Hi Dr. Strong, very useful series of lectures. thanks for posting them free of cost. You are making a great contribution to the medical fraternity and helping junior medical staff. Thanks
This particular set of videos is focused on treatment of acute bacterial infections. H. pylori, a fascinating gram negative, helix-shaped bacteria is the cause of an extremely common chronic infection of the stomach, which isn't covered here. Eventually, I hope to come back to chronic bacterial infections, including H.pylori, along with mycobacteria and a number of other interesting and important pathogens.
I'm glad to see Bayesian modeling explicitly mentioned, it's a powerful tool, and one that's sadly ignored or insufficiently stressed, at least where I come from!
Staph is part of normal skin flora, and it certainly can be a contaminant. However, when one considers the rates of contamination against the rates of true bacteremia, along with the risk of untreated Staph aureus bacteremia, unless the pretest probability (i.e. prob of bacteremia prior to blood cx results) of Staph bacteremia is near zero, the risk/benefit ratio favors treating as a true infection.
Joe, I have a long term goal of making printable lecture notes for all of these videos available on line somewhere, but it will be at least 6-12 months away. I'll definitely post something on here once they're ready.
Dr. Strong, have you ever got round to making those notes? For now, I am making my own. It actually took me 80 pages to "transcribe" Professor Fink's entire pharmacology course. Your lectures on the other hand are more dense when it comes to the sheer volume of information.
In comparing Staph aureus with Staph epi, the reason Staph epi is more frequently believed to be a contaminant, is that true Staph epi bacteremia is much less common.
Great video! 15:25 What does the contamination rate mean here? Does it mean that for example from 100 cases of having isolated coag-negative staph, 62 % of these cases were false-positive?
Hi Dr. Strong, Could you please elaborate on the bacteria that are Enteric GNR (as opposed to GNR)? I mean which organisms are considered non enteric GNRs?
Why should staph aureus never be presumed to be a contaminant? I thought this was normal skin flora and would therefore be very likely contaminant. Great videos by the way, very useful for medical finals revision
In the previous lecture on classification of bacteria, you described H. flu under gram negative rods whereas in this lecture you describe H. flu as gram negative coccobacilli. Please clarify.
Fatima, thanks for pointing this out. I hadn't even realized I had done that! The issue is that H.flu is pleomorphic, meaning that the individual bacteria can assume different shapes primarily depending upon environmental conditions. Sometimes it looks like a gram negative coccobacillus, sometimes it looks like a gram negative rod, and most textbooks and other sources just arbitrarily pick one category under which to list it.
Hi dr. I just want it to know in wich books , or any references that you can bring , to keep reading about it?. Great work. Im a technician laboratorist in Juarez Mexico, and this makes me keep studing, take you for shares this material.
In my case, learning about drugs is one of my hobbies and I make ordinary people surprised with my knowledge of drugs - During my service years, I knew the spellings of about 3,000 drugs. And the State Corporation had entrusted me to group drugs therapeutically though some of the staff had more academic qualifications than me and they also had never checked my work knowing my knowledge. Therefore, I had to check everything for myself to ensure accuracy.
Thanks a lot you are so amazing so kindly helpful so intelligent god bless you dear wishes you all the best good and many thanks for your education lectures so wow fantastic I love it 🥰❤️😊👋
Eric - great to see Feynman on the wall! Were you a physics undergrad? Also, thanks for these lectures. Very useful for us instrument geeks - we're developing a rapid AST method.
Feynman was a hero of mine in my youth. I was a physics major until I decided to go to med school in my 3rd year. I was midway through quantum mechanics at the time and decided it wasn't worth pushing through it (i.e. finishing the physics degree) if I'd never actually use the advanced stuff that was still left. Switched to biology. Ironically, I don't actually use 98% of what I learned in the undergrad bio classes either (and in retrospect, wish I stayed with physics, or maybe did engineering instead). It's amazing how poorly premed education prepares people for being health care professionals. Thanks for watching, and best of luck with your research!
