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
Magnum, P.I.
An 11-year-old boy with cerebral palsy presented to the emergency department unresponsive. His mother said the child was in his normal state earlier that morning, but was blue and unresponsive when she tried to wake him from his morning nap. A home pulse oximeter reported an oxygen level of 55%.The mother placed the child on oxygen and called 911. He was still unresponsive on arrival, and his physical examination demonstrated flaccid paralysis and a GCS score of 3 with fixed dilated pupils. He was tachycardic with shallow respirations. His initial vital signs were a temperature of 36.9°C, a heart rate of 136 bpm, a res...
Source: The Tox Cave - June 1, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Baby boomers and hepatitis C: What ’s the connection?
Hepatitis C is a viral infection that is spread through contact with infected blood. Hepatitis C infection can be short-term (acute) or long-term (chronic). Most people with acute hepatitis C eventually develop chronic hepatitis C.
Hepatitis C usually does not cause symptoms, which is why most people with hepatitis C don’t know that they are infected. Left untreated, hepatitis C can lead to cirrhosis, liver cancer, and liver failure.
Why screen baby boomers for hepatitis C?
Why are we recommending screening of adults in the baby boomer generation? To understand this, it’s worth reviewing how we got here.
In 1998, t...
Source: Harvard Health Blog - May 1, 2019 Category: Consumer Health News Authors: Raymond Chung, MD Tags: Health Healthy Aging Infectious diseases Screening Source Type: blogs
ClearGuard HD Caps Cleared in Europe to Prevent Dialysis Infections
Catheter-related bloodstream infections are one of the biggest fears for people receiving hemodialysis, as these can cause serious systemic reactions in patients. When catheters are used, the hubs through which blood is drawn and returned, are often the pathways that start bacteremia. Disenfection methods help, but they are not perfect since catheter-based infections continue to happen at alarming rates.
The ClearGuard HD caps from Pursuit Vascular, a company based outside of Minneapolis, Minnesotta, provide an unique solution and they’ve just received European regulatory approval.
The caps, which already have FDA cl...
Source: Medgadget - April 9, 2019 Category: Medical Devices Authors: Editors Tags: Medicine Vascular Surgery Source Type: blogs
Health care team members ’ perceptions and attitudes about emergency only hemodialysis (EOHD)
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - March 8, 2019 Category: Internal Medicine Tags: ethics nephrology Source Type: blogs
How to become a diabetic
It’s so easy, anyone can do it!
Becoming a type 2 diabetic and proudly having to finger stick your way to blood sugar control is patriotic, as it builds revenues for Big Pharma and the healthcare industry. What better way to support your country than to help successful industries grow larger, increase shareholder value, and increase the salary and perks for hard working executives?
So if you want to join the growing ranks of people who are becoming diabetic, now the largest epidemic of chronic disease ever witnessed in the history of the world, here’s what you do:
Cut your fat intake — Because it leaves you ...
Source: Wheat Belly Blog - October 23, 2018 Category: Cardiology Authors: Dr. Davis Tags: News & Updates diabetes gluten gluten-free grain-free grains wheat belly Source Type: blogs
Clinical Ethics and Inappropriate Care at ASBH 2018
In conclusion. patients assessed as receiving inappropriate critical care receive much burdensome and resource-intensive medical care, largely while non-alert, demonstrating the effects of mismatch between treatment and prognosis.
Creeping Noninterference-Focused Autonomy in Modern Medicine: How We Created and Continue to Feed the Problem of FutilityCatherine S. Heith, MD
The intersection of autonomy with modern-technologized and patient-satisfaction-driven medicine has had unexpected consequences. Although autonomy sprung from informed consent and the "right to die" movement, modern medicine, when paired with “ortho...
Source: blog.bioethics.net - September 29, 2018 Category: Medical Ethics Authors: Thaddeus Mason Pope, JD, PhD Tags: Health Care syndicated Source Type: blogs
A dialysis patient with nonspecific symptoms and pseudonormalization of ST segments
This study from Herzog et al (from our own Hennepin County Medical Center) included patients from a national registry and compared 3049 patients on dialysis admitted and eventually found to have acute MI compared with 534,395 patients not on dialysis admitted with an eventual diagnosis of acute MI. Of these groups, only 22% of dialysis patients had an admission diagnosis consistent with acute MI while 43.8% of nondialysis patients had the correct admission diagnosis of acute MI. Dialysis patients had double the rate of cardiac arrest (11% vs 5%), were less likely to receive reperfusion therapy when eligible (47% vs. ...
Source: Dr. Smith's ECG Blog - September 29, 2018 Category: Cardiology Authors: Daniel Lee Source Type: blogs
A Bayer of a Case
A 30-year-old woman was brought in by EMS tearful and reluctant to answer questions initially. Her mother was with her and stated that the patient had been depressed and may have taken some pills in a suicide attempt. Her initial vitals on presentation were a temperature of 99.1°F, heart rate of 128 bpm, blood pressure of132/92 mm Hg, and a respiratory rate of 26 bpm. She had clear lungs and sinus tachycardia on cardiac monitoring. She admitted to having taken "a lot" of aspirin.Initial LabsCBC: WBC of 14, hemoglobin of 14 g/dL, hematocrit of 42%, platelet count of 250,000BMP: Sodium of 132 mEq/L, pot...
