The Proteomic Effects of Cardiopoietic Stem Cell Therapy Following Heart Attack
Cardiopoietic stem cells are used in a form of autologous mesenchymal stem cell therapy. Cells are extracted from patient bone marrow, expanded in culture, and provoked into adopting a cardiac lineage, such that they produce daughter cardiac muscle cells. Human trials have shown benefits in heart attack patients, but, as for all such therapies, it is a question as the degree to which signaling versus integration produces these benefits. Is greater regeneration the result of signaling that changes native cell behavior, followed by the death of near all of the transplanted cells, versus integration of a fraction of those tra...
Source: Fight Aging! - March 19, 2020 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
5 steps to improve your diastolic dysfunction of life
I recently attended a cardiology conference where a dear friend of mine was presenting on the topic of hypertrophic cardiomyopathy. She discussed how fibrosis within the ventricle causes diastolic dysfunction, an inability of the myocardium to relax. My ears perked up. Just the week before, while on vacation, I personally experienced the inability to relax. […]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 - March 17, 2020 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/susan-maclellan-tobert" rel="tag" > Susan MacLellan-Tobert, MD < /a > < /span > Tags: Physician Practice Management Source Type: blogs
Fight Aging! Newsletter, March 16th 2020
We report a new class of natural-product-inspired covalent inhibitors of telomerase that target the catalytic active site. Age-Related Epigenetic Changes that Suppress Mitochondrial Function https://www.fightaging.org/archives/2020/03/age-related-epigenetic-changes-that-suppress-mitochondrial-function/ Today's open access research reports on two specific epigenetic changes observed in old individuals that act to reduce mitochondrial function. This joins an existing list of genes for which expression changes are known to impact mitochondrial function with age. A herd of hundreds of mitochondria are found ...
Source: Fight Aging! - March 15, 2020 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
CEACAM1 and TNF- α in Age-Related Vascular Dysfunction
Researchers here report on their investigations of one small part of the complex biochemistry of chronic inflammation and oxidative stress that is observed in aging blood vessels. This sort of work is carried out in search of novel target proteins and mechanisms that might be influenced in order to treat age-related vascular conditions, those that arise from the downstream consequences of chronic inflammation in older individuals. It would be a better approach to address the causes of age-related chronic inflammation rather than adjust its mechanisms or immediate consequences, but this remains a less popular strategy in th...
Source: Fight Aging! - March 13, 2020 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
New Onset Heart Failure and Frequent Prolonged SVT. What is it? Management?
This middle-aged man with no cardiac history but with significant history of methamphetamin and alcohol use presented with chest pain and SOB, worsening over days, with orthopnea.BP:143/99, Pulse 109, Temp 37.2 °C (99 °F), Resp (!) 32, SpO2 95%On exam, he was tachypneic and had bibasilar crackles.Here was his ED ECG:There is sinus tachycardia (rate about 114) with nonspecific ST-T abnormalities.There is a large peaked P-wave in lead II (right atrial enlargement)There is left axis deviation consistent with left anterior fascicular block.There are nonspecific ST-T abnormalities.There is no evidence of infarction or i...
Source: Dr. Smith's ECG Blog - March 6, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
What are these wide complexes? If unclear by explanation, the laddergram helps to understand.
An 18 y.o. female who presented for chest pain. Patient reports productive cough and headache x 4 days. She notes persistent sternal chest pain worse at night and waking her from sleep. She also notes intermittent abdominal pain, describing as a " tightness " ." Sinus arrhythmia with variable right bundle origin PVCs "Is this accurate?No.This is sinus bradycardia with a slightly accelerated right ventricular escape, such that sometimes:1. the sinus beat is conducted before any ventricular escape (beats 7)2. the ventricular beat starts at almost the exact same time as the P-wave, and the P-wa...
Source: Dr. Smith's ECG Blog - February 20, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
H/o MI and stents with brief angina has this ED ECG. And what is Fractional Flow Reserve?
A middle-aged man complained of 15 minutes of classic angina that resolved upon arrival to the ED.Here is his initial ECG:What do you think?There is sinus rhythm with RBBB and possible LPFB (see Dr. Grauer's detail below). There is ST elevation in II, III, and aVF, and reciprocal ST depression in aVL. And there are Q-waves in both inferior and lateral leads. So this is indeed diagnostic of myocardial infarction.Should we activate the cath lab?No! Not immediately, at least, because this is NOT diagnostic of ACUTE (occlusion) myocardial infarction (Acute OMI). We need to do some more investigatio...
