Log in to search using one of your social media accounts:

 

FDA authorizes marketing of first blood test to aid in the evaluation of concussion in adults
Advances in technology are leading to a host of innovations around reducing and detecting concussions.Today, the FDA authorized the marketing of the first blood test to evaluate mild traumatic brain injury (mTBI), commonly referred to as concussion, in adults.The FDA reviewed and authorized for marketing the Banyan Brain Trauma Indicator in fewer than 6 months as part of its Breakthrough Devices Program.The Brain Trauma Indicator works by measuring levels of proteins, known as UCH-L1 and GFAP, that are released from the brain into blood and measured within 12 hours of head injury. Levels of these blood proteins after mTBI/...
Source: Medicine and Technology by Dr. Joseph Kim - February 14, 2018 Category: Information Technology Source Type: blogs

New and Improved Planmed Verity CBCT Scanner Unveiled
Planmed, based in Helsinki, Finland, is releasing an upgraded new version of its popular Planmed Verity CBCT (Cone Beam Computed Tomography) extremity scanner. The system is intended for ortho, as well as head and neck imaging, and even advanced dental applications. It is CE marked in Europe and is now available wherever the mark applies. While the new device looks much like its previous version, the major changes are on the inside, such as a new and improved detector, a new operating system, and a number of new features and applications. For instance, there’s now a greater ability to capture maxillofacial and ENT im...
Source: Medgadget - February 9, 2018 Category: Medical Devices Authors: Editors Tags: Dentistry Medicine Orthopedic Surgery Radiology Source Type: blogs

2018 AHA/ASA stroke guidelines & Radiology
The following are key points to remember from the American Heart Association (AHA)/American Stroke Association (ASA) 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke:These 2018 guidelines are an update to the 2013 guidelines, which were published prior to the six positive “early window” mechanical thrombectomy trials that emerged in 2015 and 2016 showed a clear benefit of“extended window” mechanical thrombectomy for certain patients with large vessel occlusion who could be treated out to 16-24 hours IV tPA should be administered to all eligible acute stroke patien...
Source: Sumer's Radiology Site - February 4, 2018 Category: Radiology Authors: Sumer Sethi Source Type: blogs

MKSAP: 75-year-old man with very severe COPD
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 75-year-old man is seen for routine follow-up for very severe COPD. He has constant dyspnea and air hunger and spends most of the day in a chair. He has had no change in baseline cough and sputum production. He has had multiple COPD exacerbations that required ICU admission and intubation. He has not benefited from pulmonary rehabilitation in the past. He quit smoking 3 years ago. His medical history is also notable for hypertension, type 2 diabetes mellitus, and a myocardial infarction 3 years ago. Hi...
Source: Kevin, M.D. - Medical Weblog - February 3, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Palliative Care Pulmonology Source Type: blogs

HoloLens Augmented Reality Headset Helps Surgeons to Reconnect Blood Vessels
After a traumatic injury, surgeons may need to repair damage using flaps of tissue taken from elsewhere in the body. One of the challenges with this approach is that the blood vessels of the “new” tissue must be connected with those at the injury site. At the moment, surgeons use a handheld ultrasound scanner that can detect blood pulsing under the skin, to approximate where blood vessels are. Researchers at Imperial College London have now developed an augmented reality system, based on the Micosoft HoloLens, that allows surgeons to see the positions of key blood vessels and bones in a CT image overlay on a pa...
Source: Medgadget - January 31, 2018 Category: Medical Devices Authors: Conn Hastings Tags: Radiology Surgery Vascular Surgery Source Type: blogs

The Ongoing Challenges of Schizophrenia
They are silent because the division walls are broken down in the brain, and hours when they might be understood at all begin and leave again. —Rainer Maria Rilke, “The Insane” Schizophrenia is an elusive disease, which makes it a difficult one to relate to among the general population. It is easy to sympathize with someone who is suffering from an evident physical malady, such as a broken leg, or even an invisible illness, like cancer, which generally attacks the body in ways that are not cognitive in nature. One is readily able to put oneself in that person’s place and empathize with their plight....
Source: World of Psychology - January 24, 2018 Category: Psychiatry & Psychology Authors: Casey Clabough Tags: Communication Personal Psychology Schizophrenia Stigma Suicide Violence and Aggression Delusions Depression Empathy Hallucinations Miscommunication Mystery Nonverbal communication Paranoia Psychosis Schizoaffective Disorder Source Type: blogs

