Bedside ultrasound is not yet the standard of care. But it will be.

I just read a Clinical Problem Solving case from the New England Journal of Medicine (NEJM). It was entitled “Stream of Consciousness“and it told the story of a 65-year-old man who was a patient at the Brigham and Women’s Hospital of Harvard Medical School, arguably one of the finest medical institutions in the world. These cases are presented in single paragraphs to a clinical expert physician who then comments about his or her thought processes and discusses how he or she would have handled the situation. In this narrative, the patient presented to a different hospital in New England with kidney failure and a gradual onset of confusion in the setting of very high blood pressure. He was then transferred to the Brigham and Women’s Hospital for further evaluation and treatment. He had lab tests of all color and stripe along with MRI and CT scans of his brain which showed some disconcerting spots. He had a lumbar puncture, and his high blood pressure was treated. Eventually, after 2 or 3 days in the hospital (I can’t tell from the narrative), an ultrasound was done which showed that his bladder had not been emptying properly, which had caused the kidney failure and probably the high blood pressure. A Foley catheter was placed which drained nearly 3 liters (!) of urine after which his blood pressure was much more easily controlled. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social medi...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Hospital-Based Medicine Neurology Source Type: blogs

Related Links:

High blood pressure? There ’s an app for that. Diabetes? There’s an app for that, too. Want to quit smoking? Keep track of your exercise? Is your anxiety getting the better of you? There are apps for all of those health issues, hundreds of thousands of apps. Developers at Blue Shield of California have rolled out a ne w, enhanced Wellvolution website — Wellvolution Next — that brings together roughly 40 of the best “digital therapeutics” applications in one place where members can…
Source: Health Care:Biotechnology headlines - Category: Biotechnology Authors: Source Type: news
Publication date: Available online 12 November 2019Source: Life SciencesAuthor(s): Eman Soliman, Shereen F. Behairy, Nabila N. El-maraghy, Shimaa M. ElshazlyAbstractPeroxisome proliferator-activated receptor γ (PPAR-γ) agonist, pioglitazone, is used clinically to improve the glycemic state in patients with type-2 diabetes mellitus. Independent of its blood glucose-lowering properties, pioglitazone ameliorates different cardiovascular disorders. The aim of the present study was to investigate the effect of pioglitazone on cardiovascular complications of N-nitro-L-arginine methyl ester (L-NAME)-induced hypertensi...
Source: Life Sciences - Category: Biology Source Type: research
Publication date: Available online 12 November 2019Source: The Journal of Steroid Biochemistry and Molecular BiologyAuthor(s): Luisa Paizoni, Matthias K. Auer, Heinrich Schmidt, Angela Hübner, Martin Bidlingmaier, Nicole ReischAbstractData on cardiovascular morbidity in adults with congenital adrenal hyperplasia (CAH) is sparse. We therefore aimed to determine the role of androgen control and glucocorticoid therapy on metabolic health. For that purpose, we included 90 patients (N = 39 men, N = 51 women) with classic CAH due to 21-hydroxylase deficiency (N = 61 salt wasting, N&...
Source: The Journal of Steroid Biochemistry and Molecular Biology - Category: Biochemistry Source Type: research
ConclusionsIn patients with CKD referred for right heart catheterization, PH is common and associated with poor survival. Combined pre- and postcapillary PH was common and portended the worst survival for patients with CKD
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
We present the case of a 77-year-old woman with a history of a Whipple procedure for pancreatic adenocarcinoma who presented to the emergency department after the start of gemcitabine therapy with increased erythema, swelling, and tenderness in her lower legs. Relevant past medical history included peripheral vascular disease, dyslipidemia, and hypertension. A diagnosis of gemcitabine-induced pseudocellulitis aggravated by venous stasis was confirmed after an extensive workup. This case report and the literature review describe this rare reaction, highlighting the need for increased recognition to avoid unnecessary therape...
Source: Current Oncology - Category: Cancer & Oncology Tags: Curr Oncol Source Type: research
ConclusionAlthough Meckel’s diverticulitis is a rare entity, it can appear as an acute abdomen. An early diagnosis and treatment to prevent subsequent complications is essential to ensure an optimal recovery.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Condition:   Arterial Hypertension Intervention:   Sponsor:   Federal State Budgetary Scientific Institution, Research Institute of Cardiology Recruiting
Source: - Category: Research Source Type: clinical trials
Condition:   Hypertension, Dyslipidemia Interventions:   Drug: Amlodipine/Olmesartan 10/40mg (Combination drug), Ezetimibe/Rosuvastatin 10/20mg(Combination drug);   Drug: Olmesartan 40mg, Ezetimibe/Rosuvastatin 10/20mg(Combination drug);   Drug: Amlodipine/Olmesartan 10/40mg (Combination drug) Sponsor:   Daewoong Pharmaceutical Co. LTD. Recruiting
Source: - Category: Research Source Type: clinical trials
Conditions:   Dyslipidemias;   Diabetes Mellitus, Type 2;   Hypertension Intervention:   Dietary Supplement: Nutraceutical Sponsor:   University of Pavia Recruiting
Source: - Category: Research Source Type: clinical trials
ConclusionThe changes in functional connectivity and structural connectivity within the DMN attributed to WMH progression were responsible for the development of cognitive impairment.
Source: NeuroImage: Clinical - Category: Radiology Source Type: research
More News: Blogging | Brain | CT Scan | General Medicine | Harvard | Hospitals | Hypertension | Lumbar Puncture | Neurology | PET Scan | Ultrasound | Urology & Nephrology | Women