Why didn ’ t you try ECMO for my dad , doctor ? I feel really guilty !
It is just past midnight: This is a gloomy conversation between a patient’s son and a cardiologist in the silent waiting room, just outside the dim-lit ICU of a popular 4-star hospital in Chennai. “I am sorry to say, Mr. B., your father didn’t make it. Has succumbed to the heart attack. We have been trying to resuscitate him for the past one hour. We have done everything. We have managed to open up IRA, and 2 more critical blocks still it couldn’t help. It was a massive one. Sorry again. “Doctor, I feel very bad. What went wrong, I want to know. Doc, did you try ECMO ?,” the ...
Source: Dr.S.Venkatesan MD - February 1, 2021 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology -Technology ecmo IABP impella tandem heart ecmo Source Type: blogs

Wellens' syndrome: to stent or not? IVUS negative, Symptoms persist, Stress Testing, Instantaneous Wave Free Ratio, and Fractional Flow Reserve.
A 55 y.o. male with no cardiac PMHX presented for 2 weeks of exertional chest pain, worsened on the day prior to presentation.  On the day of presentation, the chest discomfort was particularly intense, and associated with diaphoresis and nausea.  It was resolved (pain free) when the ECG was recorded:This ECG was read as " nonspecific " by the providers.  What do you think?These is classic Wellens ' pattern A (biphasic, terminal T-wave inversion), and it isWellens 'syndrome (Angina, resolved -- pain free -- with preserved R-waves and Wellens ' pattern A T-waves).  The morphology of these T-wav...
Source: Dr. Smith's ECG Blog - January 28, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs

Fight Aging! Newsletter, January 11th 2021
This study demonstrates the potential of a natural (o-Vanillin) and a synthetic (RG-7112) senolytic compounds to remove senescent IVD cells, decrease SASP factors release, reduce the inflammatory environment and enhance the IVD matrix production. Removal of senescent cells, using senolytics drugs, could lead to improved therapeutic interventions and ultimately decrease pain and a provide a better quality of life of patients living with intervertebral disc degeneration and low back pain. From Ying Ann Chiao of Oklahoma Medical Research Foundation: Mitochondrial dysfunction plays a central role in aging and cardiovasc...
Source: Fight Aging! - January 10, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

Arterial Stiffening with Age Correlates with Structural Damage to the Brain
In this study, we show that an increased rate of arterial stiffening is associated with lower white matter (WM) microstructural integrity and cerebral blood flow (CBF) in older age. Furthermore, these associations were present in diffuse brain areas, suggesting that exposure to excess pulsatility may result in a widespread damaging effect on the fragile cerebral microstructure. Cognitive function at follow-up related more closely with baseline arterial stiffness rather than rate of arterial stiffening. Taken together, these findings suggest that although faster rates of arterial stiffening in the transition to old age may ...
Source: Fight Aging! - January 8, 2021 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs

Fight Aging! Newsletter, December 21st 2020
In this study, we have found that administration of a specific Sgk1 inhibitor significantly reduces the dysregulated form of tau protein that is a pathological hallmark of AD, restores prefrontal cortical synaptic function, and mitigates memory deficits in an AD model. These results have identified Sgk1 as a potential key target for therapeutic intervention of AD, which may have specific and precise effects." Targeting histone K4 trimethylation for treatment of cognitive and synaptic deficits in mouse models of Alzheimer's disease Epigenetic aberration is implicated in aging and neurodegeneration. Using p...
Source: Fight Aging! - December 20, 2020 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

Recellularizing a Rat Thymus with Human Thymic Epithelial Cells Produces a Functional Thymus
Decellularization followed by recellularization is a well explored approach to tissue engineering. Researchers take a donor organ or tissue section, decellularize it to leave the intricate extracellular matrix and all of its chemical cues, and then recellularize with with the desired mix of cells. When those cells are derived from a patient, it is possible to generate tissue that can be transplanted into that patient with minimal risk of rejection. There are also groups working on enabling cross-species transplantation from pigs to humans via this strategy of replacing all of the cells in an organ with patient-matched cell...
Source: Fight Aging! - December 18, 2020 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs

FFR with CT angiography
Fractional flow reserve (FFR) is usually estimated invasively using a Doppler flow wire introduced into the coronary artery and measuring the pressure drop across the coronary stenosis during maximal hyperemia induced by adenosine. FFR has been shown to be of great significance while assessing the severity of borderline coronary stenosis in deciding the need for coronary angioplasty. Fractional flow reserve estimated by computed tomographic angiography (FFRCT) is a novel technique of getting similar information non invasively. FFR with CT angiography has been shown to be superior to conventional CT coronary angiography a...
Source: Cardiophile MD - December 18, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiac CT scan FFR FFRCT Noninvasive Fractional Flow Reserve Source Type: blogs

Extreme widespread ST depression, with ST Elevation in aVR. What do you think?
ConclusionsSTE-aVR with multilead ST depression was associated with acutely thrombotic coronary occlusion in only 10% of patients. Routine STEMI activation in STE-aVR for emergent revascularization is not warranted, although urgent, rather than emergent, catheterization appears to be important. (Source: Dr. Smith's ECG Blog)
Source: Dr. Smith's ECG Blog - December 16, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs

Fight Aging! Newsletter, November 23rd 2020
In conclusion, the study indicates that HBOT may induce significant senolytic effects that include significantly increasing telomere length and clearance of senescent cells in the aging populations. Data on the Prevalence of Liver Fibrosis in Middle Age https://www.fightaging.org/archives/2020/11/data-on-the-prevalence-of-liver-fibrosis-in-middle-age/ Fibrosis is a consequence of age-related disarray in tissue maintenance processes, leading to the deposition of scar-like collagen that disrupts tissue structure and function. It is an ultimately fatal issue for which there are only poor treatment options ...
Source: Fight Aging! - November 22, 2020 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

More Physical Activity, Less Progression to Dementia
Researchers here note a correlation between greater exercise in late life and reduced risk of progressing from mild cognitive impairment to dementia. As is the case for most human data, causation cannot be shown, but animal data on the benefits of exercise are unambiguous. It seems safe to suggest that human physiology works much the same way, and that the correlation exists because exercise provides benefits that slow down processes of age-related neurodegeneration. Physical activity has been suggested to prevent the conversion of mild cognitive impairment (MCI) to dementia in patients. We investigated the associ...
Source: Fight Aging! - November 17, 2020 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

FDA Clears Masimo ’s Go Anywhere Pulse Oximeter and Respiration Rate Monitor
Masimo won FDA clearance for its Rad-G pulse oximeter, a rugged device developed with the help of The Bill & Melinda Gates Foundation. Originally created to spot-check patients for SpO2 (oxygen saturation), respiration rate from the plethysmograph (RRp), pulse rate (PR), perfusion index (Pi), and pleth variability index (PVi®), this latest generation of the Rad-G allows for continuous monitoring as well. Thanks to the new Rad-G sensor, the oximeter can be used on both adults and children, allowing the same device to be used on all patients without having to switch the sensor. However, the Rad-G can use any of Masim...
Source: Medgadget - October 1, 2020 Category: Medical Devices Authors: Medgadget Editors Tags: Cardiology Emergency Medicine Geriatrics Pediatrics Public Health Source Type: blogs

It ’s complicated. A deep dive into the Viz/Medicare AI reimbursement model.
By LUKE OAKDEN-RAYNER In the last post I wrote about the recent decision by CMS to reimburse a Viz.AI stroke detection model through Medicare/Medicaid. I briefly explained how this funding model will work, but it is so darn complicated that it deserves a much deeper look. To get more info, I went to the primary source. Dr Chris Mansi, the co-founder and CEO of Viz.ai, was kind enough to talk to me about the CMS decision. He was also remarkably open and transparent about the process and the implications as they see them, which has helped me clear up a whole bunch of stuff in my mind. High fives all around! So...
Source: The Health Care Blog - September 24, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Artificial Intelligence Health Tech AI Luke Oakden-Rayner Medicare reimbursement Radiology Viz.ai Source Type: blogs

Repost: Syncope, Shock, AV block, RBBB, Large RV, " Anterior " ST Elevation in V1-V3
I came across this post from 2015 while answering a question on Twitter, and decided to repost it:http://hqmeded-ecg.blogspot.com/2015/12/syncope-shock-av-block-large-rv.htmlSyncope, Shock, AV block, RBBB, Large RV, " Anterior " ST Elevation in V1-V3An elderly male had a syncopal episode. 911 was called. When medics arrived, the patient was alert and following commands. In the presence of the medics, he lost consciousness and became apneic and underwent 30 seconds of chest compressions, after which he started moaning and was again able to communicate and follow commands.  No shock was ever delivered.A 1...
Source: Dr. Smith's ECG Blog - September 23, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs

3 days of shoulder and chest pain, and now cardiogenic shock
I was texted these ECGs." Bad chest pressure with severe left shoulder pain 3 nights ago.  Then SOB and nausea the next day.  Now appears to be in cardiogenic shock. "(Later review showed systolic BPs in the range of 55 to 83.  So she was quite hypotensive.)First recorded at time zero:There is sinus rhythm. Rate of only 70 suggests some beta blockade.The QT is very long.There is T-wave inversion in inferior leads, suggestive of reperfused or subacute MI.There is a Q-wave in III, so this may be subacuteThere is ST depression in V2-V4.20 minutes:Again, very long QT.Now, T-waves are upright in inferior leads, i...
Source: Dr. Smith's ECG Blog - August 27, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs

Fight Aging! Newsletter, August 10th 2020
This study aimed to characterize the role of BDNF in age-related microglial activation. Initially, we found that degrees of microglial activation were especially evident in the substantia nigra (SN) across different brain regions of aged mice. The levels of BDNF and TrkB in microglia decreased with age and negatively correlated with their activation statuses in mice during aging. Interestingly, aging-related microglial activation could be reversed by chronic, subcutaneous perfusion of BDNF. Peripheral lipopolysaccharide (LPS) injection-induced microglial activation could be reduced by local supplement of BDNF, while shTrkB...
Source: Fight Aging! - August 9, 2020 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs