The delay between OMI and STEMI claims yet another patient's anterior wall
Written by Pendell Meyers with edits by Steve SmithAn elderly woman with HTN presented with L sided chest pain, intermittent over the past week but worse over the past hour, associated with shortness of breath. She had no known history of CAD.Here is her presenting EKG at 2210:What do you think?This is quite an obvious anterior OMI, with STE in V2 with hyperacute T-waves in V2-V3, however it unfortunately does not meet STEMI criteria as there is insufficient STE in either lead V1 or V2 to have two consecutive leads. There is a small amount of coved, convex STE in aVL with a terminal T-wave inversion. There is also the begi...
Source: Dr. Smith's ECG Blog - April 11, 2019 Category: Cardiology Authors: Pendell Source Type: blogs
They Still Call It An " Opioid Epidemic. " Why's That?
TheCleveland Plain Dealer recently reported that, while overdose deaths have come down slightly over the past year in the Cleveland metropolitan region, a new killer has emerged on the scene: cocaine mixed with fentanyl.The Cuyahoga County Coroner ’s Office informs the public that cocaine was involved in 45 percent of overdose deaths last year, the highest rate in ten years. It reports that cocaine is being found in combination with fentanyl with increasing frequency, and it is believed that many cocaine users are either unaware of the pres ence of fentanyl or, if they are, they are uncertain as to the amount that is ...
Source: Cato-at-liberty - April 9, 2019 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Fentanyl, How Bad Is It?
How Bad Is Fentanyl?
Fentanyl is an extremely dangerous synthetic opioid. Unlike some other opioids that occur naturally, it is man-made for the purpose of helping aid people suffering from extreme pain. It can be administered for recovery after surgery, during cancer treatments or for recovery after a painful injury. The Drug Enforcement Administration (DEA) classifies fentanyl as a Schedule II controlled substance. This means that it is legal for medical use, however, it has an extremely high potential for abuse and addiction.
Understanding Fentanyl
Significantly stronger than morphine or oxycodone, Fentanyl can be fatal...
Source: Cliffside Malibu - April 2, 2019 Category: Addiction Authors: Jaclyn Uloth Tags: Addiction Addiction to Pharmaceuticals Drug Rehab Information Drug Treatment Heroin Painkiller Substance Abuse Synthetic fentanyl prescription drug abuse prescription drug addiction prescription drug detox prescription drug use p Source Type: blogs
End-of-Life Comfort Drugs Provided By Hospice Sometimes Misunderstood
Photo credit Sam-x
Dear Carol: My mother, who has advanced dementia, went into a nursing home six months ago. She’s received excellent care but is now declining quickly so that she no longer swallows any type of food. Her doctor has determined that she is ready for hospice and that makes sense to me. Hospice took her off of medications that didn’t seem to be helping and then prescribed some occasional Ativan for agitation and low-dose morphine for pain. Her response has been satisfying to watch since she’s more alert and far more peaceful than she has been. Here’s the problem. I’ve gone to a support group for sev...
Source: Minding Our Elders - March 30, 2019 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs
The iovera ° Cryoanalgesia Device: Interview with Tim Still, CEO of Myoscience
Myoscience, a medtech company based in California, has developed the iovera° cryoanalgesia device. The device was FDA cleared in 2013, with an additional clearance in 2017 for knee pain, and uses cryotherapy to freeze peripheral nerves to reduce pain without affecting nearby tissues. The company claims that the device is a useful alternative to opioid therapy for chronic pain.
The iovera° is handheld, and can deliver precise, controlled doses of cryotherapy to specific sensory nerves through a series of needles. The needles create a cold zone around the nerve which is −20°C (-4° F). This causes the myelin sheath and ...
Source: Medgadget - March 28, 2019 Category: Medical Devices Authors: Conn Hastings Tags: Exclusive Orthopedic Surgery Pain Management Source Type: blogs
Doctors Wearing VR Headsets Might Soon Set Up Diagnoses Sitting In Caf és
The evolution of VR hardware and software What’s the best VR will do VR, AR, MR or spatial computing? The potential of interactive immersive reality Challenges and obstacles in adoption How will immersive reality transform everyday life? What was the last time you met sci-fi? The dark side of technology
Imagine that a doctor sits down in Starbucks, places some glasses on his head, instantly invokes five screens and starts doing his diagnostic work. Robert Scoble, virtual reality expert, and tech evangelist believes that will be possible in the coming years – sooner than we might think. He told us why his wife c...
Source: The Medical Futurist - March 16, 2019 Category: Information Technology Authors: nora Tags: Great Thinkers AR augmented reality future HoloLens Innovation MR Oculus technology virtual virtual reality VR XR Source Type: blogs
The Placebo Effect, Digested – 10 Amazing Findings
By Christian Jarrett
The placebo effect usually triggers an eye-brow raise or two among even the most hard-nosed of skeptics. We may not be able to forecast the future or move physical objects with our minds, but the placebo effect is nearly as marvellous (Ben Goldacre once called it the “coolest, strangest thing in medicine”).
The term “placebo effect” is short-hand for how our mere beliefs about the effectiveness of an inert treatment or intervention can lead to demonstrable health benefits and cognitive changes – an apparently incontrovertible demonstration of the near-magical power of mind ove...
Source: BPS RESEARCH DIGEST - March 11, 2019 Category: Psychiatry & Psychology Authors: BPS Research Digest Tags: Feature Source Type: blogs
Innovation Amidst the Crisis: Health IT and the Opioid Abuse Epidemic | Part 4 – Resource Allocation and Access
By COLIN KONSCHAK, FACHE and DAVE LEVIN, MD
Dave Levin
Colin Konschak
The opioid crisis in the United States is having a devastating impact on individuals, their families, and the health care industry. This multi-part series will focus on the role technology can play in addressing this crisis. Part one of the series proposed a strategic framework for evaluating and pursuing technical solutions.
