Inferior Subtle ST elevation: straight ST segment, but also no reciprocal ST depression in aVL: which is more important?
60-something with h/o MI and stents presented with chest pain radiating to the back and nausea/vomiting.Time zeroWhat do you think?There is inferior ST elevation. Is it normal variant? Is it ischemic (OMI)? [Pericarditis? (NOT!)]There is one finding that argues against inferior OMI (There is absence of reciprocal ST depression in aVL; STD aVL is extremely sensitive for inferior OMI; Reference: Bischof and Smith). However, there is alsostraightening of the inferior ST segments, and astraight ST segment in aVF; this is extremely rare in normal variant STE)._______There is alsoterminal QRS di...
Source: Dr. Smith's ECG Blog - June 27, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Headaches: What to know, when to worry
Everyone gets the occasional when-will-this-day-end headache. These headaches may even follow a certain pattern. (Mine usually strike like clockwork if I miss my morning cup of French press coffee.)
But when is a headache cause for concern?
“Most bouts of regular headaches are not serious and can be treated on their own,” says Dr. Elizabeth Loder, chief of the division of headache in the department of neurology at Harvard-affiliated Brigham and Women’s Hospital. “However, being aware of the features of the different types of headaches can help you determine if your headaches are something more serious that requires...
Source: Harvard Health Blog - June 11, 2019 Category: Consumer Health News Authors: Matthew Solan Tags: Headache Health Migraines Source Type: blogs
Options to Opioids: How to Manage Chronic Pain Without Prescribing Pain-Killers
You're reading Options to Opioids: How to Manage Chronic Pain Without Prescribing Pain-Killers, originally posted on Pick the Brain | Motivation and Self Improvement. If you're enjoying this, please visit our site for more inspirational articles.
While there is considerable debate as to how much blame doctors should be assigned for the ongoing opioid crisis, there is little doubt they can do something to curtail it -- that instead of prescribing drugs that have been found to be highly addictive they can resort to alternate forms of pain management.
Doctors’ prescription of powerful painkillers like OxyContin is frequentl...
Source: PickTheBrain | Motivation and Self Improvement - May 14, 2019 Category: Consumer Health News Authors: DrStanleyMatthew Tags: health and fitness addiction health and wellness opioids self improvement Source Type: blogs
The new aspirin guidelines: The media does a disservice to patients
Much media attention has been paid to the new guidelines from American College of Cardiology/American Heart Association (ACC/AHA) on the primary prevention of cardiovascular disease. Based on new clinical trial data, ACC/AHA no longer recommends that healthy adults without cardiovascular disease— emphasis on without cardiovascular disease— take daily aspirin for the primary prevention […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - May 13, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/olubadewa-a-fatunde" rel="tag" > Olubadewa A. Fatunde, MD, MPH < /a > < /span > Tags: Meds Cardiology Mainstream media Source Type: blogs
Acute chest pain in a patient with cardiomyopathy and a paced rhythm.
A 70-something with h/o cardiomyopathy, ICD, LVH was awoken with sharp chest pain, 8/10, non-radiating. It worsened through the morning and she was eventually brought to the hospital.An ECG was recorded:What do you think?Here is one from 3 years prior:There is a paced rhythm in all 12 leads. The new ECG has new ST Elevation that meets the Smith modified Sgarbossa criteria in leads I, aVL, and V2. (ST elevation at the J-point is at least 25% of the depth of the preceding S-wave). Meeting the criteria in just one lead is very specific for OMI in paced rhythm.She was given aspirin, ticagrelor, and...
Source: Dr. Smith's ECG Blog - May 12, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Watch this for a minute . . . keep your blood vessels healthy life long !
https://drsvenkatesan.files.wordpress.com/2019/05/vid-20190504-wa0014-1.mp4
Yes, Its “evidence-based fun”. Forget all those anti-platelet trial dramas … showing in the cardiovascular theatres near you . There is only one genuine drug , that’s the good old humble Aspirin . Mind you ,none of other actors can ever be imagined for primary prevention.
By the way , there is absolutely no controversy for the role of Aspirin in secondary prevention after established CAD.(We know , how Aspirin has taken up a critically Integral role in saving the life of the stents as well as patients, post ...
Source: Dr.S.Venkatesan MD - May 5, 2019 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized arrive and ascend study primary prevention of cad with aspirin Source Type: blogs
The Paracetamol Papers
I have secretly obtained a large cache of files from Johnson& Johnson, makers of TYLENOL ®, the ubiquitous pain relief medication (generic name: acetaminophen in North America,paracetamol elsewhere). The damaging information contained in these documents has been suppressed by the pharmaceutical giant, for reasons that will become obvious in a moment.1After a massive upload of materials to Wikileaks, it can now be revealed that Tylenol not only...eases social rejectionmends a broken heartlessens mortality salience(i.e., fear of death)reduces antisocial behaviortreats chronic anxiety disorder...but along with the good c...
