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20-something with huge verapamil overdose and cardiogenic shock
A 20-something presented after a huge verapamil overdose in cardiogenic shock.  He had been seen at an outside institution and been given 6 g calcium gluconate, KCl, and a norepinephrine drip.The initial K was 3.0 mEq/L and ionized calcium was 5.5 mg/dL (sorry, Europeans, for the weird units)Here was the initial ED ECG:There is a junctional rhythm with retrograde P-waves (see the dip in the T-wave in lead II across the bottom; you can follow that up to all the other leads and see the retrograde P wave).  There is also Left Bundle Branch Block (LBBB). There is huge proportionally excessively discord...
Source: Dr. Smith's ECG Blog - May 26, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs

Translational aspect in peptide drug discovery and development: An emerging therapeutic candidate
AbstractIn the last two decades, protein –protein interactions (PPIs) have been used as the main target for drug development. However, with larger or superficial binding sites, it has been extremely difficult to disrupt PPIs with small molecules. On the other hand, intracellular PPIs cannot be targeted by antibodies that cannot penetrate the cell membrane. Peptides that have a combination of conformational rigidity and flexibility can be used to target difficult binding interfaces with appropriate binding affinity and specificity. Since the introduction of insulin nearly a century ago, more than 80 peptide drugs have bee...
Source: BioFactors - November 4, 2022 Category: Biochemistry Authors: Uttpal Anand, Anustup Bandyopadhyay, Niraj Kumar Jha, Jos é M. Pérez de la Lastra, Abhijit Dey Tags: REVIEW ARTICLE Source Type: research

Unstable Angina still exists. It can be missed especially high sensitivity troponin is not used. Sometimes you can catch it on the ECG.
A 50-something woman with H/o HTN, ESRD, CAD S/p complex PCI to ostial LAD and ramus (10/2020) and CABG x3 (LIMA to LAD, SVG to OM, SVG to ramus)She complained of intermittent episodes of substernal chest pain, radiating to left shoulder, lasting 2-3 minutes.This had been worked up before at another ED on 3 occasions for the same chest discomfort.--The 1st time, she was " ruled out " with a point of care (POC) troponin ＜0.03 ng/mL.--The 2nd time, she was " ruled out " again with a POC troponin ＜0.03 ng/mL.--The 3rd time, she " ruled out " with a laboratory-based 4th generation troponin at 0.018 ng/m...
Source: Dr. Smith's ECG Blog - September 5, 2022 Category: Cardiology Authors: Steve Smith Source Type: blogs

Slipped capital femoral epiphysis with hypopituitarism in adults: A case report and literature review
Rationale: Slipped capital femoral epiphysis (SCFE) is a common disease in pediatric orthopedics. Most research on SCFE has focused on high-risk groups or the whole population, and studies focusing on adult SCFE patients are rare. In the present study, we report the case of an adult patient with SCFE. Patient Concern: A 37-year-old man presented to our clinic with persistent pain that was poorly localized to both hips, groin regions, and thighs for more than 1 year. Diagnoses: A bilateral hip X-ray examination was performed, and the femoral epiphyses were found to be unfused on both sides. Low levels of...
Source: Medicine - December 23, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Fight Aging! Newsletter, November 8th 2021
In conclusion, in less common and visible cardiovascular diseases, it is crucial to recognize substantial progress and achievement, given that penetration of such information into clinical practice and the patient community can be inconsistent. Diseases such as hypertrophic cardiomyopathy, pulmonary arterial hypertension, and ATTR cardiac amyloidosis, once linked to a uniformly adverse prognosis, are now associated with the opportunity for patients to experience satisfactory quality of life and extended longevity. VitaDAO, a Novel Approach to Crowdfunding Life Science Research https://www.fightaging.org/archive...
Source: Fight Aging! - November 7, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

Fight Aging! Newsletter, August 30th 2021
Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: https://www.fightaging.org/newsletter/ Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out mo...
Source: Fight Aging! - August 29, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

