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Failing Mitochondria and Cellular Senescence in the Aging Lung
Mitochondrial dysfunction and cellular senescence are two of the root causes of aging targeted by the SENS rejuvenation research programs. They overlap at least a little, in that one might cause the other, but it is unclear as to whether this is significant for the specific types of mitochondrial damage considered important in the SENS view of aging. The open access paper here walks through this territory in the case of the aging lung; in recent years, it has become clear that senescent cells are important in the development of fibrosis in lungs and other organs, as well as in other aspects of aging in lung tissue. The pre...
Source: Fight Aging! - November 21, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Health Affairs Puts The Place Of Technology In Health Care In A Larger Perspective.
This appeared last week:How The Rise Of Medical Technology Is Worsening DeathJessica Nutik Zitter November 6, 2017 10.1377/hblog20171101.612681 Our aging population is at risk from a most benign-appearing source —the medical technologies we trust to keep us healthy.When they were first widely used in the 1930s and 1940s, breathing machines did what humans could never have imagined a generation earlier: They kept young polio victims alive until their bodies cleared the virus that had temporarily weakened t heir respiratory system. Thanks to these miraculous machines, tens of thousands of these patients recovered and ...
Source: Australian Health Information Technology - November 15, 2017 Category: Information Technology Authors: Dr David More MB PhD FACHI Source Type: blogs

Data Driven Predictive Medical Devices: An Interview
In 1987, James Gleick wrote the book Chaos which was a layman’s description of different instances where chaotic behavior was displayed in systems. In one of the last chapters titled Inner Rhythms, he described the then latest research regarding physiological system characteristics and the seemingly oxymoronic idea that variable response of the system indicated health versus illness, specifically with regard to heart rate variability, and that these systems exhibited characteristics of nonlinear dynamics in which physiologists ‘began to see chaos as health.’ That book, which I read in 1988, and in particu...
Source: Medical Connectivity Consulting - November 13, 2017 Category: Information Technology Authors: Tim Gee Tags: Clinical Decision Support Interviews Source Type: blogs

Multi-Purpose Soft Mist Inhaler Produces Different Size Medication Droplets
Pneuma Respiratory, a young company out of Boone, North Carolina, has announced that it developed a digital soft mist inhaler that can be set to deliver different size drug particles to the lungs, and that works with a variety of medications including large-molecule compounds. The company’s droplet ejector technology generates whichever size droplets are preferred and intelligently injects the soft mist into the air stream as the patient breathes in from the inhaler. Having different size droplets may significantly help improve a drug’s effectiveness, as the droplet’s size plays a role in determining whic...
Source: Medgadget - November 13, 2017 Category: Medical Devices Authors: Editors Tags: Medicine Pediatrics Thoracic Surgery Source Type: blogs

Sleep Sensors for Data-Driven Asthma Management: Interview with Tueo Health ’s Dr. Bronwyn Harris
About 10% of children between 5-17 years of age, or more than 7 million kids in the US alone, suffer from asthma. In half of these cases, the child’s asthma is not well controlled. This is typically due to a variety of reasons, such as inconsistent use of inhalers or the inability of parents or caregivers to successfully identify signs of poor asthma control. Given the difficulty that families face in keeping track of their child’s symptoms, solutions that enable better measurement of asthma control are urgently needed. That’s why Tueo Health (pronounced as “too-ee-oh”) , a startup out of Stan...
Source: Medgadget - November 13, 2017 Category: Medical Devices Authors: Mohammad Saleh Tags: Exclusive Medicine Pediatrics Source Type: blogs

NYTimes: The Growing Toll of Our Ever-Expanding Waistlines
The Growing Toll of Our Ever-Expanding WaistlinesBy  JANE E. BRODY NOV. 13, 2017Paul Rogers I hope you ’re not chomping on a bagel or, worse, a doughnut while you read about what is probably the most serious public health irony of the last half century in this country: As one major killer — smoking — declined, another rose precipitously to take its place: obesity.Many cancer deaths were averted after millions quit lighting up, but they are now rising because even greater numbers are unable to keep their waistlines in check.Today, obesity and smoking remain the two leading causes of pre...
Source: Dr Portnay - November 13, 2017 Category: Cardiology Authors: Dr Portnay Source Type: blogs

