Coronary artery disease: Primary care and prevention
Symptomatic coronary artery disease can be divided into stable coronary artery disease and acute coronary syndromes. Asymptomatic coronary artery disease seldom present to the primary care physician and is often detected by a routine health check up or pre-operative evaluation. Stable coronary artery disease usually presents in the form of chronic stable angina. Acute coronary syndromes could be either unstable angina or acute myocardial infarction. Acute myocardial infarction can be further subdivided into ST elevation myocardial infarction (STEMI) and non ST elevation myocardial infarction (NSTEMI) depending on the prese...
Source: Cardiophile MD - December 17, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Source Type: blogs
Ticagrelor No Better Than Clopidogrel In Peripheral Artery Disease
AstraZeneca announces top-line results from EUCLID trial ahead of the AHA. Ticagrelor is no better than clopidogrel in patients who have peripheral artery disease, a large new study will show. On Tuesday morning AstraZeneca announced the top line results of the EUCLID (Examining Use of Ticagrelor in PAD) trial. The full results will be presented...Click here to continue reading... (Source: CardioBrief)
Source: CardioBrief - October 4, 2016 Category: Cardiology Authors: Larry Husten Tags: MI/ACS People, Places & Events clopidogrel EUCLID peripheral artery disease ticagrelor Source Type: blogs
40-something with severe CP. True + vs. False + high lateral MI. ST depression does not localize.
This was sent by Jason Winter of the Facebook PageClinical Electrocardiology This post presents one new case, then reviews some interesting aspects of high lateral MI and of ST Depression in " inferior " leads. Down below are 3 more cases and a discussion of how to differentiate false positive isolated STE in aVL from True positive.CaseA 47 year old male called 911 for severe chest pain. He was clammy and looked unwell. He had a previous MI with cardiac arrest 2 years prior. This is his prehospital ECG:There is very subtle ST elevation in I and aVL, with very subtle ST depression in III and aVF.Is ...
Source: Dr. Smith's ECG Blog - September 3, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs
Intravenous P2Y12 receptor inhibitor – Cardiology MCQ
Intravenous P2Y12 receptor inhibitor:
a) Ticagrelor
b) Clopidogrel
c) Prasugrel
d) Cangrelor
Correct answer: d) Cangrelor
Cangrelor is a reversible intravenous P2Y12 receptor inhibitor. It is a rapid and potent inhibitor of ADP induced platelet aggregation. Its plasma half life is less than 10 minutes and platelet function is restored within 2 hours of discontinuation of infusion. (Source: Cardiophile MD)
Source: Cardiophile MD - August 27, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
What PPIs and the Kardashians have in common
The science we conduct often reflects the society we live in. One phenomenon of current society is the rise of the reality television show. Participants are promised instant media fame without having to struggle through acting school. I worry that this has rubbed off on some of the studies we now conduct. Sir Richard Doll and Austin Hill, the architects of modern epidemiology, realized that it was hard for epidemiology to prove or disprove anything. Their studies were driven by clear hypotheses as some took five to 10 years to complete. Furthermore, their landmark paper on smoking and lung cancer devoted over a page of dis...
Source: Kevin, M.D. - Medical Weblog - August 24, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/dr-paul-moayyedi" rel="tag" > Dr. Paul Moayyedi < /a > Tags: Conditions GI Source Type: blogs
Prasugrel – Cardiology MCQ
Wrong statement about prasugrel:
a) Not influenced by CYP inhibitors
b) Higher bleeding risk in those with previous cerebrovascular events
c) Use in acute coronary syndrome is better restricted to the cathlab
d) Recommended in those above 75 years
Correct answer: d) Recommended in those above 75 years
Prasugrel has a higher bleeding risk in those above 75 years and in those with body weight less than 60 Kg. Prasugrel is not interfered with by CYP inhibitors, CYP2C19 gene variants or proton pump inhibitors, unlike clopidogrel. Rapid onset of action enables its use in the cathlab after coronary angiography if percutaneous i...
