Research and Reviews in the Fastlane 151
This study takes data from a trauma registry and shows a survival rate for resuscitative thoracotomy (RT) of 9.7% vs. 37.5% for REBOA. There are a number of issues with this study due to the retrospective design. Additionally, the RT group was more likely to be dead on presentation in comparison to the REBOA group (71% vs. 38% without vital signs). While this data supports REBOA use, a prospective study should be undertaken to gauge the benefit of this modality.
Recommended by: Anand Swaminathan
Retrieval, Pre-hospital and Disaster
Sadek S, et al. Resuscitative endovascular balloon occlusion of the aorta (REBOA) in the ...
Source: Life in the Fast Lane - September 14, 2016 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Cardiology Disaster Education Emergency Medicine Intensive Care Pre-hospital / Retrieval Trauma critical care examination literature R&R in the FASTLANE recommendations research and reviews Resuscitation Source Type: blogs
Are these prescription drugs preventing your weight loss?
A number of drugs prescribed to treat common conditions, such as hypertension, allergies, depression, inflammation, and diabetes, block your ability to lose weight. Several of these drugs actually cause weight gain, and most doctors fail to inform their patients of such side effects. Among the drugs that block weight loss are:
Beta-blockers: metoprolol, atenolol, carvedilol, and propranolol
Antidepressants: amitriptyline (Elavil), nortriptyline (Pamelor), doxepin, paroxetine (Paxil), trazodone, and others
Steroids: prednisone and hydrocortisone (but not inhaled or nasal steroids for allergies)
Antihistamines: diphenhydr...
Source: Wheat Belly Blog - September 13, 2016 Category: Cardiology Authors: Dr. Davis Tags: Depression Dr. Davis Drugs and wheat Nutritional supplements Weight loss Wheat Belly Wheat Belly Lifestyle Wheat Belly Total Health Wheat-Free Lifestyle anxiety Source Type: blogs
MKSAP: 34-year-old woman with very dry, painful hands
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 34-year-old woman is evaluated for very dry, painful hands. She works in a daycare center and washes her hands 15 to 20 times daily, often for 2 to 3 minutes at a time. She has been applying lotion multiple times daily with no relief of the pain. She has a history of obsessive-compulsive disorder and takes no medications.
On physical examination, vital signs are normal. She has xerosis on the dorsal aspect of her hands with lichenification, erythema, and fissuring.
The remainder of the physical examination is ...
Source: Kevin, M.D. - Medical Weblog - September 10, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Dermatology Source Type: blogs
The maker of EpiPen sticks it to patients
Recently, friends of ours had a frightening experience: They were on vacation, and ordered takeout from an unfamiliar restaurant. They specifically asked about peanuts: “Are the egg rolls fried in peanut oil? Our daughter has an allergy.”
The server replied: “No, no peanut oil.”
And so they ordered the egg rolls.
Awhile after eating an egg roll, their school-aged child Anna (not her real name) complained of a tummy ache. Then, nausea. They thought maybe she’d eaten too quickly, or too much.
Suddenly, she started sneezing, sneezing repeatedly and uncontrollably, and wheezing. “Pollen,” ...
Source: Kevin, M.D. - Medical Weblog - August 31, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/monique-tello" rel="tag" > Monique Tello, MD < /a > Tags: Meds Pediatrics Source Type: blogs
Is your doctor guilty of treating grain consumption?
Jennifer shared these comments about her husband’s early Wheat Belly transformation:
“My husband found your site a while back while doing research into symptoms he’s been experiencing for years. After following your advice with food, the doctor visits have stopped and I have a normal husband back.
“Prior to meeting him, he has always had issues with his weight and gut. He would exercise to the point of passing out and it just wouldn’t go anywhere. When I met him 5 years ago, he was jogging every night and exercising. He just couldn’t get the flabby stomach to go away and, every time the ...
Source: Wheat Belly Blog - August 4, 2016 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Success Stories abdominal distress diabetes gluten grains headache IBS Inflammation obesity overweight Source Type: blogs
Research and Reviews in the Fastlane 143
Welcome to the 143rd edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Justin Morgenstern, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R ...
Source: Life in the Fast Lane - July 21, 2016 Category: Emergency Medicine Authors: Jeremy Fried Tags: Clinical Research Education Emergency Medicine Neurology R&R in the FASTLANE Trauma EBM literature recommendations research and reviews Source Type: blogs
Infusion Number Five
And the Orange County Marathon in California last Sunday, my 95th since diagnosis, Whooee - still on track for 100 marathons this year.
This was also the third weekly Darzalex infusion at our local hospital. Arriving at the infusion center at 7:45 am, I left at 2:45 pm, total seven hours. That includes a blood draw for a CBC and metabolic panel, a visit with the doctor, the pre-medications (Tylenol, Benadryl, and prednisone), and finally the Darzalex itself.
No issues. In particular, I have never had any kind of infusion reaction from Darzalex. Apparently that makes me a lucky myelomiac, bec...
Source: Myeloma Hope - May 3, 2016 Category: Cancer & Oncology Tags: daratumumab Darzalex Source Type: blogs
Infusion Number Five
And the Orange County Marathon in California last Sunday, my 95th since diagnosis, Whooee - still on track for 100 marathons this year.
