Can I take something to prevent colorectal cancer?
Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. There is compelling evidence that screening to detect CRC early to find and remove precancerous polyps can reduce CRC mortality. However, screening has associated harms, including procedural complications, and inherent limitations. For example, colonoscopy, the most common screening tool in the US, is less effective in preventing cancers of the right, or ascending side, of the colon compared with cancers of the left, or descending, side of the colon.
Moreover, only 60% of US adults recommended for screening actually follow through. Ev...
Source: Harvard Health Blog - January 13, 2021 Category: Consumer Health News Authors: Andrew Chan, MD, MPH Tags: Cancer Prevention Screening Source Type: blogs
Acute chest pain, ST Depression in V2 and V3, relief with Nitroglycerine, " normal " coronaries, and apical ballooning. Is it takotsubo?
This was submitted by Michael Fischer, one of our outstanding2nd year EM residents at Hennepin Healthcare.CaseA previously healthy female in her 40s presented 1 hour after abrupt onset 10/10 crushing chest pain that started while brushing her hair that morning. The pain radiated to her bilateral jaw and right shoulder, and did not seem to be exertional or pleuritic in nature. Here is her pre-hospital ECG: What do you think?Smith: V2 and V3 have some minimal ST depression with downsloping. This is highly suggestive of posterior MI.This was read by EMS as non-specific. Aspirin 324mg was given by EMS. Ni...
Source: Dr. Smith's ECG Blog - January 8, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
Quality in Healthcare: Cultural Competence, Diagnostic Accuracy or Patronizing Insensitivity?
By HANS DUVEFELT
I sometimes tell patients “I work for the government”, but sometimes I say the opposite, “I work for you”.
Herein lies a dichotomy that is eating away at primary care in this country, like a slow growing cancer. I suspect everybody is aware of it, but it seems nobody has the inclination to deal with it.
2020 exposed how differently Americans view and prioritize things like personal freedom and public safety. We have also seen how vastly different perceptions of reality suddenly exist about what constitutes medical facts. Alternative facts and fake news are suddenly household concepts.
F...
Source: The Health Care Blog - January 4, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Primary Care Source Type: blogs
Fight Aging! Newsletter, January 4th 2021
The objective of this study is to quantify the overall and cancer type-specific risks of subsequent primary cancers (SPCs) among adult-onset cancer survivors by first primary cancer (FPC) types and sex. Among 1,537,101 survivors (mean age, 60.4 years; 48.8% women), 156,442 SPC cases and 88,818 SPC deaths occurred during 11,197,890 person-years of follow-up (mean, 7.3 years). Among men, the overall risk of developing any SPCs was statistically significantly higher for 18 of the 30 FPC types, and risk of dying from any SPCs was statistically significantly higher for 27 of 30 FPC types as compared with risks in the general po...
Source: Fight Aging! - January 3, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
The Health Improving Effects of Aspirin Depend on Autophagy
Many groups are attempting to develop calorie restriction mimetic drugs that produce benefits to health - and slow the progression of aging - by triggering some fraction of the stress response mechanisms engaged by the practice of calorie restriction. The most notable such mechanism is autophagy, a collection of cellular housekeeping processes that recycle damaged proteins and structures in the cell. Greater efficiency or activation of autophagy is a feature of a great many interventions known to slow aging in laboratory species.
Based on existing data, we should not expect any of these therapies to move the needle ...
Source: Fight Aging! - December 30, 2020 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Chest pain after motor vehicle collision with an abnormal ECG - blunt cardiac injury? OMI? normal variant?
Discussion:Significant cardiac trauma occurs in approximately 10% of patients with severe blunt chest trauma. Isolated coronary artery dissection from blunt trauma is a very rare event. Traumatic dissections are most often seen in the LAD, followed by the RCA and LCX. It is thought that this is due to the relative anterior position of the LAD. The ECG is a report from the myocytes of their condition. They do not know the etiology of acute complete ischemia. No matter if its typical ACS, traumatic dissection causing acute occlusion, or spasm, it is the same result to the myocytes, and the same findings can be present o...
Source: Dr. Smith's ECG Blog - December 30, 2020 Category: Cardiology Authors: Pendell Source Type: blogs
“VRx”: A Medgadget Book Interview with Author Dr. Brennan Spiegel
In the recently released science-fiction novel Ready Player Two, protagonist Wade Watts spends the majority of the book inside a virtual reality universe called the “OASIS”. Though the OASIS is merely a simulation consisting of computer-generated imagery, immersive sound, and gesture-based interaction, it has a profound impact on reality. It’s a place where one loses the sense of time, both physical and emotional pain is identified and eased, and users can confront and overcome their deepest longings and fears.
The OASIS may be fictional, but some of its seemingly therapeutic effects are factual, b...
Source: Medgadget - December 8, 2020 Category: Medical Devices Authors: Scott Jung Tags: Exclusive Informatics Medicine Pain Management Psychiatry Source Type: blogs
The Diagnosis of OMI does not depend on the ECG. But if you recognize it, that's great.
An elderly woman presented with 4 days of waxing and waning epigastric/substernal chest pain, worse on the day she presented. She described the pain as a constant chest pressure, 6/10, without radiation to left arm, jaw or back, and without change in with breathing or movement.Here is her ED ECG:This was read as non-specific. What do you think?I found this case while looking through a stack of ECGs, without clinical information. I immediately thought " Acute LAD occlusion. " Why? There are QS-waves in V2-V4. These suggest old anterior MI, or subacute MI. But as we ' ve de...