A Framework for Innovation
In part one of our series, we declared the opioid crisis an “All Hands-On Deck” moment and made the case that health IT (HIT) has a lot to offer. Given the many different possibilities, having a meth...
Source: The Health Care Blog - February 7, 2019 Category: Consumer Health News Authors: matthew holt Tags: Tech Access to care Colin Konschak Dave Levin Divurgent Health IT Sansoro Health Source Type: blogs
Overprescribing Is a Key Component of the Opioid Crisis — Here’s How to Stop It
By DAVE CHASE
Today’s opioid crisis is one of the most dire side effects driven by our dysfunctional U.S. healthcare system. A recent JAMA Surgery report found that many surgeons prescribe four times more opioids than their patients use. This opens the door for misuse and abuse later on. In fact, the total combined cost of misuse, abuse, dependence and overdose is about $78.5 billion.
Unfortunately, there’s a direct connection between the low-quality care many patients receive, and the astounding rates of opioid addiction. Often, insurance plans offer access to high-cost, volume-centric physicians and include high de...
Source: The Health Care Blog - January 29, 2019 Category: Consumer Health News Authors: matthew holt Tags: Patients Value-Based Care Dave Chase Opioid epidemic Source Type: blogs
A Randomized Controlled Trial for Fan Therapy in Dyspnea
by Bob Arnold (@rabob)Winter suits me just fine since I do not like heat. I have a lot of sympathy for patients with chronic obstructive lung disease who do not have an air conditioner during the summer. I am told that there is nothing worse than sitting in hot, humid weather and not being able to breathe.As a palliative care physician, I love fans. When my patients are short of breath and opiates do not work (1,2) I send their families down to the local ACE hardware store to buy a hand-held fan. Therefore, I was excited tosee an article in the Journal of Pain and Symptom Management on fan therapy being effective in treati...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 11, 2019 Category: Palliative Care Tags: arnold dyspnea journal article JPSM Source Type: blogs
The Mysteries Surrounding Rhodes Pharmaceuticals, the Sackler Family's Second Opioid Company
Mysteries still abound in the not so wonderful world of health care dysfunction, so, quick, the game ' s afoot...Today ' s mysteries involve beneficial ownership. Beneficial ownership questions are important to anti-corruption campaigners. Beneficial ownership simply refers to " anyone who enjoys the benefits of ownership of a security or property, without being on the record as being the owner. " (per Wikipedia). Concealing who really owns a company enables concealing sources of funds (as in money laundering), market power (when the owner also owns competitors), and sources of political influence, and en...
Source: Health Care Renewal - January 8, 2019 Category: Health Management Tags: anechoic effect concentration of power conflicts of interest dark money deception Donald Trump health care corruption marketing narcotics Purdue Pharma Source Type: blogs
The Fentanyl Crisis and What You Need to Know
What is Fentanyl?
According to the National Institute on Drug Abuse, Fentanyl is a powerful synthetic opioid analgesic that is similar to morphine, but is 50 to 100 times more potent. It is a schedule II prescription drug, and it is typically used to treat patients with severe pain, for side effects surrounding aggressive cancer treatments or to manage pain after major surgery. It can be administered as an injection, a transdermal patch or as a lozenge. Under the medical supervision of a professional, there is little risk for addiction. However, that is not to be overlooked, as any exposure to Fentanyl at all will run the ...
Source: Cliffside Malibu - January 3, 2019 Category: Addiction Authors: Jaclyn Uloth Tags: Addiction Addiction Recovery Addiction to Pharmaceuticals Detox Resources for Alcohol and Drugs/Opiates Drug Rehab Information Drug Treatment Heroin Medical Substance Abuse Synthetic drug abuse drug abuse epidemic fentanyl opioid Source Type: blogs
Can exercise help conquer addiction?
As an athlete, I think regularly about the potential health benefits of exercise for my patients. Every week, I treat patients hospitalized at Brigham and Women’s Hospital with significant medical problems that are a direct result of severe addiction, ranging from seizures and strokes to heart valve and joint infections. I also care for outpatients at the Brigham and Women’s Faulkner Hospital Addiction Recovery Program. In both settings, I provide medication-assisted treatment (MAT) such as buprenorphine-naloxone for opioid use disorder, and extended-release naltrexone for both alcohol use disorder and opioid use disor...
Source: Harvard Health Blog - December 26, 2018 Category: Consumer Health News Authors: Claire Twark, MD Tags: Addiction Exercise and Fitness Health Source Type: blogs
Better Late Than Never?
As I have written many times before, the opioid prescribing guidelines put forth by the Centers for Disease Control and prevention have been criticized for not being evidence-based. This has even caused the Food and Drug Administration to begin the process of developing its own set of guidelines.In publishing the guidelines, the CDC emphasized they were meant to be suggestive, not “prescriptive,” pointing out that health care practitioners know their patients’ situations better than any regulators and should therefore individualize their prescribing to meet their patients’ unique needs. That has not prevent...
Source: Cato-at-liberty - November 15, 2018 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Acute Angle Closure: Mastering Tonometry
Identifying and managing disease often requires the delicate and skillful use of temperamental emergency department machinery. The ability to apply these may appropriately help determine a difficult diagnosis.Glaucoma, we all know, can cause blindness, and acute narrow angle glaucoma refers to the angles within the eye that are not as wide and open as normal. People with acute angle glaucoma have abnormal anatomy within the eye where the angle changes as the eye is dilated. This can cause blockages of fluid drainage from the anterior to posterior changes resulting in increased intraocular pressure. It ca lead to acute a...
Source: The Procedural Pause - November 9, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