Source: The Neurocritic - April 26, 2019 Category: Neuroscience Authors: The Neurocritic Source Type: blogs
No Quick Fix for the Culture of Prescribing that Drives Medication Overload
By THERESA BROWN, RN
In my mid-twenties, I was twice prescribed the common antihistamine
Benadryl for allergies. However, my body’s reaction to the drug was anything
but common. Instead of my hives fading, they erupted all over my body and my
arms filled with extra fluid until they were almost twice normal size. I subsequently
described my experience to a new allergist, who dismissed it as “coincidence.”
When I later became a nurse, I learned that seemingly “harmless” medications often cause harm, and older adults are particularly vulnerable. Every year, Americans over age 65 have preventable “adverse dr...
Source: The Health Care Blog - April 25, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Patients Physicians overprescribing prescription medication Theresa Brown Source Type: blogs
Fight Aging! Newsletter, April 15th 2019
In this study, we found that senescent chondrocytes isolated from OA patients secrete more EVs compared with nonsenescent chondrocytes. These EVs inhibit cartilage ECM deposition by healthy chondrocytes and can induce a senescent state in nearby cells. We profiled the miR and protein content of EVs isolated from the synovial fluid of OA joints from mice with SnCs. After treatment with a molecule to remove SnCs, termed a senolytic, the composition of EV-associated miR and protein was markedly altered. The senolytic reduced OA development and enhanced chondrogenesis, and these were attributable to several specific differenti...
Source: Fight Aging! - April 14, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
The Interventions Testing Program Finds Glycine Supplementation has a Tiny Effect on Mouse Life Span
The NIA Interventions Testing Program (ITP) is a very conservative organization. The organizers take compounds that cannot possibly do more than slightly slow aging, largely those that upregulate stress response mechanisms in a similar way to calorie restriction, and rigorously test them in large mouse studies. The results are of the best quality, and tend to demonstrate that most earlier, less rigorous studies overestimated the effects of compounds on life span. This is an expensive business, but I would say one of dubious practical value.
The practice of calorie restriction shows us the likely bounds of the possib...
Source: Fight Aging! - April 10, 2019 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
What happens when a patient with LAD OMI does not go immediately to the cath lab?
This patient was extremely elderly, and although the diagnosis was recognized, she did not go to the cath lab for reasons related to age and patient/family choice.Nevertheless, there is a lot to learn from the ECGs.I was shown this ECG without any information:QTc = 431 msWhat was my response?I immediately said:" Acute LAD occlusion. OcclusionMI (OMI) " (And sinus rhythm with a PVC.) (Not quite a STEMI, but same effect.)Why did I diagnose LAD occlusion?There isST elevation in V2-V4 that does not quite meet " STEMI criteria. " Is it normal ST elevation? No! How do I know? First, there is re...
Source: Dr. Smith's ECG Blog - April 2, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
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 ...
Source: Dr. Smith's ECG Blog - March 28, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Fight Aging! Newsletter, March 25th 2019
This study defines a new clinically relevant concept of T-cell senescence-mediated inflammatory responses in the pathophysiology of abnormal glucose homeostasis. We also found that T-cell senescence is associated with systemic inflammation and alters hepatic glucose homeostasis. The rational modulation of T-cell senescence would be a promising avenue for the treatment or prevention of diabetes.
Intron Retention via Alternative Splicing as a Signature of Aging
https://www.fightaging.org/archives/2019/03/intron-retention-via-alternative-splicing-as-a-signature-of-aging/
In recent years researchers have in...
Source: Fight Aging! - March 24, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Chronic Inflammation as the Primary Cause of Declining Bone Regeneration with Age
Researchers here show that it is the chronic inflammation of aging that is the dominant contributing cause of loss of capacity in bone regeneration in later life. We should all feel a degree of relief whenever it turns out that chronic inflammation is the primary proximate cause of an age-related condition. Age-related inflammation is driven by senescent cells and immune system failure. Therapies to remove senescence cells are well advanced in clinical development, and there are many potential lines of work that will lead to ways to reverse the dysfunction of the aged immune system in years to come. The inflammatory profil...
Source: Fight Aging! - March 21, 2019 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Over-the-counter cold and flu medicines can affect your heart
As the cold and flu season continues this year, it is important to be aware that many of the most commonly used over-the-counter (OTC) remedies for congestion, aches, pains, and low-grade fevers contain medicines that can have harmful effects on the cardiovascular system. Chief among these medications are nonsteroidal anti-inflammatory drugs (NSAIDs) and decongestants.
NSAIDs and your heart
Certain NSAIDs are associated with a small increase in the relative risk for developing a heart attack, stroke, heart failure, atrial fibrillation, increased blood pressure, and blood clots. NSAIDs relieve pain and inflammation by inhib...
Source: Harvard Health Blog - March 20, 2019 Category: Consumer Health News Authors: Mark Benson, MD, PhD Tags: Cold and Flu Drugs and Supplements Health Heart Health Source Type: blogs
