Issues in thrombolysis: There may not be anything called “ Absolute contraindication ”
This post was originally written in 2013.
A middle-aged man with STEMI came to our CCU. It is just another case of STEMI and asked my fellow to lyse.
But it was not the case . He, told me, Sir, the patient had a syncope following chest pain and he has injured his face and Jaw. He was actively bleeding. When I saw this face, it was indeed frightening.
What shall we do ? When a patient with STEMI presents with bleeding facial Injury
Rush for Immediate PCI (Which was of course not possible in our place as it happened out of office hours! )
Take that ultimate risk and thrombolysis
Give only heparin ( Many times it ...
Source: Dr.S.Venkatesan MD - May 16, 2020 Category: Cardiology Authors: dr s venkatesan Tags: bio ethics Cardiology -Therapeutic dilemma cardiology -Therapeutics Cardiology -unresolved questions Cardiology Risk assesment cardiology- coronary care Cardiology-Coronary artery disese Primary PCI Thrombolysis relative and absolute con Source Type: blogs
What do you think the echocardiogram shows in this case?
A 60-something man presented by EMS with 5 hours of fairly typical sounding substernal chest pain. Here is the EMS ECG:Obviously massive diffuse subendocardial ischemia, with profound STD and STE in aVROf course this pattern is most often seen from etoliogies other than ACS. The ECG only tells you there is ischemia, not the etiology of it.Nevertheless, the clinical situation made other etiologies unlikely.EMS gave 324 mg aspirin and 3 sublingual NTG, which the patient stated reduced the substernal chest pain from an 8/10 to 4/10.Here is the ED ECG on arrival:Less STE/STDProvider ' s Clinical Impression:&nbs...
Source: Dr. Smith's ECG Blog - May 12, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
Platelet-rich plasma: Does the cure for hair loss lie within our blood?
Platelet-rich plasma, or PRP, is derived from the bloodstream and has been used for years to treat musculoskeletal conditions, and more recently, skin conditions. Colloquially termed “vampire” treatments, PRP injected into the skin or used after microneedling (a technique that uses small needles to create microscopic skin wounds) may help to improve skin texture and appearance. Recently, PRP has garnered attention as a promising solution for one of the most challenging problems in dermatology: hair loss.
Platelets and hair growth: What’s the connection?
Platelets are one of four primary components of blood (the other...
Source: Harvard Health Blog - May 11, 2020 Category: Consumer Health News Authors: Neera Nathan, MD, MSHS Tags: Health Skin and Hair Care Source Type: blogs
Your headaches are getting worse. Do you need an imaging test?
Headache is a very common condition that affects up to 60% of the world’s population. In general, headache can be classified into two main categories: primary and secondary headaches. A primary headache is related to increased sensitivities, but not structural alterations of brain tissues. Common primary headaches are migraine with and without aura, tension-type headache, and trigeminal autonomic cephalalgias (headaches, such as cluster headache, that also involve facial pain and autonomic symptoms such as tear production and nasal congestion). Secondary headaches have various underlying causes including structural vascu...
Source: Harvard Health Blog - May 7, 2020 Category: Consumer Health News Authors: Hsinlin Thomas Cheng, MD, PhD Tags: Headache Tests and procedures Source Type: blogs
COVID-19 and Opening the Country: Lessons from 1918 Philadelphia
By CHADI NABHAN, MD, MBA, FACP
Everyone has an opinion on whether and when we should open
the country. Never in the history of America have we had so many “correct”
theories and experts to pontificate on a new pandemic. But somehow, few seem to
recall history or attempt to learn from it.
Over a century ago, almost 100 million people out of a world population of 1.8 billion lost their lives to the so-called “Spanish Flu”. At 8.5 million casualties, the death toll from World War I pales in comparison. In the US alone, we lost over 675,000 people in one year to this pandemic. In fact, we lost more people to the ...
Source: The Health Care Blog - May 3, 2020 Category: Consumer Health News Authors: Christina Liu Tags: COVID-19 Health Policy Chadi Nabhan Pandemic Philadelphia Spanish Flu Source Type: blogs
How the USMLE fails COVID-19
Since the first case of COVID-19 on January 21st, there have been countless stories highlighting the healthcare heroes. Individuals are risking their lives and demonstrating unanticipated sacrifices to close the wounds on a bleeding healthcare system. Amongst those watching these stories are students of future healthcare professions, getting a glimpse at what their lives might […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - May 1, 2020 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/colin-quinn" rel="tag" > Colin Quinn < /a > < /span > Tags: Education COVID-19 coronavirus Infectious Disease Medical school Source Type: blogs
Olympus High End EVIS X1 Endoscopy System Unveiled
Olympus is unveiling its new top-of-the-line endoscopy system, the EVIS X1. The company hopes that the new features offered on-board the EVIS X1 will help with the diagnosis and management of a variety of GI disorders and bronchial conditions.
The system sports a number of advancements, including Extended Depth of Field (EDOF), Red Dichromatic Imaging (RDI), Texture and Color Enhancement Imaging (TXI), and Narrow Band Imaging (NBI). TXI, in particular, is an interesting feature that can provide physicians with novel imaging information while displaying tissues almost as they would look under simple white light illu...
Source: Medgadget - April 23, 2020 Category: Medical Devices Authors: Medgadget Editors Tags: Diagnostics ENT GI Ob/Gyn Oncology Source Type: blogs
Knee arthroscopy: Should this common knee surgery be performed less often?
