin accumulation that scaffolds fibrin(ogen)‑dependent polymicrobial biofilms on the catheter and urothelium, under‑represented in planktonic urine cultures Question 2 — Antibiotic Selection & Dosing in CAUTI A 72‑year‑old woman in a nursing facility has a 7‑day indwelling catheter and develops dysuria and suprapubic pain. Empiric TMP–SMX 160/800 mg orally for 3 days is started for presumed UTI. She returns 48 hours later with persistent symptoms. Which management is most appropriate given CAUTI treatment outcomes cited in the review? B. Switch to an oral fluoroquinolone (e.g., ciprofloxacin or levofloxacin) 500–1,000 mg daily for 5–7 days, while tailoring to urine culture and resistance data Question 3 — uUTI Symptom Control & COX‑2 Biology A 45‑year‑old otherwise healthy woman presents with an uncomplicated UTI (uUTI): dysuria, frequency, and suprapubic pain for 24 hours. She asks whether she can avoid antibiotics if possible. Which statement best reflects the clinical evidence and mechanistic context presented in the article? B. In a randomized 3‑day pilot trial, ibuprofen (COX‑2 inhibition) and ciprofloxacin produced a similar ~50% reduction in mean symptomatic scores, with the ibuprofen arm showing no additional adverse effects or need for rescue antibiotics Paper for Next Week:  Beyrer, C., Ratevosian, J., Gelderblom, H., & Rosenberg, N. E. (2025). The HIV/AIDS pandemic: where are we now? AIDS, 39(11), 1497–1504. 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 conten

    48 min

  2. FEB 9

    Rotations 2.0 Episode 53 UTI

    Send a text Episode 53 UTI (Now with Chapter Markers!) Shoot me any comments or questions @Rotation2ptoh  on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: Fate Embrace by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use. Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS  Answers for Episode 52 Brain Immune Gut Axis Question 1 Which of the following best describes the role of short-chain fatty acids (SCFAs) in the gut–immune–brain axis? C. SCFAs modulate immune responses by promoting regulatory T cell differentiation and influencing microglial maturation Question 2 Which immune cell type is most associated with IL-17A production in the meninges, influencing synaptic plasticity and anxiety-like behaviors? C. γδ T cells Question 3 Which statement about the vagus nerve in gut–brain communication is correct? C. Vagus nerve acts as a bidirectional pathway, transmitting microbial and immune signals to the brain and modulating gut immunity Question 4 Which of the following best explains the mechanism by which maternal immune activation (MIA) increases autism spectrum disorder (ASD) risk in offspring? C. IL-17A produced by Th17 cells in response to segmented filamentous bacteria disrupts fetal brain development Question 5 Which of the following is a therapeutic implication of targeting the gut microbiota in neurodegenerative disorders such as Alzheimer’s disease (AD)? C. Administering probiotics to reduce microglial activation and improve barrier integrity Question 6 Which of the following best describes the role of astrocytes in neuroinflammation? C. Astrocytes release TNF-α and IL-6, amplifying microglial activation and sustaining neuroinflammation Paper for Next Week: Esin S, Del Bono L, Pistello M. Sexually Transmitted Infections: Global Trends, Diagnostic Advances, and Emerging Challenges. New Microbiol. 2025 Jul;48(2):113-136. PubMed PMID: 41123498.  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.

