Fight Aging! Newsletter, March 7th 2022
This study estimates that prescreening with a 500 blood test could reduce by half both the cost and the time it takes to enroll patients in clinical trials that use PET scans. Screening with blood tests alone could be completed in less than six months and cut costs by tenfold or more, the study finds. Known as Precivity AD, the commercial version of the test is marketed by C2N Diagnostics. The current study shows that the blood test remains highly accurate, even when performed in different labs following different protocols, and in different cohorts across three continents.
xCT Knockout Modestly Extends Life in M...
Source: Fight Aging! - March 6, 2022 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
xCT Knockout Modestly Extends Life in Mice
As a general rule, methods that produce 10-20% life extension in mice are unlikely to prove all that interesting in humans. But it depends on what is going on under the hood. In most cases interventions act on life span by upregulating cellular stress response mechanisms, and there is more than enough evidence to suggest that this category of approaches is far more effective at extending life in short-lived species than is the case in long-lived species such as our own. In this case, the mechanism of interest may be anti-inflammatory, a reduction of age-related chronic inflammation. There is not yet a body of evidence to t...
Source: Fight Aging! - March 2, 2022 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Hypothermia at 18 Celsius in V Fib arrest: CPR, then ECMO rewarming, for 3 hours, then Defib with ROSC. Interpret the ECG.
A middle-aged man was found outside in the cold in full arrest in ventricular fibrillation.Chest compressions and ventilation were begun.On arrival, CPR was continued and core temperature was measured at 18 ° C (64.4° F).The patient was put on Extracorporeal Life Support in the ED3 hours after initial resuscitation, the core temp was 30 ° C and the patient was defibrillated with a single attempt.A 12-lead ECG was recorded:There is sinus rhythm with RBBB and right axis deviation. In all leads, there is a 2nd wave after the initial QRS. This is an Osborn wave. I have not found any previous report of...
Source: Dr. Smith's ECG Blog - February 8, 2022 Category: Cardiology Authors: Steve Smith Source Type: blogs
What does LBBB look like in severe hypothermia? Is there a long QT? Is the QT appropriate for the temperature?
This patient was found down in a Minneapolis winter. He was very cold with frostbitten fingers and toes. He was alert but encephalopathic and delirious and very agitated and could not be adequately calmed with olanzapine and lorazepam, so we intubated him. The first reliable temperature could only be obtained with a Foley thermistor, and it was 26.5 degrees C (79.7 F).His BP was 76/60. K was 2.8 mEq/L.Here was his first ECG:There is sinus bradycardia with left bundle branch block (LBBB), with proportional ST-T, and VERY long QT and a PVC. I measure the QT at 800 ms. Notice that there are ...
Source: Dr. Smith's ECG Blog - January 6, 2022 Category: Cardiology Authors: Steve Smith Source Type: blogs
Cold Cap Therapy for Chemo Patients: Interview with Kate Dilligan, CEO of Cooler Heads Care
Cooler Heads Care, a medtech company based in San Diego, created Amma, a cold cap therapy device that aims to help chemotherapy patients to preserve their hair. Hair loss is a very common side-effect of chemo, and poses a significant psychological challenge for patients who are already struggling with their diagnosis and treatment.
Simply cooling the scalp during chemotherapy can dramatically reduce the amount of drug absorbed by the hair follicles, leading to reduced hair loss. However, current technology to achieve this comes with a hefty price tag, and may cost the patient as much as $8,000. This is out of reach for ...
Source: Medgadget - November 16, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Exclusive Medicine Oncology Source Type: blogs
Triboelectric pacemaker
Usually modern pacemakers are powered by built-in batteries and you need to replace the pulse generator when the battery reaches end of life. What if the device gets charged itself using energy of cardiac contractions? That is exactly what a triboelectric pacemaker powered by cardiac contractions aims to achieve. Triboelectric effect is typically the static electricity which is generated when a plastic comb is used on dry hair. Researchers have tested a symbiotic cardiac pacemaker which uses an implantable triboelectric nanogenerator (iTENG) which harvests energy from cardiac contractions and stores in a capacitor [1].
T...
Source: Cardiophile MD - August 25, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Cardiology MCQs
Which of the following is NOT a drug used for metabolic modulation in heart failure?
Trimetazidine
Ranolazine
Perhexiline
Sacubitril-valsartan
Correct answer: 4. Sacubitril-valsartan
Sacubitril-valsartan is an angiotensin receptor-neprilysin inhibitor (ARNI). Trimetazidine is a 3-ketoacyl coenzyme A thiolase inhibitor, while ranolazine inhibits the late sodium current. Perhexiline inhibits carnitine palmitoyl transferase. Latter three are metabolic modulators while sacubitril-valsartan is a hemodynamic modulator in heart failure [Ashrafian H, Neubauer S. Metabolic modulation in heart failure: high time for a definitive ...
