New Onset Heart Failure and Frequent Prolonged SVT. What is it? Management?
This middle-aged man with no cardiac history but with significant history of methamphetamin and alcohol use presented with chest pain and SOB, worsening over days, with orthopnea.BP:143/99, Pulse 109, Temp 37.2 °C (99 °F), Resp (!) 32, SpO2 95%On exam, he was tachypneic and had bibasilar crackles.Here was his ED ECG:There is sinus tachycardia (rate about 114) with nonspecific ST-T abnormalities.There is a large peaked P-wave in lead II (right atrial enlargement)There is left axis deviation consistent with left anterior fascicular block.There are nonspecific ST-T abnormalities.There is no evidence of infarction or ischemia.Troponin I was 0.054 ng/mLNT-ProBNP was 8316 (0-900 pg/mL)."NT-proBNP values less than 300 pg/ml have a 99% negative predictive value for excluding congestive heart failure. A cutoff of 1200 pg/ml for patients with a normal eGFR is very specific for heart failure. A diagnostic NT-proBNP cutoff of 900 pg/mL has been suggested in adults 50-75 years of age in absence of renal failure. "A bedside POC cardiac ultrasound was done:Findings: Decreased left ventricular systolic function.The patient was given furosemide and admitted to the hospital.Later, he underwent a formal echocardiogram:Very severe left ventricular enlargement (LVED diameter 7.4 cm).Severely decreased left ventricular systolic function with an estimated EF of 20-25%.No left ventricular wall motion abnormality identified.Severe right ventricular enlargement and mildly d...
Publication date: Available online 3 June 2020Source: Pharmacology Biochemistry and BehaviorAuthor(s): Yasunori Haranishi, Koji Hara, Tadanori Terada
Publication date: Available online 3 June 2020Source: PolymerAuthor(s): Ahmed Gamal El-Shamy
CONCLUSIONS: the prevalence of symptoms was high and changed throughout the hospitalization period. Patients with poorer functional capacity and poorer performance had greater symptom overload. PMID: 32490991 [PubMed - in process]
CONCLUSION: the findings have implications for the implementation of health promotion strategies among nursing students, in view of lifestyle changes. PMID: 32490956 [PubMed - in process]
CONCLUSION: Quality of life and social support were identified as protective factors for depressive symptoms while being at risk of malnutrition, living alone, reporting pain and being female are predictors. PMID: 32490955 [PubMed - in process]
CONCLUSION: BD on a single or multiple occasion during the month was associated with a higher prevalence of overweight. Therefore, such a lifestyle should be considered in weight gain prevention strategies. PMID: 32490946 [PubMed - in process]
I've finished my AMCAS application and am ready to send it in...almost. I'm conflicted over whether or not I should write the disadvantaged student essay. To make a long story relatively short, my parents divorced when I was five, and my dad subsequently became absent from my life until 11th grade-ish. My mom developed alcoholism after the divorce and became very volatile (and incredibly abusive, but I'm not sure if I should mention that); she did not receive a formal education, and... Should I write the disadvantaged student essay?
Renal angiomyolipoma (AML) is the most common benign solid renal neoplasm seen in daily clinical practice, with an estimated prevalence of 0.2% to 0.6%.1 It is a triphasic mesenchymal neoplasm composed of varying amounts of dysmorphic vasculature, smooth muscle, and mature adipocytes. Pathologically, AML is now considered among the family of perivascular epithelioid cell tumors. Approximately 80% of cases are sporadic, with mean age at presentation being 43 years and most cases identified at fourth to sixth decades of life. There is also a strong female predilection, with female-to-male ratio of 4:1 in sporadic cases.1 Twe...
Publication date: Available online 3 June 2020Source: NeuropsychologiaAuthor(s): Selene Petit, Nicholas A. Badcock, Alexandra Woolgar
Fitbit is continuing its rapid trajectory into the medtech industry with a new Emergency Use Authorization from FDA. The San Francisco, CA-based company said the EUA is for a low-cost emergency ventilator to help address patientsâ needs during the COVID-19 pandemic. The company said after seeing the need for ventilators, it applied its deep in-house expertise in advanced sensor development and hardware design to quickly create Fitbit Flow, an automatic resuscitator inspired by the MIT E-Vent Design Toolbox and based on specifications for Rapidly Manufactured Ventilation Systems. Fitbit said during develop...
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