Source: Dr. Smith's ECG Blog - January 31, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
Cardiology MCQ – Recurrence of stress cardiomyopathy
Cardiology MCQ – Recurrence of stress cardiomyopathy Though stress cardiomyopathy is a reversible condition, recurrence is known. Average recurrence rate is about: 2% to 4% per year 6% to 12% per year 14% to 20% per year 20% to 40% per year Post your answer as a comment below (Source: Cardiophile MD)
Source: Cardiophile MD - January 1, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Cardiology MCQ – Anti-Ro/SSA – Answer
Cardiology MCQ – Anti-Ro/SSA – Answer Maternal Anti-Ro/SSA antibodies are associated with fetal: Correct answer: 4. All of the above Fetal echocardiographic features of anti-Ro/SSA antibody–mediated cardiac disease includes dilated cardiomyopathy, pericardial effusion, endocardial fibroelastosis, complete heart block and atrioventricular valve regurgitation . But the one familiar to most people is complete heart block in the infant of mother with systemic lupus erythematosus or other maternal connective tissue disease . Back to question Reference Cuneo BF, Sonesson SE, Levasseur S, Moon-Grady AJ, K...
Source: Cardiophile MD - December 31, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
InterTAK diagnostic score for Takotsubo cardiomyopathy
InterTAK Diagnostic Score was developed from the results for International Takotsubo Registry  by the InterTAK International Registry Group. The score was developed for differentiating Takotsubo cardiomyopathy from acute coronary syndrome in the acute stage. InterTAK Diagnostic Score estimates the probability for Takotsubo cardiomyopathy and was found to have high sensitivity and specificity for differentiating it from acute coronary syndrome. Points were allocated as follows: Female gender: 25 points Emotional trigger: 24 points Physical trigger: 13 points Absence of ST-segment depression: 12 points Psychiatric disord...
Source: Cardiophile MD - December 31, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
16 fold higher risk of cancer with peripartum cardiomyopathy
German cancer registry (Robert-Koch-Institute) data has shown a 16 fold risk of cancer in those with peripartum cardiomyopathy . According to the report 21 of 236 patients had cancer, of which 12 had cancer diagnosed before peripartum cardiomyopathy. 11 of them had cardiotoxic chemotherapy. Of these, 17% fully recovered cardiac function compared to 55% of peripartum cardiomyopathy patients without cancer. Of the 10 patients who developed cancer after peripartum cardiomyopathy, 80% had left ventricular ejection fraction of 50% or more after cancer therapy. Authors mention that the high prevalence could be due to geneti...
Source: Cardiophile MD - December 23, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardio Oncology Source Type: blogs
Anesthesia before MRI Results in Death of Teen
A 14-year girl in England has died due to complications of being anesthetized prior to her imaging scan.Alice Sloman ’s heart was twice the size of normal hearts, a condition that put her in danger when administered anesthesia. Before her scan, she was described as “extremely anxious” and “hypersensitive,” prompting physicians to give her a dose of general anesthesia. According to her parents, they repea tedly insisted to her doctors that she suffered from a series of symptoms including breathlessness.However, the anesthesia was a miscalculated decision, and three days later Sloman died. Coron...
Source: radRounds - December 23, 2019 Category: Radiology Authors: Julie Morse Source Type: blogs
Wide-complex tachycardia that didn ’t follow the rules
ConclusionIt is well worth remembering that this was a rare case! In most middle-aged patients with a history of cardiomyopathy, a WCT will usually be VT. Furthermore, while specific criteria (e.g. precordial RS duration, aVR morphology) may not be perfectly sensitive, the are more likely to be helpful than suspecting 1:1 atrial flutter in patients not taking sodium-channel-blocking antiarrhythmics.Comparison of the old and WCT ECGsmight have suggested an SVT or atrial flutter at the time of presentation. However, it would not have been prudent for most clinicians to try e.g. a calcium-channel blocker as the first age...
