A Deeper Dive: How Vulnerable Can a Therapist Be?
For as long as I can remember, “Peeling off the layers to reveal the real” has been my credo. In a dream, the words “Bare Boldly,” echoed through my sleeping but ever so active brain.” When messages come through that insistently, they can’t be ignored. My inner and outer work as a hybrid therapist-journalist prepare me to take this on every day. When that happens, I question if I am too self-revealing.
Last year, I penned an article for Psych Central called When A Therapist and Journalist Comes Clean About Her Self Doubt. It takes a confessional tone as I admit that the way I present isn’t always an accurate ...
Source: World of Psychology - January 17, 2020 Category: Psychiatry & Psychology Authors: Edie Weinstein, MSW, LSW Tags: Aging Personal Authenticity Shame Vulnerability Source Type: blogs
Christmas Eve Special Gift!! Prehospital Cath Lab Activation: What do you think?
A 60-something male was sent from Dialysis for several days of SOB. He did not know his medical history well.The patient was in no distress.The paramedics recorded an ECG:Here I magnify the limb leads and precordial leads:Now of course you see the convex ST elevation in V3 and V4, and the STE in V2 that is preceded by a spike. Is this STEMI?Here is the Computer Interpretation:The medics activated the cath lab. Do you agree? I was in the ED, and whenever I hear that there has been a prehospital cath lab activation, I like to go take a look because there are many false positive activations, es...
Source: Dr. Smith's ECG Blog - December 23, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Does elevated RVEDP cause dyspnea ?
Exertional dyspnea disproportional to the effort is the most common (cardinal)symptom of heart disease. Whenever we discuss the mechanism of cardiac dyspnea , we primarily attribute it to left heart disease, elevated LVEDP and the resultant pulmonary congestion.Conventional teaching in the past (may be in the present too !) doesn’t implicate raised RVEDP in the genesis of dyspnea.
It’s good to recall , the sensation of dyspnea is felt at the peri -Amygdala nuclear zone after complex processing with various cortical and sub-cortical level .It is subjected to as many afferent triggers other than J receptors in pu...
Source: Dr.S.Venkatesan MD - December 18, 2019 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology - Clinical Clinical cardiology Uncategorized does raised rvedp cause dyspnea dyspnea in pulmonary hypertension mechanism of dyspnea Source Type: blogs
Interview with Medtronic ’s Mark Pacyna on Approval of IN.PACT AV DCB for Failing AV Fistulae
End-stage renal disease (ESRD) patients experiencing kidney failure typically require hemodialysis in order to artificially remove fluid and waste from blood and maintain appropriate electrolyte concentrations. For many patients on hemodialysis, an arteriovenous (AV) fistula is created to link an artery to a vein. Veins are too fragile for frequent access, but arteries are too deep. Creating an AV fistula makes the vein that is linked to an artery more resilient and capable of providing regular vascular access for dialysis.
While effective, and a standard of care for ESRD patients, vessel restenosis can occur over time ...
Source: Medgadget - December 5, 2019 Category: Medical Devices Authors: Medgadget Editors Tags: Exclusive Medicine Vascular Surgery Source Type: blogs
Can an Incapacitated Patient Revoke Her Advance Directive?
Thirteen years ago, Charlotte Azuma signed an advance directive that said she didn’t want doctors to prolong her life if she had an incurable and irreversible condition that would quickly result in death. Azuma's sister and healthcare agent says that directive means Azuma, who suffers from dementia, should be taken off dialysis, which would end her life.
But Azuma recently told people that she wants to live. Because of this, Queen’s Medical Center is refusing to stop the treatment. What is the right course of action?
1. If Azuma lacks capacity, then her current statements are not sufficient to revoke the ...
Source: blog.bioethics.net - November 27, 2019 Category: Medical Ethics Authors: Thaddeus Mason Pope, JD, PhD Tags: Health Care syndicated Source Type: blogs
IN.PACT AV Drug Coated Balloon for Dialysis Patients to Heal AV Fistulaes
Medtronic has won FDA approval to introduce its IN.PACT AV drug-coated balloon as a treatment option for failing arteriovenous (AV) fistulae.
People with non-functional kidneys who undergo dialysis receive AV fistulae, which link an artery to a vein. Veins tend to be too fragile for regular access, but arteries are too deep. Creating an AV fistula makes the connected vein much more resilient and capable of providing vascular access for dialysis.
Eventually, AV fistulae tend to fail because of restenosis, limiting blood flow, and have to be expanded. This is a frequent procedure that comes with dangers, costs, and dis...
Source: Medgadget - November 25, 2019 Category: Medical Devices Authors: Medgadget Editors Tags: Medicine Vascular Surgery Source Type: blogs
Surgeons Succeed In Implanting Donor Kidney Using Robot Through Single Port
Surgeons at the Cleveland Clinic managed to implant a donor kidney into a patient using a surgical robot, and all through one small incision. The technique, in which instruments as well as the donor kidney can be passed through a four centimeter (1.6 inch) wide incision, is designed to make it easier to perform transplants on patients with difficult anatomies and to cause less collateral damage to internal and external tissues.
