Why I Seldom Recommend Vitamins or Supplements
By HANS DUVEFELT
People here in northern Maine, as in my native Sweden, don’t get a whole lot of natural sunlight a good part of the year. As a kid, I had to swallow a daily spoonful of cod liver oil to get the extra vitamin D my mother and many others believed we all needed. Some years later, that fell out of fashion as it turned out that too much vitamin A, also found in that particular dubious marine delicacy, could be harmful.
This is how it goes in medicine: Things that sound like a good idea often turn out to be not so good, or even downright bad for you.
Other vitamins, like B12, can also cause harm: Exce...
Source: The Health Care Blog - July 2, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Patients Physicians Hans Duvefelt primary care supplements vitamins Source Type: blogs
Ischemic ST depression maximal in V1-V4 (vs. V5-V6), even if less than 0.1 millivolt, is specific for Occlusion Myocardial Infarction (vs. subendocardial non-occlusive ischemia)
Conclusion: Among high-risk ACS patients, the specificity for OMI of suspected ischemic STDmaxV1-4 was 97%. STEMI criteria missed half of OMIs detected by STDmaxV1-4. These data support that any ischemic STD maximal in V1-V4 in ACS is due to OMI until proven otherwise. (Source: Dr. Smith's ECG Blog)
Source: Dr. Smith's ECG Blog - June 27, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
HOST-EXAM trial
This study is definitely hypothesis generating and calls for a multi national, double blind comparison on a larger scale to get a better conclusion on long term antiplatelet monotherapy after PCI with DES.
AUGUSTUS trial
A somewhat similar disadvantage for aspirin was suggested in the AUGUSTUS trial among patients with atrial fibrillation and recent ACS or PCI [2]. Adding apixaban to P2Y12 inhibitor resulted in lower bleeding compared with vitamin K antagonist and a lower rate of death or rehospitalization. Addition of aspirin resulted in greater bleeding without any difference in efficacy. 92.6% of the patients...
Source: Cardiophile MD - June 15, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Atrial Fibrillation w Rapid Ventricular Response and ST Depression Maximal V1-V4: Not always subendocardial.
A patient presented a few years ago with chest pain, but also cough, low grade fever, and malaise. She had one prehospital saturation at 88%, but otherwise all vital signs and labs were normal, without tachycardia, elevated BP or anemia. She was never in any distress.She had this prehospital ECG:What do you think?There is diffuse ST depression, in I, II, III, aVF and V3-V6. It is diagnostic of ischemia. It is maximal in V5 and II, with reciprocal STE in aVR, and is thus most consistent with subnendocardial ischemia (Posterior OMI would have maximal STD in V1-V4, and Posterolateral OMI would have STD...
Source: Dr. Smith's ECG Blog - May 25, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
Healthcare AI, Limiting Biases, and Gold Standard Data Sets: Exclusive with Vatsal Ghiya, CEO of Shaip
Shaip is an online platform that focuses on healthcare AI data solutions and offers licensed healthcare data designed to help construct AI models. It provides text-based patient medical records and claims data, audio such as physician recordings or patient/doctor conversations, and images and video in the form of X-rays, CT scans, and MRI results.
Like most algorithms, healthcare AI requires diverse data to train machine learning algorithms to identify clinical anomalies, diseases, or cancers more accurately.
Vatsal Ghiya, co-founder and CEO of Shaip, is an expert in improving healthcare AI by using diverse...
Source: Medgadget - May 4, 2021 Category: Medical Devices Authors: Alice Ferng Tags: Exclusive Informatics Source Type: blogs
See this: Occlusion/Reperfusion/Re-occlusion/Reperfusion/Re-occlusion/Reperfusion
A 60-something y.o. male presented with intermittent left-sided chest and shoulder pain that is achy in nature and lasted a few minutes or sometimes just a few seconds. " The symptoms come and go, not associated with any exertion or history of trauma. Patient does have a history of hypertension and has been taking his medications. Prehospital EKGs appeared consistent with anterior tombstone ST elevation with pain. " Prior to arrival the patient was given full dose aspirin, as well as nitroglycerin, which relieved his pain, after which T wave inversions were noted in the anterior precordial leads.&...
Source: Dr. Smith's ECG Blog - May 3, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
This is really good Prehospital, ED, and Cardiology care. Inferior de Winter's T-waves.
A 50-something y.o. male with history of previous acute MI and stent was shoveling snow. Shortly thereafter he had the onset of tight chest pain across the front of his chest, without radiation, but associated with diaphoresis and nausea without vomiting. It felt similar to his prior heart attack 9 years ago. He called EMS immediately. Here is his first prehospital ECG: What do you see?There is ST depression maximal in V3, and also in inferior leads. There is minimal T-wave inversion in aVL, by itself a soft sign of inferior MI. Are the T-waves large? Does this inferior ST depression ...
Source: Dr. Smith's ECG Blog - April 21, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
This case was flagged as a false positive cath lab activation. Why? And do you agree?
Conclusions/Summary " Indication: Chest pain with dynamic EKG changes concerning for ACS "--CAD with moderate stenosis of ostial left main.--CAD with long segment of serial stenosis of proximal to mid LAD.--Successful PCI of proximal to mid LAD with placement of 3.5 x 38 and 3.5 xLAD: Large caliber vessel.There is a long segment of serial 50-80% stenosis noted in the mid portion of the vessel. The LAD is severely tortuous and there is large caliber diagonal after an acute bend in the mid vessel. The distal and apical segments are without significant stenosis. Lesion on Mid LAD was stented in a comp...