Source: Dr. Smith's ECG Blog - December 23, 2019 Category: Cardiology Authors: Brooks Walsh Source Type: blogs
Cardiology MCQ – Treatment of transthyretin amyloid cardiomyopathy – Answer
Cardiology MCQ – Treatment of transthyretin amyloid cardiomyopathy – Answer Recently developed pharmacotherapy which has been shown to halt and reverse the progression of transthyretin amyloid cardiomyopathy: Correct answer: 2. Tafamidis Transthyretin amyloid cardiomyopathy is due to transthyretin amyloid fibril deposition in the myocardium. Tafamidis acts by binding to transthyretin and prevents tetramer dissociation, thus preventing amyloid formation. Back to question Reference Maurer MS, Schwartz JH, Gundapaneni B, Elliott PM, Merlini G, Waddington-Cruz M, Kristen AV, Grogan M, Witteles R, Damy T, Dr...
Source: Cardiophile MD - December 14, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Cardiology MCQ – Treatment of transthyretin amyloid cardiomyopathy
Cardiology MCQ – Treatment of transthyretin amyloid cardiomyopathy Recently developed pharmacotherapy which has been shown to halt and reverse the progression of transthyretin amyloid cardiomyopathy: Trastuzumab Tafamidis Tranexamic acid Tamoxifen Click here for the correct answer (Source: Cardiophile MD)
Source: Cardiophile MD - December 13, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
All About Blood Alcohol Levels
Blood alcohol levels, also known as blood alcohol content, is a way to measure an individual’s level of alcohol intoxication. It represents the percentage of alcohol that is concentrated in the bloodstream. Blood alcohol levels are used for legal purposes, such as measuring individuals for drunk driving incidents, and for medical purposes, such as testing patients who enter the hospital for alcohol-related health issues. What Are The Different Blood Alcohol Levels? There are many factors that influence a person’s blood alcohol levels. They can include body weight, gender, genetics, tolerance to alcohol, drinki...
Source: Cliffside Malibu - December 11, 2019 Category: Addiction Authors: Jaclyn Uloth Tags: Addiction Alcohol Alcoholism alcohol abuse alcohol dependence alcohol dependency alcohol detox alcohol treatment alcohol treatment center alcohol treatment facility alcohol use Alcoholics Anonymous Source Type: blogs
BioethicsTV (Dec 2-6, 2019): #TheResident
by Craig Klugman, Ph.D. The start of the winter holidays means winter hiatus for many shows. This week only one show dealt with bioethical issues. The Resident (Season 3: Episode 9): Maternal-fetal conflict; Politics, Business, and Torture; Problems with outpatient surgery in offices In one storyline, a pregnant patient has trouble breathing during a standard ultrasound. She is diagnosed with an enlarged heart, cardiomyopathy brought on by her prior chemo. Okafor suggests delivering the baby early to protect her heart. This situation is a classic case of maternal-fetal conflict: What is good for the baby (being carried to...
Source: blog.bioethics.net - December 6, 2019 Category: Medical Ethics Authors: Craig Klugman Tags: BioethicsTV Featured Posts Professionalism Reproductive Ethics harm Source Type: blogs
Why ventricular tachycardia has wide QRS complex ?
Why VTs have wide QRS complex? Brief answer: VT usually presents with wide QRS tachycardia because it originates in ventricular myocardium, travels muscle to muscle instead of the normal conduction system. However, VTs need not be wide always, if it captures the conduction system early and more proximally it can be as narrow as SVT. Further reading: Only for cardiology fellows Two empirical statements are made here. (The scientific chances of both being reasonably correct are fair) 80 % of wide QRS tachycardia by default is VT. That means 20 % of wide QRS is not VT. We all accept that. 80 % of narrow QRS tachy...
Source: Dr.S.Venkatesan MD - December 4, 2019 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
Maternal Mortality – Separating Signal from Noise
By AMEYA KULKARNI, MD When Samuel Morse left his New Haven home to paint a portrait of the Maquis du Lafayette in Washington DC, it was the last time he would see his pregnant wife. Shortly after his arrival in Washington, his wife developed complications during childbirth. A messenger took several days on horseback to relay the message to Mr Morse. Because the trip back to New Haven took several more, his wife had died by the time he arrived at their home. So moved was he by the tragedy of lost time that he dedicated the majority of the rest of his life to make sure that this would never happen to anyone again. H...
