Sun protection: Appropriate sunscreen use
Summer holidays are here and the sunny, warm weather is in full swing. Now is not the time to get lazy about sun protection!
Sun: The good and the not-so-good
Sunlight is essential for many important bodily functions, including producing vitamin D and maintaining your circadian rhythm and mood. Yet too much sun exposure can also be harmful. Ultraviolet (UV) radiation may result in short-term and long-term skin damage, including sunburn, signs of aging, and even skin cancer. Approximately one out of five people in the United States may develop skin cancer in their lifetimes.
Approximately 95% of the UV radiation reaching ou...
Source: Harvard Health Blog - June 21, 2018 Category: Consumer Health News Authors: Dominic Wu, MD Tags: Health Prevention Skin and Hair Care Source Type: blogs
Tropical Travel Trouble 008 Total TB Extravaganza
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
aka Tropical Travel Trouble 008
Peer Reviewer Dr McBride ID physician, Wisconsin
TB affects 1/3rd of the population and one patient dies every 20 seconds from TB. Without treatment 50% of pulmonary TB patients will be dead in 5 years. In low to middle income countries both TB and HIV can be ubiquitous, poor compliance can lead to drug resistance and malnourished infants are highly susceptible. TB can be very complex and this post will hopefully give you the backbone to TB m...
Source: Life in the Fast Lane - June 16, 2018 Category: Emergency Medicine Authors: Neil Long Tags: Clinical Cases Tropical Medicine Genexpert meningitis TB TB meningitis Tuberculosis Source Type: blogs
" Shark Fin " : A Deadly ECG Sign that you Must Know!
Conclusions:Shark Fin is an electrocardiographic sign of acute coronary occlusion. It is a unique ECG phenomenon consisting of complexes formed by the blurring together of QRS and T-wave as a result of extreme ST-Deviation. These complexes manifest in contiguous ECG leads corresponding with coronary anatomy, and represent transmural ischemia. Shark Fin Sign should be recognized based on its characteristic morphology, and confirmed by delineating the J-point using the technique described above. While there is a paucity of literature on the topic, the presence of this sign appears to be associated with a significant mortalit...
Source: Dr. Smith's ECG Blog - June 11, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs
Antiphospholipid Syndrome
Antiphospholipid Syndrome (APS) important in vascular medicine as well as obstetrics. In obstetrics, it is important because it can cause fetal loss, intrauterine growth retardation and severe preeclampsia. In vascular medicine it is important because it can cause thrombotic events which could be arterial, venous or microvascular [1]. It can also be accompanied by moderate thrombocytopenia [2]. Thrombotic events involving multiple organs may be termed catastrophic Antiphospholipid Syndrome [3].
APS is an autoimmune disease with antibodies directed against beta2 glycoprotein I. This leads to suppression of tissue factor p...
Source: Cardiophile MD - May 27, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology anti beta2 glycoprotein I antibodies anti cardiolipin antibodies lupus anticoagulant Source Type: blogs
Factors enhancing risk of limb loss after revascularization
are:
Infra inguinal bypass using prosthetic material
Bypass below the knee
Use of sub optimal conduit
Poor arterial runoff
Extensive lesion
When these risk factors are noted, anti thrombotic therapy can be intensified by adding either rivaroxaban or warfarin to aspirin. Another option is to give dual antiplatelet therapy. While intensifying therapy, risk of limb loss should be weighed against the potential bleeding risk in each individual. Triple therapy with two antiplatelet agents and one anticoagulant is better avoided in view of high bleeding risk.
The post Factors enhancing risk of limb loss after revascularization...
Source: Cardiophile MD - May 26, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Peripheral Interventions Source Type: blogs
A middle aged man with ST depression and a narrow window of opportunity
Written by Pendell MeyersI received a text at 18:13 of an ECG taken several minutes prior, with no clinical information and only the question " De Winters? "Here is the ECG:What would you tell the treating team???I responded at 18:14 PM:" I think it ' s posterior STEMI (OMI) instead of de Winter. Cath lab immediately is indicated. "I clarified further:" De Winter would need hyperacute T waves (not present here), and would indicate acute occlusion of the territory in the affected leads; so if there was de Winter in anterior leads, that would mean the anterior wall is the one involved. Here we have isolated posterior STD, wi...
Source: Dr. Smith's ECG Blog - May 19, 2018 Category: Cardiology Authors: Pendell Source Type: blogs
Fight Aging! Newsletter, May 7th 2018
The objective here is a set of tests that (a) match up to the expected outcome based on human trials of mitochondrially targeted antioxidants, and (b) that anyone can run without the need to involve a physician, as that always adds significant time and expense. These tests are focused on the cardiovascular system, particularly measures influenced by vascular stiffness, and some consideration given to parameters relevant to oxidative stress and the development of atherosclerosis.
A standard blood test, with inflammatory markers.
An oxidized LDL cholesterol assessment.
Resting heart rate and blood pressure.
Heart r...
Source: Fight Aging! - May 6, 2018 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
What Can be Achieved if the Epigenetic Clock is an Accurate Reflection of Aging?