Eric's Medical Lectures Well Dr Eric, I'm certainly glad you made the switch. Most of medschool seems to be geared towards the kind of people with colossal memory and hence few "explain with a view to understand". Your lectures certainly help me understand as I prep for my finals in a few days time!
Ordinary people like me, though I have categorized 1000's of drugs for the benefit of the State Pharmaceuticals Corporation of Sri Lanka based on WHO essentials drugs list, also should be interested in learning about drugs.This should be the field of the common man also as they are treated mainly with drugs and also , unless they do, they have no means of knowing whether they had received the right drug or not.
The latest guidelines on asymptomatic bacteriuria from the Infectious Disease Society of America (written in 2004, but formally reviewed in 2013 and felt to be still current) explicitly recommend against treatment of asymptomatic bacteriuria in women. The guidelines make no explicit recommendation one way or another regarding diabetic men (probably because there is no literature on the issue), but given that they are not included in the list of people who should have asymptomatic bacteriuria treated, it is implied that they should not. The IDSA is not necessarily the final word on all topics related to infectious disease, and I am not sure how applicable these guidelines are in other parts of the world. But most clinicians at American medical centers (at least academic medical centers) follow them on this issue.
+missvibes I would have thought people whose diabetes is complicated by neuropathy (or otherwise because of the risk of it) would automatically be included in the third category. No?
+basim ali That's an interesting thought...Diabetic neuropathy is a length-dependent process, affecting the longest nerves first - thus, it almost always first manifests in the feet. I suppose it's possible for diabetic neuropathy to become so severe that it impacts your intraabdominal organs, leading to an inability to experience dysuria. (For example, diabetics are anecdotally more likely to have heart attacks without chest pain.) However, I've never personally encountered a diabetic patient who I suspected lacked the ability to feel a UTI due to neuropathy (and I take care of some phenomenally out-of-control diabetes).
Hmm. Besides the inability to feel pain secondary to neuropathy, I was also thinking of the possibility of neurogenic bladder in these patients leading to stasis. Thank you for your input!
Diabetics definitely can develop a sensory neuropathy (i.e. decreased sensation), but this is usually limited to the distal extremities. I would not consider diabetes, even severe diabetes, to be a category of patients who have asymptomatic bacteruria automatically treated. One group where this could potentially apply is spinal cord injury patients who have absent sensation from their pelvis and intrapelvic/intraabdominal organs. You might consider treating asymptomatic bacteruria in these patients, unless they have an indwelling urinary catheter (i.e. either Foley or suprapublic cath), which many of them do, because patients with indwelling urinary catheters almost always have bacteruia all of the time.
+Strong Medicine Thanks for your response. I read this somewhere in a textbook and am glad to have this clarified...it seems surprising to me that diabetes could impede sensation to that degree. According to AAFP treating asymptomatic bacteriuria in diabetic women showed no benefit in preventing occurrence of symptomatic UTI or hospitalization for UTI at 3 years follow up. I have really learned so much from your videos! How very egalitarian to have the best teaching available to everyone...you have a knack for presenting information in a way that is cohesive and makes sense for clinical practice. I appreciate this approach...the countless hours I have spent learning disparate pieces of information without elaboration, context or a sense of what it might mean for me as a practitioner...to many textbooks and lectures miss the mark.
@drericstrong thank you very much for your reply, I will not be ignoring any staph aureus bacteraemias when I start work in August! Thank you for your prompt replies, excellent videos I will certainly be watching more if these
I'm sorry you had trouble hearing it. Between the UA-cam player volume control and my computer's main volume control, I can hear it ok. Unfortunately, I don't know why it might sound so much softer on another computer, and I also don't think there's a way for me to increase the volume once the video has been uploaded. I can certainly boost the volume on future posted videos.