Source: The Tox Cave - August 31, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
This Device Helps Improve Accuracy of Dialysis Catheter Placement
Patients on hemodialysis have to undergo vascular access procedures, typically arteriovenous fistulas or arteriovenous grafts. Some, though, are limited to tunneled cuffed catheters due to heart failure or poor cardiac reserve. Properly placing tunneled cuffed catheters can be challenging and failures can lead to serious complications such as clots and central vein thrombosis, in addition to having to repeat the placements.
At the Okayama University in Japan, clinical researchers have developed a tool that helps to accurately place dialysis catheters and avoid repeat procedures. This can reduce the burden on patients, low...
Source: Medgadget - August 15, 2018 Category: Medical Devices Authors: Editors Tags: Radiology Vascular Surgery Source Type: blogs
Could you have prevented this young man's cardiac arrest?
Written by Pendell MeyersWe received a call from an outside hospital asking to transfer a " traumatic post arrest " patient. We were told that a young patient was brought in with altered mental status but complaining of right hip and/or leg pain after being found by his mother at the bottom of the stairs into the basement. His history was significant only for IV heroin abuse, but he denied any recent use. Apparently he had been confused about why he was at the bottom of the stairs, unsure if he had fallen, unsure whether there was any specific traumatic mechanism.The practitioner on the phone stated that he suddenly develo...
Source: Dr. Smith's ECG Blog - July 24, 2018 Category: Cardiology Authors: Pendell Source Type: blogs
Surgery-Free Hemodialysis Fistula Creation With everlinQ endoAVF
TVA Medical of Austin, Texas, a newly acquired subsidiary of Becton Dickinson, won de novo marketing clearance from the FDA for its innovative everlinQ endoAVF system for creating arteriovenous fistulas for hemodialysis without relying on open surgery.
The system relies on catheters inserted into adjoining arteries and veins. When in proximity, built-in magnets within the catheters attract each other and snap the catheter pair together. A small electrode is then used to ablate the tissue between the catheters, creating a fistula.
The location of the catheters and whether they have snapped together can be seen under X-ra...
Source: Medgadget - July 10, 2018 Category: Medical Devices Authors: Editors Tags: Medicine Surgery Vascular Surgery Source Type: blogs
‘ Going to Extremes ’ Hall of Fame
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
In 2012, Greg Kelly suggested that LITFL collate the most extreme ‘medical extremes’.
This is how things currently stand:
ParameterLevelDiagnosisSubmitted by
Ammonia514 umol/LTorsten Behrens
Base excess (postive)40.6 mmol/LChronic Type 2 respiratory failureJakob Mathiszig-Lee
Bilirubin1113 umol/lDrug-induced hepatitis (anabolic steroids)Jurij Hanžel
Blood pressure345/245 mmHgDuring weightlifting (P. Palatini et al, 1989: https://www.ncbi.nlm....
Source: Life in the Fast Lane - April 21, 2018 Category: Emergency Medicine Authors: Chris Nickson Tags: Emergency Medicine Intensive Care Investigation extremes hall of fame Investigations parameters Physiology Source Type: blogs
Tropical Travel Trouble 007 Mega Malaria Extravaganza
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
aka Tropical Travel Trouble 007
When you think tropical medicine, malaria has to be near the top. It can be fairly complex and fortunately treatment has become a lot simpler. This post is designed to walk you through the basic principals with links to more in depth teaching if your niche is travel medicine, laboratory diagnostics or management of severe or cerebral malaria. If you stubbled on this post while drinking a cup of tea or sitting on the throne and want a few basi...
Source: Life in the Fast Lane - April 5, 2018 Category: Emergency Medicine Authors: Neil Long Tags: Clinical Cases Tropical Medicine malaria Plasmodium plasmodium falciparum plasmodium knowles plasmodium malariae plasmodium ovale plasmodium vivax Source Type: blogs
Reprogrammed Patient-Specific Pig Organs for Human Transplants: Interview with Dr. Jeff Ross, CEO of Miromatrix
The waiting lists for organ transplants are long, and people die daily waiting for transplants that never become available. For those that get a transplant, there is a risk that their immune system could reject it. Using organs from pigs is an alternative to human organs since many are a similar size. However, there is a major risk of rejection, so pig organs aren’t suitable for transplantation into humans in an unmodified state. Miromatrix, a company based in Minnesota, is working hard to find ways to make pig organs more suited to individual human patients. They have developed a “reprogramming” process, in which mi...
Source: Medgadget - October 30, 2017 Category: Medical Devices Authors: Conn Hastings Tags: Exclusive Genetics Materials Surgery Source Type: blogs