The difference between having and not having an accurate, rapid, low-cost measure of biological age is night and day. If such a thing did exist, then it is immediately the case that a good few dozen interventions could be rapidly tested in humans, taking a month or two between before and after measurements. The cost is low enough that volunteer groups and philanthropy could manage it. Look at what Betterhumans is doing in trials of cheap senolytic compounds, for example, and then add a robust assessment to that in order to definitively say whether or not rejuvenation occurred. I expect that only a few of the obvious candid...
Source: Fight Aging! - April 30, 2018 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
4 ways to protect against skin cancer (other than sunscreen)
It’s almost May and here in the northeast, front-of-the-pharmacy aisles are filled with myriad brands and types of sunscreen. While sunscreen is essential to lowering your risk for skin cancer, there are other simple, over-the-counter options you can incorporate into your summer skin protection routine.
Nicotinamide may help prevent certain skin cancers
Nicotinamide is a form of vitamin B3 that has been shown to reduce the number of skin cancers. In a randomized controlled trial performed in Australia (published in the New England Journal of Medicine), the risks of basal cell carcinoma and squamous cell carcinoma were si...
Source: Harvard Health Blog - April 27, 2018 Category: Consumer Health News Authors: Emily S. Ruiz, MD, MPH Tags: Cancer Health Prevention Skin and Hair Care Source Type: blogs
A 33 year old male with acute back pain radiating to the chest
Written by Pendell Meyers, with edits by Steve SmithCaseI was called to the EMS control room to answer an RMA (Refusal of Medical Advice). After the call was over, just before I was about to go back to the grind in our acute emergency department, my fantastic EMS colleague paramedic Jess Boyle asked me for an opinion on these 2 ECGs from a single patient, one done immediately after the other, without any other clinical information:What do you think?Both of the ECGs show sinus rhythm with normal QRS complex morphology. There is ST segment depression in leads III and aVF with inappropriate large " volume " T-wave inversion. ...
Source: Dr. Smith's ECG Blog - April 23, 2018 Category: Cardiology Authors: Pendell Source Type: blogs
MKSAP: 62-year-old man is evaluated during a routine visit
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 62-year-old man is evaluated during a routine visit. He is asymptomatic and walks 1 mile most days of the week. Medical history is significant for aortic stenosis, type 2 diabetes mellitus, hypertension, and hyperlipidemia. Medications are aspirin, metformin, lisinopril, metoprolol, and rosuvastatin.
On physical examination, the patient is afebrile, blood pressure is 130/66 mm Hg, pulse rate is 68/min, and respiration rate is 14/min. BMI is 29. Cardiac examination reveals a grade 2/6 early-peaking systolic mur...
Source: Kevin, M.D. - Medical Weblog - April 21, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Cardiology Diabetes Source Type: blogs
A Decade+ Later, Biosimilar Insulin Is Here
More than a decade ago (the article I published on my blog was originally posted on January 8, 2007 although I began research into the subject the preceding summer, see the article athttp://blog.sstrumello.com/2007/01/business-of-diabetes-real-story-behind.html for more background), I asked a number of very legitimate questions (some of which were later answered, others were not), with the most notable one being about why so many other diabetes medicines had " generics " but insulin did not (in spite of the fact that its patents had expired years ago). Unfortunately, in my research, I discovered the some of the sordi...
Source: Scott's Web Log - April 21, 2018 Category: Endocrinology Tags: insulin analogs 2018 biogenerics biosimilars Source Type: blogs
A Decade+ Later, Biosimilar Insulin Is Here
More than a decade ago (the article I published on my blog was originally posted on January 8, 2007 although I began research into the subject the preceding summer, see the article athttp://blog.sstrumello.com/2007/01/business-of-diabetes-real-story-behind.html for more background), I asked a number of very legitimate questions (some of which were later answered, others were not), with the most notable one being about why so many other diabetes medicines had " generics " but insulin did not (in spite of the fact that its patents had expired years ago). Unfortunately, in my research, I discovered the some of the sordi...
Source: Scott's Web Log - April 21, 2018 Category: Endocrinology Tags: insulin analogs 2018 biogenerics biosimilars Source Type: blogs
OMI Can be Diagnosed by " Pseudonormalization of ST Segments "
This post was written by Tarissa Lai, one of our outstanding EM residents at Hennepin County Medical Center, with comments by Steve Smith and Dan Lee.CaseA 30 something y.o. female with HTN, HLD, diabetes, ESRD on dialysis is brought in by EMS with sudden onset, left -sided chest pain for the past four hours.This is her pre-hospital ECG: This is her first ECG in the ED:What do you think?I interpreted this as normal sinus rhythm with LVH, but no significantly peaked T waves concerning for hyperkalemia. I did not appreciate any significant ST elevation.However, the prehospital ECG is more worrisome:the T-...
Source: Dr. Smith's ECG Blog - April 20, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs
Funtabulously Frivolous Friday Five 233
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF…introducing Funtabulously Frivolous Friday Five 233.
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Question 1:
Who popularised museli?
+ Reveal the Funtabulous Answer
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Dr Maximilian Birc...
Source: Life in the Fast Lane - April 6, 2018 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five Bircher Bircher Museli Clare Stanton Ekbom syndrome II Ernest W Goodpasture Essex Lopresti Goodpastures disease hugo flecker irukandji irukandji syndrome jack barnes John Range Maximilian Bircher-Benner Pa Source Type: blogs