A middle-aged man with severe syncope, diffuse weakness
p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 11.0px Helvetica; background-color: #fefefe}A middle-aged male diabetic who is otherwise healthy was found unconscious by his wife, with incontinence.  He quickly awoke but was too weak to stand.  Initial vitals by EMS were BP 100/50 with pulse of 80 and normal glucose.  He remained weak and somnolent, and without focal neurologic abnormality.  He recovered full consciousness, but still felt weak and " not normal. "  There was a prehospital ECG:What do you think?He arrived in the ED and had this ECG recorded:This one was sent to me for my ...
Source: Dr. Smith's ECG Blog - January 20, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs

Aortic Dissection Detection Risk Score
Acute aortic dissection may be present in only about one in ten thousand patients presenting to the emergency department. But missing an aortic dissection can be catastrophic. At the same time submitting all patients with suspected dissection to imaging studies may not be feasible in view of the cost and potential risks. Hence a good clinical bedside risk score may be useful, in addition to diligent clinical evaluation. Aortic Dissection Detection Risk Score (ADD Risk Score) was formulated by IRAD investigators using the International Registry of Acute aortic Dissection. Three groups of high risk features have b...
Source: Cardiophile MD - January 19, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs

Research and Reviews in the Fastlane 192
This article defines the concept of ‘translational simulation’ and is the perfect succinct, academic overview of this exciting area. Recommended by: Chris Nickson The Best of the Rest Emergency Medicine Crowell EL, et al. Accuracy of Computed Tomography Imaging Criteria in the Diagnosis of Adult Open Globe Injuries by Neuroradiology and Ophthalmology. Acad Emerg Med. 2017. PMID: 28662312  Some people rely on CT scan of the orbits to rule in or rule out an open globe. This retrospective chart review, in which CT scans were reviewed independently by a blinded neuroradiologist and ophthalmologist (x2...
Source: Life in the Fast Lane - January 17, 2018 Category: Emergency Medicine Authors: Justin Morgenstern Tags: Education Emergency Medicine ENT and Maxillofacial Intensive Care Ophthalmology R&R in the FASTLANE Trauma EBM recommendations research and reviews Resuscitation Source Type: blogs

An Example of the Need for Research and Development Investment in Cryonics
Cryonics is a field that requires commercial success of some form for further expansion, such as in the reversible vitrification of organs, not least because either that or wealthier patrons than presently exist will be needed as a source of significant funding to improve current methodologies of preservation. The recent report from Alcor noted here illustrates the well-understood need for this sort of technical improvement. Alcor presents comparatively unfiltered reports on cryopreservations, where patients agree to it, and the staff and patients should be commended for this. Such reports are important to the quality of a...
Source: Fight Aging! - January 17, 2018 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Healthcare for the Uninsured Is Wasteful (For a Surprising Reason)
Shutterstock American physicians dole out lots of unnecessary medical care to their patients. They prescribe things like antibiotics for people with viral infections, order expensive CT scans for patients with transitory back pain, and obtain screening EKGs for people with … Continue reading → The post Healthcare for the Uninsured Is Wasteful (For a Surprising Reason) appeared first on PeterUbel.com. (Source: blog.bioethics.net)
Source: blog.bioethics.net - January 10, 2018 Category: Medical Ethics Authors: Peter Ubel Tags: Health Care health insurance health policy Medicare Peter Ubel syndicated Uncategorized Source Type: blogs

High ST Elevation in a Patient with Acute Chest Pain
ConclusionThe ECG findings could be due to either dynamic early repolarization (normal variant ST elevation), or to pericarditis, or to acombination of the 2 entities.Yes, normal variant ST elevation can be dynamic:Increasing ST elevation. STEMI vs. dynamic early repolarization vs. pericarditis.ST elevation of early repolarization may vary with the rateChest pain, Dynamic ST Elevation and T-waves, and High VoltageAlternatively, the ECG could represent pericarditis superimposed on early repol.  There certainly was pericarditis, but that does not mean the ECG findings were due to pericarditis.This paradox is extremely w...
Source: Dr. Smith's ECG Blog - January 8, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs

