STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes
Conclusions: In the select group of hypokalemic patients studied, potassium infusions of 20 to 40 mmol delivered over 1 hr were safe to administer and effectively increased serum potassium levels in a dosedependent and predictable fashion. Furthermore, these results were independent of the patient's underlying renal function or associated diuretic administration. (Crit Care Med 1991; 19:694)Concentrated Potassium Chloride Infusions in Critically Ill Patients with HypokalemiaThe Journal of Clinical Pharmacology. Volume 34, Issue 11, pages 1077–1082, November 1994Although concentrated infusions of pota...
Source: Dr. Smith's ECG Blog - April 7, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs
What Accounts For The Lower Growth In Health Care Spending?
Several recent studies have examined the factors accounting for the recent slowdown in growth in real per capita health care spending. The most recent entrant to this literature is the newly published work of Dunn, Rittmueller, and Whitmire. Earlier work has identified two large categories of change as contributors to slower growth: the 2007-2009 recession, and other structural changes in the delivery and payment of health care. Understanding the relative role of these two factors is important in determining whether the slowdown is temporary or will be sustained.
The new paper by Dunn and colleagues builds on a framework t...
Source: Health Affairs Blog - February 18, 2016 Category: Health Management Authors: Kenneth Thorpe Tags: Costs and Spending Drugs and Medical Technology Featured Organization and Delivery Diabetes hyertension off patent drugs Prescription Drugs Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 7
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Source: Cardiophile MD - January 23, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
A Year in Review: FDA 2015 New Drug Approvals
The approval of first-of-a-kind drugs rose last year to forty-one, resulting in the highest level of newly approved U.S. drugs in nineteen years. The total number of new drugs approved last year was even higher at sixty-nine. The rising figures reflect an industry-wide desire to research and develop drugs for rare and hard-to-treat diseases.
The newly approved drugs serve to advance medical care and the health of patients suffering from many ailments, including various forms of cancer, heart failure, and cystic fibrosis. Additionally, more than 40% of the new therapies were approved for treatment of rare or "orphan" dise...
Source: Policy and Medicine - January 13, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Diuretic or Calcium Channel Blocker for CKD
It has been suggested by researchers that the diuretic clorthalidone should be the first line of antihypertensive therapy with a few caveats. Firstly in the presence of certain co-morbidities other drugs with a proven track record of reducing end organ damage should be instituted as first line instead. Thus it has been suggested that in patients with diabetic kidney disease and angiotensin receptor blocker (ARB) be commenced early due to its proven reno-protective effects in type 2 diabetics with kidney disease.
The results of the ACCOMPLISH trial as reported in the LANCET may change the above approach. From the available ...
Source: All Kidney News - September 29, 2015 Category: Urology & Nephrology Authors: jadhavbca Tags: Kidney News ACCOMPLISH Calcium Channel Blocker CKD DIOVAN Source Type: blogs
Jennifer’s over-the-top Wheat Belly success
Jennifer is wild for the Wheat Belly lifestyle after just her first 4 weeks. Here are her recent comments:
“Before Wheat Belly, my blood pressure was 180/90 ON 3 MEDS!
“I was on Lisinipril for 8/9 yrs. Had a bad reaction and spent 2 days in the hospital with a transfusion to get it out of my system. Thought I was dying! Ambulance and the whole thing. I told myself in that hospital bed I’m done. I want to NEVER rely on meds again. Then I was on 100 mg Metropolol, 5 mg Norvasc, 12.5 mg HCTZ, 100 mg Zoloft, and 25 mg Vistaril as needed for anxiety.
“Thanks to you, Dr. D, I have a life again with my 7-y...
Source: Wheat Belly Blog - February 2, 2015 Category: Cardiology Authors: Dr. Davis Tags: News & Updates Wheat Belly Success Stories grains hypertension joint pain Source Type: blogs
Low atrial rhythm – ECG
Low atrial rhythm
Brief Review
Abstract: Low atrial rhythm manifests with inverted P waves in inferior leads. It may be seen in sinus venosus atrial septal defect.
Low atrial rhythm
(Click on the image for an enlarged view)
This ECG shows inverted P waves in inferior leads (II, III and aVF). This indicates that the atrial activation is spreading from below upwards. It is suggestive of a focus either in the low atrium or high junction. A mid junctional rhythm will have no visible P waves as the P wave will be within the QRS due to simultaneous activation of the atria and ventricles. In low junctional rhythm the P wave occu...
Source: Cardiophile MD - January 24, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: ECG / Electrophysiology Source Type: blogs
Is Meaningful Use Killing Us?
It took days to unravel what happened.The patient first presented to her cardiologist a few weeks prior. We figured that she must have doubled her amlodipine dose that morning, because her blood pressure was uncharacteristically low. He dutifully documented the hypotension and discontinued the 5 mg of amlodipine, not realizing that she had accidentally taken too much.Seven days later, her systolic pressure reached the 200 mark. She, of course, didn’t know that. She only knew that her head started to hurt and that she was slurring her speech. By the time she arrived at the emergency room, she could barely move her right a...