    50 min

  3. FEB 2

    Rotations 2.0 Episode 52 Brain Immune Gut Axis

    Send us a text Episode 52 Brain Immune Gut Axis Shoot me any comments or questions @Rotation2ptoh  on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: Trap Beat (Dripin’ Sauce) by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use. Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS Answers for Episode 51 Sprains and Strains  1) Acute management and expected outcome A 24‑year‑old recreational basketball player presents 36 hours after an inversion injury. Examination is consistent with a grade II lateral ankle sprain; Ottawa ankle rules are negative. He asks what intervention is most likely to reduce his pain at rest over the next 1–2 weeks. Which is the best evidence‑based recommendation?  A. Early, supervised physical therapy using a multimodal program (e.g., progressive exercise, stretching, thermotherapy/ultrasound or hydrotherapy, and functional training) 2) Outcome interpretation A 19‑year‑old soccer player undergoes early physical therapy after a grade I ankle sprain. At follow‑up, the clinician reviews expected benefits from the literature. Which outcome did not show a significant difference between physical therapy and conventional treatment in the pooled analysis? C. Dorsiflexion range of motion (ROM) 3) Evidence synthesis and methodology In the same review, Trial Sequential Analysis (TSA) showed the Z‑curve crossed the monitoring boundary and reached the required information size for the primary pain outcome. What is the best interpretation of this finding? A. The cumulative evidence is sufficient to conclude that physical therapy reduces pain versus conventional care while controlling for type I and type II errors   Paper for Next Week: Jonathan J. Molina, Ana L. Flores-Mireles, CAUTIon – not all UTIs are the same, Nat Rev Urol. 2025 December ; 22(12): 799–814 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.

    49 min

  4. JAN 26

    Rotations 2.0 Episode 51 Sprains and Strains

    Send us a text Episode 51 Sprains and Strains  Shoot me any comments or questions @Rotation2ptoh  on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: Power of the Hero by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use. Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS Answers for Episode 50 Tendonitis Question 1 A 32-year-old marathon runner presents with chronic Achilles tendon pain for 3 months. He has tried rest and NSAIDs without improvement. According to current evidence, which of the following is the most effective treatment for his condition? C. Heavy slow resistance training program Question 2 A professional soccer player sustains an acute hamstring strain. Which rehabilitation approach is associated with the fastest return to play and lowest re-injury rate? B. Early initiation of progressive eccentric exercises and running drills Question 3 A 40-year-old recreational basketball player suffers an acute Achilles tendon rupture. He asks about long-term outcomes. Which statement is most accurate based on current evidence? C. Both surgical and non-surgical treatments often lead to permanent functional deficits Paper for Next Week: O’Riordan KJ, Moloney GM, Keane L, Clarke G, Cryan JF. The gut microbiota-immune-brain axis: Therapeutic implications. Cell Reports Medicine. 2025; 6 Park JC, Chang L, Kwon H-K, Im S-H. Beyond the gut: decoding the gut–immune–brain axis in health and disease. Cellular & Molecular Immunology. 2025; 22:1287–1312 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.

    40 min

  5. JAN 19

    Rotations 2.0 Episode 50 Tendonitis

    Send us a text Episode 50 Tendonitis Shoot me any comments or questions @Rotation2ptoh  on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: Operation Biscuit by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use. Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS  Answers for Episode 49 Carpal Tunnel Syndrome Question 1 A 52-year-old woman presents with numbness and tingling in her thumb, index, and middle fingers. Physical exam shows a positive Phalen’s test. You suspect carpal tunnel syndrome. Which diagnostic modality is considered the gold standard for assessing disease severity? C. Nerve conduction studies (NCS) Question 2 Which of the following ultrasound measurements is most commonly used to diagnose carpal tunnel syndrome? C. Median nerve cross-sectional area (m-CSA) Question 3 A neurologist uses the inching technique during electrodiagnostic testing for CTS. What is the primary advantage of this technique? C. It improves localization of nerve compression and diagnostic accuracy Paper for Next Week: Yang C, Gao W, Jia Z, Li J, Tang M. Physical therapy versus conventional treatment for grade I and II acute ankle sprains: trial sequential analysis and meta-analysis. J Orthop Surg Res. 2025;20:861. doi:10.1186/s13018-025-06272-3 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.

