Mural endocarditis
Vegetations in infective endocarditis are usually situated on the valves. If they are located on the walls of the cardiac chambers, it is known as mural endocarditis [1]. When mural endocarditis occurs without any cardiac structural abnormalities like ventricular septal defects, it is called primary mural endocarditis [2]. Primary mural endocarditis is extremely rare.
Left atrial mural endocarditis usually occurs due to the jet lesion of mitral regurgitation [1,3]. Left atrial mural endocarditis is usually picked up by trans esophageal echocardiography. Vegetations are mostly located just distal to the mitral orifice betw...
Source: Cardiophile MD - October 31, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: General Cardiology Source Type: blogs
A 50s year old man with lightheadedness and bradycardia
Written by Pendell Meyers with edits by Smith and GrauerA man in his 50s with history of end stage renal disease on dialysis, prior bradycardia episode requiring transvenous pacemaker, diabetes, and hypertension, presented to the ED for evaluation of acute onset dizziness and lightheadedness starting several hours prior to arrival. These symptoms prevented him from going to dialysis, and his last session was three days ago. EMS found him with a heart rate of 30 bpm but normal blood pressure. He received 0.5 mg atropine with increased in heart rate to the 60s with improvement in symptoms. He denied chest pain or short...
Source: Dr. Smith's ECG Blog - October 16, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
Fight Aging! Newsletter, October 4th 2021
In conclusion, premature thymic involution and chronic inflammation greatly contribute to increased morbidity and mortality in CKD patients. Mechanisms are likely to be multiple and interlinked. Even when the quest to fountain of youth is a pipe dream, there are many scientific opportunities to prevent or to, at least in part, reverse CKD-related immune senescence. Further studies should precisely define most important pathways driving premature immune ageing in CKD patients and best therapeutic options to control them.
Extending Life Without Extending Health: Vast Effort Directed to the Wrong Goals
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Source: Fight Aging! - October 3, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Chronic Kidney Disease and an Accelerated Aging of the Immune System
In conclusion, premature thymic involution and chronic inflammation greatly contribute to increased morbidity and mortality in CKD patients. Mechanisms are likely to be multiple and interlinked. Even when the quest to fountain of youth is a pipe dream, there are many scientific opportunities to prevent or to, at least in part, reverse CKD-related immune senescence. Further studies should precisely define most important pathways driving premature immune ageing in CKD patients and best therapeutic options to control them. (Source: Fight Aging!)
Source: Fight Aging! - September 29, 2021 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Wide and weird
Written by Clare Gunn MD, peer reviewed by Smith, Meyers, BraceyA 74-year-old female presented to the ER after a trip and fall (unclear if purely mechanical or due to possible unsteadiness) causing her to cut her leg. Due to chronic anticoagulation for atrial fibrillation, she could not stop the bleeding, so she came the ED. On arrival she is found to be hypoxemic requiring four liters of oxygen via nasal cannula. While getting her leg wound repaired, the patient was also evaluated for hypoxemia and tachycardia and was found to have this ECG:What do you think?Here was her most recent prior ECG on file for comparison:...
Source: Dr. Smith's ECG Blog - August 27, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
Remote patient monitoring: a health IT perspective [PODCAST]
“The primary benefits for mobile care units are the fact that they decrease patient travel times by arriving at their residences and ensuring that appointments are never missed. It also relieves the stress of finding transportation for dialysis patients, outright eliminating the need for the CMS to find alternative transport methods for patients. By utilizingRead more …Remote patient monitoring: a health IT perspective [PODCAST] originally appeared inKevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - July 29, 2021 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/the-podcast-by-kevinmd" rel="tag" > The Podcast by KevinMD < /a > < /span > Tags: Podcast Cardiology Health IT Nephrology Source Type: blogs
Hypotension, altered mental status, and aVR sign - activate the cath lab?
ConclusionsSTE-aVR with multilead ST depression was associated with acutely thrombotic coronary occlusion in only 10% of patients. Routine STEMI activation in STE-aVR for emergent revascularization is not warranted, although urgent, rather than emergent, catheterization appears to be important. (Source: Dr. Smith's ECG Blog)
Source: Dr. Smith's ECG Blog - July 21, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
Treatment of infective endocarditis
Discussion of whole list of options of antimicrobials for different varieties of endocarditis is quite a large topic. This discussion is only a broad outline of the antimicrobial treatment of infective endocarditis, meant mainly for exam purpose rather than actual clinical treatment. References to more detailed guidelines have been provided for those who wish to learn more.
Inoculum Effect
High microbial density as in vegetations cause less antimicrobial activity of some antimicrobial agents. This is known as inoculum effect and has been documented with β-lactams and glycopeptides but not linezolid, in the treatment of St...
