LITFL Review 328
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 328th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. Readers can subscribe to LITFL review RSS or LITFL review EMAIL subscription The Most Fair Dinkum Ripper Beauts of the Week Simon Car...
Source: Life in the Fast Lane - April 22, 2018 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: LITFL review LITFL R/V Source Type: blogs

Tropical Travel Trouble 007 Mega Malaria Extravaganza
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 007 When you think tropical medicine, malaria has to be near the top. It can be fairly complex and fortunately treatment has become a lot simpler. This post is designed to walk you through the basic principals with links to more in depth teaching if your niche is travel medicine, laboratory diagnostics or management of severe or cerebral malaria. If you stubbled on this post while drinking a cup of tea or sitting on the throne and want a fe...
Source: Life in the Fast Lane - April 5, 2018 Category: Emergency Medicine Authors: Neil Long Tags: Clinical Cases Tropical Medicine malaria Plasmodium plasmodium falciparum plasmodium knowles plasmodium malariae plasmodium ovale plasmodium vivax Source Type: blogs

The Agony of Withdrawal
​Part 3 in a Four-Part Series​A 26-year-old man presented with fatigue. He complained of body aches, diarrhea, and nausea. His history was significant for chronic back pain, for which he had been prescribed oxycodone that he has taken daily for three years. He reported that he had stopped taking it two days before his visit.He denied other medication or drug use. He was alert but restless and diaphoretic. His ECG showed sinus tachycardia. His labs included a WBC of 12, Hgb of 12, glucose of 89 mg/dL, creatinine of 1.0 mg/dL, sodium of 140 mEq/L, potassium of 3.8 mEq/L, and CK of 140 U/L. He was experiencing opioid with...
Source: The Tox Cave - February 28, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

One Barely Noticed Settlement by Pfizer Suggests the Futility of Polite Protests about Health Policy
A few days ago we noticed just one more marcher in theparade of legal settlements.  But it was once again a huge health care corporation, and it had aspects that demanded attention.Pfizer Makes $94 Million Settlement of Allegations of Fraud to Delay Generic CompetitionA tinyitem in Becker's Hospital News on November 28, 2017, stated:Pfizer will pay $94 million to resolve allegations that it used fraudulent patents to delay generic competition for its anti-inflammatory drug Celebrex.The lawsuit, brought by 32 direct purchasers of Celebrex in April and certified a class action lawsuit in August, claimed Pfizer attempted...
Source: Health Care Renewal - December 3, 2017 Category: Health Management Tags: adverse effects Celebrex deception impunity legal settlements Pfizer restraint of competition Source Type: blogs

Vaccines Blamed for Alarming Increase in Seizure Disorders Among Children
Conclusion Epilepsy is a serious medical condition with far-reaching implications for children, adults, and their families who are affected by this neurological disorder. Many different vaccines put children at an increased risk of developing epilepsy, and the effects of suffering repeated seizures can last for years or for a lifetime. Has your child suffered a seizure following vaccination? If so, please share your story in the comments below, and share this article with other parents to help them learn about the true risks of vaccines.   References: http://www.examiner.com/article/parents-question-vaccines… ...
Source: vactruth.com - July 25, 2016 Category: Allergy & Immunology Authors: Missy Fluegge Tags: Logical Missy Fluegge Top Stories Epilepsy seizures truth about vaccines Source Type: blogs

To See or Not to See
A   A 17-year-old boy presented to the emergency department after having a seizure. Initial vital signs included a temperature of 38°C, heart rate of 134 beats/min, respiratory rate of 22 breaths/min, blood pressure of 142/93 mm Hg, and pulse oximetry of 97% on room air. His physical exam is significant for tachycardia and pupils are 5 mm bilaterally and reactive to light with horizontal nystagmus. He is awake, confused, and combative.   Paramedics report that his mother found him in his bedroom was acting strangely before he fell to the floor and began convulsing. ED staff administered 2 mg intravenous ...
Source: The Tox Cave - January 4, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Funtabulously Frivolous Friday Five 125
Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia…introducing Funtabulously Frivolous Friday Five 125 Question 1 How often does acute angioedema occur as a complication of IV thrombolysis for acute stroke? In which patients is it most common? Which part of the body is typically affected? + Reveal the Funtabulous Answer expand(document.getElementById('ddet415804920'));expand(document.getElementById('ddetlink415804920')) Angioedema occurs in 1.3% – 5% of cases. Patients taking ACE-inhibitors are predisposed. I...
Source: Life in the Fast Lane - November 13, 2015 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five angioedema Bryant's sign Chvostek sign DRESS syndrome Kindling Stabler's sign Source Type: blogs