Source: In My Humble Opinion - January 12, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Updates on a Crowdfunded Mouse Life Span Study
For all that I think it isn't an efficient path forward, one likely to produce meaningful results in moving the needle on human life spans, there is considerable interest in testing combinations of existing drugs and various dietary compounds in mice to see if healthy life is extended. I expect that as public interest grows in the prospects for aging research to move from being an investigative to an interventional field, wherein researchers are actively trying to treat aging, we'll only see more of this. There is certainly a sizable portion of the research community who think that the the best path ahead is in fact the ph...
Source: Fight Aging! - January 1, 2015 Category: Research Authors: Reason Tags: Healthy Life Extension Community Source Type: blogs
Is Malaysia ready for separation of dispensing?
Discussion on Separation of Dispensing in the DOBBS Doctors forum
Please note that Dobbs forums discussions are available only to logged in Dobbs members. Membership is FREE for all Malaysian doctors and done in two easy steps
1) Register at http://dobbs.my/daftar
– automatic signup and activation link will be sent via email
2) After activating, do LOGIN and VERIFY as a doctor here:
http://dobbs.my/verify (Source: Malaysian Medical Resources)
Source: Malaysian Medical Resources - December 22, 2014 Category: Global & Universal Authors: palmdoc Tags: - Nation Dispensing Drugs Pharmacists Pharmacy Source Type: blogs
Cardiology MCQ: Omapatrilat
Omapatrilat inhibits:
a) Angiotensin converting enzyme
b) Neprilysin
c) Aminopeptidase P
d) All of the above
Correct answer: d) All of the above
Omapatrilat inhibits angiotensin converting enzyme, neprilysin, and aminopeptidase P [McMurray JJ et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014 Sep 11;371(11):993-1004]. This would finally cause vasodilation, natriuresis and diuresis. Hence omapatrilat can have potential use in hypertension and heart failure. Since its actions are not confined to the renin-angiotensin system, its antihypertensive effect occurs in both high renin and...
Source: Cardiophile MD - November 28, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
MKSAP: 55-year-old man with nonischemic cardiomyopathy
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 55-year-old man is evaluated during a routine examination. He has a 2-year history of nonischemic cardiomyopathy. (Echocardiogram 2 years ago demonstrated a left ventricular ejection fraction of 35%.) He is feeling well and reports no shortness of breath; he walks 2 miles daily without symptoms. Medical history is remarkable for hypertension. Medications are lisinopril, carvedilol, and chlorthalidone.
On physical examination, blood pressure is 150/90 mm Hg and pulse rate is 50/min. No jugular venous distention...
Source: Kevin, M.D. - Medical Weblog - November 15, 2014 Category: Journals (General) Authors: mksap Tags: Conditions Heart Source Type: blogs
MKSAP: 48-year-old man with urinary frequency
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 48-year-old man is evaluated during a follow-up visit for urinary frequency. He reports no hesitancy, urgency, dysuria, or change in urine color. He has not experienced fevers, chills, sweats, nausea, vomiting, diarrhea, or other gastrointestinal symptoms. He feels thirsty very often; drinking water and using lemon drops seem to help. He has a 33-pack-year history of smoking. He has hypertension, chronic kidney disease, and bipolar disorder. Medications are amlodipine, lisinopril, and lithium. He has tried oth...
Source: Kevin, M.D. - Medical Weblog - October 11, 2014 Category: Journals (General) Authors: mksap Tags: Conditions Medications Nephrology Source Type: blogs
Japanese Research Scandal Involving Novartis Blood Pressure Drug Widens
The Japanese scandal over research using the Novartis blockbuster hypertension drug Diovan (valsartan) continues to widen. The first major figure brought down in the scandal was Hiroaki Matsubara, a prominent cardiologist and researcher at Kyoto Prefectural University in Japan, who resigned from his position after numerous retractions and investigations. Then last year accusations surfaced about another prominent researcher, Issei Komuro, a professor at Chiba University. Chiba University has now completed an investigation of one of Komuro’s most important papers, the 2011 report of the Valsartan Amlodipin...
Source: CardioBrief - September 11, 2014 Category: Cardiology Authors: Larry Husten Tags: People, Places & Events Policy & Ethics Diovan Komuro Matsubara Novartis valsartan Source Type: blogs
MKSAP: 72-year-old man with community-acquired pneumonia
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 72-year-old man is hospitalized for treatment of community-acquired pneumonia. Despite 4 days of treatment with intravenous fluids and antibiotics appropriate for the bacteria cultured from sputum and blood, he remains febrile with mild tachycardia. The patient subsequently develops mild hypotension and is transferred to the intensive care unit. Results of two subsequent blood cultures are negative for bacteria. Medical history is significant for hypertension treated with amlodipine and recurrent osteoarthriti...
Source: Kevin, M.D. - Medical Weblog - August 9, 2014 Category: Journals (General) Authors: mksap Tags: Conditions Endocrinology Hospital Source Type: blogs