Drug price hikes sometimes have catastrophic effects on patients
When I found out my patient was in the hospital again for the third time in six months, I wondered why her asthma had flared. Was the cold weather bothering her? Was her treatment regimen inadequate? When I spoke with her, I discovered the heartbreaking truth: she had been limiting her albuterol inhaler use because she simply could not afford to take it as much as she needed. For many of the over 600,000 Massachusetts residents who suffer from asthma, albuterol is a necessity. Albuterol inhalers allow asthmatics to go about their lives without worrying about the threat of debilitating respiratory attacks. Un...
Source: Kevin, M.D. - Medical Weblog - November 9, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/zoe-tseng-and-suhas-gondi" rel="tag" > Zoe Tseng, MD and Suhas Gondi < /a > Tags: Meds Public Health & Policy Pulmonology Source Type: blogs

An Ingredient Technology Company Powering the World of Wearables: Interview with Valencell VP Ryan Kraudel
At Medgadget, we cover a lot of digital health devices and wearables. Some are developed by startups, while others come from brand name businesses that have branched out into this new and growing market. A common thread among most of the digital health technologies covered is the need to record data through various sensor technologies. However, most companies do not have the intellectual property or capability to develop sensors themselves and instead turn to “ingredient technology” companies to provide these components. Valencell is one of these ingredient technology companies, making some of the sensors ...
Source: Medgadget - November 8, 2017 Category: Medical Devices Authors: Michael Batista Tags: Diagnostics Exclusive Source Type: blogs

High flow nasal canula: a game changer in respiratory medicine
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - November 7, 2017 Category: Internal Medicine Tags: critical care pulmonary Source Type: blogs

High flow nasal cannula in hypoxemic respiratory failure
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - November 4, 2017 Category: Internal Medicine Tags: critical care pulmonary Source Type: blogs

Sharing Negotiated Discounts Could Save Patients Money
Providing access to discounted medicine prices at the point of sale (i.e., at the pharmacy directly) could save certain commercially insured patients with high deductibles and coinsurance anywhere between $145 to more than $800 annually, according to a new analysis from Milliman that was commissioned by the Pharmaceutical Research and Manufacturers of America (PhRMA). The data also show sharing negotiated rebates with patients would have a minimal impact on premiums because it would only increase health plan costs on average 1 percent or less. “Shifting costs to the sickest patients by requiring higher rates of cost...
Source: Policy and Medicine - November 3, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

From Data Management to Leader in Healthcare Informatics: Interview with Information Builders ’ Michael Corcoran
In an age in which data is generated at faster rates than ever before, the struggle to streamline and interpret the plethora of available information has been the core driver for many business analytics companies. The challenge is arguably more pressing in an environment as complex as a hospital, where data is constantly gathered at every bedside and where decisions often differentiate between life and death. While healthcare institutions have historically attempted to keep track of best practices, it remains difficult for high-level administrators to consider the holistic picture and make data-driven decisions. Informatio...
Source: Medgadget - November 2, 2017 Category: Medical Devices Authors: Mohammad Saleh Tags: Exclusive Informatics Public Health Source Type: blogs

World ’s First MRI Compatible Patient Monitor Cleared by FDA
Traditional vital signs monitors found in most patient hospital rooms can’t be taken into the MRI suite, as that may lead to tragicomic consequences. A patient requiring close monitoring has to be transferred to a specialty monitor attached to a heavy cart that prevents it from being sucked into the bore of the MRI’s magnet, or monitor has to be kept outside of the the MRI room. That’s about to change thanks to FDA clearing the Iradimed 3880 MRI compatible patient vital signs monitoring system. The patient can now be transported from the ER or ICU, directly to the MRI suite and back, without stopping and&...
Source: Medgadget - November 2, 2017 Category: Medical Devices Authors: Editors Tags: Anesthesiology Cardiology Critical Care Radiology Source Type: blogs

