Fluoropyrimidine-Associated Cardiotoxicity: A Retrospective Case-Control Study.

We described phenotypes and outcomes of cardiotoxic cases. RESULTS: We identified 177 patients who received fluoropyrimidines. After adjudication, 4.5% of the cohort met the criteria for cardiovascular toxicity. Coronary artery disease was more common among cases than controls (38% vs. 7%, p
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Oncologist Source Type: research

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A middle-aged man complained of 15 minutes of classic angina that resolved upon arrival to the ED.Here is his initial ECG:What do you think?There is sinus rhythm with RBBB and possible LPFB (see Dr. Grauer's detail below).  There is ST elevation in II, III, and aVF, and reciprocal ST depression in aVL.  And there are Q-waves in both inferior and lateral leads.  So this is indeed diagnostic of myocardial infarction.Should we activate the cath lab?No! Not immediately, at least, because this is NOT diagnostic of ACUTE (occlusion) myocardial infarction (Acute OMI).  We need to do some more investigatio...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
A 50-something woman with history of CHF of unknown etiology, and of HTN, presented for evaluation of chest pressure.Her BP was 223/125, Sp02 98% on RA. HR 106, RR 18. Here was her ED ECG:There is sinus rhythm with Left Bundle Branch Block (LBBB)There is a large amount of ST Elevation in V2 and V3 (more than 5 mm)Thus, this meets the unweighted Sgarbossa Criteria of 5 mm of discordant ST ElevationBut it does NOT meet the Smith Modified Sgarbossa Criteria, which depend on the ST/S ratio.This ratio is critical because LBBB with very large depolarization voltage (QRS) also has very large repolarization voltage (ST/T).Her...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
In conclusion, with study of the frailty syndrome still in its infancy, frailty analysis remains a major challenge. It is a challenge that needs to be overcome in order to shed light on the multiple mechanisms involved in the pathogenesis of this syndrome. Although several mechanisms contribute to frailty, immune system alteration seems to play a central role: this syndrome is characterized by increased levels of pro-inflammatory markers and the resulting pro-inflammatory status can have negative effects on various organs. Future studies should aim to better clarify the immune system alteration in frailty, and seek to esta...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
In conclusion, long-term aerobic exercise appears to attenuate the decline in endothelial vascular function, a benefit which is maintained during chronological aging. However, currently there is not enough evidence to suggest that exercise interventions improve vascular function in previously sedentary healthy older adults. Hijacking the Proteasome to Dispose of Unwanted Molecules in Age-Related Disease https://www.fightaging.org/archives/2019/03/hijacking-the-proteasome-to-dispose-of-unwanted-molecules-in-age-related-disease/ Cells are equipped with a protein disposal system in the form of the proteaso...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
​BY GREGORY TAYLOR, DO, &SHERIF G. EL-ALAYLI, DOA 30-year-old G5P3 presented to the ED with bilateral lower-extremity edema and headache for three days. She presented one week after an uncomplicated full-term vaginal delivery with an unremarkable pregnancy course and no prior requirement for antihypertensive therapy. The headache was described as achy to sharp, with associated photophobia. She also noted occasional vaginal spotting, which was common a few weeks after delivery. She denied any chest pain, shortness of breath, nausea or vomiting, abdominal pain, or any other symptoms. She admitted to occasional mild cra...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
This case was written by one of ourgreat Hennepin 2nd year residents, Aaron Robinson, with lots of comments and edits by Smith.Thanks to Dr. Smith and Dr. Travis Olives for being part of this case. A 12 year old girl with a history of mild intermittent asthma presented to the emergency department with worsening shortness of breath over the past couple of days. She is up to date on her vaccinations and has no PMHx besides asthma and a noncontributory family history. She does not identify any specific triggers for her asthma. Initial screen in triage revealed normal vitals signs and a normal temperature. Upon interviewi...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
This case was sent by Laszlo Farkas, a paramedic from Hungary.  He discussed it with Janos Borbas MD and Robert Sepp MD from University of Szeged 2nd Department of Internal Medicine and Cardiology Clinic. The case inspired me to resurrect a case that I published 10 years ago with the same ECG finding (2nd case below).What is the finding?What does it signify?CaseAn elderly male presented with chest pain.  Here is the first ED ECG:Hint: the finding is NOT the T-wave inversion in aVLThis ECG that I published 10 years ago in Critical Decisions in Emergency and Acute Care Electrocardiography has th...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Patient Presentation A 9-year-old male came to clinic with a 1 month history of painful joint swelling. One month ago he started having right ankle pain that was intermittent but consistent. One day ago his right wrist, right ankle and bilateral knees had some swelling but no erythema or warmth. He says that he has pain in them when he moves but not when he is resting and he denies any joint stiffness or gelling. He also had 1-2 days of multiple red skin lesions on his extremities and trunk, not overlying the affected joints. The skin lesions do not come and go and do not itch. They are mainly discrete circular lesions wi...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
In this study, we collected PPG pulse wave traces from patients with oHCM and healthy volunteers. Using automated analyses, we extracted details about the shape and pattern of the tracings and applied machine learning to identify differences in these...
Source: Medgadget - Category: Medical Devices Authors: Tags: Cardiology Exclusive Source Type: blogs
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