The danger of ignoring your instincts
Recently we had a patient admitted for a diagnosis that did not really fit his problem representation. The diagnosis was a convenient one, and easily treated. He initially responded to treatment and we discharged him. The diagnosis assumption nagged at me, but I did not push forward with a test that my mind wanted.
A week later he returned (the dreaded readmission), with the same symptoms. The admitting resident expanded the treatment for the same diagnosis.
The next morning on seeing the patient we were even more uncomfortable than on the first admission.
As often happens, this is a story of community acquired p...
Source: DB's Medical Rants - March 16, 2019 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
The Heart of The Matter: Technology In The Future of Cardiology
Sound, rhythm, rate, structure, function – countless features of the heart are measured to keep it healthy for as long as possible. Recently, an army of digital health technologies joined the forces of traditional preventive tools in cardiology to counter stroke, heart attack, heart failure or any other cardiovascular risks. In the future, minuscule sensors, digital twins, and artificial intelligence could strengthen their ranks. Let’s see what the future of cardiology might look like!
Fitness trackers, chatbots and A.I.
against heart disease
Let’s say 36-year-old Maria living in Sao Paulo in
2033 decides one d...
Source: The Medical Futurist - March 12, 2019 Category: Information Technology Authors: nora Tags: Artificial Intelligence in Medicine Future of Medicine Health Sensors & Trackers Portable Diagnostics cardiology cardiovascular cardiovascular diseases digital digital twin health trackers heart heart health heart rate heart soun Source Type: blogs
What will you do for this patient transferred to you who is now asymptomatic?
A middle-aged woman with history of hypertension presented to another hospital approximately 2 hours after onset of chest pain and shortness of breath.This ECG was recorded on arrival:What do you think?This is technically a STEMI, with 1.5 mm STE in V1 and 1.5-2.0 mm in V2. The current criteria only require 1mm in V1 and 1.5mm in V2 for a female. However, I think many practitioners might not see this as a clear STEMI, and would instead call this " borderline. " The normal QRS complex with STE and large volume underneath the T-waves in V1-V3 confirm Occlusion MI (OMI). There is not technically STD in V6 and I, however the m...
Source: Dr. Smith's ECG Blog - March 5, 2019 Category: Cardiology Authors: Pendell Source Type: blogs
Philips Envisions Use of Augmented Reality in Operating Room (Video)
The Microsoft HoloLens is an impressive augmented reality (AR) system that lets the user overlay graphics over the visual scene in front. Philips is partnering with Microsoft to bring this technology to the operating room, and it has released a “concept” that foreshadows how AR can be used for image-guided minimally invasive therapies.
Physicians working in cath labs have to take into account individual patient anatomy via MRI or CT scans captured previously, live imaging coming in from the fluoroscope, and data provided by the digital patient monitors. This can be awkward and overwhelming, particularly when on...
Source: Medgadget - February 26, 2019 Category: Medical Devices Authors: Editors Tags: ENT Neurosurgery Radiology Thoracic Surgery Vascular Surgery Source Type: blogs
Marie Kondo And Digital Health
The Japanese art of decluttering and tidying up could show
medical professionals what they could get rid of in healthcare so the
surroundings of patients and care processes could become agreeable. Here, the
aim is not to “spark joy” but to make all the activities in healthcare
invisible and inevitable – no waiting times, no (necessary) medical visits,
less administration – to cause as little concern
to patients as possible. Let’s see how digital health could help make
medicine neat!
A fragile Japanese woman and the art of tidying up
After Netflix introduced its latest reality show about
Marie Kondo, th...
Source: The Medical Futurist - February 16, 2019 Category: Information Technology Authors: nora Tags: Healthcare Design administration chatbot chatbots decluttering digital health marie kondo patient management smart smart healthcare technology telemedicine tidying up waiting waiting time Source Type: blogs
Fight Aging! Newsletter, February 4th 2019
In this study, we examined the benefits of early-onset, lifelong AET on predictors of health, inflammation, and cancer incidence in a naturally aging mouse model.
Lifelong, voluntary wheel-running (O-AET; 26-month-old) prevented age-related declines in aerobic fitness and motor coordination vs. age-matched, sedentary controls (O-SED). AET also provided partial protection against sarcopenia, dynapenia, testicular atrophy, and overall organ pathology, hence augmenting the 'physiologic reserve' of lifelong runners. Systemic inflammation, as evidenced by a chronic elevation in 17 of 18 pro- and anti-inflammatory cytokin...
Source: Fight Aging! - February 3, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
The Age of A.I. Will Value Compassionate Care More Than Ever
While modern medicine created the professional, efficient, metric-driven medic alienated from the patients, the need for compassionate care is more urgent than ever. However, that’s not only up to the physician but also the organization, because individual attempts might result in burnout symptoms. Adoption of A.I. could change the situation for the better in the future, as it would create space for doctors and nurses to spend more quality time with patients. The question is, are doctors ready for it?
Medicating Albert, the plush armadillo
Two years ago, my niece had to spend two weeks in
hospital as she partially ...
Source: The Medical Futurist - February 2, 2019 Category: Information Technology Authors: nora Tags: Artificial Intelligence in Medicine AI care compassionate care digital digital health future healthare nursing physician technology Source Type: blogs
GrimAge is the Latest Evolution of the Epigenetic Clock
The original epigenetic clock is a measure of age, a weighted algorithmic combination of specific DNA methylation sites on the genome. Numerous variations on this theme are being produced, and here I'll point out news on the latest, a metric called GrimAge. DNA methylation is an epigenetic mechanism that steers protein production and thus cell behavior. Epigenetic clocks correlate well with chronological age, and it has been shown that populations of older individuals with pronounced age-related disease or otherwise exhibiting higher mortality rates tend to have higher epigenetic ages.
There are some problematic exc...
Source: Fight Aging! - January 30, 2019 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
uEXPLORER Whole Body PET-CT Cleared by FDA for Clinical and Research Use
United Imaging Healthcare, a company out of Shanghai, China, won FDA clearance for its uEXPLORER combined Positron Emission Tomography (PET) and Computed Tomography (CT) scanner. The device can perform whole-body scans using both imaging modalities at the same time.
The system is expected to be used in both clinical practice, to spot cancers and to track disease progression, and in research when studying inflammation, blood flow, and other processes affecting large parts of the body.
United Imaging believes its system can deliver superior imaging performance to existing PET/CT scanners thanks to new hardware and softwar...
Source: Medgadget - January 24, 2019 Category: Medical Devices Authors: Editors Tags: Nuclear Medicine Radiology Source Type: blogs
What Could Happen When You Don ’t Carefully Read a Radiology Report
A lawsuitinvolving a 49-year-old male with colon cancer has demonstrated the need for physicians to thoroughly read radiology reports and for radiologists to effectively relay image interpretations.The patient had undergone a CT scan for pre-procedure workup for his extracorporeal shock wave lithotripsy to remove kidney stones. The scan showed a possible indication of colon cancer, and the radiologist had made note of those findings on the second page of the report that was sent to the urologist that same day. However, the urologist neglected to read the second page, and 19 months later, the patient was diagnosed with la...
Source: radRounds - January 18, 2019 Category: Radiology Authors: Julie Morse Source Type: blogs
Fatty liver disease: What it is and what to do about it
Non-alcoholic fatty liver disease (NAFLD), a condition of extra fat buildup in the liver, is on the rise — it now affects roughly 20% to 40% of the US population. It usually doesn’t cause any symptoms, and is often first detected by accident when an imaging study (such as an abdominal ultrasound, CT scan, or MRI) is requested for another reason. A fatty liver may also be identified on an imaging test as a part of investigating abnormal liver blood tests. NAFLD is intimately related to conditions like diabetes and obesity. It’s also linked to an increased risk of cardiovascular disease. Understanding NAFLD and its cau...
Source: Harvard Health Blog - January 10, 2019 Category: Consumer Health News Authors: Wynne Armand, MD Tags: Digestive Disorders Health Source Type: blogs
Heart disease and breast cancer: Can women cut risk for both?
Very often I encounter women who are far more worried about breast cancer than they are about heart disease. But women have a greater risk of dying from heart disease than from all cancers combined. This is true for women of all races and ethnicities. Yet only about 50% of women realize that they are at greater risk from heart disease than from anything else.
Currently in the US, three million women are living with breast cancer, which causes one in 31 deaths. Almost 50 million women have cardiovascular disease, which encompasses heart disease and strokes and causes one in three deaths.
Here’s what’s really interestin...
Source: Harvard Health Blog - January 8, 2019 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Breast Cancer Exercise and Fitness Health Healthy Eating Heart Health Women's Health Source Type: blogs
When AI Looks at X-Rays: Interview with Qure.ai CEO, Prashant Warier
If you follow the recent advances in medical technology and artificial intelligence, you may have heard people make bold claims that AI will replace tomorrow’s doctors. While there are still ways to go for technology to reach these sci-fi levels, many companies are actively designing AI systems that will accompany doctors or assist them with their daily tasks. One particularly challenging task has been to enable algorithms to examine medical images and make intelligent conclusions, create reports, or provide recommendations. Medgadget recently had the chance to ask Qure.ai’s CEO, Prashant Warier, about the strides his ...
Source: Medgadget - January 3, 2019 Category: Medical Devices Authors: Mohammad Saleh Tags: Exclusive Informatics Radiology Source Type: blogs
Meet Susan Potter: Immortal Corpse
At the age of 72, German immigrant Susan Potter was adamant about donating her body to science. Her body would be turned inside out and created into a 3D digital landscape of 6,900 photos for medical students to learn from. In 2015, her wish finally came true. In a storyforNational Geographic, journalist Cathy Newman details Potter ’s journey from living human to “immortal corpse.”Potter ’s body was donated to the National Library of Medicine’s Visible Human Project, a program started by Vic Spitzer and David Whitlock at the University of Colorado in 1991. At the time, they received a government contract grant ...
Source: radRounds - December 28, 2018 Category: Radiology Authors: Julie Morse Source Type: blogs
Weird accounting
I manage my mother ' s affairs. She ' s been in a nursing home since she was hospitalized last July for 11 days. So all of a sudden, on December 26, I get a bill from the hospital. I didn ' t expect one since she has a Medicare Advantage plan, but apparently there is a copay for this. Here ' s the itemization of the bill:CT Scan: $5,075EKG/ECG: $198Emergency Room: $2,609Laboratory: $3,429Medical/Surgical Supplies/Devices: $2,192.76Occupational Therapy: $2,901Other Care Items: $3,734Pharmacy: $1,369Physical Therapy: $5,913Room and Board: $46,838Total: $74,259In case you ' re wondering, room and board comes to $4,258 a day. ...
Source: Stayin' Alive - December 27, 2018 Category: American Health Source Type: blogs