Cancer Cure?
No there is not a cancer cure. We need to keep remembering that. We are told by our doctors that there is no evidence of disease or some thing along those lines - which just boils down to " we are not capable of finding it yet " . If your doctor tells you that you are cured, please find a new one asap.In this day and ageshould there be a new definition of cured of cancer? I'm not sure. I have friends who tell me they are cured. I try to figure out what they are talking about. Seriously, where did this cured business come from? I want to question their position on this but in some ways do not want to know." U...
Source: Caroline's Breast Cancer Blog - January 7, 2018 Category: Cancer & Oncology Tags: being a patient cancer bonds cancer cure cancer treatment lies Source Type: blogs

An apology from a telemedicine physician
In the emergency room, the stress is palpable. The hairs on your neck rise up as you enter the resuscitation bay where the next unconscious patient has just arrived. You can almost feel death as it circulates through the air, like a vulture in the sky. The air tastes sterile, and you hear the crash cart and ultrasound being rolled over to the patient’s bed. The patient was fine 20 minutes ago, a healthy middle-aged woman who collapsed at home while preparing dinner with her husband. He now stands in the corner, face flushed and dampened by tears. You avoid making eye contact with him at first, until that empty feelin...
Source: Kevin, M.D. - Medical Weblog - January 6, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/james-e-siegler" rel="tag" > James E. Siegler, MD < /a > Tags: Physician Emergency Medicine Mobile health Neurology Source Type: blogs

What Do Medicare ’s Policies Mean for Your Imaging Practice?
Back in August, Anthemdecided they would no longer cover MRI and CT scans for outpatient services. Some of the factors that led to this decision might point to Medicare’s proposed rules for 2018 and could affect other private insurers policies. At a Radiology Business Management Association ’s annual meeting, Pam Kassing, MPA, the senior economic advisor at the American College of Radiology, untangled the reasoning behind these new policy strategies. She explained that the incorporation of the “site neutral” policy in Medicare’s Physician Fee Schedule (PFS) will be used “to c reate ...
Source: radRounds - December 30, 2017 Category: Radiology Authors: Julie Morse Source Type: blogs

Medgadget ’s Best Medical Technologies of 2017
We reported a surge in the use of augmented reality in healthcare at the end of 2016, with the trend continuing in 2017. Notably, Microsoft’s HoloLens was successfully used for spinal surgery applications by a surgical navigation company named Scopis. There are several advantages to this system including reduced radiation exposure of patients, improved screw placement accuracy, and decreased surgery times. It has been an exciting year for healthcare with many advances in how diseases are diagnosed, treated, and cured. Medical devices are constantly becoming smaller, smarter, cheaper, more precise and user ...
Source: Medgadget - December 26, 2017 Category: Medical Devices Authors: Editors Tags: Exclusive Source Type: blogs

Dose reference levels in cardiac CT scan
Dose reference level is the level used for the dose that does not lead to adverse effects . usually studies in this field using multiple dose including overdose. In the case of several studies that deal with different effects the lowest level is determined that does not cause significant damage, then the level is divided along with the differences in sensitivity among Humans . The processes and steps towards establishing DRLs are likely to involve many players, including the imaging facilities, the health authority, the professional bodies, and the regulatory body. In particular there should be collective ‘ownership&...
Source: radRounds - December 18, 2017 Category: Radiology Authors: Sura Ahmad alkhateeb Source Type: blogs

RSNA 2017: 2016 Redux...Centaurs Will Make Radiology Great Ag-AI-n!
In readinglast year's RSNA report, I was struck with just how little has changed.Here I am this year, 2017, and here's how I looked at RSNA 2016:A little grayer, perhaps a pound or two more. But otherwise same ol'Dalai. And same ol'RSNA. I even manned the RAD-AID booth again:Yes, I tied the bow-tie all by myself.This is a model housed at the Bayer booth of the airship RAD-AID hopes to use to bring imaging to underserved areas; I think the official rendering is much more impressive, and maybe even a little, well,buxom:I'm still lobbying for a seat on the first flight. Did I saybuxom? I meanthandsome!I did attend the requisi...
Source: Dalai's PACS Blog - December 17, 2017 Category: Radiology Source Type: blogs