    33 min

  6. JAN 12

    Rotations 2.0 Episode 49 Carpal Tunnel Syndrome

    Send us a text Episode 49 Carpal Tunnel Syndrome Shoot me any comments or questions @Rotation2ptoh  on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: The New Awakening by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use. Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS Answers for Episode 48 Osteoporosis/RA Question 1 A 64-year-old postmenopausal woman with rheumatoid arthritis presents after sustaining a vertebral fracture. Which factor most strongly contributes to her increased fracture risk compared to age-matched controls? B. Chronic systemic inflammation activating osteoclasts  Question 2 According to current recommendations, which patient should undergo bone mineral density (BMD) screening for osteoporosis? C. A 42-year-old woman with RA taking ≥2.5 mg prednisolone daily for 4 months Question 3 Which medication is most effective for increasing bone mineral density and reducing vertebral fractures in patients with RA and glucocorticoid-induced osteoporosis? C. Denosumab Paper for Next Week: Michael Kj, Jesper Petersen, Michael Ries Dünweber, Jesper L.vind Andersen, Lars Engebretsen, Stig Peter Magnusso,Dilemma in the Treatment of Sports Injuries in Athletes: Tendon Overuse, Muscle Strain, and Tendon Rupture, Scandinavian Journal of Medicine & Science in Sports, 2025; 35:e70026 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.

    31 min

  7. JAN 5

    Rotations 2.0 Episode 48 Osteoporosis

    Send us a text Episode 48 Osteoporosis Shoot me any comments or questions @Rotation2ptoh  on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: A Promise Kept by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use. Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS Answers for Episode 47 Fibromyalgia Question 1: Pathophysiology A 42-year-old woman presents with chronic widespread pain, fatigue, and cognitive difficulties. Functional MRI reveals increased activation in the posterior insula and secondary somatosensory cortex. Which of the following neurotransmitters is most likely elevated in her cerebrospinal fluid and contributes to her pain hypersensitivity? B. Substance P Question 2: Diagnosis According to the 2016 American College of Rheumatology (ACR) criteria, which of the following combinations is sufficient to establish a diagnosis of fibromyalgia? C. WPI = 5, SSS = 9, symptoms for 3 months Question 3: Treatment A 50-year-old female with fibromyalgia is started on pharmacologic therapy. Which of the following medications is FDA-approved for fibromyalgia and has shown efficacy at doses of 300–600 mg/day? B. Pregabalin Paper for Next Week: Mikahla E. Gay, Jose G. Lima, Vanessa Vieites, Starlie C. Belnap, Richard Morgan Comparison of Diagnostic Modalities for Carpal Tunnel Syndrome: A Systematic Review, Cureus, September 17, 2025  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.

    35 min

  8. 12/29/2025

    Rotations 2.0 Episode 47 Fibromyalgia

    Send us a text Episode 47 Fibromyalgia  Shoot me any comments or questions @Rotation2ptoh  on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: Beats Through the Ashes by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use. Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS  Answers for Episode 46 Gout Question 1: Pathophysiology and Molecular Mechanisms A 58-year-old male presents with recurrent gout flares. Genetic testing reveals a mutation in the NFAT5 gene. Based on recent findings, which of the following best describes the role of NFAT5 in gout pathogenesis? C. NFAT5 enhances uric acid production through a feedback loop involving aldose reductase Question 2: Diagnostic Imaging in Gout According to the 2023 EULAR recommendations, which imaging modality is most effective for both diagnosing gout and monitoring crystal deposition and inflammation? C. Dual-Energy Computed Tomography (DECT) Question 3: Therapeutic Innovations A new oral drug, dapansutrile (OLT1177), is being evaluated in Phase II/III trials for gout. What is its primary mechanism of action? C. Selective inhibition of the NLRP3 inflammasome Paper for Next Week:  Fiona Kirkham-Wilson, Elaine Dennison1, Osteoporosis and Rheumatoid Arthritis: A Review of Current Understanding and Practice, British Journal of Hospital Medicine, 2024 Nov 30;85(11):1-11. 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.

    39 min
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A weekly discussion of medicine and science trends between people far too old to be trying something this new.

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  • Creator
    Todd Fredricks DO MSS
  • Years Active
    2025 - 2026
  • Episodes
    63
  • Rating
    Clean
  • Copyright
    © 2026 Rotations 2.0
  • Show Website
    Rotations 2.0