Epigastric pain radiating to the chest for 18 hours. ECG makes the Dx. Troponin makes the Dx. CT makes the Dx!

I was shown this ECG with no other information:What do you think?Hint: try to see through the artifact!I answered immediately: " High lateral MI with posterior MI. OMI. " (Occlusion Myocardial Infarction)I asked, " Did the patient present with chest pain? "Here is the history:" A middle-aged male complained of about 18 hours of epigastric pain that radiated to the chest.  He also had an apparently new facial droop of equal duration.  A stroke code was called, NIH stroke scale was only 1, and attention was turned to the chest pain. "  BP was 148/83.How did I make this ECG diagnosis?There is subtle STE in aVL with reciprocal STD in II, III, aVF,and STD in V3 and V4.While there are ECGs that have STE in aVL with reciprocal STD in II, III, aVF in the absence of OMI, they do not also have STD in right precordial leads.  Furthermore, the morphology here is perfect for OMI.(See the bottom of the post for 3 ECGs from this week with STE aVL and STD III, for which my answer was " no ischemia. " )They performed a point of care cardiac ultrasound (parasternal short axis):What do you think?Notice the upper right (septum) contracts much more vigorously than the lower right and right (lateral wall)The physician did not appreciate this because he was thinking about the patient's pain combined with the facial droop, and so he appropriately obtained a chest CT aortogram to look for aortic dissection.  It did n...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs

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In this paper we develop an adaptive transform-domain technique based on rational function systems. It is of general importance in several areas of signal theory, including filter design, transfer function approximation, system identification, control theory etc. The construction of the proposed method is discussed in the framework of a general mathematical model called variable projection. First we generalize this method by adding dimension type free parameters. Then we deal with the optimization problem of the free parameters. To this order, based on the well-known particle swarm optimization (PSO) algorithm, we develop ...
Source: IEEE Transactions on Signal Processing - Category: Biomedical Engineering Source Type: research
CONCLUSION: In real-world patients at high risk of bleeding, implantation of the polymer-free metallic stent coated with Biolimus-A9 (Biofreedom®; Biosensors Europe, Morges, Switzerland) followed by 1 -month DAPT showed encouraging results without any stent thrombosis. PMID: 31965195 [PubMed - as supplied by publisher]
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
Structured light illumination is an active three-dimensional scanning technique that uses a projector and camera pair to project and ...
Source: Applied Optics - Category: Physics Authors: Source Type: research
AbstractTo investigate the prevalence of different patterns of cemento-enamel junction (CEJ) morphology under swept-source optical coherence tomography (SS-OCT). One hundred extracted human teeth were used consisting of incisors, premolars, and molars. Each sample was observed for every 500  μm circumferentially along CEJ and OCT images of the pattern were noted. Microscopic observations were done for the representative sample using confocal laser scanning microscope (CLSM) and transmission electron microscope (TEM). The OCT images exhibited four CEJ patterns: edge-to-edge (type I), exposed dentin (type II), cement...
Source: Lasers in Medical Science - Category: Laser Surgery Source Type: research
AbstractOsteoarthritis (OA) is a chronic joint disease that leads to pain and functional incapacity. The aim of the study is to investigate the effects of the incorporation of photobiomodulation (PBM) (via cluster) into a physical exercise program on the level of pain, lower limb muscle strength, and physical capacity, in patients with knee OA. Sixty-two female volunteers with a diagnosis of knee OA were distributed in 4 groups: exercise associated with placebo PBM group, exercise associated with active PBM group, active PBM group, and placebo PBM group. Sixteen sessions of lower limb strength exercises and PBM via cluster...
Source: Lasers in Medical Science - Category: Laser Surgery Source Type: research
Authors: Nardone V, Tini P, Pastina P, Botta C, Reginelli A, Carbone SF, Giannicola R, Calabrese G, Tebala C, Guida C, Giudice A, Barbieri V, Tassone P, Tagliaferri P, Cappabianca S, Capasso R, Luce A, Caraglia M, Mazzei MA, Pirtoli L, Correale P Abstract Immune checkpoint blockade is an emerging anticancer strategy, and Nivolumab is a human mAb to PD-1 that is used in the treatment of a number of different malignancies, including non-small cell lung cancer (NSCLC), kidney cancer, urothelial carcinoma and melanoma. Although the use of Nivolumab prolongs survival in a number of patients, this treatment is hampered b...
Source: Oncology Letters - Category: Cancer & Oncology Tags: Oncol Lett Source Type: research
Publication date: Available online 22 January 2020Source: PeptidesAuthor(s): Anshul Panjeta, Simran PreetAbstractThe escalating predicament of multidrug resistant cancer cells and associated side effects of conventional chemotherapy necessitates the exploration of alternative anticancer therapies. The present study evaluated anticancer therapeutic potential of human defensin 5 (HD-5) against colon cancer. The in vivo anticancer efficacy of HD-5 against 1,2-dimethylhydrazine (DMH) induced colon cancer was elucidated in terms of tumor biostatistics, number of aberrant crypt foci (ACF), in situ apoptosis assay,changes in morp...
Source: Peptides - Category: Biochemistry Source Type: research
Curved screens are widely used in smart wearables, optics, aerospace, and other display fields. To overcome the difficulty of overall ...
Source: Applied Optics - Category: Physics Authors: Source Type: research
Publication date: Available online 22 January 2020Source: Composites Science and TechnologyAuthor(s): Zhen Zhang, Shifeng Guo, Qian Li, Fangsen Cui, Andrew Alexander Malcolm, Zhongqing Su, Menglong LiuAbstractA multi-frequency ultrasonic method was proposed to detect and characterize delamination and rich resin in thick composites with waviness. Addressing the challenges for ultrasonic inspection caused by waviness, multi-layer structure, and multiple defect types, ultrasound propagation in thick wavy composite was investigated through a dedicated numerical model built in OnScale®. Key features of ultrasonic testing an...
Source: Composites Science and Technology - Category: Science Source Type: research
CONCLUSIONS: HSV may induce perianal infections, anal infections and HSV proctitis. Diagnosis of HSV1 and HSV2 using PCR is recommended. Anal and genital HSV infections are a risk factor for subsequent HIV infection. The risk is higher for HSV2 infection due to more frequent recurrences. PMID: 31965208 [PubMed - as supplied by publisher]
Source: Der Hautarzt: Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete - Category: Dermatology Tags: Hautarzt Source Type: research
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