Source: Cardiophile MD - August 22, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Limitations of clopidogrel
Slow onset of antiplatelet effect
Unpredictable maximal level of platelet inhibition
Wide variability of pharmacodynamic response due to:
Genotype polymorphisms of enzymes needed for its intestinal absorption and conversion to active metabolite
Interactions by drugs that activate or inhibit cytochrome P450 (Source: Cardiophile MD)
Source: Cardiophile MD - August 21, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Source Type: blogs
Anorectal Procedures: Thrombosed Hemorrhoids
We are going to get up close and personal this month to talk about hemorrhoids. You should be familiar with these painful offenders because half to two-thirds of people between 45 and 65 will suffer from their cruelty. (Am Surg 2009;75[8]:635.) Patients may seek emergency department care if they experience bleeding or severe pain from hemorrhoids.Hemorrhoids are highly vascular structures that are round or oval in shape. They arise from the rectal and anal canal, and sometimes appear around the anus itself. It is important to note that hemorrhoids do not have arteries and veins but special blood vessels called sinusoid...
Source: The Procedural Pause - August 1, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Law and Order? - Bristol-Myers-Squibb Settles Case Alleging Fraud and Kickbacks, No Admissions of Guilt, No Individuals Charged
< b > Introduction & nbsp; < /b > < br / > < br / > Donald Trump, Republican candidate for the US presidency last week announced he is the " law and order " candidate, accompanied by then vice presidential contender and New Jersey Governor Chris Christie. < br / > < br / > < iframe allowfullscreen= " " frameborder= " 0 " height= " 315 " src= " https://www.youtube.com/embed/NxDmUcRYe9o " width= " 560 " > < /iframe > < br / > < br / > I wonder if all this interest in law and order will lead to increasing the effectiveness of enforcing laws when large US health care corporations are accused? < br / > < br / > For years, ...
Source: Health Care Renewal - July 21, 2016 Category: Health Management Tags: Abilify Bristol-Myers-Squibb crime impunity kickbacks legal settlements logical fallacies Source Type: blogs
Health Expenditure Projections: When Does ‘New’ Become ‘Normal’?
The Centers for Medicare and Medicaid Services (CMS) has released its latest forecast of medical spending for the next decade. The headline number is that medical care as a share of gross domestic product (GDP) is expected to increase from its current 17.5 percent of GDP to 20.1 percent by 2025, resuming an upward increase after a several year slowdown.
Forecasting is an inexact science. To make guesses about the future, analysts typically examine the past. The history of medical spending can roughly be described using Fuchs’ law: medical spending increases have exceeded GDP increases by about 2.5 percentage points annua...
Source: Health Affairs Blog - July 13, 2016 Category: Health Management Authors: David Cutler Tags: Costs and Spending Featured Insurance and Coverage Medicaid and CHIP Medicare Payment Policy ACA ACOs Alternative Payment Models MACRA spending projections Source Type: blogs
DM / DNB Cardiology Entrance New Test Series 1
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Source: Cardiophile MD - June 28, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
LITFL Review 227
Welcome to the 227th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
The old and new titans of critical care Paul Marik and Rob MacSweeney throw down over the futility of predicting fluid responsiveness in resuscitation. [JS]
Natalie May provides a thought-provoking post looking at our polarised perspectives in th...
Source: Life in the Fast Lane - April 17, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes
Conclusions: In the select group of hypokalemic patients studied, potassium infusions of 20 to 40 mmol delivered over 1 hr were safe to administer and effectively increased serum potassium levels in a dosedependent and predictable fashion. Furthermore, these results were independent of the patient's underlying renal function or associated diuretic administration. (Crit Care Med 1991; 19:694)Concentrated Potassium Chloride Infusions in Critically Ill Patients with HypokalemiaThe Journal of Clinical Pharmacology. Volume 34, Issue 11, pages 1077–1082, November 1994Although concentrated infusions of pota...
Source: Dr. Smith's ECG Blog - April 7, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 25
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Source: Cardiophile MD - April 4, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
