Catastrophising – and controversy
There are few constructs more widely known in pain psychology than catastrophising. Defined as “an exaggerated negative mental set brought to bear during actual or anticipated pain experience” (Sullivan et al., 2001), catastrophising is associated with poor outcomes including greater pain intensity, distress and disability in almost every situation where pain is experienced (Sullivan & Tripp, 2024). Cognitive biases associated with catastrophising include interpretive bias, attentional bias and attentional fixation – in other words negatively interpreting situations, attending to the negative in a situation, ...
Source: HealthSkills Weblog - April 21, 2024 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Coping Skills Pain Pain conditions Research Science in practice catastrophising catastrophizing Chronic pain pain-related worry Source Type: blogs
One good tern …
Yesterday, I spotted a Sandwich Tern, Thalasseus sandvicensis patrolling the open river lock at Brownshill Staunch on the Great River Ouse. It flew back and forth over a stretch of about 100 metres for 20 minutes or so before heading off downstream.
The river cuts through the RSPB Ouse Fen nature reserve (I’d walked in from the Over end rather than Needingworth). I’ve seen several Common Terns and even a Black Tern on this reserve. But, a Sandwich seemed unusual so I posted my spot to the local patch’s birding WhatsApp group when I first saw it. There was a flurry of interest and one member, Richard Thoma...
Source: David Bradley Sciencebase - Songs, Snaps, Science - April 18, 2024 Category: Science Authors: David Bradley Tags: Birds Source Type: blogs
Is OMI an ECG Diagnosis?
Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency
department with 2 weeks of increasing exertional chest pain radiating to the
left arm, associated with nausea. The pain recurred at rest 90 minutes prior to
presentation, felt like the patient ’s prior MIs, and was not relieved by 6
sprays of nitro. Paramedics provided another 3 sprays of nitro, and 6mg of
morphine, which reduced but did not resolve the pain. What do you think of the ECG, and does it
matter?There ’s normal sinus rhythm, LAFB, old anterior Q waves,
and no diagnostic sign of OMI. I sent th...
Source: Dr. Smith's ECG Blog - April 18, 2024 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
Need High Awareness of Symptoms of Heart Attack
High degree of awareness of heart attack symptoms in the community will go a long way in seeking early treatment. For life threatening diseases like heart attack, early recognition of symptoms and prompt reporting to the emergency department is highly desirable.
But a study from United States showed that 47% were not able to recognize some heart attack symptoms while 6% were not able to recognize any heart attack symptoms.
The main heart attack symptoms assessed by the study were:
Chest pain or discomfort
Shortness of breath
Pain or discomfort in arms or shoulders
Feeling weak, lightheaded, or faint
Jaw, neck, or back pai...
Source: Cardiophile MD - April 16, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
The current STEMI paradigm: Because STEMI criteria are not met, let's wait until the myocardium is dead!!
This was sent to me by an inpatient nurse who reads this blog but wants to remain anonymous.An inpatient rapid response was called for a patient with hypotension. The patient was originally admitted for pneumonia and had been transferred out of
the ICU a day prior. He had a history of HFrEF, HTN, and AML. " When I
arrived his blood pressure was 70s/40s and he was pale and profusely
diaphoretic. " " He spoke Spanish but we did deduce that he had 7/10 chest pain radiating to the
back. " " We couldn ’t initially get a hold of the primary physician but our
hospital allows the rapid response nur...
Source: Dr. Smith's ECG Blog - April 16, 2024 Category: Cardiology Authors: Steve Smith Source Type: blogs
Differentiating Between Cardiac and Non-Cardiac Chest Pain
It is not always possible to be certain about the origin of chest pain just by its characteristics as the variation between individuals is quite a bit. A medical opinion should be sought in case of any significant chest pain so that important ailment is not missed. There can be a lot of overlap between symptoms due to heart disease and disease of other nearby organs.
Still some general observations are possible regarding chest pain originating from the heart. The typical pain of cardiac origin is a central chest pain which occurs on walking or other forms of exercise, known as effort angina. This pain is caused by insuffic...
Source: Cardiophile MD - April 10, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
A 29 year old male with chest pain, ST Elevation, and very elevated troponin T
By Magnus NossenThis ECG is from a young man with no risk factors for CAD, he presented with chest pain. How would you assess this ECG? How confident are you in your assessment? What is your next step? Note: lead format is CabreraI was sent this ECG in real time. The patient is a young adult male with chest pain. The chest pain was described as pressure like and radiation to both arms and the jaw. Symptoms were on and off. The pain was worse in the night and better when moving. The patient sought medical attention when the pain recurred for a second straight night accompanied by arm numbness as well as radiating pain. The ...
Source: Dr. Smith's ECG Blog - April 9, 2024 Category: Cardiology Authors: Magnus Nossen Source Type: blogs
Complexity and chronic pain*
*Persistent didn’t alliterate so well!
I’ve been pondering what makes persistent pain so complicated? What is it about this problem that means clinicians use terms like ‘heart-sink’, or ‘problematic’, or ‘difficult’ when they talk about people living with pain?