Source: The Health Care Blog - December 3, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Health Policy Medical Practice Ameya Kulkarni Global Health Maternal mortality public health Source Type: blogs
A 50-something Australian with sudden severe epigastric and chest pain presented looking extremely ill.
A 50-something with sudden severe epigastric and chest pain presented looking extremely ill.Here is her ECG:What do you think?There is ST Elevation in V2-V6, worrisome for ischemia.Or is it?Notice the very large R-waves and the very prominent J-point notching, with small S-waves.This is typical ofBenign T-wave Inversion, which is commonly seen in black patients of African heritage.This case was sent from Australia and the patient was aboriginal. I have never heard of or seen benign T-wave inversion in Australian aboriginal blacks.The cath lab was activated and the patient was taken for angiogram, which was norma...
Source: Dr. Smith's ECG Blog - November 27, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Fight Aging! Newsletter, November 25th 2019
This study demonstrates for the first time that senescent cells secrete functional LTs, significantly contributing to the LTs pool known to cause or exacerbate idiopathic pulmonary fibrosis. Against Senolytics https://www.fightaging.org/archives/2019/11/against-senolytics/ There is no consensus in science that is so strong as to have no heretics. So here we have an interview with a naysayer on the matter of senolytic treatments, who argues that the loss of senescent cells in aged tissues will cause more harm to long-term health than the damage they will do by remaining. To be clear, I think this to be a ...
Source: Fight Aging! - November 24, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Dogs as a Model of Human Aging
Dogs are an interesting species when it comes to the study of aging. Firstly they are much closer to human metabolism and cellular biochemistry than mice, and secondly selective breeding has generated lineages with a very wide range of sizes and life spans. Thirdly, they occupy a good compromise position in the range of life spans, study cost, and similarity to humans. Mice live short lives, so studies are rapid and comparatively cheap, but there are sizable, important differences between mouse and human biochemistry. Humans live so long that most studies of aging are simply out of the question. Even in non-human primates ...
Source: Fight Aging! - November 21, 2019 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Fight Aging! Newsletter, November 4th 2019
In this study, we hypothesized that moderately and chronically reducing ACh could attenuate the deleterious effects of aging on NMJs and skeletal muscles. To test this hypothesis, we analyzed NMJs and muscle fibers from heterozygous transgenic mice with reduced expression of the vesicular ACh transporter (VAChT), VKDHet mice, which present with approximately 30% less synaptic ACh compared to control mice. Because ACh is constitutively decreased in VKDHet, we first analyzed developing NMJs and muscle fibers. We found no obvious morphological or molecular differences between NMJs and muscle fibers of VKDHet and contro...
Source: Fight Aging! - November 3, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
A man in his 50s with witnessed arrest and ST elevation in aVR
Written by Meyers, edits by SmithA 50-ish year old man was working construction when he suddenly collapsed. Coworkers started CPR within 1 minute of collapse. EMS arrived within 10 minutes and continued CPR and ACLS, noting alternating asystole and sinus bradycardia during rhythm checks. He received various ACLS medications and arrived at the ED with a perfusing rhythm.Initial vitals included heart rate around 100 bpm and BP 174/96. Here is his initial ECG, very soon after ROSC:What do you think?Sinus tachycardia. There is incomplete RBBB (QRS duration less than 120 ms). There is diffuse STD, maximal in V4-V5 a...
Source: Dr. Smith's ECG Blog - November 3, 2019 Category: Cardiology Authors: Pendell Source Type: blogs
Is LV dilatation (with normal EF) Indicate LV dysfunction?
LV dysfunction is one of the most commonly used terminology by cardiac professionals.It can be systolic, diastolic or global, regional etc. But, before dysfunction sets in, the heart fights. The Left ventricle can behave in many different ways when confronted with stress. It increases the force of contraction, elevates it’s Intra cavitary filling pressure and still accomplishes its task of pumping adequately. Further, It can build fresh muscle (LVH). It can double up with more heartbeats. (All these factors are referred to as cardiac reserve mechanisms) These reserve mechanisms can be activated in the short or l...
