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
The Latest AI Craze: Ambient Scribing
By MATTHEW HOLT
Okay, I can’t do it any longer. As much as I tried to resist, it is time to write about ambient scribing. But I’m going to do it in a slightly odd way
If you have met me, you know that I have a strange English-American accent, and I speak in a garbled manner. Yet I’m using the inbuilt voice recognition that Google supplies to write this story now.
Side note: I dictated this whole thing on my phone while watching my kids water polo game, which has a fair amount of background noise. And I think you’ll be modestly amused about how terrible the original transcript was. But then...
Source: The Health Care Blog - March 18, 2024 Category: Consumer Health News Authors: matthew holt Tags: Health Tech Matthew Holt abridge AI Ambient Scribing Anthropic clinical care Coding Google Microsoft Nabla Nuance OpenAI Suki Source Type: blogs
Why is the angiogram normal?
Written byWilly FrickA man in his 50s with a 15 pack-year smoking history presented to his primary care physician ' s office complaining of intermittent headache. He also complained of intermittent mild chest pain radiating into into both shoulders and his back, as well as occasional unexplained sweating. (Although radiation into the left arm is most classic for coronary ischemia, radiation into both arms is actually modestly more predictive). The primary care physician ' s note indicates low suspicion for cardiac ischemia, but " for completion, check troponin and ECG. " If an ECG was obtained in the office,...
Source: Dr. Smith's ECG Blog - March 17, 2024 Category: Cardiology Authors: Willy Frick Source Type: blogs
Goodness!
The essential, first-order or pure concept of " public goods " is whatever we benefit from that is " non-excludable " and " non-rivalrous. " That means you can use it without paying for it, and if you use it, it ' s still there for others. An example, at least for the time being, is the oxygen in the air. Back in the good old paleolithic, there was a lot more of that. Basically, the land and the water and the plants and animals were there for the taking, and there was usually plenty so rivalry was uncommon. Of course, this only worked within your own tribe -- sometimes people of different tribes tried exclusion and rivalry...
Source: Stayin' Alive - March 14, 2024 Category: American Health Source Type: blogs
Three patients with chest pain and “normal” ECGs: which had OMI? Which were normal? And how did the Queen of Hearts perform?
This study had such low risk patients that not a single patient was ultimately diagnosed with ACS. It is well known that NOMI usually has a normal ECG or nonspecific ECG. The fact that not a single one of these patients had ACS shows that the population studied could not possibly support their conclusion. It should never have been published.According to this data a triage ECG labeled ‘normal’ rules out the possibility of acute coronary occlusion.This is obviously unreliable
data, as Dr. Smith ’s Blog has published51
cases of OMI with ECGs labeled ‘normal’, 35 of which were identified by the
Queen ...
Source: Dr. Smith's ECG Blog - March 14, 2024 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
A man in his 40s with 3 days of stuttering chest pain
Written byWilly FrickA man in his early 40s with BMI 36, hypertension, and a 30 pack-year smoking history presented with three days of chest pain. It started while he was at rest after finishing a workout. He described it as a mild intensity, nagging pain on the right side of his chest with nausea and dyspnea. It woke him the next day and radiated into his back. He was only able to sleep while sitting in a chair. He went to urgent care and had an ECG (not available) which was interpreted as normal, and was sent home. His pain returned, and he went back to the urgent care but was sent to the ER. His ECG is shown:What do you...
Source: Dr. Smith's ECG Blog - March 13, 2024 Category: Cardiology Authors: Willy Frick Source Type: blogs
“ Exercise ” – what does it do for people living with persistent pain?
No, I’m not going to assemble a bunch of papers and point out the effect sizes of exercise on pain and disability! In fact, I’m not even going to point to much research in this post. I want to pose some questions and put some thoughts out for discussion.
See, the people I’ve seen over the years who live with pain have, by and large, not been great ‘exercisers’ before their pain came on, and many haven’t really changed their lifestyle a heap since their pain either. In fact, there is research showing that people with chronic pain don’t change the overall quantity of their activit...
Source: HealthSkills Weblog - March 10, 2024 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Assessment Chronic pain Clinical reasoning Occupational therapy Physiotherapy Psychology Resilience Science in practice Health Research Source Type: blogs
Acute chest pain and ST Elevation. CT done to look for aortic dissection.....