Increase it from the youtube player or try increasing the main volume. i have tried 3 diff computers and the volume is pretty loud ....may be some problem with your computer....thanks
Hi Dr. Strong, very useful series of lectures. thanks for posting them free of cost. You are making a great contribution to the medical fraternity and helping junior medical staff. Thanks
The asymptomatic bacteriuria management you mentioned is an amazing addition to the lecture. Everyone should know that! :)
Dr. Strong-- thank you for all of these videos.. They are logical, clear, informative and incredibly useful
As a stressed out medstudent I want to thank you for your wonderful lectures!
My new hobby - watching Your videos!
This particular set of videos is focused on treatment of acute bacterial infections. H. pylori, a fascinating gram negative, helix-shaped bacteria is the cause of an extremely common chronic infection of the stomach, which isn't covered here. Eventually, I hope to come back to chronic bacterial infections, including H.pylori, along with mycobacteria and a number of other interesting and important pathogens.
What about a pneumonia and diarrhea infections
Awesome! One of the best microbiology lectures I've seen.
Pharm D here, thank you for putting this together. Nice review/overview
I enjoyed your nice touch of the Richard Feynman portrait.
I'm glad to see Bayesian modeling explicitly mentioned, it's a powerful tool, and one that's sadly ignored or insufficiently stressed, at least where I come from!
Staph is part of normal skin flora, and it certainly can be a contaminant. However, when one considers the rates of contamination against the rates of true bacteremia, along with the risk of untreated Staph aureus bacteremia, unless the pretest probability (i.e. prob of bacteremia prior to blood cx results) of Staph bacteremia is near zero, the risk/benefit ratio favors treating as a true infection.
Excellent presentation Eric . What a great idea using Bach's music on your videos !
cant believe im binge watching these great videos
Joe, I have a long term goal of making printable lecture notes for all of these videos available on line somewhere, but it will be at least 6-12 months away. I'll definitely post something on here once they're ready.
That would be useful! But I'm more than grateful for the videos that you have been uploading just on their own
Dr. Strong, have you ever got round to making those notes? For now, I am making my own. It actually took me 80 pages to "transcribe" Professor Fink's entire pharmacology course. Your lectures on the other hand are more dense when it comes to the sheer volume of information.
@@autentyk5735 notes are on Google drive link
@Ja B how do you get to the google drive link?
Great Lectures! Thank you so much for being generous! It helps a lot particularly to us, novice in teaching profession...
I can’t thank you enough to give a great lecture , it is nice to learn from experience competent Doctor.
I'm glad that someone finally noticed it!
In comparing Staph aureus with Staph epi, the reason Staph epi is more frequently believed to be a contaminant, is that true Staph epi bacteremia is much less common.
Thank you very much for providing this content. Very helpful for studying for my final med school exams :)
Im a big fan of Feynman too. I didnt expect to see him here!
Thanks Eric Strong for the lecture on Bacterial Etiologies of Common Infections(antibiotics-lectures 2)is useful,RSC membership-Oliver Heng
This was great, thank you!
Also for UTI- pseudomonas
Your lectures are simple and awesome
thank you for all your lectures :) I can learn a lot from them as a beginner in microbiology
Thanks for this lecture. Here in Venezuela Legionella's pulmonary infection is not registered officially by the government's EPI, yet! :-)
v. informative video - thank you so much
Thanks for these great videos Eric! I can learn a lot from them. Have a great day!
Great video!, thanks for all your hard work. You're videos have helped me immensely, keep up the good work.
Thank you so much for all the great lectures
As always very helpful and very interesting, thank you so much!
Great video! 15:25 What does the contamination rate mean here? Does it mean that for example from 100 cases of having isolated coag-negative staph, 62 % of these cases were false-positive?
My favorite scientist
Hi Dr. Strong,
Could you please elaborate on the bacteria that are Enteric GNR (as opposed to GNR)? I mean which organisms are considered non enteric GNRs?