Pfizer's Latest International Pfiascos - Charges of Anti-Competitive Practices, Inflated Prices, Deception and Secrecy
Many big health care organizations seem to just be unable to keep out of trouble, and the bigger they are, the more kinds of trouble.  Pfizer Inc, considered to be one of the world's largest pharmaceutical companies, has supplied us with plenty of stories.  Enough new stories about Pfizer have accumulated since last year to do a roundup.    Presented in chronological order....Italy Demands Damages from Pfizer for Anti-Trust ViolationsThis story came out in May, 2014, via Reuters,Italy said on Wednesday it was seeking more than a billion euros in damages from multinational drug companies following a...
Source: Health Care Renewal - September 13, 2015 Category: Health Management Tags: adverse effects antitrust deception executive compensation health care prices legal settlements marketing Pfizer suppression of medical research vaccines Source Type: blogs

First Order and Zero Order Kinetics
BSCC Pharmacology 001 Question: Describe First Order elimination Kinetics? How is this different to zero order kinetics? Examiner explanation: + Show: Drawing and explanation in real-time video/audio expand(document.getElementById('ddet1763382177'));expand(document.getElementById('ddetlink1763382177')) + Show Transcript expand(document.getElementById('ddet103356245'));expand(document.getElementById('ddetlink103356245')) First order and Zero Order kinetics First order kinetics occur when a constant proportion of the drug is eliminated per unit time. Rate of elimination is proportional to the amount of drug in the body. T...
Source: Life in the Fast Lane - June 18, 2015 Category: Emergency Medicine Authors: Neil Long Tags: Basic Science Pharmacology 1st order BSCC elimination first order kinetics zero order zero order kinetics Source Type: blogs

Galaxy portfolio for aed's-- low priced drugs
var gaJsHost = (( " https: " == document.location.protocol) ? " https://ssl. " : " http://www. " ); document.write(unescape( " %3Cscript src='" + gaJsHost + " google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E " )); UPSHER SMITH PORTFOLIO INCLUDES TOPIRAMATE ER (QUDEXY) 25,50,100, 150 , 200 MG TABS (NOT DISCOUNTED) Discounted: topiramate tablets divalproex delayed release tbalets valproic acid capsules, USP lamotrigine tablets carbamazepine tablets phenytoin extended release.   advantages receive a consistent product use a specialty pharmacy form ...
Source: neurologyminutiae - October 17, 2014 Category: Neurology Source Type: blogs

AdDRESSing the Causes of Rash
Conclusion: DRESS syndrome is a rare but potentially life-threatening condition with an estimated mortality rate of 10 percent. Suspicion must be high because it may present as a spectrum of nonspecific clinical and laboratory findings.Tags: rash, tox cave, DRESS, DRESS syndrome, RegiSCAR, hepatitis, myocarditis, myositisPublished: 8/7/2014 2:50:00 PM (Source: The Tox Cave)
Source: The Tox Cave - August 7, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

AdDRESSing the Causes of Rash
Conclusion: DRESS syndrome is a rare but potentially life-threatening condition with an estimated mortality rate of 10 percent. Suspicion must be high because it may present as a spectrum of nonspecific clinical and laboratory findings.Tags: rash, tox cave, DRESS, DRESS syndrome, RegiSCAR, hepatitis, myocarditis, myositisPublished: 8/7/2014 2:50:00 PM (Source: The Tox Cave)
Source: The Tox Cave - August 7, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

A Hot Topic
A 58-year-old man presented unresponsive following a seizure at home. His brother stated that he became progressively confused over the course of a few hours and then started shaking. EMS reports tonic-clonic seizures that resolved following administration of 5 mg of midazolam IM. The patient was unresponsive and hyperthermic on arrival. He was intubated for airway protection, covered with ice packs, and administered normal saline intravenously. His rectal temperature is 41.9˚C (107.4˚F), blood pressure is 94/45 mm Hg, heart rate is 160 beats/minute, and the respiratory rate is 16 breaths/minute with an oxygen saturat...
Source: The Tox Cave - June 23, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

A Hot Topic
A 58-year-old man presented unresponsive following a seizure at home. His brother stated that he became progressively confused over the course of a few hours and then started shaking. EMS reports tonic-clonic seizures that resolved following administration of 5 mg of midazolam IM. The patient was unresponsive and hyperthermic on arrival. He was intubated for airway protection, covered with ice packs, and administered normal saline intravenously. His rectal temperature is 41.9˚C (107.4˚F), blood pressure is 94/45 mm Hg, heart rate is 160 beats/minute, and the respiratory rate is 16 breaths/minute with an oxygen saturatio...
Source: The Tox Cave - June 23, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

UK Taxpayers Suffer As Pharma Commits 'Highway Robbery'?
A pricing scandal is unfolding in the UK, where drugmakers are being accused of exploiting a loophole that allegedly is costing the National Health Service – and taxpayers – tens of millions each year. And while the maneuver is legal, the British Medical Association is charging the pharmaceutical industry is committing ‘highway robbery,’ according to The Independent. Basically, the issue is that brand-name drugmakers sell older medicines, which no longer have patent protection, to other drugmakers. The medications are then renamed and sold to the NHS at a much higher price because the drug is not co...
Source: Pharmalot - July 16, 2013 Category: Pharma Commentators Authors: esilverman Source Type: blogs