The Modern-Day Plague
​Part 1 in a Four-part SeriesA 32-year-old man was taken to the ED by EMS after being found unresponsive in a subway station. His pupils were pinpoint, and he was breathing at fourth breaths per minute. He had a blood pressure of 94/63 mm Hg, pulse oximetry of 91% on room air, and a heart rate of 51 beats per minute. He was given 2 mg of intranasal Narcan by EMS and became more responsive, breathing at 14 breaths per minute with a blood pressure of 125/82 mm Hg, heart rate of 74 bpm, and 98% on room air. He admitted in the ED to using three bags of heroin.​The opioid epidemic is a national public health crisis in the U...
Source: The Tox Cave - November 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Fix the system to address physician burnout
The prevalence of burnout among physicians is estimated to be more than 50 percent and has grown in recent years. This alarming trend is largely due to changing patient demographics, increasing cost constraints, new federal and state regulations, and other external factors that have reshaped the daily work experience of physicians. Too often today, physicians spend more time on data entry than in direct patient care. Professional burnout, as it has been defined by researchers, is a response to stress in the workplace. It consists of three components: emotional exhaustion, depersonalizatio...
Source: Kevin, M.D. - Medical Weblog - October 31, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/diane-w-shannon" rel="tag" > Diane W. Shannon, MD, MPH < /a > Tags: Physician Health IT Hospital-Based Medicine Primary Care Psychiatry Source Type: blogs

Technologies Change Health Insurance: The Most Innovative Ventures
The accumulation of medical data enables health insurance companies to move from the 100-year-old concept of reactive care to preventive medicine. The future points to simple, fast and highly personalized insurance plans based on information from the healthcare system and data from health sensors, wearables, and trackers. Here is the changing health insurance scene and its most innovative solutions! Health insurance systems are unsustainable partly due to costly chronic diseases According to OECD predictions, exceeding budgets on health spending remains an issue for OECD countries. Maintaining today’s healthcare...
Source: The Medical Futurist - October 31, 2017 Category: Information Technology Authors: nora Tags: Future of Medicine Healthcare Design big data chronic illness digital digital health gc3 health data health insurance healthcare data technology trackers wearables Source Type: blogs

PP interval
Short Notes PP interval is the interval between the P waves due to atrial depolarization (measured from the onset of one P wave to the onset of the next P wave). PP interval is used to calculate the atrial rate. In sinus rhythm, PP interval and RR interval are the same. Hence atrial rates and ventricular rates are not calculated separately. But when there is AV (atrioventricular) dissociation as in complete heart block, atrial rate is different from the ventricular rate. In complete heart block, PP interval is shorter than the RR interval, meaning that atrial rate is higher than the ventricular rate. In ventricular ...
Source: Cardiophile MD - October 29, 2017 Category: Cardiology Authors: Johnson Francis Tags: Heart Disease FAQ Source Type: blogs

Test almost all of your most important ECG rhythm interpretation skills with this case.
Sent by Anonymous, written by Meyers, edits by Smith:A female in her 70s with history of HTN woke up around 2am with severe shortness of breath. EMS found the patient in moderate respiratory distress, hypoxemic on room air, with diffuse rales. CPAP was initiated. The prehospital ECG is unavailable but reportedly showed a wide complex regular tachycardia at around 150 bpm. 150mg amiodarone was given for presumed VT with no obvious effect.She arrived at the ED at 2:52 AM. She had normal mental status, and was in moderate respiratory distress with diffuse rales, with respiratory rate 30/min, and initial blood pressure 129/60....
Source: Dr. Smith's ECG Blog - October 26, 2017 Category: Cardiology Authors: Pendell Source Type: blogs

Respiratory syncytial virus: Are we making any progress?
It’s fall in the PICU, and we just saw our first severe case of respiratory syncytial virus (RSV) of the season. RSV is by far the most common cause of bronchiolitis in infants. To scientists, RSV is a fascinating virus with several unique properties. One of these is its behavior in the population. When it’s present, RSV is everywhere. Then it suddenly vanishes. There are exceptions to everything in medicine — I have seen sporadic cases during the off-months– but generally RSV arrives with a bang in mid-winter and then leaves suddenly in the spring. It’s the only virus that cons...
Source: Kevin, M.D. - Medical Weblog - October 23, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/christopher-johnson" rel="tag" > Christopher Johnson, MD < /a > Tags: Conditions Critical Care Pediatrics Source Type: blogs