Why should staph aureus never be presumed to be a contaminant? I thought this was normal skin flora and would therefore be very likely contaminant. Great videos by the way, very useful for medical finals revision
you said don't memorize this slide- bro I got boards part 1 coming up. no choice! good video.
In the previous lecture on classification of bacteria, you described H. flu under gram negative rods whereas in this lecture you describe H. flu as gram negative coccobacilli. Please clarify.
Fatima, thanks for pointing this out. I hadn't even realized I had done that! The issue is that H.flu is pleomorphic, meaning that the individual bacteria can assume different shapes primarily depending upon environmental conditions. Sometimes it looks like a gram negative coccobacillus, sometimes it looks like a gram negative rod, and most textbooks and other sources just arbitrarily pick one category under which to list it.
Thank you.
Eric's Medical Lectures
What about videos about pneumonia and UTIs? Thanks Professor
Thank you for the great lecture.
Wow very interesting I love it 🥰❤️😊👋
ti is really very interesting please have extra educational video? great respect to you
Feynman! Nice touch!
sorry, can i hav the handout of this lecture? it's better for me to learn with papers
but with only this video is more than enough already! thanks
Hi dr. I just want it to know in wich books , or any references that you can bring , to keep reading about it?. Great work. Im a technician laboratorist in Juarez Mexico, and this makes me keep studing, take you for shares this material.
In my case, learning about drugs is one of my hobbies and I make ordinary people surprised with my knowledge of drugs - During my service years, I knew the spellings of about 3,000 drugs. And the State Corporation had entrusted me to group drugs therapeutically though some of the staff had more academic qualifications than me and they also had never checked my work knowing my knowledge. Therefore, I had to check everything for myself to ensure accuracy.
That is amazing so how you memorize it ?
Thanks a lot you are so amazing so kindly helpful so intelligent god bless you dear wishes you all the best good and many thanks for your education lectures so wow fantastic I love it 🥰❤️😊👋
Eric - great to see Feynman on the wall! Were you a physics undergrad?
Also, thanks for these lectures. Very useful for us instrument geeks - we're developing a rapid AST method.
Feynman was a hero of mine in my youth. I was a physics major until I decided to go to med school in my 3rd year. I was midway through quantum mechanics at the time and decided it wasn't worth pushing through it (i.e. finishing the physics degree) if I'd never actually use the advanced stuff that was still left. Switched to biology. Ironically, I don't actually use 98% of what I learned in the undergrad bio classes either (and in retrospect, wish I stayed with physics, or maybe did engineering instead). It's amazing how poorly premed education prepares people for being health care professionals.
Thanks for watching, and best of luck with your research!
Eric's Medical Lectures Well Dr Eric, I'm certainly glad you made the switch. Most of medschool seems to be geared towards the kind of people with colossal memory and hence few "explain with a view to understand". Your lectures certainly help me understand as I prep for my finals in a few days time!
medschneverends Best of luck on your exams!
Ordinary people like me, though I have categorized 1000's of drugs for the benefit of the State Pharmaceuticals Corporation of Sri Lanka based on WHO essentials drugs list, also should be interested in learning about drugs.This should be the field of the common man also as they are treated mainly with drugs and also , unless they do, they have no means of knowing whether they had received the right drug or not.
And we thank King David for his modeling in the graphic.
Great talk!!!! Question..Shouldn't Diabetics also be treated for asymptomatic bacteruria?
The latest guidelines on asymptomatic bacteriuria from the Infectious Disease Society of America (written in 2004, but formally reviewed in 2013 and felt to be still current) explicitly recommend against treatment of asymptomatic bacteriuria in women. The guidelines make no explicit recommendation one way or another regarding diabetic men (probably because there is no literature on the issue), but given that they are not included in the list of people who should have asymptomatic bacteriuria treated, it is implied that they should not. The IDSA is not necessarily the final word on all topics related to infectious disease, and I am not sure how applicable these guidelines are in other parts of the world. But most clinicians at American medical centers (at least academic medical centers) follow them on this issue.