Fat Distribution Predicts a Person ’s Risk for Heart Attack
Obesity and overweight can lead to a heart attack, stroke, or diabetes. Yet, there are other ways to determine someone ’s chances of developing a cardiometabolic health condition. According to a recentstudy presented at the Radiological Society of North America annual meeting, the way fat is distributed throughout the body can indicate someone ’s cardiometabolic risk. Study lead Miriam A. Bredella, MD, a radiologist at Massachusetts General Hospital and associate professor at Harvard Medical School, and her colleagues evaluated 200 overweight and obese people who were the mean age of 37 and had similar BMI. The...
Source: radRounds - December 15, 2017 Category: Radiology Authors: Julie Morse Source Type: blogs

The Boys From Silicon Valley
By MARGALIT GUR-ARIE A few weeks ago one man, named @jack, decided that millions of people will be allowed to use up to 280 characters when expressing themselves on Jack’s public square platform. One man decides how many letters each and every one of us, including the “leader of the free world”, can use when we talk to each other. Just like that. Nobody seemed the least bit perturbed by this notion. Another dude, named Mark, decided to ask people for nude pictures of themselves, so he can better protect them from the bad guys. We shrugged that off too. Then, in a most embarrassing exercise in public humil...
Source: The Health Care Blog - December 14, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Dopamine Labs Keytruda Mark Zuckerberg Sean Parker Techno-drugs Source Type: blogs

The patient who was a former bowling champion
My new patient was having trouble breathing and had lost his ability to swallow; despite this, he had been too proud to call either friends or family for help. He had lost thirty pounds and his clothes hung loosely. His belt was far too long. The day I met him, I thought, “This man could walk through a harp.” People had tried. Over the previous months, his worried family members had made several attempts to see him, but he always pushed them away with excuses why they should not visit. One day over his protests, his daughter went to his house. “His voice sounded so different!” she said. When she pus...
Source: Kevin, M.D. - Medical Weblog - December 14, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/bruce-campbell" rel="tag" > Bruce Campbell, MD < /a > Tags: Physician Oncology/Hematology Source Type: blogs

The Joy and Challenge of Simple Medicine in India
​BY KATE BANKS, MDThe Himalayan Health Exchange (HHE) is an organization that assembles volunteers and health care providers from all over the world to deliver care in underserved areas in northern India. I had the amazing opportunity in my second year of residency to spend a month delivering medical care with HHE in the beautiful inner Himalayan mountains. The month was full of exploring, trekking, camping, learning, doctoring, and personal and professional growth.The clinics were scattered throughout different areas in the state of Himachal Pradesh. Our convoy of interpreters, cooks, volunteers, and health care profess...
Source: Going Global - December 12, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

A first-time case in a 35-year medical career
A couple of years ago I saw a young man with pain in his lower right abdomen. I sent him for an urgent CT scan with a “wet read” to check for appendicitis. It was afternoon, and things were crazy at the office. I forgot all about the pending CT report. I have learned this about myself: I am efficient because I have the ability to hyperfocus, but that has made me dependent on my support staff to see the big picture of my schedule or pending, unfinished tasks. The next morning there was a fax from Cityside with a lengthy explanation saying he had an epiploic appendagitis, and it went on to explain that this is a ...
Source: Kevin, M.D. - Medical Weblog - December 8, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/a-country-doctor" rel="tag" > A Country Doctor, MD < /a > Tags: Conditions Gastroenterology Surgery Source Type: blogs

3D Printing Helps to Implant Risky Transcatheter Mitral Valves
Transcatheter aortic valve implantations are now routine at a number of high-end hospitals around the world. Minimally invasive mitral valve replacements, on the other hand, are a lot more difficult and prone to post-op complications, and so are still a rarity. Yet, 60% of patients over 75 have mitral valve disease, and it’s an even bigger problem than aortic valves. We visited the Henry Ford Hospital in Detroit to learn about an innovative program where clinicians use 3D printing and computer simulations to help install replacement mitral valves without having to resort to open surgery. The Center for Structural Hea...
Source: Medgadget - December 8, 2017 Category: Medical Devices Authors: Editors Tags: Cardiac Surgery Cardiology Exclusive Source Type: blogs

