“ Dialysable LV dysfunction In CKD ” : Myocardial edema clearance plays a role.
In CKD, LVH is a near-constant feature with echo showing thick, bright echoes from IVS. The LV mass increases, partly due to physiological hypertrophy ,also contributed by deposits of uremic middle molecules and fluid collection in the interstitium as myocardial edema.This, is recognised as T 2 weighted MRI signals. Chronic fluid stasis may progress to myocardial fibrosis. (Kidney Blood Press Res 2018;43:134–142 )
Effect of Frusemide on myocardial edema
We know, loop diuretics cause aggressive depletion of ECF volume and to a lesser extent Interstitial fluid. The effect of diuretic on myocardial wate...
Source: Dr.S.Venkatesan MD - October 11, 2020 Category: Cardiology Authors: dr s venkatesan Tags: cardiology research topics for fellows cardiology thesis topics Uncategorized myocardial edema in ckd myocardial edema mri Source Type: blogs
Health in 2 Point 00, Episode 152 | 2 IPOs, At-Home Care, & Youtube for Employees?
With 2 IPOs this week, On Episode 152 of Health in 2 Point 00, Jess asks me about Amwell’s IPO with a market cap at $5B for its telehealth solutions, Outset Medical’s IPO with a market cap of $1.5B for its kidney dialysis technology, Ready raising $54M for its care at- home platform, Lifespeak getting $42M for its “YouTube” like platform for employee mental health and wellness training program. – Matthew Holt
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Source: The Health Care Blog - September 18, 2020 Category: Consumer Health News Authors: Zoya Khan Tags: Health in 2 Point 00 Health Tech AmWell Jessica DaMassa lifespeak Matthew Holt Outset Medical Ready Source Type: blogs
A patient with chest pain and ST Elevation in V1 and V2
A 56 year old male complained of chest pain and called 911.They recorded a prehospital ECG:As you can see, at the top it says ***Meet ST Elevation MI Criteria***The medics activated the cath lab prehospital.It is a pathognomonic ECG.What is it?This is hyperkalemia, severe. Surprisingly, there appear to be P-waves, which are often extinguished when the K is so high.Severe hyperkalemia often presents with STE in V1 and V2, often with a Brugada-like morphology (tall R in V1, or rSR ' ; downsloping ST segment; negative T-wave. There is a very wide QRS and very peaked T-waves. Especially in V4 and V5, T-waves ...
Source: Dr. Smith's ECG Blog - September 4, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
Health in 2 Point 00, Episode 145 | Amwell, OneDrop, Outset Medical & Podimetrics
Today on Health in 2 Point 00, Jess asks me about the big news that Google Cloud has entered into a partnership with Amwell and invested $100 million into the company—looks like their IPO is really a thing! OneDrop gets $98.7 million in a partnership with Bayer, following at $40 million partnership last November, in a funding and development agreement. Outset Medical files their S1 and is going to go public, looking for $100 million for their portable dialysis system, and finally Podimetrics raises another $8 million for their foot ulcer detection platform for diabetics. —Matthew Holt (Source: The Health Care Blog)
Source: The Health Care Blog - August 25, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Health in 2 Point 00 Health Tech Jessica DaMassa Matthew Holt AmWell google cloud OneDrop Outset Medical podimetrics Source Type: blogs
Targeted Therapeutics for Critical Illnesses: Interview with Jason Springs, CEO of Endpoint Health
With the COVID-19 pandemic, critical illnesses, such as Acute Respiratory Distress Syndrome and sepsis are coming into the spotlight. Despite their severity and risk for patients, critical illnesses remain understudied and lack the number of treatment options of many other diseases with a similar level of mortality and morbidity.
Part of the challenge lies in the time sensitivity of such conditions, whereby clinicians have little time to make treatment decisions and typically can’t tailor the treatment for individual patient needs. The quest to develop more tailored treatments for such illnesses is what drives Endpoin...
Source: Medgadget - August 13, 2020 Category: Medical Devices Authors: Conn Hastings Tags: Critical Care Exclusive Informatics Medicine Source Type: blogs
Redefining Values in American Health Care
By RICHARD HOEHN, MD
Experts claim we could have been better prepared when the COVID-19 pandemic struck in early 2020. With an annual budget of $400-700 million, the Strategic National Stockpile (SNS) is designed to respond to chemical, biological, and other disasters. Its $8 billion inventory included 13,000 ventilators and a limited supply of personal protective equipment, N95 masks, and medical supplies. This left state and local governments scrambling as the COVID-19 pandemic accelerated and the capacity of many hospitals was overwhelmed.
Faced with immediate and visible death and suffering, leaders took drastic...
Source: The Health Care Blog - August 6, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Economics Health Policy Healthcare spending Richard Hoen Source Type: blogs
Real-Time Urine Flow Rate Measurement: Interview with Christopher Strafaci, VP of Sales and Marketing at RenalSense
Fluid overload is a serious issue for critically ill patients. It can occur in a variety of situations, including as a result of acute kidney injury, and can also be an issue in critically ill COVID-19 patients. The condition requires prompt treatment to restore health fluid levels, and Medgadget recently featured an interview with CHF Solutions CEO John Erb about the Aquadex Ultrafiltration system, which is designed to safely restore fluid levels as an alternative to dialysis.