Thank you!
+missvibes I would have thought people whose diabetes is complicated by neuropathy (or otherwise because of the risk of it) would automatically be included in the third category. No?
+basim ali That's an interesting thought...Diabetic neuropathy is a length-dependent process, affecting the longest nerves first - thus, it almost always first manifests in the feet. I suppose it's possible for diabetic neuropathy to become so severe that it impacts your intraabdominal organs, leading to an inability to experience dysuria. (For example, diabetics are anecdotally more likely to have heart attacks without chest pain.) However, I've never personally encountered a diabetic patient who I suspected lacked the ability to feel a UTI due to neuropathy (and I take care of some phenomenally out-of-control diabetes).
Hmm.
Besides the inability to feel pain secondary to neuropathy, I was also thinking of the possibility of neurogenic bladder in these patients leading to stasis. Thank you for your input!
Good job..
Do Staph coagulase positives cause increased risk of coagulation in vivo or they are named because coagulation occurs in vitro (test only)? Thanks.
Do you believe that possibly many of the oddities seen within the coined “ morgellons” condition are due to a possible strain of fungi?
A huge amount of thank you
thank you, you are awesome :)
Hi, where is H.pylori on this list? Thanks
Question: abnormal sensation can be caused in diabetics, should this group be treated when asymptomatic too?
Diabetics definitely can develop a sensory neuropathy (i.e. decreased sensation), but this is usually limited to the distal extremities. I would not consider diabetes, even severe diabetes, to be a category of patients who have asymptomatic bacteruria automatically treated.
One group where this could potentially apply is spinal cord injury patients who have absent sensation from their pelvis and intrapelvic/intraabdominal organs. You might consider treating asymptomatic bacteruria in these patients, unless they have an indwelling urinary catheter (i.e. either Foley or suprapublic cath), which many of them do, because patients with indwelling urinary catheters almost always have bacteruia all of the time.
+Strong Medicine Thanks for your response. I read this somewhere in a textbook and am glad to have this clarified...it seems surprising to me that diabetes could impede sensation to that degree. According to AAFP treating asymptomatic bacteriuria in diabetic women showed no benefit in preventing occurrence of symptomatic UTI or hospitalization for UTI at 3 years follow up. I have really learned so much from your videos! How very egalitarian to have the best teaching available to everyone...you have a knack for presenting information in a way that is cohesive and makes sense for clinical practice. I appreciate this approach...the countless hours I have spent learning disparate pieces of information without elaboration, context or a sense of what it might mean for me as a practitioner...to many textbooks and lectures miss the mark.
@drericstrong thank you very much for your reply, I will not be ignoring any staph aureus bacteraemias when I start work in August! Thank you for your prompt replies, excellent videos I will certainly be watching more if these
May be valuable to add yersinia to gasteroenteritis differential :)
grateful!
Very nice.......
Cheers Bossman!
Here after I learnt that my 1yr son has uti wtf!! Hope he gets well soon he feels pain while peeing
the voice volume was too low, can it be elevated?
I'm sorry you had trouble hearing it. Between the UA-cam player volume control and my computer's main volume control, I can hear it ok. Unfortunately, I don't know why it might sound so much softer on another computer, and I also don't think there's a way for me to increase the volume once the video has been uploaded. I can certainly boost the volume on future posted videos.
@ 李宣澤: The voice volume is great on my computer!
Increase it from the youtube player or try increasing the main volume. i have tried 3 diff computers and the volume is pretty loud ....may be some problem with your computer....thanks
thank you very much
ThankYou, Sir
form italy's med students, thx.
thank you!!!
Stay safe
Awesomely informative and perfectly explained! Thank you so much! 😊😊 15/9/2019
thanx alot
Any 2018?
wowwww
Stay safe
thanks alot
Stay safe