The hurricane in Puerto Rico is leading a shortage in saline bags
“Doc, you mind switching that to an oral preparation?” our clinical pharmacist inquired during multi-disciplinary rounds as intravenous infusion devices beeped annoyingly in the background.  Taking care of ICU patients can be extraordinarily complicated, so doing it as part of a team helps make sure that all bases are covered. Like many hospitals, ours uses a multidisciplinary model which makes rounds on all patients in the ICU.  An ICU nurse, clinical pharmacist, dietitian,  social worker, pastoral care, respiratory therapist, each provides important insight and perspective that guides patient c...
Source: Kevin, M.D. - Medical Weblog - October 17, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/deep-ramachandran" rel="tag" > Deep Ramachandran, MD < /a > Tags: Physician Critical Care Source Type: blogs

X-Ray Locates a Toy Traffic Cone Stuck in Patient ’s Lungs
Kids have a unique knack for getting toys stuck up their nose or surreptitiously digesting them. As stressful as it might be when they swallow a figurine or trinket, seldom do we imagine that this kind of accident could manifest into a false cancer diagnosis down the road. But, that ’s what happened to one British man who had a Playmobil traffic cone stuck in his lungs for 40 years. The 47-year-old patient struggled with several respiratory issues including coughing and excess mucus. Initially, he was treated for pneumonia, after which his physicians noted some improvement. Yet, the symptoms persisted, so he underwen...
Source: radRounds - October 13, 2017 Category: Radiology Authors: Julie Morse Source Type: blogs

Mastering Intensive Care 018 with John Marshall
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog John Marshall – Getting patients out of the ICU as soon as we can Are your ICU patients ever in a holding pattern? Do you aim to liberate your patients from ICU as soon as possible? Is your caution about moving things forward harmful to our patients? I don’t think we talk often enough about the dangers of conservatism in intensive care. About how if we are cautious in thinking the patient is not quite ready to be extubated, or have the sedation turned off...
Source: Life in the Fast Lane - October 13, 2017 Category: Emergency Medicine Authors: Andrew Davies Tags: Intensive Care Mastering Intensive Care Andrew Davies dangers of conservatism John Marshall Source Type: blogs

Human Metapneumovirus in India
As of October 2017, the Gideon database (www.GideonOnline.com) chronicles 57,331 prevalence- and seroprevalence surveys.  Data relevant to Human metapneumovirus in India follow below. 60% of New Delhi children below age 5 years were found to be seropositive toward Human metapneumovirus, increasing to>80% by age 55 years (2011 publication)   Prevalence surveys: 2004 – 2005 / Delhi / 12% of acute respiratory infections in children below age 5 years 2005 – 2007 / Delhi / 3% of children with acute respiratory infection 2005 – 2007 / Delhi / 3.6% of children (
Source: GIDEON blog - October 12, 2017 Category: Databases & Libraries Authors: Dr. Stephen Berger Tags: Epidemiology Source Type: blogs

This is who ’s to blame for the opioid crisis
“Do not get caught” seems to be the real rule of the law in South Florida, where I live. I was trained to limit the use of controlled substances, narcotics, hypnotics and sedatives. Their use can affect consciousness, ability to drive a car and work.  More severe consequences include respiratory depression and overdose from too high of a dosage or mixing too many medications and over the counter items. The Joint Commission, medicine’s good housekeeping seal of approval authority, along with major medical organizations have accused clinicians of undertreating pain. “Pain is the fifth vital sign,...
Source: Kevin, M.D. - Medical Weblog - October 11, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/steven-reznick" rel="tag" > Steven Reznick, MD < /a > Tags: Physician Pain Management Primary Care Source Type: blogs