Source: Cardiophile MD - July 16, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Remote Monitoring for Peritoneal Dialysis: Interview with Aly ElBadry, CEO of CloudCath
CloudCath, a medtech company based in San Francisco, has created the CloudCath system, a remote monitoring technology that provides clinicians with data on the spent dialysate fluid of at-home peritoneal dialysis patients. CloudCath is incorporated into the drain line of peritoneal dialysis systems, and wirelessly transmits data to the cloud, with proprietary algorithms then highlighting issues, such as infection, to clinicians.
At present, abnormalities with peritoneal dialysis patients may not be flagged in a timely manner. For instance, patients are advised to check their dialysate using the “newspaper test,...
Source: Medgadget - July 14, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Exclusive Medicine cloudcath peritonealdialysis Source Type: blogs
This ECG Pattern Told the Story When the Patient Could Not
Submitted by Spencer Lord MD, written by Alex Bracey with edits by Meyers and SmithA patient presents as a transfer from an outside facility. On arrival, he appeared air hungry, volume overloaded, and agitated. EMS was not available for a history at the time and the patient was unable to provide any details regarding his circumstances. During the initial minutes of his resuscitation the following ECG was performed:This ECG is pathognomonic. What is it?Sinus bradycardia with first degree AV blockWide, bizarre QRS complexes with STE in V1 and aVRPeaked T waves in I, II, V4-V6QRS duration is nearly 200 ms.There is a lar...
Source: Dr. Smith's ECG Blog - July 2, 2021 Category: Cardiology Authors: Bracey Source Type: blogs
GARNET Pathogen Filter to Treat Sepsis: Exclusive with Nisha Varma, COO of BOA Biomedical
We reported about this technology back in 2014 and 2015 when it was first conceptualized, and it is exciting to see the progress of the device, which has been named GARNET and is being further developed by BOA Biomedical. We recently had the opportunity to interview the Chief Operating Officer Ms. Nisha Varma, to understand more about the applications of the device and its future potential.
Rukmani Sridharan, Medgadget: Can you detail the capabilities of GARNET for pathogen filtration? What range of pathogens can be detected?
Ms. Nisha Varma, BOA Biomedical : GARNET is an extracorporeal blood cleansing therapeuti...
Source: Medgadget - May 19, 2021 Category: Medical Devices Authors: Rukmani Sridharan Tags: Critical Care Exclusive Medicine Source Type: blogs
Fight Aging! Newsletter, May 17th 2021
This study is consistent with previous evidence showing that inflammaging, or age-related inflammation, is naturally heightened in the nervous system. Moreover, the authors disproved their hypothesis that anti-inflammatory microglia-specific genes are responsible for the elevated inflammatory response in aged brains since the expression of anti-inflammatory mediators was elevated in middle-aged brains following infection. Thus, the cause for the increase in pro-inflammatory genes remains to be elucidated.
Mixed Results in Animal Studies of Gene Therapy Targeting Axonal Regrowth
https://www.fightaging.org/archi...
Source: Fight Aging! - May 16, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Age-Related Loss of Kidney Function Correlates with Dementia Risk
The relationship between age-related kidney failure and neurodegeneration is interesting to consider in the context of research into the longevity-associated gene klotho. Overexpression of klotho slows aging, while loss of expression accelerates aging. Klotho also affects cognitive decline; more klotho slows age-related neurodegeneration. Klotho, however, appears to act in the kidney, not the brain. This is a point of emphasis on the importance of the kidneys to long term health; loss of kidney function leads to deterioration of tissue function throughout the body, due to the failure to clear waste products from the bloods...
Source: Fight Aging! - May 12, 2021 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
ISCHEMIA Trial – Review
ISCHEMIA Trial – Review
International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA) trial was funded by National Heart, Lung, and Blood Institute and others. 5179 patients with moderate or severe ischemia was randomized to an initial invasive strategy or an initial conservative strategy. Initial invasive strategy was angiography and revascularization when feasible. Initial conservative therapy was of medical treatment alone and angiography if medical therapy failed [1].
Primary composite outcome included death from cardiovascular causes, myocardial infarction or hospitaliz...
Source: Cardiophile MD - April 25, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Coronary Interventions Source Type: blogs
Advance Care Planning? Meh. - Part 1
by Drew Rosielle (@drosielle) (no degrees)Several years ago I was giving a talk in front of a mostly palliative care audience and asked, "How often do you find yourself, in the care of your patients, saying to yourself something like ' Thank the stars this patient has a healthcare directive (HCD) ' ? " The overwhelming answer was a bunch of shrugs and people agreeing occasionally (but not routinely) HCDs are helpful.For something that seems so central to our work, why is it that so many of my colleagues that day were lukewarm about their utility?It ' s fair to say that the last few months have been a controversial one in t...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 29, 2021 Category: Palliative Care Tags: advance care planning rosielle Source Type: blogs