Merged CVS and Aetna Will Move Toward a Community-Based Healthcare Model
Following the purchase of Aetna, the third largest U.S. health insurance company, CVS has lost no time in describing the healthcare goal for this large new entity:a community based care model (see:CVS and Aetna seek community-based care model in giant healthcare deal). I have previously blogged about this same topic (see:Possible Purchase of Aetna by CVS; Strategic Healthcare Implications). Below is an excerpt from this current article:Through their $69 billion deal, CVS Health and Aetna are swinging an axe at the traditional ways in which patients access healthcare in hopes of building a new kind of model that's ...
Source: Lab Soft News - December 6, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Cost of Healthcare Healthcare Insurance Lab Industry Trends Medical Consumerism Point-of-Care Testing Quality of Care Reference Laboratories Telemedicine Source Type: blogs

Could Artificial Intelligence destroy radiology by litigation claims?
By, Hugh Harvey MBBS BSc (Hons) FRCR MD (res) We’ve all heard the big philosophical arguments and debate between rockstar entrepreneurs and genius academics – but have we stopped to think exactly how the AI revolution will play out on our own turf? At RSNA this year I posed the same question to everyone I spoke to: What if radiology AI gets into the wrong hands? Judging by the way the crowds voted with their feet by packing out every lecture on AI, radiologists would certainly seem to be very aware of the looming seismic shift in the profession – but I wanted to know if anyone was considering th...
Source: The Health Care Blog - December 3, 2017 Category: Consumer Health News Authors: at RogueRad Tags: Uncategorized Source Type: blogs

List of Open Access Medical Imaging Datasets
Open access medical imaging datasets are needed for research, product development, and more for academia and industry.   We hope this guide will be helpful for machine learning and artificial intelligence startups, researchers, and anyone interested at all.  This is a growing list and will be periodically updated - if you know of another open medical imaging dataset, please email data@radrounds.com.Radiology Open Repositories:NIH- 100,000 chest x-rays with diagnoses, labels, annotationTCIA - The Cancer Imaging Archive consisting of extensive number of datasets from Lung IMage Database Consortium (LIDC), Refe...
Source: radRounds - December 2, 2017 Category: Radiology Authors: radRounds Radiology Network Source Type: blogs

Midgut Volvulus CT
Discussion by Dr MGK Murthy, Dr Pritam, Dr GA PrasadIntestinal malrotation is described as abnormal positioning of the bowel loops within the peritoneal cavity in the intrauterine life. It is caused by defective rotation of primitive intestinal loop around the axis of SMA during embryogenesis.Midgut volvulus is a complication of malrotation in which clockwise twisting of the bowel around the superior mesenteric artery axis occurs because of the narrowed mesenteric attachment. Degree of twisting is variable& determines symptoms. Severe volvulus = 3& ½ turns, can lead to bowel necrosis.Age at presentation &nda...
Source: Sumer's Radiology Site - November 24, 2017 Category: Radiology Authors: Sumer Sethi Source Type: blogs

Multislice computed tomography (MSCT) for evaluation of myocardial viability
Iodinated contrast used for CT scanning accumulate in infarcted myocardium similar to what happens with late gadolinium enhanced (LGE) magnetic resonance imaging (MRI). With the high spatial resolution inherent to MSCT (also called multi detector CT or MDCT), differentiation of transmural and subendocardial infarction is possible. Old infarcts have lower density on CT compared to recent infarcts. In general, there is good agreement between LGE MRI and late enhancement noted on MSCT. In a comparison with dobutamine stress echocardiography, MSCT with 64 multislice CT findings agreed with stress echo findings in 97.3% of th...
Source: Cardiophile MD - November 21, 2017 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Positron emission tomography (PET) for assessing myocardial viability
PET is usually taken as the gold standard for assessment of myocardial viability. PET scan with 13NH3 (ammonia) gives the perfusion while 18FDG (fluorodeoxyglucose) shows the metabolic activity of the myocardium. A mismatch between perfusion and metabolism whereby underperfused region of myocardium is shown to have active metabolism, is an indicator of myocardial viability. The most important limitation of PET is its high cost and limited availability. It has some radiation risk when compared to echocardiography and cardiac magnetic resonance (CMR) imaging. Important advantages of PET are that the validity is well establ...
Source: Cardiophile MD - November 21, 2017 Category: Cardiology Authors: Johnson Francis Tags: Positron emission tomography Source Type: blogs