Is “Nonteaching” a Bad Word?
By: Allen B. Repp, MD, MSc, professor and vice chair for quality, Department of Medicine, The Larner College of Medicine at The University of Vermont, Burlington, Vermont For years I’ve been trying to eradicate a word from my vocabulary.  Yet, in my role as an academic hospitalist, I still find myself uttering it almost every day.   Everyone around me is saying it, too.  The word isn’t vulgar.  It’s “nonteaching.” What does it mean? Medicine services at many academic medical centers (AMCs) in the US are divided into teaching and nonteaching services.  Teaching ser...
Source: Academic Medicine Blog - October 10, 2017 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective competencies medical education patient care residency residents Source Type: blogs

Though Much Maligned, BVM is a Good Tool
​I’ve heard for years in emergency medicine circles that it was impossible to preoxygenate with a bag-valve mask (BVM) unless one is actually compressing the bag and forcing oxygen flow to the patient. I recently did an informal survey of my colleagues at work, and the responses varied from confident affirmation that the BVM was an inadequate tool for preoxygenation to quasi-warnings not to tread on this dogma without first consulting anesthesia or respiratory therapy. What started as a simple quest to clarify whether the dogma about BVMs and preoxygenation was true turned into a fascinating review and new personal...
Source: M2E Too! Mellick's Multimedia EduBlog - October 5, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

The Proof is the Bottle
​An 18-year-old woman presented for altered mental status. EMS reported that she was at a beach party when she became unresponsive. Friends said she may have been drinking alcohol, but denied other illicit drug use. Initial vital signs included a blood pressure of 117/69 mm Hg, heart rate of 110 bpm, respiratory rate of 11 bpm, SPO2 99% on room air, and a temperature of 98.9°F. ​The patient was somnolent and reacted intermittently to physical stimuli on exam. She intermittently moved all four extremities. Her gag reflex was intact. Pupils were 4 mm bilaterally reactive without nystagmus. She had tachycardia, her lu...
Source: The Tox Cave - October 2, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

A Case of Missing Teeth
​An older man presented to the emergency department for respiratory complaints, and a routine series of studies—blood work, ECG, and a chest x-ray—almost automatically appeared in the orders.​Haziness on the left side—left hilar fullness probably isn't good. A CT scan would likely confirm the fears of cancer.​The large mass wasn't unexpected, but did you see the metallic foreign body in the stomach? There was something on the left side under the diaphragm on the upright chest radiograph. The same thing appeared on the coronal CT image. Did he swallow something?Upon detailed questioning, the patient ...
Source: Lions and Tigers and Bears - October 2, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Masimo ’s Smaller, More Comfy RAS-45 Acoustic Respiration Sensor Released Globally
Masimo is now making fully available its RAS-45 acoustic respiration sensor that works with the company’s rainbow Acoustic Monitoring platform and that is compatible with both adult and pediatric patients. It performs the same as the RAS-125c sensor, but being considerably smaller and featuring a more flexible adhesive, it is easier to put on and more comfortable to wear, particularly for children and adults with stubby necks. The sensor provides continuous respiratory rate, its waveform, as well as the ability to actually listen to the sounds being detected directly from the sensor. It relies on Masimo&rsq...
Source: Medgadget - September 29, 2017 Category: Medical Devices Authors: Editors Tags: Anesthesiology Cardiology Critical Care Medicine Pediatrics Source Type: blogs

Fight Aging! Newsletter, September 25th 2017
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - September 24, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

In Iraq I saved lives. Now, I can ’t give an allergy shot.
I entered the room to see a face that I recognized. As soon as I looked at my chart, I immediately knew this patient. I saved their life last year. I know this because the patient told me so. The teachers and mentors that I was privileged to learn from and train with 25 years ago emphasized the essential principle of osteopathic medicine — we make physical contact with our patients. Some of this is in the form of manual medicine skills to help balance the musculoskeletal, respiratory, lymphatic and digestive systems, and some of this contact is in the form of a thorough, focused physical exam. Some of the contact occ...
Source: Kevin, M.D. - Medical Weblog - September 18, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/todd-fredricks" rel="tag" > Todd  Fredricks, DO < /a > Tags: Physician Allergies & Immunology Primary Care Public Health Policy Source Type: blogs