Source: Dr. Smith's ECG Blog - April 19, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
Fight Aging! Newsletter, April 12th 2021
In conclusion, the MR exhibited the protective effects against age-related behavioral disorders, which could be partly explained by activating circulating FGF21 and promoting mitochondrial biogenesis, and consequently suppressing the neuroinflammation and oxidative damages. These results demonstrate that FGF21 can be used as a potential nutritional factor in dietary restriction-based strategies for improving cognition associated with neurodegeneration disorders.
Senescent T Cells Cause Changes in Fat Tissue that are Harmful to Long-Term Health
https://www.fightaging.org/archives/2021/04/senescent-t-cells-cause...
Source: Fight Aging! - April 11, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
A Non-Invasive Biomarker to Measure the Effectiveness of Senolytic Drugs
In this study, mice were given chemotherapy which induces widespread senescence, followed by a senolytic drug. The biomarker was only detected in the blood and urine of mice treated with both chemotherapy and the senolytic, but not with either on its own, confirming specificity for senolysis.
Link: https://www.buckinstitute.org/news/the-first-non-invasive-biomarker-to-track-and-verify-efficacy-of-senolytic-drugs/ (Source: Fight Aging!)
Source: Fight Aging! - April 8, 2021 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
A 53 year old with chest pressure has a diagnostic EKG (EKG 1). What is it? Chest pressure resolves (EKG 2)
A 50-something male had onset of pain approximately 30 min prior to arrival and was still present on arrival. The pain was described as a pressure with radiation to his back. No nausea or SOB. No diaphoresis. He had never had this pain before.Computer and physician read:SINUS RHYTHMMODERATE ST DEPRESSION [0.05+ mV ST DEPRESSION]What do you think?After looking, compare with the patient ' s previous ECG (next), and then see what you think.There is ST Elevation in V2 and V3Previous ECG from 3 months prior, during a visit for angioedema:This ECG is normal, with a bit of normal ST elevation in V2 and V3The first ECG above...
Source: Dr. Smith's ECG Blog - March 3, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
When there is less than 1 mm of ST depression, can you make the diagnosis of posterior OMI?
DiscussionApproximately 10% of OMIs will involve the posterior wall, most of which also have concomitant involvement of the lateral and/or inferior walls (though usually not meeting STEMI criteria). Isolated posterior OMI, however, manifests as STD without associated STE since the subepicardial myocardial ischemia that would normally generate STE on overlying leads is occurring in the opposing or negative vector compared to the recording ECG leads. The majority of isolated posterior OMIs will be due to occlusion of the LCX, RCA, or a variety of their posterior branches.The 4th Universal Definition of Myocardial Infarc...
Source: Dr. Smith's ECG Blog - February 27, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
Saw this ECG while reading through a stack. Lots here: myocardial stunning, MRI viability, P2Y12 inhibitors and CABG.
I had just finished passing the shift off to my partner and the next shift of residents. It was 11:30 PM. I turned to the computer system to finish reading any EKGs from the shift and I saw this one, which had been recorded after the end of my shift at 11:11.Usually these are brought immediately by the tech to the faculty physician. I ' m not certain whether another faculty had seen this or not.What do you think?I immediately saw the ST depression in V2 and V3 of at least 1.5 mm. There is also minimal STD in II, III, aVF. When you see this inferior STD, you should not think " in...
Source: Dr. Smith's ECG Blog - February 26, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
What ’s your approach to health? Check your medicine cabinet
Do all kids spy? Just me? When I was a child, I spent hours snooping in my parents’ nightstands, Granny’s pocketbook, my older brothers’ dresser drawers. I’m not sure what I was looking for, exactly, other than validation of my suspicion that the teenagers and adults in my life were keeping secrets from me.
And no opportunity for sleuthing seemed richer than the twin mirrored medicine cabinets hanging from my parents’ bathroom wall. My mother’s was kind of boring, its glass shelves lined with bottles of aspirin and antacids, plus a dusty jar of jewel-toned bath oil beads. My father’s was a treasure trove ...
Source: Harvard Health Blog - February 16, 2021 Category: Consumer Health News Authors: Suzanne Koven, MD, MFA Tags: Health Healthy Aging Healthy Eating Managing your health care Source Type: blogs
Understanding Leprosy on World Leprosy Day
Leprosy is a chronic and progressive disease that primarily affects the skin and peripheral nervous system. Leprosy has been with us for thousands of years. There is evidence of the disease as far back as 4000 BC, in ancient Egypt.[1] In 1873, Norwegian physician Dr. Gerhard Armauer Hansen discovered that leprosy was caused by a bacterium. [2] Today, we call this bacterium Mycobacterium leprae, and we often refer to leprosy as Hansen’s Disease, in honor of Dr. Hansen. While leprosy caused significant morbidity and mortality in the past, cases today are rare and are curable with proper treatment.
How Is Leprosy Transmitte...
Source: GIDEON blog - January 28, 2021 Category: Databases & Libraries Authors: Uri Blackman Tags: News Leprosy Source Type: blogs