Balanced myocardial ischaemia
If all three major coronary branches have similar degree of stenosis, the radionuclide used for perfusion study will have equal uptake in all regions of the myocardium. Thus a balanced three vessel coronary artery disease can produce a false negative myocardial perfusion scan. This situation is called balanced myocardial ischemia. In most cases this is picked up by the treadmill ECG usually done along with stress myocardial perfusion imaging. Since the ECG findings of myocardial ischemia does not depend on the relative perfusion in the coronary tree, ischemic changes will be noted in treadmill ECG even when nuclear ...
Source: Cardiophile MD - November 20, 2017 Category: Cardiology Authors: Johnson Francis Tags: Nuclear Cardiology Source Type: blogs

SPECT – advantages and disadvantages
SPECT (single photon emission computed tomography) – advantages and disadvantages Advantages of SPECT Important advantages of SPECT are that it has been extensively validated and has a good sensitivity, compared to other methods of assessment of myocardial viability. Cost of SPECT is lower than PET (positron emission tomography) imaging and is more widely available than PET in most regions. SPECT can be used in the presence of cardiac implantable electronic devices (CIED) while cardiac magnetic resonance (CMR) imaging has important limitations in this setting. Disadvantages of SPECT SPECT has a much higher cost comp...
Source: Cardiophile MD - November 20, 2017 Category: Cardiology Authors: Johnson Francis Tags: Nuclear Cardiology Source Type: blogs

Thallium 201 single photon emission computed tomography (SPECT)
Thallium 201 SPECT imaging is one of the oldest methods of assessing myocardial viability, though of late it is seldom used because of short half life of Thallium 201 and the free availability of Technetium 99, the alternate tracer. Initial uptake of Thallium 201 into the myocardium is proportional to the blood flow of the region. But the washout is dependent on the difference in the concentration in blood and myocardium cell as well as the integrity of the sodium potassium adenosine triphosphatase (Na/K ATPase) pump. This is because Thallium 201 is a potassium analogue. Hence in regions of lower uptake (reduced blood su...
Source: Cardiophile MD - November 20, 2017 Category: Cardiology Authors: Johnson Francis Tags: Nuclear Cardiology Source Type: blogs

What is the meaning of hypokinesia, dyskinesia and akinesia?
These terms are used in connection with the heart muscle. Akinesia means lack of movement or contraction of a region of the heart muscle. Dyskinesia means an abnormal movement – instead of contracting in systole, that segment of myocardium bulges out in systole. Hypokinesia means reduced movement or contraction of a segment of the heart muscle. Another term which is sometimes used is hyperkinesia, meaning increased contraction of heart muscle. Hyperkinesia can occur as a compensatory mechanism by which normal heart muscle does a little bit of extra work instead of the heart muscle which is defective with akinesia, hy...
Source: Cardiophile MD - November 18, 2017 Category: Cardiology Authors: Johnson Francis Tags: Heart Disease FAQ Source Type: blogs

Myocardial contrast echocardiography
Myocardial contrast echocardiography has been used in the assessment of myocardial viability. Downside of myocardial contrast echocardiography is the cost of ultrasound contrast agent (UCA). Intravenous administration of UCA improves the visualisation of myocardial segments and enables the assessment of perfusion. Myocardial segments with normal perfusion and those with patchy perfusion are considered to be viable. Those segments which have no perfusion are taken as non viable myocardial segments. UCA consists of ultrasonic microbubbles. A recent study compared myocardial contrast echocardiography with gated single photon...
Source: Cardiophile MD - November 17, 2017 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

NICE Guidelines for CT Scan in Head Injury: DAMS Unplugged
This guideline covers the assessment and early management of head injury in children, young people and adults. It promotes effective clinical assessment so that people receive the right care for the severity of their head injury, including referral directly to specialist care if needed. Presenting a short video on Guidelines for advising CT Imaging. Reference and Further Reading https://www.nice.org.uk/guidance/cg176Famous Radiology Blog http://www.sumerdoc.blogspot.com TeleRad Providers at www.teleradproviders.com Mail us at sales@teleradproviders.com (Source: Sumer's Radiology Site)
Source: Sumer's Radiology Site - November 15, 2017 Category: Radiology Authors: Sumer Sethi Source Type: blogs