Source: Dr.S.Venkatesan MD - November 2, 2019 Category: Cardiology Authors: dr s venkatesan Tags: cardaic physiology cardiac physiology LV dilatation is diastolic dysfunction cardiac reserve cardiology research papers cardiology thesis topics dilated left ventricle lv dilatation is lv dysfunction Source Type: blogs
NLRP3 Knockout Extends Maximum Life Span by 29% in Mice
Today's open access research is an interesting demonstration of the importance of chronic inflammation in aging. Researchers generate a mouse lineage in which the NLRP3 gene is deleted, and show that these mice live significantly longer, and in better health, as a result. The protein produced from the NLRP3 gene is important in the innate immune response; it is a component part of one of the inflammasomes, protein complexes with a central role in regulation of the inflammatory response. NLRP3 appears important in the inflammatory signaling generated by senescent cells as well. Inflammation is a necessary part of wou...
Source: Fight Aging! - October 28, 2019 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
40-something male in a head-on Motor Vehicle Collision and Splenic Injury
A 40-something male presents to the stabilization room for evaluation following head on motor vehicle collision (MVC). Pt was reported restrained driver, hit at city speeds, with + airbag deployment.The MVC was unquestionably caused by the other car, not by this driver.The patient complained to EMS of chest pain and a prehospital EKG en route was concerning for STEMI.The patient was at all times hemodynamically stable, without evidence of any profuse bleeding.He had an ECG recorded on arrival to the ED:Anterior and Inferior STEMI with diffuse hyperacute T-waves. This ECG really can't be anything else. ...
Source: Dr. Smith's ECG Blog - October 27, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
A 50-something woman with chest pain, BP 230/120, and LBBB with 7 mm ST Elevation
A 50-something woman with history of CHF of unknown etiology, and of HTN, presented for evaluation of chest pressure.Her BP was 223/125, Sp02 98% on RA. HR 106, RR 18. Here was her ED ECG:There is sinus rhythm with Left Bundle Branch Block (LBBB)There is a large amount of ST Elevation in V2 and V3 (more than 5 mm)Thus, this meets the unweighted Sgarbossa Criteria of 5 mm of discordant ST ElevationBut it does NOT meet the Smith Modified Sgarbossa Criteria, which depend on the ST/S ratio.This ratio is critical because LBBB with very large depolarization voltage (QRS) also has very large repolarization voltage (ST/T).Her...
Source: Dr. Smith's ECG Blog - September 25, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Ischemic cardiomyopathy: Why is it, still searching for a definition?
The term Ischemic cardiomyopathy(ICM) was originally coined by Dr. Burch from Tulane University, New Orleans, USA in 1970. For many decades there was skepticism regarding the existence of such entity. WHO classification over the years never included this term. ESC working group of 2008 (Elliott P, European Heart 29(2):270–276) decided not to include CAD as a cause for cardiomyopathy. Even the current MOGES system doesn’t invoke CAD as a cause for cardiomyopathy. But, I am sure, most of practicing cardiologists would agree, there is a need for such an entity. Why there is m...
Source: Dr.S.Venkatesan MD - September 21, 2019 Category: Cardiology Authors: dr s venkatesan Tags: Criteria and Nomenclature ischemic cardiomyopathy Uncategorized defintion of ischemic cardiomyopathy MOGES classification what is ischemic cardiomyopathy who whf classification of cardiomyopathy Source Type: blogs
MINOCA vs TpNOCA
TpNOCA: Troponin-positive nonobstructive coronary arteries Apparent myocardial infarction in the absence of obstructive coronary artery disease MINOCA: Myocardial Infarction With Nonobstructive Coronary Arteries Term reserved for only those who have evidence of ischemia related myocardial necrosis MINOCA included only coronary disorders like coronary dissection, plaque disruption, coronary spasm, microvascular dysfunction, coronary thrombus and embolism (recanalized). TpNOCA includes in addition to MINOCA, myocardial disorders like myocarditis, takotsubo cardiomyopathy and other cardiomyopathies as well as non cardia...
Source: Cardiophile MD - September 10, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
What is the differential of this very unusual ECG?