“The aim was not only to make a smaller incision, but also to minimize the area in which the operation was performed by limiting the number of cuts inside the patient,” said Dr. Jihad Kaouk, ...
Source: Medgadget - November 13, 2019 Category: Medical Devices Authors: Medgadget Editors Tags: Surgery Urology Source Type: blogs
Sonavex Secures NIH Grant to Pursue New Vascular Surgery Applications
Last week, Sonavex, a Baltimore-based medical device company, announced receipt of a $3M Phase IIB Small Business Innovation Research (SBIR) grant for prospective clinical studies and ongoing research and development of its EchoMark and EchoSure devices. This grant funding from the National Institutes of Health (NIH) will specifically allow Sonavex to validate its technology’s application to arteriovenous (AV) fistula maturation and viability for patients with end-stage renal disease (ESRD).
Earlier this year, Sonavex received FDA clearance for its EchoSure 3D ultrasound system. EchoSure, in combination with ...
Source: Medgadget - September 3, 2019 Category: Medical Devices Authors: Medgadget Editors Tags: Cardiology Surgery Vascular Surgery Source Type: blogs
Seraph 100 Blood Filter For Blood Stream Infections Cleared in Europe
ExThera, a company based outside of Oakland, California, won European regulatory approval for its Seraph 100 Microbind Affinity Blood Filter.
The device removes a variety of pathogens in patients with bloodstream infections thanks to its “sorbent-type” filter. It can remove not only molecular compounds, such as cytokines and endotoxin, but also infectious pathogens such as bacteria, viruses, and fungi directly from whole blood.
The device can help to reduce the load of drug resistant pathogens, as shown in pre-clinical and clinical trials, and so may end up being a common first line of defense against su...
Source: Medgadget - August 12, 2019 Category: Medical Devices Authors: Medgadget Editors Tags: Medicine Public Health Source Type: blogs
New Device Supports Dialysis Fistulas
Vascular Graft Solutions, a company based in Tel Aviv, Israel, has won the European CE Mark for its FRAME FR device for repair and support of high flow and aneurysmal arteriovenous fistulas. These are created in hemodialysis patients to allow for more blood to flow through a vein and give easy access for dialysis needles.
Although a properly performed fistula can work for many years, in many patients they tend to dilate and create all kinds of problems, including increased toxicity for the heart. These so-called high flow fistulas are difficult to maintain.
The FRAME FR device keeps blood flow within a reasonable...
Source: Medgadget - August 7, 2019 Category: Medical Devices Authors: Medgadget Editors Tags: Medicine Source Type: blogs
Landmark Results Achieved in Aging and Chronic Disease: Danish Group Extends Disease-free Life by 8 Years
By WILLIAM H. BESTERMANN JR., MD
New Scientific Breakthroughs Can
Provide a Longer Healthier Life
Twenty-one years of follow-up comparing usual care with a protocol-driven team-based intervention in diabetes proved that healthy life in humans can be prolonged by 8 years. These results were achieved at a lower per patient per year cost. Aging researchers have been confident that we will soon be able to prolong healthy life. This landmark study shows this ambitious goal can be achieved now with lifestyle intervention and a few highly effective proven medications. These medications interfere with the core molecular biol...
Source: The Health Care Blog - July 11, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Patients aging chronic disease Denmark Diabetes William Bestermann Source Type: blogs
Executive Order Changes Approaches to Treating Kidney Disease
by Craig Klugman, Ph.D.
Few people would say that the system of payment and organ distribution is perfect. About 37 million Americans suffer from kidney disease and 94,831 are candidates (as of July 10, 2019) for kidney transplant. In 2018, 21,167 kidney transplants and 836 combined kidney/pancreas transplants were performed in the U.S. Many ESRD patients (468,000) receive dialysis treatment, usually in privately owned clinics, while 193,000 have received a transplant. The system of distribution of kidneys was changed a year ago, when the system sought to increase the number of successful transplants by decreasing the amou...
Source: blog.bioethics.net - July 10, 2019 Category: Medical Ethics Authors: Craig Klugman Tags: Clinical Trials & Studies Featured Posts Health Care Health Regulation & Law HIV/AIDS Informed Consent Organ Transplant & Donation Privacy Public Health Source Type: blogs
av-Guardian Makes AV Fistula Access Easy for Dialysis
To perform hemodialysis, vascular access needs to be available on a regular basis. Veins are naturally too fragile for this, but arteries are too deep seated to be tapped frequently. Arteriovenous (AV) fistulas, which link an artery and a nearby vein, are typically created to overcome this since after only a few weeks the vein becomes much more resilient.
Probably the most nerve wrecking, painful, and critical step during a dialysis session is placing the needle into the AV fistula. Complications are frequent and patients generally hate this step, whether it goes well or not.
Advent Access, a company based in Singapo...
Source: Medgadget - July 9, 2019 Category: Medical Devices Authors: Medgadget Editors Tags: Medicine Source Type: blogs