Imagine you’re walking along and suddenly experience excruciating knee pain. Though it initially seems stuck in one position, after a minute or two you can limp along home, but just barely. At your doctor’s visit, an x-ray is normal but symptoms continue for weeks. An MRI is performed and now you have an explanation: a torn meniscus. (Two menisci — rubbery cartilage pads that act as shock absorbers — separate the bottom of your knee bone from the top of your shin bone.) A month later, you’re no better despite rest, pain medicines, and physical therapy. It’s time for surgery to fix it, right? Maybe not.
Knee art...
Source: Harvard Health Blog - April 20, 2020 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Injuries Osteoarthritis Pain Management Surgery Source Type: blogs
Benefit of DOAC over warfarin – Cardiology MCQ
Benefit of DOAC over warfarin – Cardiology MCQ
Which of the following is NOT a known advantage of direct oral anticoagulant (DOAC) over warfarin?
a) Reduction in stroke
b) Lesser intracranial bleeds
c) Lower gastrointestinal bleeding
d) Lower mortality
Post your answer as a comment below
The post Benefit of DOAC over warfarin – Cardiology MCQ appeared first on All About Cardiovascular System and Disorders. (Source: Cardiophile MD)
Source: Cardiophile MD - April 17, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Rationale for Testing Anticoagulants Against COVID-19
This article originally appeared on the Timmerman Report here.
The post Rationale for Testing Anticoagulants Against COVID-19 appeared first on The Health Care Blog. (Source: The Health Care Blog)
Source: The Health Care Blog - April 16, 2020 Category: Consumer Health News Authors: Christina Liu Tags: COVID-19 Patients Physicians anticoagulants cardiology coronavirus Ethan Weiss thrombosis Source Type: blogs
What's new in midwifery - 15th April 2020
Things you might want to know about...ResearchThe cost-effectiveness of progesterone in preventing miscarriages in women with early pregnancy bleeding: an economic evaluation based on the PRISM trial (BJOG)Antibiotic prophylaxis for operative vaginal delivery (Cochrane review)Umbilical cord milking in preterm infants: a systematic review and meta-analysis (Archives of Diseases in Childhood)Telehealth Interventions to Improve Obstetric and Gynecologic Health Outcomes: A Systematic Review (Obstetrics and Gynecology)Includes discussion related to smoking cessation, breastfeeding and pre-eclampsia.Ask your librarian if you hav...
Source: Browsing - April 15, 2020 Category: Databases & Libraries Tags: midwifery Source Type: blogs
Left atrial appendage closure devices
Anticoagulation for prevention of stroke is a well established modality of treatment in atrial fibrillation. But a significant number of them have bleeding complications. Hence the option of left atrial appendage closure with multiple types of devices have been developed. Left atrial appendage with its sluggish flow is the most common location for thrombus formation in atrial fibrillation.
Following devices have been used with varying success:
Watchman
Amplatzer Cardiac Plug/Amulet
Lariat suture ligation
Atriclip
PROTECT-AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillatio...
Source: Cardiophile MD - April 15, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Scores predicting bleeding risk in AF
Anticoagulation is vital for reducing the risk of stroke in atrial fibrillation (AF). There are several scores predicting bleeding risk in AF. These can be used to weigh between the need for anticoagulation and the risk of bleeding with it while taking an individualised decision.
HAS-BLED: Hypertension, Abnormal liver or renal function, Stroke, Bleeding, Labile INRs, Elderly (>65 years), Drugs or Ethanol Abuse
HEMORR2HAGES: (Hepatic or Renal Disease, Ethanol Abuse, Malignancy History, Older than age 75, Reduced platelet count or function, Rebleeding risk, Hypertension, Anemia, Genetic factors (CYP2C9 single nucleotide ...
Source: Cardiophile MD - April 14, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Why is uncertainty so stressful?
Stress caused by uncertainty can be paralyzing.
The information we are getting about the coronavirus seems to be changing by the hour — creating unprecedented uncertainty. There is a good reason your nerves are jangle, or you are feeling unsettled or anxious.
Uncertainty is perceived as unsafe and potentially painful. Whether the situation is predictably positive or predictably negative, your brain prefers something familiar to something unfamiliar.
Under stress, our brains depend on instinct rather than rational thought because the part of the brain responsible for critical thinking is busy dealing with the psychologica...
Source: Embrace Your Heart Wellness Initiative - March 25, 2020 Category: Cardiology Authors: Eliz Greene Tags: Stress Management uncertainty Source Type: blogs
Skin tag removal: Optional but effective
Skin tags are common, benign skin growths that hang from the surface of the skin on a thin piece of tissue called a stalk. They are made up of many components, including fat, collagen fibers, and sometimes nerve cells and small blood vessels. It’s possible that these collagen fibers and blood vessels become wrapped up inside a layer of skin, leading to the formation of a skin tag. The medical term for a skin tag is acrochordon, and they can also be referred to as soft fibromas or fibroepithelial polyps.
Skin tags are frequently found in areas of friction on the skin, such as the neck, underarms, under the breasts, eyeli...
Source: Harvard Health Blog - March 23, 2020 Category: Consumer Health News Authors: Kristina Liu, MD, MHS Tags: Cosmetic surgery Health Skin and Hair Care Source Type: blogs