Take a look at this ECG first without clinical context:What do you think?There is sinus bradycardia with very unusual shortened QT interval (approximately 400 ms), for a QTc (Bazett) 358 ms. The T-waves have high amplitude and narrow bases, reminiscent of hyperkalemia, maybe also with hypercalcemia. The T-waves are not bulky or fat, and are therefore not hyperacute regardless of their amplitude.Short QTc is rare, but has been described as less than 360 ms for males and less than 370 ms for females. Furthermore, less than 330 ms (males) or less than 340 ms (females) can be termed " very short QTc " and, in the abs...
Source: Dr. Smith's ECG Blog - September 2, 2019 Category: Cardiology Authors: Pendell Source Type: blogs
The ECG was correct. The angiogram was not.
In this study, approximately 10% of Transient STEMI had no culprit found:Early or late intervention in patients with transient ST ‐segment elevation acute coronary syndrome: Subgroup analysis of the ELISA‐3 trialOne must use all available data, including the ECG, to determine what happened.Final Diagnosis?If the troponin remained under the 99% reference, then it would be unstable angina. If it rose above that level before falling, it would be acute myocardial injury due to ischemia, which is, by definition, acute MI. If that is a result of plaque rupture, then it is a type I MI. The clinical presentat...
Source: Dr. Smith's ECG Blog - August 13, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Fight Aging! Newsletter, August 5th 2019
In conclusion, with study of the frailty syndrome still in its infancy, frailty analysis remains a major challenge. It is a challenge that needs to be overcome in order to shed light on the multiple mechanisms involved in the pathogenesis of this syndrome. Although several mechanisms contribute to frailty, immune system alteration seems to play a central role: this syndrome is characterized by increased levels of pro-inflammatory markers and the resulting pro-inflammatory status can have negative effects on various organs. Future studies should aim to better clarify the immune system alteration in frailty, and seek to esta...
Source: Fight Aging! - August 4, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Impaired Monocyte to Macrophage Transition Implicated in Cardiovascular Disease
The innate immune cells called macrophages are vitally important to the health and function of tissues. They help to coordinate the intricate dance of stem cells, somatic cells, and immune cells that produces tissue regrowth and tissue maintenance. They destroy errant cells and pathogens. They have a variety of other roles as well. But where do macrophages come from? While some macrophages are generated within tissues, it is generally the case that in damaged or diseased tissues, most macrophages were originally monocytes. Circulating monocytes in the bloodstream enter tissues in response to chemical cues and then transfor...
Source: Fight Aging! - July 29, 2019 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Bizarre T-wave inversions, with Negative U-waves and Very long QT. And a myocardial viability study.
This 60-something year old male was admitted and his hospital course complicated by GI bleed, hemodynamic instability, and a nadir hemoglobin less than 5 g/dL. An ECG was relatively normal.The next AM, his potassium was measured at 2.9 mEq/L, so another ECG was recorded.He was asymptomatic.The previous ECG from one week prior had been relatively normal.There are bizarre inverted T-waves and also inverted U-waves (see the 2nd inverted bump?)The QT is incredibly longThere is some subtle STE in inferior leads but also STE in I, aVL.There is STE before the bizarre TU inversion in leads V3-V6.There are some artifacts that...
Source: Dr. Smith's ECG Blog - July 24, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Do you recognize these ECGs? STEMI? LVH? What?
What do you think of these ECGs?I came across the first one reading it blind for a study. I was certain I knew the diagnosis, and went to the chart to confirm.The first 3 were recorded on one day.ECG 1:ECG 2:ECG 3:ECG 4, recorded 12 days later:These ECGs are classic for abenign variant in Black males. I was certain it would be a relatively young black male without cardiac pathology.Result from chart:It was a black male in his 40s.The first ECG, and then the next two (1-3), were recorded for chest and abdominal pain. The patient was ultimately diagnosed with biliary colic.The patient ruled out for MI by se...
Source: Dr. Smith's ECG Blog - June 20, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
ROSC: does the ECG to rule out OMI? And why does a heart just stop beating? And what rhythm is this?
This study had afatal flaw: they did not keep track of all the Non-STEMI patients who were NOT enrolled, but instead were sent for immediate angiogram. It was done in Europe, where the guidelines suggest taking all shockable arrests emergently to the cath lab. So it is highly likely that physicians were very reluctant to enroll patients; they did not want them to be randomized to no angiogram. This strong suspicion is supported by their data:only 22 of 437 (5.0%) patients in this study had OMI. What percent of shockable arrests without STE have an OMI? This large registry in Circ...
