Pulmonary embolism: the killer clot in your veins
We had just exchanged“I love yous” about 15 minutes before the intercom blared:“Code blue.” Just like that, my sister was gone — all from what seemed like a simple knee surgery. Simple in the fact that the type of surgery my sister was supposed to have had that fateful morning was an open […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 28, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/jennifer-bradley" rel="tag" > Jennifer Bradley, FNP-C < /a > < /span > Tags: Conditions Critical Care Pulmonology Source Type: blogs
Fight Aging! Newsletter, June 24th 2019
This study sought to investigate what could be learned from how these men have fared. The men were born in 1925-1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age.
Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, ...
Source: Fight Aging! - June 23, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Extracting Evidence for Causation from the Correlation Between Excess Fat Tissue and Risk of Cardiovascular Disease
Given a good enough data set, there are ways to produce evidence for causation in the observed relationships between patient characteristics and risk of age-related disease. While it is well accepted by now that being overweight does in fact cause a raised risk of all the common age-related diseases, a shorter life expectancy, and a raised lifetime medical expenditure, more data never hurts. Researchers have a good understanding of the mechanisms involved in these relationships. In particular, visceral fat tissue around the abdominal organs generates chronic inflammation, which acts to accelerate tissue decline and age-rel...
Source: Fight Aging! - June 18, 2019 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
ROSC: does the ECG rule out OMI? And why does a heart just stop beating? And what rhythm is this?
This study had afatal flaw: they did not keep track of all the Non-STEMI patients who were NOT enrolled, but instead were sent for immediate angiogram. It was done in Europe, where the guidelines suggest taking all shockable arrests emergently to the cath lab. So it is highly likely that physicians were very reluctant to enroll patients; they did not want them to be randomized to no angiogram. This strong suspicion is supported by their data:only 22 of 437 (5.0%) patients in this study had OMI.What percent of shockable arrests without STE have an OMI? This large registry in Circulatio...
Source: Dr. Smith's ECG Blog - June 17, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
ROSC: does the ECG to rule out OMI? And why does a heart just stop beating? And what rhythm is this?
This study had afatal flaw: they did not keep track of all the Non-STEMI patients who were NOT enrolled, but instead were sent for immediate angiogram. It was done in Europe, where the guidelines suggest taking all shockable arrests emergently to the cath lab. So it is highly likely that physicians were very reluctant to enroll patients; they did not want them to be randomized to no angiogram. This strong suspicion is supported by their data:only 22 of 437 (5.0%) patients in this study had OMI. What percent of shockable arrests without STE have an OMI? This large registry in Circ...
Source: Dr. Smith's ECG Blog - June 17, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Syncope evaluation from ECG: A check list and a focused review.
In the evaluation of syncope, history is most important to arrive at a diagnosis.The first step is to confirm whether its truly a syncope or (Metabolic/TIA or seizure. We are easily carried away by the urge to order a Holter monitoring routimely. In reality, the yield is too low (<15%) .Even the utility value of Head up tilt (HUT) is being downgraded.
Paradoxically, resting ECG might give important clue in many. One need to specifically look into a set pattern of ECG. It generally falls in one the following in any patient with syncope.
This post specifically may not be exclusive but stresses the importance of resting EC...
Source: Dr.S.Venkatesan MD - June 10, 2019 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
Podcasts for medical students on internal medicine
Today, we received two 3rd year medical students starting their IM rotation. I told them I would give them a list of podcasts that should help them get oriented to internal medicine. This is my podcast v1.0 list:
From the Curbsiders:
142 Cirrhosis TIPS for Acute Complications
104: Renal tubular acidosis with Kidney Boy, Joel Topf MD
92: Pulmonary Embolism for the Internist
86: COPD: Diagnosis, treatment, PFTs, and nihilism
76: Pneumonia Pearls with Dr Robert Centor
61: Vasculitis and Giant-Cell Arteritis: ‘Rheum’ for improvement
52: Anemia: Tips, and tools for diagnosis and treatment
20: Hyp...
Source: DB's Medical Rants - April 29, 2019 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
An elderly woman transferred to you for chest pain, shortness of breath, and positive troponin - does she need the cath lab now?
Written by Alex Bracey, with edits by Smith and MeyersA female in her 70s presented to the ED at sign out while working in our acute zone (medium acuity). I picked up the chart and the triage note indicated that the patient was transferred from another hospital, with " EKG changes " and elevated troponin, for cardiology evaluation of NSTEMI. Symptoms were ongoing.Interest now piqued, I looked at the EKG and saw the following:What do you think? Baseline for comparison below.This is nearly pathognomonic! Of what?Baseline on file from outside hospital:This is her first ECG at our hospital:Meyers ECG interpretation: ...
Source: Dr. Smith's ECG Blog - April 4, 2019 Category: Cardiology Authors: Pendell Source Type: blogs
Trocar during Times of Trauma
Seventy-five percent of trauma injuries involve some kind of thoracic insult, a quarter of which need a procedural intervention like a chest tube. (Surg Clin North Am 2007;87[1]:95; http://bit.ly/2HaoX90.) Long-term illness, lung disease, and post-operative complications may cause pleural effusions or a pneumothorax, so treating these conditions quickly can significantly decrease patient morbidity and mortality. Other indications for chest tube placement include:Trauma: Pneumothorax, hemopneumothorax, or tension pneumothoraxLong-term illness: Pleural effusion (cancer, pneumonia)Infection: Em...
Source: The Procedural Pause - April 1, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Investigations and management of dilated cardiomyopathy
Investigations in dilated cardiomyopathy
Chest X-ray PA view will assess the cardiac size in dilated cardiomyopathy and show evidence of pulmonary congestion. Sick persons may present with features of frank pulmonary edema in the form of hilar haze or bat wing pattern of pulmonary edema. Significant left ventricular dysfunction can exist without much of cardiomegaly on chest X-ray as well.
ECG may show sinus tachycardia, left atrial overload and sometimes left ventricular hypertrophy. A wide QRS complex with left bundle branch block pattern may indicate potential benefit from cardiac resynchronization therapy (CRT). ECG ...
Source: Cardiophile MD - March 30, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: General Cardiology Source Type: blogs
Thrombolytic versus conventional therapy for submassive PE
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - March 21, 2019 Category: Internal Medicine Tags: cardiovascular critical care hospital medicine pharmacology pulmonary Source Type: blogs
Exercise: Don ’ t Forget to Make Amends to Your Body
In a world where nothing is in my control and living with a head that constantly tells me I’m not doing enough, exercising every day makes me feel like I’ve checked a box.
Last year, my mom fell and broke her hip. During the surgery, she had a mild heart attack and a pulmonary embolism. Since that fall, she’s become wheelchair bound and has started showing the signs of early dementia. She’s now in assisted living, being bathed by caretakers. On the other hand, my father has a girlfriend, writes screenplays, teaches kids to read, swims, and delivers food to the elderly (even though he is the elderly). My parents are...
Source: World of Psychology - February 26, 2019 Category: Psychiatry & Psychology Authors: Psych Central Guest Author Tags: Addiction Exercise & Fitness Health-related Publishers Recovery The Fix healthy coping mechanisms Source Type: blogs
Ultrasound Case 079
Presentation A previously well 49 year old man presents with chest pain. He is tachycardic, tachypneoic and hypoxic with blood pressure 110/65. He is 2 weeks post ankle surgery. Describe and interpret these scans
The post Ultrasound Case 079 appeared first on Life in the Fast Lane • LITFL • Medical Blog. (Source: Life in the Fast Lane)
Source: Life in the Fast Lane - February 25, 2019 Category: Emergency Medicine Authors: Dr James Rippey Tags: Respiratory TOP 100 Ultrasound D-shaped septum McConnell's sign Pulmonary Embolism Source Type: blogs
Ultrasound Case 079
Presentation A previously well 49 year old man presents with chest pain. He is tachycardic, tachypneoic and hypoxic with blood pressure 110/65. He is 2 weeks… Read more → (Source: Life in the Fast Lane)
Source: Life in the Fast Lane - February 25, 2019 Category: Emergency Medicine Authors: Dr James Rippey Tags: Respiratory TOP 100 Ultrasound D-shaped septum McConnell's sign Pulmonary Embolism Source Type: blogs