Reviewing the Effects of Exercise on Mitophagy and Mitochondrial Function
Mitochondrial damage is important in aging, and many of the means shown to modestly slow aging in various species involve increased cellular maintenance activities directed towards mitochondria. One of these is mitophagy, a specialized form of autophagy that recycles damaged mitochondria. There is plenty of evidence to suggest that more efficient mitophagy is good for long-term health. There is also plenty of evidence for increased autophagy of all sorts to be one of the more important mediating mechanisms in many of the interventions shown to slow aging in laboratory species, including the long-studied and simple approach...
Source: Fight Aging! - September 18, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Mastering Intensive Care 016 with Charles Gomersall
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Charles Gomersall – Training junior doctors in the BASIC practice of intensive care How did you feel the first day you worked in ICU? Was it like walking on the moon? So foreign, because you didn’t understand much about the machines, the techniques, or even the words that were being used. That’s what it felt like for me, all those years ago. Thanks to one of my consultants who really “held my hand” on that first day, I was OK, but I wi...
Source: Life in the Fast Lane - September 18, 2017 Category: Emergency Medicine Authors: Chris Nickson Tags: Education Andrew Davies basic charles gomersall Mastering Intensive Care training doctors Source Type: blogs

Fight Aging! Newsletter, September 18th 2017
In this study, researchers put some numbers to the correlation, and improve on previous attempts to rule out wealth and other effects as significant contributing causes. A study finds that a Chinese policy is unintentionally causing people in northern China to live 3.1 years less than people in the south, due to air pollution concentrations that are 46 percent higher. These findings imply that every additional 10 micrograms per cubic meter of particulate matter pollution reduces life expectancy by 0.6 years. The elevated mortality is entirely due to an increase in cardiorespiratory deaths, indicating that air poll...
Source: Fight Aging! - September 17, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

Funtabulously Frivolous Friday Five 205
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 205. Question 1 Meigs’ Syndrome resolves after removal of the tumour. What is the classic triad of Meigs’ Syndrome? + Reveal the Funtabulous Answer expand(document.getElementById('ddet771338363'));expand(document.getElementById('ddetli...
Source: Life in the Fast Lane - September 15, 2017 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five allergic bronchopulmonary aspergillosis Argyll Robertson aspergilloma aspergillus Calabar extrinsic allergic alveolitis invasive aspergillosis kartagener's syndrome liver Loa loa worms Meigs syndrome ocular oa Source Type: blogs

Wide Complex Tachycardia: is the patient stable or unstable?
Here is another case written by Pendell Meyers, a G2 at Stony Brook. As I mentioned before, Pendell will be helping to edit and write the blogSpecial thanks to Dr. Atif Farooqi who cracked this case for me.CaseA male in his 50s with history of " SVT with two prior failed ablations " presented for acute onset palpitations and shortness of breath. He appeared mildly short of breath and diaphoretic, but he was mentating perfectly, laughing about how many times he had been in this same situation. His initial automatic BP was 83/51, immediate manual pressure was 98/58.Before we even get to his ECG, is he &qu...
Source: Dr. Smith's ECG Blog - September 14, 2017 Category: Cardiology Authors: Pendell Source Type: blogs

Joint Commission Releases Report Regarding Pain Assessment and Management Standards
The Joint Commission recently released a report to help hospitals better understand and comply with new pain assessment and management standards that will be applicable to all Joint Commission-accredited hospitals, effective January 1, 2018. An independent, not-for-profit organization, The Joint Commission accredits and certifies over 21,000 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards. The August 29, 2017, issue of ...
Source: Policy and Medicine - September 14, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

