Risk and Consequences of Stroke in Decline, While Overall Incidence Increases
The objective of this study is to show geographic patterns of incidence, prevalence, mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs) and their trends for ischemic stroke and hemorrhagic stroke in the world for 1990-2013. Stroke incidence, prevalence, mortality, DALYs and YLDs were estimated following the general approach of the Global Burden of Disease (GBD) 2010 with several important improvements in methods. Data were updated for mortality (through April 2014) and stroke incidence, prevalence, case fatality and severity through 2013. Death was estimated using an ensemble modeling ...
Source: Fight Aging! - October 28, 2015 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Shaken Baby Syndrome or Death by Vaccine? Doctor Speaks Out…
Conclusion
Head and spinal cord injury consistent with non-accidental injury.” (emphasis added)
Comment from Dr. Innis
“There is no conflict with Dr. Al-Sarraj’s findings, but it is the interpretation of those findings which I dispute. He is evidently prepared to review his interpretation if further information becomes available and I would like to draw his attention to the fact that Amelia had biochemical as well as anatomical abnormalities. The biochemical diagnoses of hyperglycaemia, glycosuria, coagulation abnormality (INR 1,3, APTT 39.6) all suggest she was suffering from an autoimmune disorder tissue scurvy, [1...
Source: vactruth.com - October 27, 2015 Category: Allergy & Immunology Authors: Christina England Tags: Christina England Human Top Stories Adverse Reaction Darryl Elliot ischemic encephalopathy Shaken Baby Syndrome (SBS) truth about vaccines Vaccine Death Source Type: blogs
Central Nervous System T-waves
A middle-aged woman presented with symptoms of mild ischemic stroke. There were no chest symptoms.An ECG was recorded as part of the workup:Bizarre inverted T-waves in nearly every lead, with greatly prolonged QT interval. QT = 560 ms. Bazett corrected QT = 727 msThese are classic for CNS catastrophe, especially hemorrhagic strokeThey are unusual in a small ischemic stroke.An Echocardiogram showed apical WMA and both LV and RV thrombi.The stroke had a very low NIH score and did not receive any reperfusion the therapy for this.Incredibly, no troponins were ever measured.A CT Coronary Angiogram showed normal coronary a...
Source: Dr. Smith's ECG Blog - September 25, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
Praluent, the Next Expensive "Game Changer," Blockbuster," "New Hope," - But Not Yet Shown to Benefit Patients
ConclusionsThe NEJM study was accompanied by an editorial by Stone and Lloyd-Jones(2) which documented that drugs previously shown to lower cholesterol were never proved to do any good for patients, and concluded,it would be premature to endorse these drugs for widespread use before the ongoing randomized trials, appropriately powered for primary end-point analysis and safety assessment, are available. After an FDA advisory committee recommended approval of aliromucab and another PCSK9 inhibitor in June, 2015, John Mandrola entitled a Medscape article,Dear FDA: Resist the Urge on PCSK9 DrugsHis reasons included lack o...
Source: Health Care Renewal - August 5, 2015 Category: Health Management Tags: aliromucab evidence-based medicine health care prices manipulating clinical research PCSK9 inhibitor Praluent Regeneron Sanofi-Aventis Source Type: blogs
Care of the dying adult: draft guideline for consultation
National Institute for Health and Care Excellence (NICE) -This guideline applies to all adults who are potentially entering the last days of their lives in any setting that is covered by NHS services. It includes those who may be dying from chronic diseases and it also includes people who have deteriorated after a subacute event such as a stroke, subarachnoid haemorrhage or myocardial infarction. It would not apply to people who are near to death within hours of major trauma or attempted suicide. The consultation closes on 9 September 2015.
Draft guideline
Appendices
NICE - consultations (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - July 30, 2015 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Consultations Source Type: blogs
No good options for chronic pain
In some not so good news, the FDA has substantially strengthened its warning on the risk of non-steroidal anti-inflammatory drugs, NSAIDS. Although aspirin is literally a non-steroidal anti-inflammatory, and has overlapping mechanisms of action with these drugs, it is not formally classified as an NSAID, basically because the term is designed to exclude it, as I will explain.NSAIDS include ibuprofen, naproxen, and celecoxib, which was at one time heavily advertised based on safety claims. These are widely used by people with osteoarthritis and other chronic pain conditions. The problem, as the FDA now concludes, is that th...
Source: Stayin' Alive - July 14, 2015 Category: American Health Source Type: blogs
A neurosurgery case that this medical student won’t forget
After the last elective case of the day, the neurosurgeon I was shadowing told me that he was on overnight call that evening, and that I could stick around to observe more surgeries if I wanted to. “Yes,” I responded. “Absolutely yes.”
My fascination with surgery stems from its ability to provide immediate results to a patient by cutting out, repairing, reshaping, or bypassing the problem. It’s exciting and tactile, and I find that very appealing. What’s more thrilling is emergency surgery, when an operation becomes the last-ditch intervention that hopefully saves someone from imminent death.