Source: Dr. Smith's ECG Blog - December 6, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
A woman in her 40s with acute chest pain
Case written by Neha Ray MD, Brandon Fetterolf MD, and Pendell Meyers MDA woman in her 40s with a history of rheumatoid arthritis, anemia, and thrombocytopenia presented to the ED with acute onset chest pain starting around 5am on the morning of presentation. It woke her from sleep. The chest pain was midsternal, severe, sharp, and constant. On the previous night she had had a mild version of the same pain that she thought was heartburn (esophageal reflux). She reported some radiation to the left arm. She also reports 3 episodes of non-bloody vomiting over the course of the morning. She had a recent admission fo...
Source: Dr. Smith's ECG Blog - November 29, 2020 Category: Cardiology Authors: Pendell Source Type: blogs
Chest pain, ST Depression maximal in V2-V4, and a Blood Pressure of 238/118.
A Middle-aged male had sudden onset severe substernal chest pain that woke him from sleep.His BP was 238/118 on arrival.Here is his first ED ECG:What do you think?There is ST depression maximal in V2-V4, which normally would be all but diagnostic for posterior MI. However, the extremely elevated BP makes it likely thatthis STD is really subendocardial ischemia from high oxygen demand. (There are also incidentally large U-waves -- the K was 4.1).It is best to first manage the BP and then repeat the ECG.So the physician did just that. He obtained a chest CT to rule out aortic dissection (which was negative)....
Source: Dr. Smith's ECG Blog - November 27, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
Aspirin and breast cancer risk: How a wonder drug may become more wonderful
Aspirin has been called a wonder drug. And it’s easy to see why.
It’s inexpensive, its side effects are well-known and generally minor. And since it was developed in the 1890s, it’s been shown to provide a number of potential benefits, such as relieving pain, bringing down a fever, and preventing heart attacks and strokes. Over the last 20 years or so, the list of aspirin’s potential benefits has been growing. And it might be about to get even longer: did you know that aspirin may lower your risk of several types of cancer?
Studies of aspirin and cancer
A number of studies suggest that aspirin can lower the risk of...
Source: Harvard Health Blog - October 23, 2020 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Breast Cancer Health Source Type: blogs
DAPT blues in ACS : Does Prasugrel really bother to know about the coronary anatomy before it acts ?
It appears,antiplatelet agents are waging a turf war on the CAD battlefield. It is no secret either, the fight often goes beyond academic reasons. Though NSTEMI connotes a true cardiac emergency, it consists of a highly heterogeneous population. A patient with UA can be treated even at home (Low-grade angina with little ECG changes, when it’s due to Increase demand situation). While, in the other extreme of NSTEMI, a patient with a GRACE score >200, in Ischemic LVF, might need an emergency multivessel angioplasty along with Mitra clip ± ECMO support.
Antiplatelet agents along with heparin will re...
Source: Dr.S.Venkatesan MD - October 19, 2020 Category: Cardiology Authors: dr s venkatesan Tags: acute coronary syndrome oral anticoagulants warfarin acitrom prasugrel 2b3a vs prasugrel coronary anatomy in nsteacs dapt mapt NSTEMI guidelines esc acc 2020 prasugrel vs aspirin vs ticagrelor reopro vs prasugrel themis twilight study Source Type: blogs
New guidelines for aches, pains, and strains
We’ve all been there before. A minor injury leads to a sore ankle, achy shoulder, or sore neck. You could do nothing, try to ignore it, and see if it gets better. Or you may be tempted to take something, especially if significant discomfort prevents you from doing your usual activities or keeps you up at night.
So, what’s the best initial treatment? For minor injuries, your options are many, including:
Home remedies. Common approaches are the “RICE” treatments — Rest, Ice, Compression, and Elevation: applying cold to the sore area, wearing an elastic wrap to compress the sore area, rest, and elevation (such as p...
Source: Harvard Health Blog - October 2, 2020 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Bones and joints Exercise and Fitness Health Pain Management Source Type: blogs
Post #52 Overkill: When Modern Medicine Goes Too Far by Paul Offit M.D.
Overkill: When Modern Medicine Goes Too Far by Paul Offit M.D.I am admittedly a huge fanboy of Paul Offit, an infectious disease guru at Children ' s Hospital of Philadelphia, one of the preeminent pediatric hospitals in the world. His latest bookOverall: When Modern Medicine Goes Too Far, is a collection of medical facts that are already known to the well-read individual, but fly in the face of wrongly-held, out-dated, commonly-believed medical concepts. The majority of the incorrect information was previously considered the standard of care, but newer and better science and studies have clearly demonstrate...
Source: A Pediatrician's Blog - September 23, 2020 Category: Pediatrics Source Type: blogs
A man in his 50s with 2 hours of chest pressure
Case submitted by Anonymous, written by Pendell MeyersA man in his 50s with history only smoking presented to the ED with chest pressure for the past 2 hours. His vitals were within normal limits except BP 163/109. No prior ECG was available. Here is his triage ECG:What do you think?This is probably obvious to regular readers of this blog, but it is NOT obvious to most emergency providers and cardiologists.Findings include: - Sinus rhythm - Normal QRS complex - Hyperacute T waves in leads II, III, and aVF - reciprocal STD and T wave inversion in aVL - STD in V2-V4 (max in V3) - Like...
Source: Dr. Smith's ECG Blog - September 12, 2020 Category: Cardiology Authors: Pendell Source Type: blogs
