40-something male in a head-on Motor Vehicle Collision and Splenic Injury

A 40-something male presents to the stabilization room for evaluation following head on motor vehicle collision (MVC).  Pt was reported restrained driver, hit at city speeds,  with + airbag deployment.The MVC was unquestionably caused by the other car, not by this driver.The patient complained to EMS of chest pain and a prehospital EKG en route was concerning for STEMI.The patient was at all times hemodynamically stable, without evidence of any profuse bleeding.He had an ECG recorded on arrival to the ED:Anterior and Inferior STEMI with diffuse hyperacute T-waves. This ECG really can't be anything else. Takotsubo is on the differential of anterior and inferior STE, but takotsubo just looks different (see some cases below).This must be an occluded" wraparound "LAD (wraps around the apex to the inferior wall) and one would expect an apical wall motion abnormality, as well as probable septal, anterior, and inferior wall motion abnormalities.But acute STEMI in this situation is not necessarily due to plaque rupture and/or thrombus.  It could be due to the trauma,and contusion of the LAD with thrombus or dissection.Further patient history revealed that the chest pain startedfollowingthe crash, and that he had no chest pain previously. Brief review of chart showed no h/o known CAD. DDx was possible aortic dissection or injury, cardiac contusion, LAD dissection, or type I MI w/ plaque rupture.They performed a bedside ED cardiac ultrasound...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs

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ConclusionsVitamin D insufficiency was prevalent in both newly diagnosed axSpA patients and healthy controls. There was no association between vitamin D and pain and disease activity in the newly diagnosed axSpA patients. Monitoring vitamin D levels is important and early intervention for vitamin D insufficiency is needed, especially in female patients.
Source: International Journal of Nursing Sciences - Category: Nursing Source Type: research
This article gives an overview of the current results of PET with radiolabelled amino acids in therapy monitoring of standard therapy as well as various innovative approaches in the treatment of patients with cerebral gliomas.Expert opinion: Amino acid PET has proven to be helpful in therapy monitoring of gliomas, the costs are low in relation to the costs of therapy and the clinical benefit, and a widespread clinical use is highly desirable. PMID: 31829748 [PubMed - as supplied by publisher]
Source: Expert Review of Neurotherapeutics - Category: Neurology Tags: Expert Rev Neurother Source Type: research
Publication date: Available online 13 December 2019Source: Brain, Behavior, and ImmunityAuthor(s): N.B. Teixeira, M.B. Sant'Anna, A.C. Giardini, L.P. Araujo, L.A. Fonseca, A.S. Basso, Y. Cury, G. PicoloAbstractMultiple sclerosis (MS) is a Central Nervous System inflammatory demyelinating disease that has as primary symptoms losses of sensory and motor functions, including chronic pain. To date, however, few studies have investigated the mechanisms of chronic pain in animal models of MS since locomotor impairments render difficult its evaluation. It was previously demonstrated that in the MOG35-55-induced EAE, an animal mod...
Source: Brain, Behavior, and Immunity - Category: Neurology Source Type: research
Mass abuse of the drug tramadol spans continents, from India to Africa to the Middle East. The problem is that advocates claimed it was a safer opioid, relieving pain with little risk of abuse
Source: ABC News: Health - Category: Consumer Health News Tags: Health Source Type: news
St. Vincent Healthcare, Billings MT, Sheila White, acetaminophen, hydrocodone, steal opioids, addiction, tampering,
Source: Office of Criminal Investigations (OCI) Press Releases - Category: Medical Law Authors: Source Type: news
ConclusionPatch testing is an effective method for detecting the relationship of oral lichenoid lesions with dental amalgams. Further studies should be done to support this hypothesis.
Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology - Category: ENT & OMF Source Type: research
Publication date: Available online 13 December 2019Source: Journal of Cranio-Maxillofacial SurgeryAuthor(s): Qing-Xiang Li, Rong Yang, Yi-Fei Wang, Hong-Fang Sun, Hai-Bo Wang, Hao Liu, Yu-Xing Guo, Chuan-Bin GuoSummaryIn spite of the many imaging modalities used in clinics, the one that best reflects the true delineation of skull-base (infratemporal fossa, ITF) malignancies is still unknown. In order to compare the tumor recognition capabilities of different imaging modalities, established murine models and patients with skull-base tumors were evaluated by computer tomography (CT), magnetic resonance (MR) imaging, and fluo...
Source: Journal of Cranio Maxillofacial Surgery - Category: ENT & OMF Source Type: research
ConclusionsThe results indicated that the shear bond strength between the zirconia framework and veneering ceramic was higher after laser surface treatments than after milling alone or after airborne-particle abrasion. Laser treatment methods, particularly LX2 and LX3, could be considered reliable approaches for zirconia surface treatment.
Source: The Journal of Prosthetic Dentistry - Category: Dentistry Source Type: research
Publication date: Available online 13 December 2019Source: The Journal of Prosthetic DentistryAuthor(s): Yukihiro Takeda, Jessica Lau, Hesham Nouh, Hiroshi HirayamaAbstractDigitally fabricated dentures allow clinicians to provide new prostheses for edentulous patients in an efficient manner. One approach uses a replication technique where a prosthesis in need of minor alterations is used as a basis for the definitive prosthesis. Compared with conventional duplication techniques, this method allows for the predictable fabrication of accurate dentures in less time and with increased quality. In this clinical report, int...
Source: The Journal of Prosthetic Dentistry - Category: Dentistry Source Type: research
ConclusionsZirconia crowns made by using the CS3600 and the laboratory scanner with a conventional impression showed significantly better internal discrepancies than those made by using TRIOS3 and CEREC Omnicam.
Source: The Journal of Prosthetic Dentistry - Category: Dentistry Source Type: research
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