UK NHS hit for millions by overcharging ‘scam’ - by Sanchez Manning
Drugs companies have been accused of “highway robbery” of the NHS by using a legal loophole to push up the price of medicines in some cases by up to 2,000 per cent – at a cost to the taxpayer of tens of millions a year. At least 15 drugs have substantially increased in price after being “flipped” from one firm to another, according to information obtained by doctors. The legal “scam” has prompted outrage from the British Medical Association – which has warned that vital treatments risk being denied to patients if costs rise so much that the NHS can no longer afford them. ...
Source: PharmaGossip - July 14, 2013 Category: Pharma Commentators Authors: insider Source Type: blogs

The LITFL Review 102
Welcome to the 102nd edition!The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.The Most Fair Dinkum Ripper Beaut of the WeekResus.MECliff Reid over at Resus.ME smashes his way to top spot this week, as he brings us 3 great hot-of-the-p...
Source: Life in the Fast Lane - April 23, 2013 Category: Emergency Medicine Doctors Authors: Kane Guthrie Tags: Education eLearning Emergency Medicine Featured Health Intensive Care LITFL review LITFL R/V Source Type: blogs

The LITFL Review 102
Welcome to the 102nd edition! The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around. The Most Fair Dinkum Ripper Beaut of the Week Resus.ME Cliff Reid over at Resus.ME smashes his way to top spot this week, as he brings us 3 great hot-of-...
Source: Life in the Fast Lane - April 23, 2013 Category: Emergency Medicine Doctors Authors: Kane Guthrie Tags: Education eLearning Emergency Medicine Featured Health Intensive Care LITFL review LITFL R/V Source Type: blogs

Medications that Increase the Risks of Patient Falls
Falls are the leading cause of both fatal and non-fatal injuries for adults 65 and older. Alzheimer's Reading Room “Falls are the leading cause of both fatal and non-fatal injuries for adults 65 and older, and research suggests that those taking four or more medications are at an even greater risk than those who don’t – perhaps two to three times greater,” said Susan Blalock, Ph.D., an associate professor at the UNC Eshelman School of Pharmacy. In 2007, more than 21,700 Americans died as a result of falls and more than 7.9 million were injured by a fall including over 1.8 million older adults who...
Source: Alzheimer's Reading Room, The - February 14, 2013 Category: Dementia Authors: Bob DeMarco Source Type: blogs

Drugs for Diabetes Pain
By David Spero Pain researcher Rebecca Sudore, MD, says, "Adults living with Type 2 diabetes are suffering from incredibly high rates of pain, at levels similar to patients living with cancer." Sounds awful. But what can we do about it? Actually, quite a bit. Let's look at medications first. Because chronic pain involves emotions, thoughts, stress, general health, and the entire body, there are at least six different categories of drugs that can help with pain. They include: narcotics, anxiolytics (“tranquilizers"), antidepressants, anti-inflammatories, medicines for seizures, and alternative treatment...
Source: Diabetes Self-Management - February 6, 2013 Category: Diabetes Authors: David Spero Source Type: blogs

TechTool Thursday 011 UPDATE
TECH TOOL UPDATE! TechTool review of palmPEDi by palmER Worldwide LLC  on iOS palmPEDi provides quick access to important drug doses for paediatric emergencies.  It’s all done by weight (or an estimated weight based on age).  Select the weight and a long list of drug doses are at your feet (fingertips) iTunes - Website A couple of weeks ago I posted a review of palmPEDi .  Pretty much straight after the review I was contacted by the developers of palmPEDi.  And no, there was no wailing, gnashing of teeth or shouting.  They took on board the review comments a...
Source: Life in the Fast Lane - January 10, 2013 Category: Emergency Medicine Doctors Authors: Tessa Davis Tags: Education eLearning Emergency Medicine Featured iOS Reviews TechTool App application iphone palmPEDi Source Type: blogs

TechTool Thursday 011 UPDATE
TECH TOOL UPDATE! TechTool review of palmPEDi by palmER Worldwide LLC  on iOS palmPEDi provides quick access to important drug doses for paediatric emergencies.  It’s all done by weight (or an estimated weight based on age).  Select the weight and a long list of drug doses are at your feet (fingertips) iTunes - Website A couple of weeks ago I posted a review of palmPEDi .  Pretty much straight after the review I was contacted by the developers of palmPEDi.  And no, there was no wailing, gnashing of teeth or shouting.  They took on board the review comments a...
Source: Life in the Fast Lane - January 10, 2013 Category: Emergency Medicine Doctors Authors: Tessa Davis Tags: Education eLearning Emergency Medicine Featured iOS Reviews TechTool App application iphone palmPEDi Source Type: blogs