Source: Dr. Smith's ECG Blog - June 18, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
ROSC: does the ECG rule out OMI? And why does a heart just stop beating? And what rhythm is this?
This study had afatal flaw: they did not keep track of all the Non-STEMI patients who were NOT enrolled, but instead were sent for immediate angiogram. It was done in Europe, where the guidelines suggest taking all shockable arrests emergently to the cath lab. So it is highly likely that physicians were very reluctant to enroll patients; they did not want them to be randomized to no angiogram. This strong suspicion is supported by their data:only 22 of 437 (5.0%) patients in this study had OMI.What percent of shockable arrests without STE have an OMI? This large registry in Circulatio...
Source: Dr. Smith's ECG Blog - June 18, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Understanding Machine Learning And Deep Learning In Medicine
Algorithms, datasets, machine learning, deep learning, cognitive computing, big data, and artificial intelligence: IT expressions that took over the language of 21st-century healthcare with surprising force. If medical professionals want to get ahead of the curve, they rather get familiarized with the basics of A.I. and have an idea of what medical problems they aim to solve. So, let’s take a closer look at machine learning and deep learning in medicine. The ante-room of artificial intelligence The term “artificial intelligence” might be misleading as due to the overuse of the expression, its meanin...
Source: The Medical Futurist - May 30, 2019 Category: Information Technology Authors: nora Tags: Artificial Intelligence in Medicine Future of Medicine AI algorithm deep learning Health Healthcare Innovation machine learning smart smart algorithm smart health technology Source Type: blogs
I was handed this ECG at triage with no information
I was at triage when this ECG of a 50-something was handed to me. He speaks no English and I really had no idea what his symptoms were, but someone had pointed to his chest, which is why they recorded an ECG.What do you think?I was pretty alarmed by the ST segments in V4 and V5, and the ST segment of the PVC in V3. V4 and V5 haveQR-waves, in addition to the STE, which suggests:1. Old MI with persistent STE2. Old MI with superimposed new STE, or3. Subacute MI. There is also STE in the normally conducted beats of V2 and V3, but that is in the context of a deep QS-wave, which was less alarming.So I looked for o...
Source: Dr. Smith's ECG Blog - May 28, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Histological processes in HCM
Four histological processes in hypertrophic cardiomyopathy (HCM): Myocyte hypertrophy Myocyte and myofibrillar disarray Small vessel disease Fibrosis Reference McKenna WJ, Moon JC, Sulaiman A. Understanding the Myocardial Architecture of Hypertrophic Cardiomyopathy for Clinical Care. J Am Coll Cardiol. 2019;73(20):2503-5. (Source: Cardiophile MD)
Source: Cardiophile MD - May 23, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Assessing SCD risk in HCM by CMR
Sudden cardiac death (SCD) is one of the dreaded complications of hypertrophic cardiomyopathy (HCM) and predicting it is always challenging. Clinical risk stratification algorithms lack good sensitivity and specificity. Myocardial disarray has been well documented in those who died suddenly with HCM. Cardiac magnetic resonance imaging with a novel technology known as diffusion tensor cardiac magnetic resonance (DT-CMR) is a promising way for in vivo demonstration of myocardial disarray . DT-CMR can visualise myocardial microstructure by mapping the diffusion of water molecules. But it is technically challenging and ac...
Source: Cardiophile MD - May 23, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Diagnostic criteria for peripartum cardiomyopathy
Diagnostic criteria for peripartum cardiomyopathy are: Development of heart failure in the last month of pregnancy or within 5 months after delivery Left ventricular systolic dysfunction with ejection fraction less than 45% No other identifiable cause for heart failure No recognized heart disease before the last month of pregnancy Reference van Spaendonck-Zwarts KY1, van Tintelen JP, van Veldhuisen DJ, van der Werf R, Jongbloed JD, Paulus WJ, Dooijes D, van den Berg MP. Peripartum cardiomyopathy as a part of familial dilated cardiomyopathy. Circulation. 2010 May 25;121(20):2169-75. (Source: Cardiophile MD)
Source: Cardiophile MD - May 21, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Fight Aging! Newsletter, May 20th 2019
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - May 19, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Rejuvenate Bio to Launch a Gene Therapy Trial for Heart Failure in Dogs
One of the many possible paths towards developing a new medical technology is to first focus on veterinary use. It is considerably less costly in time and resources to develop a therapy for dogs, say, than it is to develop a therapy for humans. Later, given robust success in veterinary medicine, the therapy can be brought into the sphere of human medicine. This is the approach taken by Rejuvenate Bio for their class of regenerative gene therapies. As noted here, the company is moving forward to trials in companion animals, starting later this year. Back in 2015, the Church lab at Harvard began testing a variety of...