FDA Warns Cipher Over “Misleading” Marketing Materials
The United States Food and Drug Administration (FDA) Office of Prescription Drug Promotion (OPDP) sent a warning letter to Cipher Pharmaceuticals over promotional materials for its combination immediate- and extended-release opioid tramadol hydrochloride, ConZip. The warning letter, addressed to Cipher President and CEO Robert Tessarolo, states that marketing materials for ConZip directed at healthcare providers are “false or misleading” because they omit “important risk information” regarding the use of ConZip and because of other “material facts.” The FDA said the promotional materia...
Source: Policy and Medicine - September 12, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Guest Post from Dr. PJ Cimino: Blue discoloration of the gray matter in a patient who received methylene blue for respiratory distress prior to death
Dr. PJ Cimino, whom weprofiled when he was a fellow back in November of 2013, is a now faculty member at the University of Washington. I was delighted to receive this email from him today:" I had an autopsy case with interesting gross pathology findings, which made for some nice clinical images (below). The patient received therapeutic methylene blue in the setting of respiratory distress prior to death. The gross pathology showed striking widespread green-blue gray matter discoloration. I thought these images might be of interest to share with the general neuropatholgy community, and thought your blog might be a...
Source: neuropathology blog - September 11, 2017 Category: Radiology Tags: anatomy Source Type: blogs

Follicle-Stimulating Hormone in Long-Lived Mice
It has been quite a number of years since researchers first produced dwarf mice with disabled growth hormone or growth hormone receptors, some of which still hold the record for engineered mouse longevity. Using these mice as a point of comparison to further map metabolism and aging continues to be an ongoing process, as illustrated by this open access paper. In it, the authors discuss the role of just one of many regulatory genes that might be important in many of the methods that have been used to slow aging in mice. Cellular biochemistry is enormously complex, and thus so are the details of the changes that occur...
Source: Fight Aging! - September 11, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Fight Aging! Newsletter, September 11th 2017
This study developed the first procedure for the removal of epithelium from the lung airway with the full preservation of vascular epithelium, which could be applied in vivo to treat diseases of lung epithelium. Whole lung scaffolds with an intact vascular network may also allow for recellularization using patient-specific cells and bioengineering of chimeric lungs for transplantation. In addition to the clinical potential, lung scaffolds lacking an intact epithelial layer but with functional vascular and interstitial compartments may also serve as a valuable physiological model for investigating (i) lung development, (ii)...
Source: Fight Aging! - September 10, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

The Case For Confronting Long-Term Opioid Use As A Hospital-Acquired Condition
The first principle of medicine is to “do no harm.” Over the past two decades, the medical community has attempted to honor this principle by treating patient pain with opioid prescriptions. Unfortunately, these good intentions have driven an epidemic of opioid addiction and drug overdoses, now the leading cause of accidental death in the United States. Inpatient overprescription of opioids such as morphine, oxycodone, and hydrocodone happens in a variety of ways—doctors prescribe too many doses, too large a dose, or allow patients to continue opioid treatment for too long. And many times, doctors could a...
Source: Health Affairs Blog - September 8, 2017 Category: Health Management Authors: Michael Schlosser, Ravi Chari and Jonathan Perlin Tags: Featured Health Professionals Hospitals Population Health hospital-acquired condition opioid epidemic overprescribing opioids pain management Source Type: blogs

Reduced Mitochondrial Fusion or Increased Fission Slows Aging in Flies
In this study, the condition was delayed after flies were given more Drp1. In another part of the experiment, also involving middle-aged fruit flies, the scientists turned off a protein called Mfn that enables mitochondria to fuse together into larger pieces. Doing so also extended the flies' lives and improved their health. "You can either break up the mitochondria with Drp1 or prevent them from fusing by inactivating Mfn. Both have the same effect: making the mitochondria smaller and extending lifespan." Promoting Drp1-mediated mitochondrial fission in midlife prolongs healthy lifespan of Drosop...
Source: Fight Aging! - September 6, 2017 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs

SmartTouch for Symbicort Smart Inhaler Cleared by FDA
Adherium, a company out of Auckland, New Zealand, won FDA clearance to introduce its SmartTouch for Symbicort device that monitors and promotes prescribed inhaler usage. Symbicort is an inhaled medication used to treat symptoms of asthma and COPD. The device is placed over the inhaler itself and, once paired with the patient’s smartphone, records every time the inhaler is used. Usage of the medication is shared with the patient’s physician who can make medication changes based on the data. In addition, the app motivates the user to stay on the schedule in the prescription, helping to improve compliance in ...
Source: Medgadget - September 5, 2017 Category: Medical Devices Authors: Editors Tags: Medicine Source Type: blogs

