Should You Take an Anticoagulant for AF? — Applying the 4 questions
This study of nearly 1000 elderly AF patients found that the risk of major bleeding was not different between aspirin and warfarin. I, therefore, side more with the European guidelines. Aspirin confers significant bleeding with either no or minimal stroke prevention effects.
4. What happens if I do nothing?
This is easy. For the patients above, who have two risk factors, the green faces depict what happens if they do nothing. The most likely scenario is that they will not have a stroke (approx 97%) and not have a bleed (98%).
The North American AF treatment guidelines grade the strength of their recommendations. They give ...
Source: Dr John M - April 18, 2017 Category: Cardiology Authors: Dr John Source Type: blogs
Once Again I Wasn't The Patient
And it was nice. I went to visit my brother for the weekend. And didn ' t really see him. He had a kidney stone (and a lot nastier word to describe it) that caused him intense pain.I did get to go to Lowes with him to get parts of his upstairs sink. I also ran and emptied his dishwasher twice. Drove his children all over the place and visited him in the hospital. I fed his cat several times. I walked his girlfriend ' s dog a bunch of times - including in a snowstorm. I let the dog hog the bed one night and then I let the cat snuggle the next nights. I had dinner with his ex-wife and two of the children one night. I also dr...
Source: Caroline's Breast Cancer Blog - March 7, 2017 Category: Cancer & Oncology Tags: being a patient family fatigue travel Source Type: blogs
Gaming the System
This post was originally published by The Health Care Blog on February 11.
As physicians ready themselves for the future of medicine under onerous MACRA regulations, it seems appropriate to glance into the future and visualize the medical utopia anticipated by so many. Value-based care, determined by statistical analysis, is going to replace fee for service.
Six months ago, I received my first set of statistics from a state Medicaid plan and was told my ER utilization numbers were on the higher end compared to most practices in the region. This was perplexing as my patients tend to avoid ER visits at all cost...
Source: Disruptive Women in Health Care - February 15, 2017 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Medicaid Source Type: blogs
Gaming the System
By NIRAN Al-AGBA, MD
As physicians ready themselves for the future of medicine under onerous MACRA regulations, it seems appropriate to glance into the future and visualize the medical utopia anticipated by so many. Value-based care, determined by statistical analysis, is going to replace fee for service.
Six months ago, I received my first set of statistics from a state Medicaid plan and was told my ER utilization numbers were on the higher end compared to most practices in the region. This was perplexing as my patients tend to avoid ER visits at all costs and can be found milling about in my parking lot at 7am o...
Source: The Health Care Blog - February 11, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Research and Reviews in the Fastlane 168
Welcome to the 168th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 5 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Justin Morgenstern and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check o...
Source: Life in the Fast Lane - January 11, 2017 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Anaesthetics Education Emergency Medicine Intensive Care Neurology Neurosurgery Pre-hospital / Retrieval R&R in the FASTLANE Resuscitation recommendations research and reviews Source Type: blogs
ConvertX Nephroureteral Stent System Avoids Extra Procedure
BrightWater Medical, a company based in Murrieta, California, won FDA clearance to introduce in the U.S. its ConvertX nephroureteral catheter and stent system for use in treating ureteral obstructions in patients that require perc nephrostomy tubes. The system is intended to be used by interventional radiologists and removes a separate minimally invasive procedure that is required with current treatment.
Right now, a nephrostomy catheter is first placed to drain urine into a bag. The patient comes back a few days later to have the catheter removed and a stent placed. The ConvertX is designed to have the stent delivered dur...
Source: Medgadget - December 7, 2016 Category: Medical Equipment Authors: Editors Tags: Radiology Urology Source Type: blogs
Boston Scientific Unveils Dakota Kidney Stone Retriever with OpenSure Handle
Boston Scientific is releasing in the U.S. and Europe its new Dakota nitinol kidney stone retrieval device with OpenSure handle. The device is intended to allow physicians to grab on and release kidney stones between 1 mm and 10 mm in diameter using a basket that’s carefully manipulated via the sliding handle contoller.
The nitinol memory alloy basket can be used to grab onto, move, and release a number of stones within the same procedure. This can be very helpful in treating patients with situations more complicated than a single stone blocking the urinary tract.
“The Dakota Retrieval Device with OpenSure Handle ...
Source: Medgadget - November 10, 2016 Category: Medical Equipment Authors: Editors Tags: Urology Source Type: blogs
A Kidney Stone Plus Old MS Symptoms Try My Patience
I don’t remember exactly where I heard or read a phrase about being the beneficiary of other people’s patience. I do seem to remember that it was in a negative context and that it had to do with the decline of existence.
Something like, “with nothing left but to be the beneficiary of other people’s patience…”
I’m beginning to think that, while I hope that I am far from such a place, perhaps I should be a bit more patient with myself.
Last month, after a particularly busy run of things, I was hit by a kidney stone. The sharp little bugger took some time to pass, and I must admit that when it did...
Source: Life with MS - November 6, 2016 Category: Neurology Authors: ehadmin Tags: multiple sclerosis Source Type: blogs
Water, water everywhere
Follow me on Twitter @RobShmerling
Water bottles are everywhere.