Source: Fight Aging! - May 15, 2019 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Acute chest pain in a patient with cardiomyopathy and a paced rhythm.
A 70-something with h/o cardiomyopathy, ICD, LVH was awoken with sharp chest pain, 8/10, non-radiating. It worsened through the morning and she was eventually brought to the hospital.An ECG was recorded:What do you think?Here is one from 3 years prior:There is a paced rhythm in all 12 leads. The new ECG has new ST Elevation that meets the Smith modified Sgarbossa criteria in leads I, aVL, and V2. (ST elevation at the J-point is at least 25% of the depth of the preceding S-wave). Meeting the criteria in just one lead is very specific for OMI in paced rhythm.She was given aspirin, ticagrelor, and...
Source: Dr. Smith's ECG Blog - May 13, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Fight Aging! Newsletter, April 29th 2019
In this study, we report the age-associated differences between fetal MSC (fMSC) populations and MSCs isolated from elderly donors with respect to their transcriptomes. We successfully reprogrammed fMSCs (55 days post conception) and adult MSC (aMSC; 60-74 years) to iPSCs and, subsequently, generated the corresponding iMSCs. In addition, iMSCs were also derived from ESCs. The iMSCs were similar although not identical to primary MSCs. We unraveled a putative rejuvenation and aging gene expression signature. We show that iMSCs irrespective of donor age and cell type re-acquired a similar secretome to that of th...
Source: Fight Aging! - April 28, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
MicroRNAs Assist in Heart Regeneration
Many researchers are exploring the therapeutic utility of microRNAs involved in fundamental cellular processes such as replication. These molecules act to regulate the processes of gene expression, determining how much of specific proteins are produced from their genetic blueprints, and when. Protein amounts are the switches and dials of cellular operation, and delivering microRNAs into cells is one possible way to steer cells into useful behavior - through the sheer complexity of the cell makes identifying the right tools to use quite difficult, and any given microRNA may produce quite sweeping changes, only few of which ...
Source: Fight Aging! - April 26, 2019 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Ultrasound Case 091
Dr James Rippey Ultrasound Case 091 A 56 year old woman presents with chest pain and shortness of breath. Her ECG demonstrates widespread precordial ischaemic change. (Source: Life in the Fast Lane)
Source: Life in the Fast Lane - April 21, 2019 Category: Emergency Medicine Authors: Dr James Rippey Tags: Cardiology TOP 100 Ultrasound apical ballooning Cardiac ultrasound echocardiography fractional shortening octopus trap Tako-Tsubo Takotsubo Takotsubo cardiomyopathy TCM Source Type: blogs
What is Detoxing From Alcohol Like, and How We Can Help Make It Comfortable
Detoxing from Alcohol Detoxing from alcohol can look very different to many different people. The way you may feel when you detox from alcohol depends on the severity of your addiction and how long you have been addicted to alcohol for. If someone has had a few too many drinks at a celebration, chances are, they might feel hungover the next morning. They might experience nausea or a headache, but are able to feel back to normal later that day or the following day. However, for someone suffering from an alcohol addiction, the experience is much different. The body of someone suffering from alcohol addiction is chemically wi...
Source: Cliffside Malibu - April 17, 2019 Category: Addiction Authors: Jaclyn Uloth Tags: Addiction Addiction Recovery Alcohol Alcohol Rehab Information Alcoholism Detox Resources for Alcohol and Drugs/Opiates Drinking Substance Abuse alcohol abuse alcohol dependence alcohol dependency alcohol detox alcohol treatment Source Type: blogs