While nociception and all the associated neurobiological processes associated with pain are undoubtedly complex (and poorly understood), I don’t think this is what people mean when they describe chronic pain is complex. After all, there are loads of body systems and disease processes that are complex.
I...
Source: HealthSkills Weblog - April 7, 2024 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Professional topics Science in practice healthcare pain management Source Type: blogs
Fight Aging! Newsletter, April 8th 2024
In this study, we tested a stem cell secretome product, which contains extracellular vesicles and growth factors, cytoskeletal remodeling factors, and immunomodulatory factors. We examined the effects of 4 weeks of 2×/week unilateral intramuscular secretome injections (quadriceps) in ambulatory aged male C57BL/6 mice (22-24 months) compared to saline-injected aged-matched controls.
Secretome delivery substantially increased whole-body lean mass and decreased fat mass, corresponding to higher myofiber cross-sectional area and smaller adipocyte size, respectively. Secretome-treated mice also had greater whole-bod...
Source: Fight Aging! - April 7, 2024 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
poem
IthacaOnce I finally left the islandOf Calypso the highway became an endless Series of off-ramps and mergingsEach exit sign an indecipherable medleyOf directional words — North and south, east and westFuture and past, here or now —All mixed up in inexplicable combinations That made no geographical sense The GPS on my phone showedOnly a red dot moving alongA single black line relative to nothing elseWhich is the definition Of going nowhere fast Time lysed itself from spaceWhile space moved on to whatever comes after time Three minutes allegedly elapsedAccording to the digit...
Source: Buckeye Surgeon - April 6, 2024 Category: Surgery Authors: Jeffrey Parks MD FACS Source Type: blogs
Fight Aging! Newsletter, April 1st 2024
This study supports the proposed model that aging-related loss of colonic crypt epithelial cell AMP gene expression can promote increased relative abundances of Gn inflammaging-associated bacteria and gene expression markers of colonic inflammaging. These data may support new targets for aging-related therapies based on intestinal genes and microbiomes.
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A Skeptical View of the Role of Nuclear DNA Damage in Aging
https://www.fightaging.org/archives/2024/03/a-skeptical-view-of-the-role-of-nuclear-dna-damage-in-aging/
It is evident and settled that stochastic nuclear DNA damag...
Source: Fight Aging! - March 31, 2024 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
What happened after the Cath lab was activated for a chest pain patient with this ECG?
Sent by anonymous, written by Pendell MeyersI received a text with this image and no other information:What do you think?I simply texted back: " Definite posterior OMI. " The person I was texting knows implicitly based on our experience together that I mean " Definite posterior OMI, assuming the patient ' s clinical presentation is consistent with ACS. "The patient was a middle-aged female who had acute chest pain of approximately 6 hours duration. The pain was still active at the time of evaluation.Queen of Hearts:You can see that the Queen is most concerned with the ST depression in V2 and V3The physician activated ...
Source: Dr. Smith's ECG Blog - March 31, 2024 Category: Cardiology Authors: Pendell Source Type: blogs
Predicting the Order of Arrival of the First Rejuvenation Therapies
It has been going on eight years since I last speculated on the order of arrival of the first rejuvenation therapies. Tempus fugit, and time for an updated version! Eight years is a long enough span of time for the first of those rejuvenation therapies to now exist, albeit in a prototypical form, arguably proven in principle but not concretely. The world progresses but my biases remain much the same: the first rejuvenation therapies to work well enough to merit the name will be based on the SENS vision, that aging is at root caused by a few classes of accumulated cell and tissue damage, and biotechnologies that either repa...
Source: Fight Aging! - March 25, 2024 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
A 50-something with chest pain. Is there OMI? And what is the rhythm?
Written by Willy FrickA man in his 50s with history of hypertension, hyperlipidemia, and a 30 pack-year smoking history presented to the ER with 1 hour of acute onset, severe chest pain and diaphoresis. His ECG is shown:What do you think?The history thus far is highly suggestive of OMI, so we must study the ECG very closely to see if we can confirm this. Looking at the rhythm strip, we see there is more going on than simple sinus rhythm, and in fact there are two different morphologies of QRS complexes. Take a closer look at the rhythm by itself and see if you can figure out what ' s going on before scrolling further....
Source: Dr. Smith's ECG Blog - March 22, 2024 Category: Cardiology Authors: Willy Frick Source Type: blogs
An 80 year old woman with Left Bundle Branch Block (LBBB) and pleuritic chest pain
This case was sent by Amandeep (Deep) Singh at Highland Hospital, part of Alameda Health System.The patient presented to an outside hospitalAn 80yo female per triage “patient presents with chest pain, also hurts to breathe”PMH: CAD, s/p stent placement, CHF, atrial fibrillation, pacemaker (placed 1 month earlier), LBBB.HPI:
Abrupt onset of substernal chest pain associated with nausea/vomiting
30 min PTA. She reports associated SOB but no dizziness or LOC. She
was given NTG
at home before coming to the hospital. This was the ECG obtained at triage.This ECG was recorded and was reviewed remotely by a...
Source: Dr. Smith's ECG Blog - March 19, 2024 Category: Cardiology Authors: Steve Smith Source Type: blogs