It’s a relatively recent development. Whether at work, working out, watching a movie, or just about anything else, it’s as if there’s been an epidemic of dehydration that can only be warded off by constant access to water. It seems strange to me; almost no one did this a decade or two ago. Were people in the past less healthy or did they feel less well because they drank when they were thirsty or with meals, rather than throughout the day?
Water is important
Clearly, water is a necessity. Without it, a person can only survive a few days. Water serves ...
Source: Harvard Health Blog - November 3, 2016 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Health Healthy Eating Source Type: blogs
The Beneficiary of Other Peoples ’ Patience
I don’t remember exactly where I heard or read the phrase with which I title today’s blog post. I do seem to remember that it was in negative context and that it had to do with the decline of existence. Something like ‘with nothing left but to be the beneficiary of other people’s patience…’
I’m beginning to think that, while I hope that I am far from such a place, perhaps I should be a bit more patient with myself.
Last month, after a particularly busy run of things, I was hit by a kidney stone. The sharp little bugger took some time to pass and I must admit that when it did I was left feeling quite dim...
Source: Life with MS - November 3, 2016 Category: Neurology Authors: Trevis Gleason Tags: multiple sclerosis Everyday Health life with MS Living with MS MS and family MS fatigue trevis gleason Source Type: blogs
New Dornier GentleFlex Holmium Laser Fiber Prevents Damage to Deflected Scopes During Laser Lithotripsy Procedures
Dornier MedTech, a German-based international medical device company specializing in urological treatment, revealed their newly designed ball tip laser fiber, the GentleFlex holmium laser fiber. This specific fiber was designed to accompany other urological devices available through Dornier MedTech that urologists utilize to break down and get rid of kidney stones, a procedure called lithotripsy.
Laser lithotripsy was first introduced in the 1980s and involves physicians inserting a scope into a patient’s urinary tract, locating the kidney stone, threading a laser-equipped fiber through the scope, and then destroying ...
Source: Medgadget - October 5, 2016 Category: Medical Equipment Authors: Kenan Raddawi Tags: Urology Source Type: blogs
A Trip to a Roller Coaster Park to Clear Kidney Stones?
Conclusion: The functional pyelocalyceal renal model serves as a functional patient surrogate to evaluate activities that facilitate calyceal renal calculi passage. The rear seating position on the roller coaster led to the most renal calculi passages.
Study in Journal of the American Osteopathic Association: Validation of a Functional Pyelocalyceal Renal Model for the Evaluation of Renal Calculi Passage While Riding a Roller Coaster…
Rollear coaster image credit: Hello Jessie…
Via: American Osteopathic Association…
This post A Trip to a Roller Coaster Park to Clear Kidney Stones? appeared first on Medgad...
Source: Medgadget - September 26, 2016 Category: Medical Equipment Authors: Editors Tags: News Source Type: blogs
Shockwave Lithoplasty for Peripheral Vascular Disease FDA Cleared
A unique system that uses a balloon and sound waves to break up plaque in patients with peripheral artery disease has just been cleared by the FDA. The Lithoplasty system from Shockwave, a firm out of Fremont, California, is basically a traditional angioplasty balloon catheter with added capability that resembles lithotripsy that’s used to break up kidney stones.
The transducers along the length of the balloon section are tuned to generate sound at frequencies that resonate hardened calcium. Being all shook up, the calcium deposits are motivated to crack and to allow the balloon to push them closer to the vessel ...
Source: Medgadget - September 19, 2016 Category: Medical Equipment Authors: Editors Tags: Radiology Vascular Surgery Source Type: blogs
Why we should remember our moments of vulnerability
During my first rotation of intern year, we took care of a woman who walked into the hospital with a kidney stone and never walked out. 52 years old, diabetic but otherwise healthy, she had been vacationing in Vermont with her son and extended family when she became sick with high fevers. When her symptoms didn’t improve, her son rushed her to our emergency room where an imaging scan revealed a kidney stone that was obstructing urine flow and needed urgent removal. Somewhere between the ER and the procedure suite, she suffered a cardiac arrest, likely the result of a severe infection caused by the obstructing stone. When...
Source: Kevin, M.D. - Medical Weblog - August 24, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/michelle-zhang" rel="tag" > Michelle Zhang, MD < /a > Tags: Physician Hospital Source Type: blogs
Two MODYs walk into a bar...
Recently I had my follow up with the geneticist/Endocrinologist of last August's appointment. I absolutely adore her, because I have her personal email and every question I have is a promptly answered. Learning to live with MODY hasn't been all roses and sunshine, as I've developed a swelling of my left kidney (called hydronephrosis) which I've had an ultrasound and abdominal CT for and am scheduled for a renal perfusion scan in two weeks. It hasn't affected the overall function of said kidneys but it's there,like an albatross, needing attention. There are no kidney stones (#1 cause) and the geneticist feels like it's MODY...
Source: The D-Log Cabin - June 29, 2016 Category: Endocrinology Authors: HVS Source Type: blogs