Cardiac CT – Left coronary artery
Cardiac CT scan at the level of the aortic sinuses, showing the left main coronary artery (LMCA) and its two branches. LAD: Left anterior descending coronary artery; LCX: Left circumflex coronary artery. Ao: Aorta. LAD courses down in the groove between the right and left ventricles on the anterior surface of the heart. LCX turns backwards in the atrioventricular groove between the left atrium and left ventricle. (Source: Cardiophile MD)
Source: Cardiophile MD - November 10, 2017 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

LITFL Review 305
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 305th 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 chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week What’s on the Trauma Professional’s blog this week? Lots as usual! Lear...
Source: Life in the Fast Lane - November 5, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: LITFL review Source Type: blogs

Most of the documentation physicians perform don ’t help patients
Let me post a question that neither I nor readers can answer: How much of what I do during the course of a day directly benefits patients? Perhaps, I don’t want to really know as I would be dismayed at how much of my effort benefits no one. Ask a nurse who works on a hospital ward, how much of his or her effort is directly applied to patient care. I would recommend that you have a double dose of antacid in hand: one dose for you and the other for the nurse. Just today, I was gently reproved by a hospital physician administrator for a lapse in one of my recent progress notes, which I write after seeing every hosp...
Source: Kevin, M.D. - Medical Weblog - November 3, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/michael-kirsch" rel="tag" > Michael Kirsch, MD < /a > Tags: Physician Gastroenterology Practice Management Source Type: blogs

Cardiac CT – Pulmonary veins and left atrium
Cardiac CT scan showing left atrium and pulmonary veins RSPV: Right superior pulmonary vein; LA: Left atrium; LAA: Left atrial appendage; RIPV: Right inferior pulmonary vein; LIPV: Left inferior pulmonary vein. RA: Right atrium; RV: Right ventricle; LV: Left ventricle. IVS: Interventricular septum. Left ventricle is connecting to the aorta through a narrowed region which is the left ventricular outflow tract (LVOT – not labeled). Part of the blue arrow pointing to the aortic valve is through the LVOT. Aortic leaflets are seen as negative shadows within the contrast filled aorta. Since it is not a true cross sectional...
Source: Cardiophile MD - November 3, 2017 Category: Cardiology Authors: Johnson Francis Tags: Cardiac CT scan Source Type: blogs

Cheap, Easy to Integrate Technology Converts Any 2D Ultrasound Machine into 3D Scanner
Portable ultrasound technology is improving and becoming more affordable, allowing it to be used in places previously impossible due to size and cost. Full size ultrasound imagers can do some impressive stuff, such as creating 3D reconstructions obtained from 2D probes. Now researchers at Duke University are introducing incredibly cheap and easy to integrate technology that can convert any 2D ultrasound into a 3D imaging system. It works thanks to a $10 sensor chip that detects the orientation of an ultrasound probe. As the probe is used to scan the body, the chip’s readings are combined with the 2D data coming from...
Source: Medgadget - November 2, 2017 Category: Medical Devices Authors: Editors Tags: Cardiac Surgery Cardiology Emergency Medicine Radiology Source Type: blogs

Fight Aging! Newsletter, October 30th 2017
In this study, the researchers showed a causal link between dynamic changes in the shapes of mitochondrial networks and longevity. The scientists used C. elegans (nematode worms), which live just two weeks and thus enable the study of aging in real time in the lab. Mitochondrial networks inside cells typically toggle between fused and fragmented states. The researchers found that restricting the worms' diet, or mimicking dietary restriction through genetic manipulation of an energy-sensing protein called AMP-activated protein kinase (AMPK), maintained the mitochondrial networks in a fused or "youthful" sta...
Source: Fight Aging! - October 29, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

Cardiac CT – Pulmonary artery bifurcation
Contrast CT (computerized tomography) scan of thorax showing the bifurcation of main pulmonary artery (MPA) into RPA (right pulmonary artery) and LPA (left pulmonary artery). The section is just below that of the aortic arch. Hence aorta is seen as two structures in cross section (ascending aorta anteriorly and descending aorta posteriorly). Trachea has divided into right and left bronchi at this level of the section. Air filled cross section of the esophagus is seen between the bronchi and the spine. Major thrombi in the pulmonary arteries if any in these proximal segments, will be seen as negative shadows within the cont...
Source: Cardiophile MD - October 28, 2017 Category: Cardiology Authors: Johnson Francis Tags: Cardiac CT scan Source Type: blogs

