A young woman with epigastric pain. ECG Crochetage sign? What is the significance?
A former resident texted me this ECG, done for epigastric pain in an 18 year old. The pain resolved immediately with treatment for acid reflux, and in the clinician's opinion was clearly GI in origin, but he wanted to know what the strange waves in the QRS were:See the unusual notching in II, III, aVF, and V2-V4.I had no idea what they were. They reminded me of theDelayed Activation Wave associated with circumflex acute MI.See this case: https://hqmeded-ecg.blogspot.com/2018/05/is-there-delayed-activation-wave.html.But they are clearly different from this.I put it on Facebook EKG club and this is the response:No one knew for certain what that was, butKen Grauer suspected artifact (due to lead placement over an artery) or aCrochetage sign, which is strongly associated with atrial septal defect. I looked up Crochetage sign and it sure does look like it!You can always rely on Ken.I told my former resident:The latter (Crochetage) is important because it is seen in atrial septal defect. I not sure the cardiologist will know this. You should make certain she gets an echo specifically looking for ASD (especially if still present on a repeat ECG). Let the referral cardiologist know. He will notify the patient but, unfortunately, because she will follow up in a different system, he will not have follow up.Crochetage signYou can see many more images of the Crochetage sign here.See the 5 articles below.“...
Authors: Reissier S, Cattoir V Abstract INTRODUCTION: Streptogramins (pristinamycin and quinupristin-dalfopristin) can be interesting options for the treatment of infections due to Gram-positive cocci, especially multidrug-resistant isolates. AREAS COVERED: This review provides an updated overview on structural and activity characteristics, mechanisms of action and resistance, pharmacokinetic/pharmacodynamic and clinical use of streptogramins. EXPERT OPINION: The streptogramin antibiotics act by inhibition of the bacterial protein synthesis. They are composed of two chemically distinct compounds, namely typ...
We describe the most highly recommended generic and disease-specific PRO tools in SCD and discuss the challenges of incorporating them in clinical practice. EXPERT OPINION: PRO measures are essential to incorporate into SCD clinical trials either as primary or secondary outcomes. The use of PRO measures in SCD facilitates a patient-centered approach, which is likely to lead to improved outcomes. Significant challenges remain in adapting PRO tools to routine clinical use and in developing countries. PMID: 33034214 [PubMed - as supplied by publisher]
Authors: Sabet Sarvestani F, Azarpira N Abstract Heart and cerebral infarctions, as two important ischemic diseases, lead to the death of tissues due to inadequate blood supply and high mortality worldwide. These statuses are started via blockage of vessels and depletion of oxygen and nutrients which affected these areas. After reperfusion and restoration of oxygen supply, more severe injury was mediated by multifaceted cascades of inflammation and oxidative stress. microRNAs (miRNAs) as the regulator of biological and pathological pathways can adjust these conditions by interaction with their targets. Also, miRNAs...
Currently in fellowship doing bread/butter procedures (MBB, epidurals, PNB, few SCS/PNS trials, etc.) and just interviewed at a private practice spot where they do a lot of procedures that I will have not done any training in prior to graduating (e.g. IT pump, SI fusion, Vertiflex, Kypho, MILD, Discectomy, lots of SCS/PNS trials etc) and significant amount of "OR pain procedures" at a very busy practice seeing 30-40 pts/day - how many of you are commonly performing these procedures and are... private practice concern
Publication date: Available online 9 October 2020Source: NeuropsychologiaAuthor(s): Erin L. Meier, Shannon M. Sheppard, Emily B. Goldberg, Catherine R. Head, Delaney M. Ubellacker, Alexandra Walker, Argye E. Hillis
Publication date: Available online 9 October 2020Source: Neurología (English Edition)Author(s): J.P. Martínez-Barbero, P. Tomás-Muñoz, R. Martínez-Moreno
Publication date: October 2020Source: Brain, Behavior, and Immunity, Volume 89Author(s): Fernando Lopes, Fernando A. Vicentini, Nina L. Cluny, Alexander J. Mathews, Benjamin H. Lee, Wagdi A. Almishri, Lateece Griffin, William Gonçalves, Vanessa Pinho, Derek M. McKay, Simon A. Hirota, Mark G. Swain, Quentin J. Pittman, Keith A. Sharkey
BEST supplements to relieve joint pain: Is your arthritis playing up? The wetter and colder months could partially be to blame. These two pills may help.
Authors: Mantero V, Rigamonti A, Basilico P, Sangalli D, Scaccabarozzi C, Salmaggi A PMID: 33029982 [PubMed]
Authors: Kim H, Lim YM, Lee EJ, Kim HW, Ahn HS, Kim KK PMID: 33029979 [PubMed]