The first case of ...
Source: Kevin, M.D. - Medical Weblog - July 10, 2015 Category: Journals (General) Authors: Basheer Elsolh Tags: Education Medical school Surgery Source Type: blogs
Research and Reviews in the Fastlane 088
This article seeks to protocolize this modality into 5 specific assessments (the “5Es”): Pericardial Effusion, Qualitative Left Ventricular Ejection Fraction, Ventricular Equality, Exit (Aortic Root measurement/assessment) and Entrance (IVC diameter and respirophasic variation). This approach is a nice way to remind clinicians of all the areas EP FOCUS can assess. The article also highlights a number of pitfalls that can lead to misdiagnosis that are critical to understand.
Recommended by Anand Swaminathan
Critical CareJovin TG et al. Thrombectomy within 8 Hours after Symptom Onset in Ischemic Stroke. NEJM 20...
Source: Life in the Fast Lane - June 17, 2015 Category: Emergency Medicine Authors: Soren Rudolph Tags: R&R in the FASTLANE critical care Education Emergency Medicine examination Intensive Care research and reviews Source Type: blogs
Sushi protects mosquitoes from lethal virus infections
As far as I know, mosquitoes do not eat sushi. But mosquito cells have proteins with sushi repeat domains, and these proteins protect the brain from lethal virus infections.
Mosquitoes are vectors for the transmission of many human viral diseases, including yellow fever, West Nile disease, Japanese encephalitis, and dengue hemorrhagic fever. Many mosquito-borne viruses enter the human central nervous system and cause neurological disease. In contrast, these viruses replicate in many tissues of the mosquito, including the central nervous system, with little pathological effect and no alteration of behavior or lifespan. ...
Source: virology blog - May 22, 2015 Category: Virology Authors: Vincent Racaniello Tags: Basic virology Information arbovirus complement control protein domain dengue virus encephalitis flavivirus Japanese encephalitis virus mosquito persistence sushi domain viral West Nile virus yellow fever virus Source Type: blogs
Legacy, Some Thoughts On The Death Of Jonathan Crombie
My wife loves Anne of Green Gables. And every so often she scours Netflix or Amazon Prime looking for the movie to play for the kids. She is almost always unsuccessful. Last night, however, she was able to find a version on you tube (with Spanish subtitles none the less). She popped a bowl of popcorn, and we all settled down to watch this ageless classic. We were engrossed. How could you not fall instantly in love with "Anne spelled with an E". Her hyperbolic and histrionic nature all the more endearing as the plot grows. Of course, you can't help but like Gilbert also. At fi...
Source: In My Humble Opinion - April 19, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Giant Inverted T waves in an Elderly Patient
This is another contribution from Victoria Stephen. Victoria is a third year EM Registrar from at the University of the Witwatersrand in Johannesburg, South Africa, and a great asset to FOAMed. Follow her on Twitter: @EMcardiac.Here is her previous contribution: Pulseless ventricular tachycardia – why did the AED not advise a shock? CaseA 91 year old presented to the ED of a small hospital with a history of sudden onset syncope. A family member thought she was having a seizure. She reported no chest pain or dyspnoea when conscious. The patient had a history of hypertension which was po...
Source: Dr. Smith's ECG Blog - April 15, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
ED Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.....
Conclusions: Many unnecessary tests are obtained to evaluate syncope. Selecting tests based on history and examination and prioritizing less expensive and higher yield tests would ensure a more informed and cost-effective approach to evaluating older patients with syncope._____________________________________________________________________________4) Reed MJ. The ROSE (Risk Stratification of syncope in the emergency department) Study. J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049 Objectives: The aim of this study was to develop and validate a clinical deci...
Source: Dr. Smith's ECG Blog - April 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.....
Conclusions: Many unnecessary tests are obtained to evaluate syncope. Selecting tests based on history and examination and prioritizing less expensive and higher yield tests would ensure a more informed and cost-effective approach to evaluating older patients with syncope._____________________________________________________________________________4) Reed MJ. The ROSE (Risk Stratification of syncope in the emergency department) Study. J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049 Objectives: The aim of this study was to develop and validate a clinical deci...
Source: Dr. Smith's ECG Blog - April 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
A History of General Refrigeration
Ancient societies figured out that hypothermia was useful for hemorrhage control, but it was Hippocrates who realized that body heat could be a diagnostic tool. He caked his patients in mud, deducing that warmer areas dried first.
Typhoid fever, the plague of Athens in 400 BC and the demise of the Jamestown Colony in the early 1600s, led Robert Boyle to attempt to cure it around 1650 by dunking patients in ice-cold brine. This is likely the first application of therapeutic hypothermia, but it failed to lower the 30 to 40 percent mortality rate. One hundred years later, James Currie tried to treat fevers by applying ho...
Source: Spontaneous Circulation - March 31, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