Written byWilly FrickA 67 year old man with a history of hypertension presented with three days of chest pain radiating to his back. He had associated nausea, vomiting, and dyspnea.What do you think?This ECG together with these symptoms is certainly concerning for OMI, but the ECG is not fully diagnostic, and another consideration could be acute pericarditis. Mistaking OMI for pericarditis is a much more harmful error than the converse. Still, in the interest of studying the ECG, here are some findings that could support pericarditis:Absence of large T-waves (flat ST segments)Absence of any STD in aVL (which is s...
Source: Dr. Smith's ECG Blog - March 9, 2024 Category: Cardiology Authors: Willy Frick Source Type: blogs
What do you know?
The next assumption on our list, on which the theory of the (non-existent) Free Market ™ depends, is the assumption of perfect information. Okay, it doesn ' t have to be absolutely perfect, but it has to at least be pretty good. In order for a transaction to really benefit both parties, they both have to know what they ' re getting and what they ' re giving for it. Once we ' re off the island of Bob and Alice, of course, what ' s normally happening is that one person is exchanging money for a good or service, so the transaction is asymmetrical pretty much by definition -- there ' s a seller and a buyer.Most people don ' ...
Source: Stayin' Alive - March 5, 2024 Category: American Health Source Type: blogs
From paralysis to possibility: an unexpected awakening [PODCAST]
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes! Join us as we sit down with Olivia Ong, a pain and rehabilitation medicine physician based in Australia, as she opens up about her incredible journey of resilience and self-discovery. In 2008, Olivia experienced a traumatic spinal cord injury that left
Read more…
From paralysis to possibility: an unexpected awakening [PODCAST] originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - March 4, 2024 Category: General Medicine Authors: The Podcast by KevinMD Tags: Podcast Orthopedics Source Type: blogs
When the conventional algorithm diagnoses the ECG as COMPLETELY NORMAL, but there is in fact OMI, what does the Queen of Hearts PM Cardio AI app say? (with 10 case examples)
Conclusions Need Scrutiny.Proximal LAD Occlusion with STE in I and aVL, and hyperacute T-waves in V2-V6.Algorithm: Marquette 12 SL (GE)The Queen gets it rightCase 9 (prehospital and ED ECGs). Echocardiography, even (or especially) with Speckle Tracking, can get you in trouble. The ECG told the story. 30 yo woman with trapezius pain. HEART Pathway = 0. Computer " Normal " ECG. Reality: ECG is Diagnostic of LAD Occlusion.Prehospital ECG:There are hyperacute T-waves in V3-V5.The Queen gets it rightFirst ED ECG:Hyperacute T-waves persist. Called normal again! Algorithm: Veritas (on Mortara...
Source: Dr. Smith's ECG Blog - March 4, 2024 Category: Cardiology Authors: Steve Smith Source Type: blogs
Are AI Clinical Protocols A Dobb-ist Trojan Horse?
By MIKE MAGEE
For most loyalist Americans at the turn of the 19th century, Justice John Marshall Harlan’s decision in Jacobson v. Massachusetts (1905). was a “slam dunk.” In it, he elected to force a reluctant Methodist minister in Massachusetts to undergo Smallpox vaccination during a regional epidemic or pay a fine.
Justice Harlan wrote at the time: “Real liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own, whether in respect of his person or his property, regardless of the injury that may be done to others.”
What could ...
Source: The Health Care Blog - March 1, 2024 Category: Consumer Health News Authors: matthew holt Tags: Health Policy Abortion AI Dobbs Forced Sterilization Mike Magee racial bias SCOTUS Vaccination Source Type: blogs
Generative AI in Your Desk Drawer: A Wealth of Uses
Previous articles in this series introduced the role of generative AI in the healthcare back office and examined its use in billing and revenue management. We’ll cover a lot of other uses in this article.
Patient Contact and Care Management
CEO Rahul Sharma of HSBlox says that the next version of its CureAlign platform will use generative AI to help improve the care management processes in its CareTracker module.
Many patients need reminders, if not actually coaxing, to come in for appointments. The CureAlign platform personalizes outgoing communication based on past interactions with the patient. Sharma says that ...
Source: EMR and HIPAA - February 28, 2024 Category: Information Technology Authors: Andy Oram Tags: Administration AI/Machine Learning Ambulatory C-Suite Leadership Communication and Patient Experience Health IT Company Healthcare IT Hospital - Health System LTPAC Abhishek Sharma Accenture Administrative Burden AdvancedMD Amazo Source Type: blogs