Identification of an IGF1 mutation (c.15+3G>A) in familial osteonecrosis of the femoral head: A case report
Rationale: Osteonecrosis of the femoral head is a common orthopedic disease. Some studies have shown that osteonecrosis of the femoral head is related to susceptibility genes, but there are few reports of familial osteonecrosis of the femoral head. Here, we reported two first-degree relatives with osteonecrosis of the femoral head. Patient concerns: A 27-year-old man with bilateral hip pain was diagnosed with osteonecrosis of the femoral head. The patient's mother also had a history of this disease. Diagnoses: Whole exome sequencing revealed the same mutation (c.15+3G>A) in the insulin-like growth factor ...
Source: Medicine - January 8, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Inside Schizophrenia: Evolution of Schizophrenia Treatments
Schizophrenia has been around since the dawn of time but actually treating it has only been around the past 100 years. In this episode host and schizophrenic Rachel Star Withers takes you through the dark and disturbing evolution of schizophrenia treatments. From systematic euthanasia to hydrotherapy, electroconvulsive therapy to the infamous lobotomy. Were these doctors “mad scientists” torturing the mentally ill or were they the only ones trying to help a population of people seen as a burden? About our Guest Miriam Posner is an assistant professor at the UCLA School of Information. She holds a Ph.D. in Film ...
Source: World of Psychology - December 9, 2020 Category: Psychiatry & Psychology Authors: Rachel Star Withers Tags: Brain and Behavior General History of Psychology Inside Schizophrenia Mental Health and Wellness Psychiatry Psychotherapy Brain Disorders ECT Electric shock Electroconvulsive Therapy Frontal Lobotomies History Of Mental Illness H Source Type: blogs

Stressful Newborn Memories: Pre-Conceptual, In Utero, and Postnatal Events
In this study, a link between mitochondrial changes and infant temperament has also been suggested. Maternal psychosocial stress and lifetime trauma have been associated with decreased mitochondrial DNA copy number in the placenta (115, 116).IndividualityChronic stress links changes in the epigenetic landscape with health conditions (117). Different cell types are characterized by distinct patterns of gene expression due to developmental, environmental, physiological, and pathological reasons (117). Epigenetic mechanisms affect gene function in a dynamic way as a result of different environmental exposures during fetal dev...
Source: Frontiers in Psychiatry - April 17, 2019 Category: Psychiatry Source Type: research

Ketoacidosis with euglycemia in a patient with type 2 diabetes mellitus taking dapagliflozin: A case report
We report an unusual case of SGLT2 inhibitor-induced euglycemic ketoacidosis recovered by continuous renal replacement therapy in a patient with type 2 diabetes and recurrent acute pancreatitis due to hypertriglyceridemia. We diagnosed a rare complication of the SGLT2 inhibitor in a patient with type 2 diabetes in whom uncontrolled metabolic ketoacidosis could be effectively managed via continuous renal replacement therapy.
Source: Medicine - January 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Time without CGM? No big deal, right?
I am a big fan of continuous glucose monitoring (CGM). I’ve used CGM for a more than a decade. I think it’s a tremendously valuable layer of information, and I’d argue that continuous glucose monitoring has been the the biggest improvement in diabetes since blood sugar monitors became available in the mid 1980s.  Aside from the high and low alerts, continuous monitoring brings so much awareness of blood sugar levels. It’s possible to actually see how food, exercise, insulin, stress, and more play games with our blood sugars – and we can see that in almost real-time. This is something many of...
Source: Scott's Diabetes Blog - October 22, 2018 Category: Endocrinology Authors: Scott K. Johnson Tags: Blog Posts Source Type: blogs

Fight Aging! Newsletter, September 3rd 2018
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 2, 2018 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

Euglycemic diabetic ketoacidosis caused by dapagliflozin: A case report
Rationale: Diabetic ketoacidosis is a serious and potentially life-threatening acute complication of diabetes mellitus (DM). Euglycemic diabetic ketoacidosis (eDKA) is however challenging to identify in the emergency department (ED) due to absence of marked hyperglycemia, often leading to delayed diagnosis and treatment. eDKA has been recently found to be associated with sodium-glucose cotransporter 2 (SGLT2) inhibitors, one of the newest classes of antidiabetics, though there are very limited reports implicating dapagliflozin as the offending agent in ED patients. Here we report a type 2 diabetic patient who presented t...
Source: Medicine - June 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Agenesis of the dorsal pancreas: a rare cause of insulin-dependent diabetes without abdominal painCase report
We report the case of a 23-year-old Chinese woman who visited the Department of Endocrinology and Metabolism with insulin-dependent diabetes but no specific symptoms, signs, or other deformities. Severe diabetic retinopathy indicated a long period of hyperglycemia.Diagnosis:Agenesis of the dorsal pancreas was observed incidentally during the common diagnosis of diabetes, and the diagnosis was established using magnetic resonance imaging, diffusion-weighted imaging, and magnetic resonance cholangiopancreatography.Interventions:Following the diagnosis of diabetes, insulin replacement therapy was initiated at a dosage of up t...
Source: Medicine - March 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

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