This was also the third weekly Darzalex infusion at our local hospital. Arriving at the infusion center at 7:45 am, I left at 2:45 pm, total seven hours. That includes a blood draw for a CBC and metabolic panel, a visit with the doctor, the pre-medications (Tylenol, Benadryl, and prednisone), and finally the Darzalex itself.
No issues. In particular, I have never had any kind of infusion reaction from Darzalex. Apparently that makes me a lucky myelomiac, because th...
Source: Myeloma Hope - May 3, 2016 Category: Cancer & Oncology Tags: daratumumab Darzalex Source Type: blogs
Being a Cancer Treatment Partner
Recently my wife was asked to advise one of our friends about the process of cancer treatment. As I wrote in my 2011 post about our family's experience with cancer, the treatment involves everyone close to the patient. Here are Kathy's notes for families of cancer patients, which I post in the hope that they will help others."I promised to pencil out tips for how you can best serve as a cancer treatment partner.Here is a great resource to read on the general way to help.At the treatment planning visit, you should take notes so the patient can remember things later more clearly. Also, if you have a...
Source: Life as a Healthcare CIO - April 27, 2016 Category: Information Technology Source Type: blogs
Three Infusions
Two at Mayo Clinic, and now the third at a highly-rated local hospital. We have made twelve 200-mile round trips to Mayo in Rochester so far just this year, almost one per week, and I ' m tired of the drive. Of course I ' ll do whatever it takes to stay alive, and Mayo is indeed a world-class center for myeloma treatment, so that sounds like whining. However, if the drive is not necessary, it is certainly more convenient (and safer) to have procedures like blood draws and even infusions done barely a 10-minute drive from home. My current Darzalex (daratumumab) regimen calls for weekly infusions for eigh...
Source: Myeloma Hope - April 24, 2016 Category: Cancer & Oncology Tags: Darzalex infusion Source Type: blogs
Three Infusions
Two at Mayo Clinic, and now the third at a highly-rated local hospital. We have made twelve 200-mile round trips to Mayo in Rochester so far just this year, almost one per week, and I'm tired of the drive. Of course I'll do whatever it takes to stay alive, and Mayo is indeed a world-class center for myeloma treatment, so that sounds like whining. However, if the drive is not necessary, it is certainly more convenient (and safer) to have procedures like blood draws and even infusions done barely a 10-minute drive from home. My current Darzalex (daratumumab) regimen calls for weekly infusions for eigh...
Source: Myeloma Hope - April 24, 2016 Category: Cancer & Oncology Tags: Darzalex infusion Source Type: blogs
A refreshing day of real doctoring
Back in my first year of blogging, I wrote a post, titled “A Day Without a Diagnosis,” about the way we now spend most of our time “managing” chronic diseases, some of which weren’t even considered diseases when I went to medical school.
That’s not how all my days go nowadays: A week ago I had a day of some very real doctoring.
My first patient of the day was a woman in her mid-thirties. She told me she had been suffering from hives almost every day for two years. She was taking a once a day antihistamine, loratadine, faithfully and sometimes also some diphenhydramine when the itching got too bad. She h...
Source: Kevin, M.D. - Medical Weblog - April 7, 2016 Category: Journals (General) Authors: A Country Doctor, MD Tags: Conditions Primary care Rheumatology Source Type: blogs
Pomalyst and Darzalex
Darzalex (daratumumab) is a potent myeloma treatment by itself, buteven more so when combined with Pomalyst (pomalidomide), and that is what my Dr WG wants me to have now. I couldn ' t agree more. Two studies that have benefited other people have failed for me, one after the other, and my IgG and M-Spike have increased. Far worse, my most recent PET/CT shows five lesions in my bones including three scary ones in the spine, so it ' s time to bring out the big guns.
I ' ve been taking Pomalyst again now for a month, 2 mg every day, with dexamethasone (DEX) 40 mg weekly, waiting for the drugs from the most-rece...
Source: Myeloma Hope - April 7, 2016 Category: Cancer & Oncology Tags: Darzalex infusion Source Type: blogs
Pomalyst and Darzalex
Darzalex (daratumumab) is a potent myeloma treatment by itself, but even more so when combined with Pomalyst (pomalidomide), and that is what my Dr WG wants me to have now. I couldn't agree more. Two studies that have benefited other people have failed for me, one after the other, and my IgG and M-Spike have increased. Far worse, my most recent PET/CT shows five lesions in my bones including three scary ones in the spine, so it's time to bring out the big guns.
I've been taking Pomalyst again now for a month, 2 mg every day, with dexamethasone (DEX) 40 mg weekly, waiting for the drugs from the most-recen...
Source: Myeloma Hope - April 7, 2016 Category: Cancer & Oncology Tags: Darzalex infusion Source Type: blogs
Can I Get a Side of Fat with that Overdose?
An 88-year-old woman with a history of dementia presented with dizziness. Her daughter reported that she may have taken at least 12 tablets of diltiazem, which she mistook for her other medications. She is alert and oriented with normal vital signs. Her heart rate is 40 beats per minute and blood pressure is 70/45 mm Hg. Boluses of calcium gluconate and high-dose insulin therapy are initiated. The patient remains hypotensive at 80/40 mm Hg. Toxicology is consulted about intravenous lipid emulsion therapy.How does lipid emulsion therapy work?Two main theories describe the mechanism of action of intravenous lipid emulsion...
Source: The Tox Cave - April 1, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
