Introduction to Special Series on Stroke: World Stroke Day, Women & Stroke, and the Stroke Comeback Center
Today, Disruptive Women in Health Care begins a special week-long series to raise awareness of stroke in recognition of World Stroke Day, providing opinion and actionable information, and joining in the celebration of 10 successful years of the Stroke Comeback Center in Vienna, VA.
October 29, 2014 is World Stroke Day and the launch of a 2-year, world-wide campaign, I am woman: Stroke affects me, sponsored by the World Stroke Organization (WSO) and supported by national organizations like the American Stroke Association (ASA). Women have a higher risk of stroke than men, a higher mortality rate from stroke than men, have...
Source: Disruptive Women in Health Care - October 23, 2014 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Advocacy Women's Health Source Type: blogs
LITFL Review 152
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
Welcome to the 152nd edition, brought to you by:
Anand Swaminathan [AS] (EM Lyceum, iTeachEM)
Brent Thoma [BT] (BoringEM and Academic Life in EM)
Chris Connolly [CC]
Chris Nickson [CN] ( iTeachEM, RAGE, INTENSIVE and SMACC)
Joe-Anthony Rotella [JAR]
Kane Guthrie [KG]
Mat Goebel [MG]
Segun Olusany...
Source: Life in the Fast Lane - October 14, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Review LITFL R/V Source Type: blogs
Ebola on social media shows some revealing insights
Ebola. Just the word by itself instills fear. But in some corners of our shared planet it presents itself as an all too real horror that invades communities, neighborhoods, and families. As this crisis has been unfolding, we at Symplur have been following the same news reports that all of you have with regards to the spread of this disease, the increasing death toll, and concerns of containment.
We’ve also been following Ebola through the unique lens that healthcare social media provides. On July 28, 2014 the current Ebola outbreak hit the mainstream news in the U.S. That morning Symplur began tracking it on Tw...
Source: Fox ePractice - September 29, 2014 Category: Health Managers Authors: Thomas M. Lee, B.S., NHA Tags: Connecting the dots in healthcare social media Newsletter Ebola healthcare social media analytics Source Type: blogs
Top stories in health and medicine, September 19, 2014
From MedPage Today:
Ebola Response: Fighting the Last Outbreak? The dramatic U.S. commitment of 3,000 military personnel is arguably the biggest contribution yet to the fight against the West Africa Ebola outbreak.
Microbleeds May Up Afib Mortality. The presence of cerebral microbleeds was associated with an increased risk of death from both hemorrhagic and ischemic stroke in patients with atrial fibrillation.
EHRs Don’t Save Money or Time, Docs Say. Three-fourths of U.S. physicians who use electronic health records (EHRs) said they aren’t cost-effective and don’t save time, but the majority said they s...
Source: Kevin, M.D. - Medical Weblog - September 19, 2014 Category: Journals (General) Authors: MedPage Today Tags: News Diabetes Endocrinology Heart Infectious disease Source Type: blogs
Prolonged (63 minutes) Ventricular Fibrillation, Followed by Unusual Cardiogenic Shock
In this study, 5% of VF arrest was due to PE: V fib is initial rhythm in PE in 3 of 60 cases. On the other hand, if the presenting rhythm is PEA, then pulmonary embolism is likely. When there is VF in PE, it is not the initial rhythm, but occurs after prolonged PEA renders the myocardium ischemic.--Another study by Courtney and Kline found that, of cases of arrest that had autopsy and found that a presenting rhythm of VF/VT had an odds ratio of 0.02 for massive pulmonary embolism as the etiology, vs 41.9 for PEA. (Source: Dr. Smith's ECG Blog)
Source: Dr. Smith's ECG Blog - September 19, 2014 Category: Cardiology Authors: Steve Smith Source Type: blogs
Same Care No Matter Where She Gives Birth: Addressing Variation In Obstetric Care Through Standardization
This study, along with other disturbing statistics, underscores the significant need for improvements in maternity care.
Maternal Morbidity and Disparities
Since 1990, the maternal mortality ratio in the U.S. has more than doubled. We now rank 64th in the world, with 28 maternal deaths per 100,000 live births. American women are also suffering severe maternal morbidities at higher rates: more than 60,000 women a year experience a life-threatening condition during childbirth. Potential explanations for these troubling trends include improved reporting mechanisms and escalating rates of chronic health conditions like obesity...
Source: Health Affairs Blog - September 12, 2014 Category: Health Management Authors: Priya Agrawal Tags: Access All Categories Disparities Hospitals Public Health Source Type: blogs
Management of intracerebral hemorrhage following TPA for ischemic stroke
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - August 30, 2014 Category: Internists and Doctors of Medicine Tags: guidelines neurology Source Type: blogs
Sensitivity Or Specificity? Which Would YOU Prefer?
A typical day at work...from I Love Lucy, first aired September 15, 1952There are days when the grind feels a lot like Lucy's candy factory as seen in the clip above. But the beat goes on, the images keep coming, and they have to be read. As one of my professors used to say, "Miss 'em slow, or miss 'em fast, boys!" Of course, that was a joke. Of course it was. Definitely.You probably know the difference between sensitivity and specificity. In essence, sensitivity is the percentage of the time you find something that is actually present. Specificity is the percentage of the time you don't find something when nothing is ther...
Source: Dalai's PACS Blog - August 19, 2014 Category: Radiologists Source Type: blogs
Research and Reviews in the Fastlane 043
This study claimed a sensitivity and specificity of 100% in this group of patients questioning the traditional “CT, LP” approach to managing patients with clinical suspicion for SAH. However, the study has flaws and we eagerly await external validation.
