A Look Back at 2019: Progress Towards the Treatment of Aging as a Medical Condition
Conclusion
A great deal of progress is being made in the matter of treating aging: in advocacy, in funding, in the research and development. It can never be enough, and it can never be fast enough, given the enormous cost in suffering and lost lives. The longevity industry is really only just getting started in the grand scheme of things: it looks vast to those of us who followed the slow, halting progress in aging research that was the state of things a decade or two ago. But it is still tiny compared to the rest of the medical industry, and it remains the case that there is a great deal of work yet to be done at all...
Source: Fight Aging! - December 31, 2019 Category: Research Authors: Reason Tags: Of Interest Source Type: blogs
Does elevated RVEDP cause dyspnea ?
Exertional dyspnea disproportional to the effort is the most common (cardinal)symptom of heart disease. Whenever we discuss the mechanism of cardiac dyspnea , we primarily attribute it to left heart disease, elevated LVEDP and the resultant pulmonary congestion.Conventional teaching in the past (may be in the present too !) doesn’t implicate raised RVEDP in the genesis of dyspnea.
It’s good to recall , the sensation of dyspnea is felt at the peri -Amygdala nuclear zone after complex processing with various cortical and sub-cortical level .It is subjected to as many afferent triggers other than J receptors in pu...
Source: Dr.S.Venkatesan MD - December 18, 2019 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology - Clinical Clinical cardiology Uncategorized does raised rvedp cause dyspnea dyspnea in pulmonary hypertension mechanism of dyspnea Source Type: blogs
" Pericarditis " strikes again
Written by Pendell MeyersA man in his late 40s with several ACS risk factors presented with a chief complaint of chest pain. Several hours prior to presentation, while driving his truck, he started experiencing new central chest pain, without radiation, aggravating/alleviating factors, or other associated symptoms. On review of systems the patient reported back pain for approximately 1 week which he was treating with NSAIDs with minimal relief. On exam the patient was well appearing, with normal vitals signs other than BP 155/82, no murmurs or rubs, normal pulses, no reproducible chest pain.Here is his triage ECG:Wha...
Source: Dr. Smith's ECG Blog - December 12, 2019 Category: Cardiology Authors: Pendell Source Type: blogs
The Dilemma of the Black Patient
By YOLONDA Y. WILSON, PhD
Last week a nurse posted a video of
herself on Twitter mocking patients with the caption “We know when y’all are
faking” followed by laughing emojis. Twitter responded with the hashtag #patientsarenotfaking,
created by Imani Barbarin, and
a slew of testimonials of negligent medical care. While the nurse’s video was
not explicitly racialized, plenty in the black community felt a particular
sting: there is clear evidence that this attitude contributes to the problem of
black patients receiving substandard care, and that negative behavioral traits like fak...
Source: The Health Care Blog - December 5, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Patients racial bias The OpEd Project Yolonda Wilson Source Type: blogs
Persistent Ventricular Fibrillation, ED ECMO, ED TEE, ROSC, Shark Fin ECG (also called " Giant R-wave " ), Postinfarction Regional Pericarditis. What a Case!
A 40-something suffered witnessed ventricular fibrillation, had bystander CPR, but could not be defibrillated after 4 attempts.He was transferred to the ED and put on extracorporeal life support (ECLS, ECMO).A series of ED Transesophageal echos (TEE) was done over 23 minutes before an ECG was recorded. We usually do not get ROSC before angiography in these cases, and recording the ECG is not as important as usual, because we send them all to the cath lab by our ECMO protocol.This is before another defibrillation attempt, during chest compressions:Orientation:The probe is in the esophagus, right next to the left ...
Source: Dr. Smith's ECG Blog - November 21, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Look at this ST Depression
DiscussionAtrial repolarization waves are recognized by a downsloping PR segment and are a common cause of false positive stress tests. They are augmented by tachycardia.See this paper:Sapin PM et al. Identification of false positive exercise tests with use of electrocardiographic criteria: a possible role for atrial repolarization waves. JACC 18(1):127-35; July 1991. (link is full text)Link to abstract: http://www.onlinejacc.org/content/18/1/127.abstractHere is a schematic from my book,The ECG in Acute MI (this is a link to a free pdf)Learning Points:1. Recognize the atrial repolarization wave. ...
Source: Dr. Smith's ECG Blog - October 1, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Fight Aging! Newsletter, September 30th 2019
In conclusion, older adults exhibited decreased markers of UPR activation and reduced coordination with autophagy and SC-associated gene transcripts following a single bout of unaccustomed resistance exercise. In contrast, young adults demonstrated strong coordination between UPR genes and key regulatory gene transcripts associated with autophagy and SC differentiation in skeletal muscle post-exercise. Taken together, the present findings suggest a potential age-related impairment in the post-exercise transcriptional response that supports activation of the UPR and coordination with other exercise responsive pathways (i.e....
Source: Fight Aging! - September 29, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Senescent Cells Implicated in Age-Related Changes in Blood Clotting
In this study, researchers validated the expression of some of the specific factors in cultured cells and in mice, which were treated with doxorubicin, a widely-used chemotherapy drug which induces widespread senescence. Those mice showed increased blood clotting, similar to what happens in humans who undergo chemotherapy. "Conversely, when we selectively removed senescent cells in specially bred transgenic mice, the increased clotting caused by doxorubicin went away."