Source: Cardiophile MD - July 4, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Management of aortic dissection
Aortic dissection is the most common aortic emergency. It is one of the three acute aortic syndromes, the others being aortic intramural hematoma and penetrating aortic ulcer. It has a grave prognosis with 20% pre hospital and 30% in hospital mortality. Aortic dissection is generally considered as acute when diagnosis is made within 14 days of onset and chronic after that. An intimal and medial tear in the aorta causes blood to seep into the media and the false lumen usually progresses along a variable extend of the aorta. Important risk factors for aortic dissection are hypertension, Marfan syndrome and bicuspid aortic ...
Source: Cardiophile MD - May 4, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Angiography and Interventions Cardiac Surgery Source Type: blogs
J wave syndrome
Discussion and ECG Quiz 17.
References
Antzelevitch C, Yan GX. J wave syndromes. Heart Rhythm. 2010 Apr;7(4):549-58.
Osborn JJ. Experimental hypothermia; respiratory and blood pH changes in relation to cardiac function. Am J Physiol. 1953 Dec;175(3):389-98.
Sethi KK, Sethi K, Chutani SK. J Wave Syndrome: Clinical Diagnosis, Risk Stratification and Treatment. J Atr Fibrillation. 2014 Dec 31;7(4):1173.
Haïssaguerre M, Derval N, Sacher F, Jesel L, Deisenhofer I, de Roy L, Pasquié JL, Nogami A, Babuty D, Yli-Mayry S, De Chillou C, Scanu P, Mabo P, Matsuo S, Probst V, Le Scouarnec S, Defaye P, Schlaepfer J, Rostock T, Lacroi...
Source: Cardiophile MD - April 22, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: ECG / Electrophysiology Source Type: blogs
Electrical storm – Management
Electrical storm – Management
Electrical storm: Recurrent unstable ventricular tachycardia (VT)/ventricular fibrillation (VF) requiring more than three direct current (DC) shocks per day.
Beta blocker is the single most effective therapy for recurrent VT unless the person is in shock. A combination of intravenous amiodarone with oral propranolol has been found to be superior to intravenous amiodarone with oral metoprolol [1].
Stellate ganglion block / ablation is being increasingly used as a modality for treatment of drug refractory ventricular tachycardia. Temporary blockage of stellate ganglion can be obtained by...
Source: Cardiophile MD - December 18, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: ECG / Electrophysiology Ablation of stellate ganglion Stellate ganglion block Temporary blockage of stellate ganglion Source Type: blogs
A woman in her 60s with VFib arrest and no STEMI on her post-ROSC ECG.
This study had a fatal flaw: they did not keep track of all the " Non-STEMI patients " who were NOT enrolled, but instead were sent for immediate angiogram. It was done in Europe, where the guidelines suggest taking all shockable arrests emergently to the cath lab. So it is highly likely that physicians were very reluctant to enroll patients whom they suspected had Occlusion MI (OMI), even if they didnot have STEMI. These physicians did not want a patient with an OMI that was not a STEMI to be randomized to no angiogram. This strong suspicion is supported by their data: only 22 of 437 ...
Source: Dr. Smith's ECG Blog - November 17, 2020 Category: Cardiology Authors: Pendell Source Type: blogs
Fascinating case of dynamic shark fin morphology - what is going on?
Case submitted by Magnus Nossen MD from Norway, written by Pendell MeyersA man in his 50s with no pertinent medical history suffered a witnessed cardiac arrest. EMS found the patient in VFib and performed ACLS for 26 minutes then obtained ROSC. 12 minutes later, the patient went back into VFib arrest and underwent another 15 minutes of resuscitation followed by successful defibrillation and sustained ROSC. In total, he received approximately 40 minutes of CPR and 7 defibrillation attempts. Here is his first ECG recorded after stable ROSC:Originally recorded in 50 mm/s (the standard in Norway), here converted to ...
Source: Dr. Smith's ECG Blog - October 26, 2020 Category: Cardiology Authors: Pendell Source Type: blogs
Who could understand what it ’s like to tell someone their loved one is dying?
I sat outside my patient ’s ICU room, my eyes glancing from his chart to him and his wife. The picture was grim. My patient, Tom, was a 56-year-old man, severely ill from decompensated cirrhosis, was admitted for the third time in a month with hypothermia from sepsis. Despite antibiotic therapy, he was not improving . Now […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 4, 2020 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/sami-el-dalati" rel="tag" > Sami El-Dalati, MD < /a > < /span > Tags: Physician Critical Care Hospital-Based Medicine Source Type: blogs
A woman in her 60s with chest pain and prominent J waves
Case submitted by Dan Singer MD and Ryan Barnicle MD, Written by Pendell MeyersA woman in her 60s with history of smoking presented to the ED with left sided chest pain radiating to the left arm and back, starting at about 1330. She described the pain as a " heaviness, " without exacerbating or alleviating factors. Her pain at the time of arrival was 10/10.Here is her triage ECG (no prior for comparison):What do you think?Findings: - Sinus rhythm at around 100 bpm - Grossly normal QRS complex - 1.0 mm STE in lead III, and just a hint of STE in aVF (both of which have to be measured just after significant J w...
Source: Dr. Smith's ECG Blog - September 22, 2020 Category: Cardiology Authors: Pendell 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