Recommended by: Salim R. Rezaie
Emergency Medicine
Williams CM, Maher CG, Latimer J et al. Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial. Lancet. 2014 Jul 23. pii: S0140-6736(14)60805-9. doi: 10.1016/S0140-6736(14)60805-9. PMID 25064594
Should we continue to give paracetamol for lower back pain? In this Austral...
Source: Life in the Fast Lane - August 12, 2014 Category: Emergency Medicine Authors: Jeremy Fried Tags: Anaesthetics Emergency Medicine Infectious Disease Intensive Care Neurology Pediatrics Pre-hospital / Retrieval R&R in the FASTLANE Radiology Toxicology and Toxinology critical care literature recommendations research and reviews Source Type: blogs
Two AF cases — and my changing view of AF
I receive many emails about AF. I don’t often answer them because it is bad practice to doctor without seeing the person. Recently, however, I received a note with more general questions. The sender suggested I could use the response as a blog post. The reason I am posting these two cases along with my response is that my views on AF are changing. I am in the process of putting these global thoughts on AF together as a more general update, but these cases are a start.
Here is the email from a reader: (a doctor).
Dear John,
What would you recommend?
My med school roommate and I are 69 years old and in good health, nor...
Source: Dr John M - August 4, 2014 Category: Cardiology Authors: Dr John Source Type: blogs
Bilateral carotid artery stenosis
Bilateral carotid artery stenosis can be treated by carotid stenting. Bilateral carotid artery stenting, if done carefully and as a staged procedure has a low risk. Avoid those with TIA within 2 weeks / recent stroke and those with thrombus as they have a high risk of embolisation.
Usually carotid stenting is done as a staged procedure to prevent hyperperfusion syndrome. Lesions at or above C2 and below the clavicle are not amenable to surgery and are taken up for carotid artery stenting. Same is true of severe comorbidities.
Stenting is seldom undertaken if there is large ipsilateral neurological defect. Lesion length mo...
Source: Cardiophile MD - August 3, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Angiography and Interventions Bilateral carotid artery stenosis Bilateral carotid artery stenting Bilateral carotid stenosis Carotid stenting hyperperfusion syndrome predictors of high risk risk of embolisation Source Type: blogs
Can Gingko and Turmeric Help Stop Ebola?
Summary
There is no known pharmaceutical currently available that specifically treats Ebola disease.
One treatment modality that should be considered is the use of herbal medicines, which have both centuries old anecdotal success as well as recent modern biochemical and formal research rationales for their use.
Five areas of action that could be addressed by the herbal medicines as it relates to Ebola would be:
VP24/immune system evasion
GP protein/replicatio;
herbal strategies effective against similar hemorrhagic disease
beneficial modulation of patient immune and inflammatory response systems
prophylactic use for heal...
Source: Inside Surgery - August 1, 2014 Category: Surgery Authors: Editor Tags: Infectious Disease ayurvedic baicalen cathepsin b dengue Ebola gingko herb Quercetin resveratrol rosemary sage st johns work turmeric Source Type: blogs
When Nurses Receive Their Due
Most nurses will readily admit that they didn't choose nursing because of the astronomically high paychecks. Sure, nursing can be a relatively remunerative career, but there are plenty of other professions that are significantly more financially rewarding (and free of some of the challenges that nurses face on a daily basis). So, what if nurses were paid a whole lot more in exchange for saving ---and otherwise improving---the lives of a grateful public? Multimillion Dollar PlayersWe all know that entertainers and athletes make a lot of money, whether it's deserved or not. NFL players sign multimillion dollar contracts in r...
Source: Digital Doorway - August 1, 2014 Category: Nurses Tags: nurse nurses nursing Source Type: blogs
Research and Reviews in the Fastlane 041
This study prospectively validated whether an age-adjusted D-dimer cutoff was associated with an increased diagnostic yield of D-dimer in elderly patients with suspected PE. Compared with a fixed D-dimer cutoff, the combination of pretest clinical probability assessment with age-adjusted D-dimer cutoff was associated with a larger number of patients in whom PE could be considered ruled out with a low likelihood of subsequent clinical venous thromboembolism. So if this is not your clinical practice already, maybe time to use age adjust d-dimer values?
Recommended by: Jerremy Fried
Read More: Age Adjusted D-Dimer Testing (RE...
Source: Life in the Fast Lane - July 29, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Clinical Research R&R in the FASTLANE critical care Emergency Medicine Intensive Care literature recommendations research and reviews Source Type: blogs
Research and Reviews in the Fastlane 040
In this study the role of a “1/2 dose” thrombolysis was evaluated for the reduction of pulmonary artery pressure in moderate PE. A total of 121 patients with moderate PE received either tissue plasminogen activator plus anticoagulation or anticoagulation alone with the primary end points of pulmonary hypertension and the composite end point of pulmonary hypertension and recurrent PE at 28 months. The results suggested that the ½ dose or “safe dose” thrombolysis was safe and effective in the treatment of moderate PE, with a significant immediate reduction in the pulmonary artery pressure that was ma...
Source: Life in the Fast Lane - July 21, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Anaesthetics Emergency Medicine Evidence Based Medicine Featured Gastroenterology Haematology Health Infectious Disease Intensive Care Neurology Pre-hospital / Retrieval Respiratory critical care literature R&R in the FASTLANE Source Type: blogs