SILAC Analysis Reveals Increased Secretion of Hemostasis-Related Factors by Senescent Cells
Cellular senescence irreversibly arrests cell...
Source: Fight Aging! - September 25, 2019 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Breathtaking: The Future Of Respiratory Care And Pulmonology
Smoke-measuring smart shirts, breath sound analyzing
algorithms, and smart inhalers pave the way of pulmonology and respiratory care
into the future. As the number of patients suffering from asthma, COPD, or lung
cancer due to rising air pollution and steady smoker-levels will unfortunately
not decrease any time soon, we looked around what technology can do to help
both patients and caregivers. The results are breathtaking.
Attacks of
breathlessness are too common
The diseases which pulmonologists and respiratory care
specialists attempt to fight are among the most common conditions in the modern
world – and the n...
Source: The Medical Futurist - September 25, 2019 Category: Information Technology Authors: nora Tags: Artificial Intelligence Future of Medicine Health Sensors & Trackers AI asthma cancer cancer treatment care COPD diagnostics inhaler lung lung cancer management medical specialty pulmonology respiratory respiratory care Source Type: blogs
Unusual: Troponin Trajectory to Help Determine Ongoing/Recurrent Infarction vs. Completed Infarction.
A 40-something male with no PMH of any kind presented to urgent care on a weekend (cath team is at home) with cough starting 2 weeks prior and SOB one week prior.He underwent a chest x-ray:As this was consistent with " pulmonary edema vs. viral infection, " and he was transferred to the EDThe faculty physician did an immediate cardiac and lung ultrasound:Many B lines (probable pulmonary edema)Parasternal short axis cardiac ultrasound:The anterior wall is closest to the transducer and shows an obvious wall motion abnormalityFurther history:The patient denied chest pain but stated that he had had about 3 epis...
Source: Dr. Smith's ECG Blog - September 16, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
MINOCA vs TpNOCA
TpNOCA: Troponin-positive nonobstructive coronary arteries
Apparent myocardial infarction in the absence of obstructive coronary artery disease
MINOCA: Myocardial Infarction With Nonobstructive Coronary Arteries
Term reserved for only those who have evidence of ischemia related myocardial necrosis
MINOCA included only coronary disorders like coronary dissection, plaque disruption, coronary spasm, microvascular dysfunction, coronary thrombus and embolism (recanalized).
TpNOCA includes in addition to MINOCA, myocardial disorders like myocarditis, takotsubo cardiomyopathy and other cardiomyopathies as well as non cardia...
Source: Cardiophile MD - September 10, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
The ECG was correct. The angiogram was not.
In this study, approximately 10% of Transient STEMI had no culprit found:Early or late intervention in patients with transient ST ‐segment elevation acute coronary syndrome: Subgroup analysis of the ELISA‐3 trialOne must use all available data, including the ECG, to determine what happened.Final Diagnosis?If the troponin remained under the 99% reference, then it would be unstable angina. If it rose above that level before falling, it would be acute myocardial injury due to ischemia, which is, by definition, acute MI. If that is a result of plaque rupture, then it is a type I MI. The clinical presentat...
Source: Dr. Smith's ECG Blog - August 12, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Are Radiologists Prepared for The Future?
This article originally appeared on Medium here. (Source: The Health Care Blog)
Source: The Health Care Blog - August 9, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Health Technology Medical Practice Physicians AI Alex Logsdon Artificial intelligence Radiology Source Type: blogs
How does acute left main occlusion present on the ECG?
Post by Smith and MeyersSam Ghali (https://twitter.com/EM_RESUS) just asked me (Smith):" Steve, do left main coronary artery *occlusions* (actual ones with transmural ischemia) have ST Depression or ST Elevation in aVR? "Smith and Meyers answer:First, LM occlusion is uncommon in the ED because most of these die before they can get a 12-lead recorded.But if they do present:The very common presentation of diffuse STD with reciprocal STE in aVR is NOT left main occlusion, though it might be due to subtotal LM ACS, but is much more often due to non-ACS conditions, especially demand ischemia. In these ...
Source: Dr. Smith's ECG Blog - August 8, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
A young woman with altered mental status and hypotension
Written by Pendell MeyersI texted this Prehospital ECG with no clinical information to Dr. Smith.What do you think?Dr. Smith texted back " Pulmonary Embolism " within seconds.Here is the clinical information:A woman in her 30s with no known past medical history presented by ambulance for altered mental status and syncope. She was delirious, ill-appearing, hypotensive, tachycardic, afebrile, satting 99% on 2L/min masal cannula.Sinus tachycardiaAcute RV strain pattern evidenced by the morphology of the QRS and T-wave in V1-V3, including small-moderate R-wave followed by deep S-wave, then concave ST segment into whole T-wave ...
Source: Dr. Smith's ECG Blog - August 6, 2019 Category: Cardiology Authors: Pendell Source Type: blogs