What ’s up with hiccups?
Follow me on Twitter @RobShmerling If you do an Internet search on “hiccups” you’ll find lots of supposed cures for this annoying but usually fast-passing condition — one site lists 250 of them! One thing you won’t find, though, is a good reason for why we hiccup. Hiccupping is a more complex reflex than it might seem: a sudden contraction or spasm of the diaphragm and the muscles between the ribs makes you inhale quickly and involuntarily. It ends with “glottic closure” — the space in the throat near the vocal cords snaps shut, producing the typical hiccup sound. The technic...
Source: Harvard Health Blog - September 5, 2017 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Health Source Type: blogs

Fight Aging! Newsletter, September 4th 2017
In conclusion, KPE delays intrinsic skin aging process by inhibiting cellular senescence and mitochondrial dysfunction. KPE does not only attenuate cellular senescence through inhibition of the p53/p21, p16/pRb, and PI3K/AKT signaling pathways but also improve mitochondrial biogenesis through PGC-1α stimulation. Consequently, KPE prevents wrinkle formation, skin atrophy, and loss of elasticity by increasing collagen and elastic fibers in hairless mice. The Society for the Rescue of our Elders https://www.fightaging.org/archives/2017/08/the-society-for-the-rescue-of-our-elders/ The Society for the...
Source: Fight Aging! - September 3, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

How to Be Cool
​A 27-year-old man with an unknown past medical history presented with altered mental status. Bystanders found him on the sidewalk acting strangely, according to EMS. The patient was drowsy with incomprehensible speech on arrival. He was diaphoretic, tachycardic, and combative. No signs of trauma were noted. His heart rate was 130 bpm, blood pressure 169/90 mm Hg, respiratory rate 30 bpm, SPO2 98% on room air, and temperature 105.3°F. His blood glucose was 150. The patient continued to be minimally responsive.​Etiologies of HyperthermiaNeuroleptic malignant syndromeSerotonin syndromeAnticholinergic syndromeSympatho...
Source: The Tox Cave - September 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Funtabulously Frivolous Friday Five 203
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 203. Question 1 Which Welsh comedian died on stage whilst performing live at Her Majesty’s Theatre? + Reveal the Funtabulous Answer expand(document.getElementById('ddet899544536'));expand(document.getElementById('ddetlink899544536')) Tommy Coope...
Source: Life in the Fast Lane - September 1, 2017 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five beri beri botox botulinum cardiac arrest carolina reaper chillies ghost pepper smoke alarms tommy cooper Source Type: blogs

Podcasting with the Curbsiders – please listen!
I just had the great honor of being a repeat guest for the Curbsiders.  Published today, we discuss #54: Upper Respiratory Infections: Coughs, colds, gargling, and antibiotic underuse?! Regular readers can probably imagine my comments.  I mostly focused attention on defining when upper respiratory infections are not routine.  As I have written previously, while we do not want to prescribe unnecessary antibiotics, we also do not want to withhold necessary antibiotics.  My concern with most guidelines and algorithms is the lack of specificity in defining routine bronchitis, sinusitis or pharyngitis in the...
Source: DB's Medical Rants - August 28, 2017 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

More Evidence to Reinforce " Use It or Lose It, " Even in Later Life
Most older people exercise the body and mind far less than they should; as a consequence some degree of the frailty observed in old age in wealthier parts of the world is preventable, a case of neglect rather than unavoidable outcome. You can't choose not to age, yet, but you can choose to exert yourself in order to make matters better than they would otherwise be. There are plenty of studies to show that, even in very late life, greater levels of mental and physical activity produce benefits. In this paper, the researchers dig deeper to see if certain forms of activity can be tied to specific benefits in cognitive functio...
Source: Fight Aging! - August 28, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs