Parenteral Diarrhea: Medical Myth or Reality?
Researchers have described parenteral diarrhea's association with extraintestinal infections for more than a century, but the evidence is impressively limited, which perpetuates claims that it is a medical myth and not an actual clinical entity.But it matters that noninfectious diarrhea and vomiting are sometimes associated with bacterial infections such as acute urinary tract infections because this can create diagnostic confusion. Diarrhea and vomiting in a girl or woman with a febrile UTI could lead to a misdiagnosis of acute gastroenteritis. Febrile UTIs are often pyelonephritis, so missing the diagnosis has significan...
Source: M2E Too! Mellick's Multimedia EduBlog - July 1, 2022 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

A young F is hyperthermic, delirious, and dry: Fever-induced Brugada? Diphenhydramine toxicity? Tricyclic?
Conclusion of this paper: Fever is a great risk factor for arrhythmia events in Brugada Syndrome patients. Patients with known fever-triggered Brugada syndrome should be surveilled closely during fever and be started on antipyretic therapy as soon as possible.  There are limited data regarding the impact of EP study in BrS patients triggered by fever.  An EP study might be helpful in symptomatic patients (Sroubek et al., 2016) in the presence of spontaneous BrS ECG or drug-induced ECG.The prognostic significance of fever-induced Brugada syndrome.  Heart Rhythm 2016.Eighty-eight asymptomatic patient...
Source: Dr. Smith's ECG Blog - December 4, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs

Ultrasound Case 093
Dr James Rippey Ultrasound Case 093 A 9 year old boy presented with fever and right flank pain. The concern was pyelonephritis. Look at the first image and see what you think. (Source: Life in the Fast Lane)
Source: Life in the Fast Lane - May 20, 2019 Category: Emergency Medicine Authors: Dr James Rippey Tags: TOP 100 Ultrasound Appendicitis Appendicitis in RUQ pyelonephritis Top 100 ultrasounds Source Type: blogs

Chest pain, sinus tachycardia, and ST Elevation
I was reading through ECGs on the system when I saw this one:Sinus tachycardia, rate 120Computerized QTc = 380 msWhat do you think? I was immediately worried about a proximal LAD occlusion.  Although sinus tachycardia generally argues against ACS, a large anterior MI may result in such poor stroke volume that there is compensatory tachycardia and possibly impending cardiogenic shock. I looked to see if there was an ED cardiac ultrasound, and there was:Parasternal Long Axis:Poor image, but one can see that there is poor apical functionParasternal short axis:This shows poor contractility of the anterior wall.C...
Source: Dr. Smith's ECG Blog - January 22, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs

#5goodminutes Type IV RTA
For a number of years I have advised students and residents to keep a notebook of topics that arise on rounds.  Pick 2 topics that we discussed, then read about them for 5 minutes.  Everyone has 5 minutes to read about a topic. The idea here is that cognitive science has shown that we remember better if we both hear about a topic and read about the same topic. Since I have embarked on this project of one medical tweet each day, I have embraced the 5 good minutes philosophy.  So I will use the hashtag #5goodminutes each day, along with other tags. Today I want to increase understanding of Type IV RTA as many students, re...
Source: DB's Medical Rants - January 3, 2018 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

Funtabulously Frivolous Friday Five 199
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog 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 FFFF…introducing Funtabulously Frivolous Friday Five 199. Question 1 What does this pastry have in common with cardiology? http://www.waitrose.com + Reveal the Funtabulous Answer expand(document.getElementById('ddet1872942130'));expand(document.getElementById('ddetlink1872942130')) The french call it a “Chocola...
Source: Life in the Fast Lane - July 28, 2017 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five Bazett's formula chocolate torsade gentamicin myasthenia gravis pimped renal colic rollercoaster torsades de pointes william harvey Source Type: blogs

Oldie but Goodie Pediatric Clinical Concepts
​A number of older clinical concepts may be unfamiliar to younger clinicians, but these clinical concepts are useful in pediatric medicine. Some of these concepts showed up in the medical literature for the first time nearly a century ago. Physicians should feel free to question the potential value and validity of older clinical concepts that aren't at the forefront of medical education, but my experience of more than 30 years practicing pediatrics and emergency medicine has repeatedly affirmed to me that these are valuable in emergency medicine.​Parenteral DiarrheaThe concept of parenteral diarrhea has been around for...
Source: M2E Too! Mellick's Multimedia EduBlog - March 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Oldie but Goodie Pediatric Clinical Concepts
​A number of older clinical concepts may be unfamiliar to younger clinicians, but these clinical concepts are useful in pediatric medicine. Some of these concepts showed up in the medical literature for the first time nearly a century ago. Physicians should feel free to question the potential value and validity of older clinical concepts that aren't at the forefront of medical education, but my experience of more than 30 years practicing pediatrics and emergency medicine has repeatedly affirmed to me that these are valuable in emergency medicine.​Parenteral DiarrheaThe concept of parenteral diarrhea has been around for...
Source: M2E Too! Mellick's Multimedia EduBlog - March 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Research and Reviews in the Fastlane 135
Welcome to the 135th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Justin Morgenstern, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R ...
Source: Life in the Fast Lane - May 18, 2016 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Disaster Education Emergency Medicine Intensive Care Neurology Pediatrics Pre-hospital / Retrieval Respiratory Resuscitation critical care R&R in the FASTLANE recommendations research and reviews Source Type: blogs

DATA SIMPLIFICATION: Abbreviations and Acronyms
Over the next few weeks, I will be writing on topics related to my latest book, Data Simplification: Taming Information With Open Source Tools (release date March 17, 2016). I hope I can convince you that this is a book worth reading. Blog readers can use the discount code: COMP315 for a 30% discount, at checkout."A synonym is a word you use when you can't spell the other one." -Baltasar GracianPeople confuse shortening with simplifying; a terrible mistake. In point of fact, next to reifying pronouns, abbreviations are the most vexing cause of complex and meaningless language. Before we tackle the complexities of abbre...
Source: Specified Life - March 14, 2016 Category: Information Technology Tags: abbreviations acronyms complexity computer science data analysis data repurposing data simplification simplifying data Source Type: blogs

Sirolimus for Polycystic Kidney Disease
New treatment options for polycystic kidney disease do not come along very often. The nature of the disease is such that treatment is inherently difficult as the pathophysiology is incompletely understood. Despite that various methods are currently being investigated. One such is the drug sirolimus, which  has been mentioned before. More recently however a pilot study performed in adult polycystic kidney disease patients has added further hope that sirolimus may one day be used routinely in this disease. The effect of the drug sirolimus on development and growth of cysts was investigated over 6 consecutive months in 8 pa...
Source: All Kidney News - September 29, 2015 Category: Urology & Nephrology Authors: jadhavbca Tags: Kidney News FSGS TNF Source Type: blogs

Sometimes Medical Care Requires More Than Just A Minute (Clinic)
The truth is, I know it's easy to go to the Minute Clinic.  I know the enticement of not needing an appointment, of being able to shop while you wait, of having the prescription ready to pick up by the end of your appointment.  Who doesn't like convenience and a friendly smile to add?  Who doesn't like the customer service offered at CVS, Target, or your local pharmacy?  I certainly do.  And I know that the doctor's office can be a pain.  I also loathe the annoying phone tree that leads to a tired nurse or secretary, and possibly the hours of waiting to have the physician call you back and tel...
Source: In My Humble Opinion - January 3, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs

Inferior and Lateral ST Elevation and A Positive Troponin
A young woman presented with substernal chest pain described as both crushing and stabbing, with radiation to the jaw and left arm and associated with dyspnea.  It was not positional or pleuritic.  She was otherwise healthy except for an unspecified "recent illness" and recent pyelonephritis.  She denied tobacco or other drug use.Here is her initial ECG:There is sinus rhythm and normal, though low voltage, QRS.  There is inferior and lateral ST elevation., with large T-waves very suggestive of hyperacute T-waves.  Is this MI?  Pericarditis? Early repolarization manifesting in inferior and late...
Source: Dr. Smith's ECG Blog - October 31, 2013 Category: Cardiology Authors: Steve Smith Source Type: blogs

Medical Mispronunciations and Misspelled Words: The Definitive List.
Hearing medical mispronunciations and seeing misspelled words are an under appreciated  joy of working in healthcare.  Physicians often forget just how alien the language of medicine is to people who don't live it everyday.  The best part about being a physician is not helping people recover from critical illness. The best part is not  about  listening and understanding with compassion and empathy.  Nope, the best part about being a physician is hearing patients and other healthcare providers butcher the language of medicine and experiencing great entertainment in the process.   Doctors c...
Source: The Happy Hospitalist - October 2, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs

TWiM 64: URI and UTI at ICAAC
This episode of TWiM was recorded at the 53rd ICAAC in Denver, Colorado, where Michael Schmidt and I spoke with James Gern about rhinoviruses, and James Johnson about extra-intestinal pathogenic E. coli. You can find TWiM #64 at microbeworld.org, or view the video below. (Source: virology blog)
Source: virology blog - September 20, 2013 Category: Virology Authors: Vincent Racaniello Tags: Basic virology Information This Week in Microbiology allergen antibiotic asthma exacerbation common cold escherichia coli ExPec extraintestinal pathogenic fluoroquinoline resistance pyelonephritis respiratory tract rhinovirus S Source Type: blogs