Cardiac CT scan – Aortic arch level
Cardiac Computerized Tomographic (CT) scan – Aortic arch level Cardiac CT scan requires a multi slice CT scanner, usually 64 or 128 slice or even higher. Heart rate has to be stabilized at around 60/minute for electrocardiographic (ECG) gating. If the heart rate is fast, betablockers or ivabradine (pure sinus node inhibitor) or both together are given to bring down the heart rate. Some centers use intravenous betablockers to bring down the heart rate earlier, to avoid postponing a scheduled scan. After a plain scan, contrast CT scan is acquired at a fast speed along with injection of about 100 ml of iodinated radioco...
Source: Cardiophile MD - October 27, 2017 Category: Cardiology Authors: Johnson Francis Tags: Cardiac CT scan Source Type: blogs

Doctors have a responsibility to outline options. Patients make the final decision.
As an oncologist, I want to provide the best treatment for everyone. That should mean the best chance at a long-lasting remission, if not cure. Whatever that might take. Surgery, chemotherapy, radiation therapy — a dark tunnel that I hope patients will enter and then exit, with the sun shining on the other side. But, every now and then, I have a patient who chooses not to pursue the regimen that I think will bring them the best chances. Such was the case with Jean*. I met Jean as a second opinion — referred to me for discussion about next steps. She was 90 years old, though looked 30 years younger. She lived by...
Source: Kevin, M.D. - Medical Weblog - October 26, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/don-s-dizon" rel="tag" > Don S. Dizon, MD < /a > Tags: Physician Hospital-Based Medicine Oncology/Hematology Source Type: blogs

A Growing Interest in the Contents of Exosomes in Aging
Exosomes, or extracellular vesicles, are one of the modes by which cells communicate. They are tiny membrane-wrapped packages of signal molecules, constantly secreted and ingested by any population of cells - though note that exosomes are, confusingly, not the same as the larger microvesicles, also membrane-wrapped particles that can carry molecules between cells. Nothing to do with cells is simple or straightforward. In recent years, the falling cost of core biotechnologies has enabled an increasing number of researchers to investigate the contents of exosomes and relate them to specific changes in cellular behavior. ...
Source: Fight Aging! - October 25, 2017 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs

Professionalism And Choosing Wisely
The US health care system is plagued by the use of services that provide little clinical benefit. Estimates of expenditures on overuse of medical services range from 10–30 percent of total health care spending. These estimates are typically based on analyses of the geographic variation in patterns of care. For example, researchers at the Dartmouth Institute focused on differences in care use between high-spending and low-spending regions with no corresponding reductions in quality or outcomes. An analysis by the Network for Excellence in Health Innovation (formerly known as the New England Healthcare Institute) ident...
Source: Health Affairs Blog - October 24, 2017 Category: Health Management Authors: Michael Chernew and Daniel Wolfson Tags: Costs and Spending Quality Choosing Wisely inefficiency overuse of medical services Source Type: blogs

Valuing Value-Based Payment
By ANISH KOKA, MD The idea that payment should be linked to the value lies at the heart of most of the transactions we participate in on a daily basis. Yet, value based payment in healthcare has seemingly run into very rocky waters as of late.  It is at this precarious time that stakeholders representing large employers and other purchasers of health care’ took to the Harvard Business Review to write in defense of value based payment reform.  The authors pepper their article with cherry picked ‘successes’ of the value movement and urge the country to forge ahead on the current path.  The pi...
Source: The Health Care Blog - October 16, 2017 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Value-Based Payment Source Type: blogs

Primary Care Docs Spending About Half Their Work Days Interacting with EHRs
I have posted a number of previous notes about the inefficiencies introduced by EHRs, particularly particularly relating to the fact that their use now constitutes a major time sink for physicians (see:Some of the Major Criticisms of EHRs; Why Few Changes Anticipated;Problems Associated with EHRs: A Medical Malpractice Perspective). A recent article quoted a research study about the time logged by primary care physicians on their EHRs (see:Family doctors spend 86 minutes of “pajama time” with EHRs nightly). Below is an excerpt from it:A new study using electronic health record (EHR) system event-logging data to...
Source: Lab Soft News - October 13, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Electronic Health Record (EHR) Healthcare Business Healthcare Delivery Healthcare Information Technology Hospital Executive Management Hospital Financial Quality of Care Source Type: blogs