Monitoring urine flow is crucial in assessing fluid overload and in making treatment decisions. At present, urine flow is typically asses...
Source: Medgadget - August 4, 2020 Category: Medical Devices Authors: Conn Hastings Tags: Critical Care Exclusive Medicine Urology Source Type: blogs
Covid-19 rapid guideline: arranging planned care in hospitals and diagnostic services
National Institute for Health and Care Excellence - The purpose of this guideline is to help healthcare professionals deliver efficient planned care while minimising the risk of Covid-19 in the context of increasing or decreasing local prevalence. It also aims to help patients make decisions about their planned care. It is for adults, young people and children in hospitals and diagnostic settings. Planned care covers elective surgery (day surgery and inpatient stays), interventional procedures, diagnostics and imaging. It does not include services where people have ongoing outpatient and day-case procedures such as c...
Source: Health Management Specialist Library - July 29, 2020 Category: UK Health Authors: The King ' s Fund Library Tags: Patient safety Source Type: blogs
Ethics Consultation in COVID Times
Q: What happens to clinical ethics consultation in a pandemic?A: Ethics consultation continues, only more so.During the first few months of the coronavirus pandemic, with a significantly lower overall inpatient census and fewer providers seeing outpatients, ethics consultation at the University of Kansas Health System (UKHS) increased rather than decreased. Not all of the increase is COVID related. Most consultations reflect issues that arise during normal times as well.Typical Issues, New PerspectivesSome consultation has been COVID specific, including participation on the UKHS Pandemic Triage Team assisting i...
Source: blog.bioethics.net - June 17, 2020 Category: Medical Ethics Authors: Practical Bioethics Tags: Health Care bioethics covid 19 ethics consult syndicated Source Type: blogs
A Vigilante in Statistical Badlands
This study, for instance, attributes a patient’s waitlist/transplant outcome to the very last dialysis facility the patient was associated with. In epidemiology speak, this means the causal inference authors are trying to draw between for-profit status and good transplant outcomes is subject to time-varying confounding. As an example, if one is seeking an association between testosterone levels and risk of a heart attack, using the last testosterone level available would be a poor way of doing this study because testosterone levels are known to vary over time. The same applies to dialysis facilities. Patients chan...
Source: The Health Care Blog - May 25, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Eric Weinhandl JAMA medical research public health Public Policy public policy research Source Type: blogs
Syncope and Chest Pressure, then an Unusual Bradycardia with Shock
This case is from one of our fantastic 3rd year residents, Aaron Robinson.A woman in her 60s with SyncopeA woman in her 60s presented to a facility with syncope. She had a history of CHF, pulmonary hypertension,CAD s/pCABG, and ESRD on hemodialysis. She had a dialysis run the day prior. Prehospital VS were: BP 115/70, HR 65, RR 12. The patient did not have a 12 lead completed pre-hospital.She arrived at the ED awake, alert, and complaining only ofmild chest discomfort. A 12 lead ECG was immediately completed:Aaron showed this to me and this is what I said:Suggestive of inferior posterior MI, but not dia...
Source: Dr. Smith's ECG Blog - May 15, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
Aquadex Ultrafiltration for Critical COVID Patients: Interview with John Erb, CEO at CHF Solutions
As the COVID-19 pandemic continues, many healthcare facilities around the world are inundated with critically ill patients, and resources such as equipment and staff are stretched thin. Shortages of critical equipment, such as ventilators, can mean the difference between life and death for patients, and the need to keep critically ill patients comfortable and alive has spurred healthcare staff and medtech companies to innovate and look for alternatives.
One example of this involves finding alternatives to dialysis machines. Certain critically ill COVID-19 patients are at risk of acute kidney injury, and dialysis is need...
Source: Medgadget - May 6, 2020 Category: Medical Devices Authors: Conn Hastings Tags: Critical Care Exclusive Source Type: blogs
Can We Discuss Flatten-the-Curve in COVID19? My Eight Assertions
Conclusion:
I did not have a clear answer for my couple. But after thinking and writing about this question it seems that the most reasonable approach in this crisis is transparent information–no matter how stark. And, crucially, we must have space for public debate.
I hate this virus. I wish it never came. But we can make it worse by avoiding hard discussions on tradeoffs, the limits of modern medicine and risk.
JMM
P.S. I am very interested in your rebuttals to any of my assertions but will block vitriol and politicized nonsense.
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Source: Dr John M - May 4, 2020 Category: Cardiology Authors: Dr John Source Type: blogs
Get your affairs in order, COVID-19 won ’t wait
The scourge of COVID-19 is spreading. Thousands of Americans are dying.
What can you do to help? Yes, practice social distancing, wash your hands, and donate masks to local hospitals. Also, talk to your loved ones about advance care planning.
What is advance care planning?
Advance care planning means contemplating and deciding the type of medical care you would want if you had a life-threatening illness; you are never too young or too healthy to start these conversations. It involves identifying your goals and values, learning about life-sustaining interventions — such as cardiopulmonary resuscitation (measures to restar...
Source: Harvard Health Blog - April 22, 2020 Category: Consumer Health News Authors: Ashwini Bapat, MD Tags: Emergency Planning End of life Health Health care Source Type: blogs
