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Ditch the Machine to Improve Accuracy in Blood Pressure Measurement and Diagnostics
Conclusion For the patient in this case, the decision to forego the convenience of a machine in favor of the skills of a knowledgeable paramedic was lifesaving. Much like the comparison often drawn between the old-fashioned barbell and more sophisticated exercise machines, newer, more complex, and more expensive might make a process more comfortable, but doesn’t always equate to superior results. As we surrender more and more of our hands-on skills to the ease of automated technology, we risk more than the loss of the aptitudes that form the foundation of sound patient assessment—we place our patients in jeopardy of mi...
Source: JEMS Special Topics - October 24, 2018 Category: Emergency Medicine Authors: Mark Rock, NRP Tags: Exclusive Articles Cardiac & Resuscitation Source Type: news

Acute Aortic Emergencies—Part 2 Aortic Dissections
Patients with aortic disease are some of the highest acuity patients that emergency clinicians encounter. Dissection is the most common aortic catastrophe and involves separation of the aortic layers in a longitudinal fashion leading to diminished perfusion and systemic ischemia. Characteristics of pain, branch vessel involvement, and incidence lead to an understanding of patient presentation, morbidity, and mortality. Diagnosis, selection of diagnostic studies, the degree of preoperative ischemia, and risk of operative mortality can be accomplished using validated clinical decision tools. Emergency interventions are guide...
Source: Advanced Emergency Nursing Journal - January 1, 2013 Category: Emergency Medicine Tags: Cases of Note Source Type: research

Use of the Corus® CAD Gene Expression Test for Assessment of Obstructive Coronary Artery Disease Likelihood in Symptomatic Non-Diabetic Patients
Conclusions The Corus CAD test has been extensively evaluated since it was first derived, including with two prospective multi-center trials. Given the scope of the deleterious effects of CAD and the considerable costs involved in diagnosing obstructive CAD, a blood test that can help in this determination is certainly valuable. The Corus CAD test promises to have an important role in this regard particularly if it continues to perform this well in larger, more diverse cohorts.
Source: PLOS Currents Evidence on Genomic Tests - August 26, 2013 Category: Genetics & Stem Cells Authors: Jose Vargas Source Type: research

Use of the Corus ® CAD Gene Expression Test for Assessment of Obstructive Coronary Artery Disease Likelihood in Symptomatic Non-Diabetic Patients
Conclusions The Corus CAD test has been extensively evaluated since it was first derived, including with two prospective multi-center trials. Given the scope of the deleterious effects of CAD and the considerable costs involved in diagnosing obstructive CAD, a blood test that can help in this determination is certainly valuable. The Corus CAD test promises to have an important role in this regard particularly if it continues to perform this well in larger, more diverse cohorts.
Source: PLOS Currents Evidence on Genomic Tests - August 26, 2013 Category: Genetics & Stem Cells Authors: Jose Vargas Source Type: research

Utility of Radionuclide Bone Scintigraphy in Complex Regional Pain Syndrome
AbstractPurpose of ReviewTo describe the current understanding of the role of three-phase bone scintigraphy (TPBS) in the diagnosis and management of complex regional pain syndrome (CRPS), discuss its advantages and limitations, and present three examples of TPBS patterns typically seen in CRPS patients.Recent FindingsCRPS is a debilitating disorder frequently presenting with pain to ordinarily non-painful stimuli, redness, swelling, following fractures, stroke, myocardial infarction, surgery, or even minor trauma, and its diagnosis, based on clinical criteria and supportive imaging findings, is difficult. Of the available...
Source: Current Pain and Headache Reports - February 1, 2018 Category: Neurology Source Type: research

Rates of Referral to Coronary Angiography After Positron Emission Tomography (PET) Myocardial Perfusion Imaging (MPI)
Conclusions: About 1 in 5 patients undergoing PET MPI are referred for coronary angiography within 90 days of testing, a rate greater than that reported for SPECT MPI, likely due to higher baseline risk of patients undergoing PET MPI testing. While referral rates for coronary angiography varied based on the presence or absence of prior documented clinical CAD and presence of test abnormalities, nearly 36% of patients with moderate-severe ischemia were not referred. Further work is needed to characterize why such patients are not referred for invasive evaluation to optimize the use of PET MPI in this high-risk population.
Source: Journal of Nuclear Medicine - May 23, 2018 Category: Nuclear Medicine Authors: Patel, K., Spertus, J., Kureshi, F., Al Badarin, F., McGhie, A., Kennedy, K., Courter, S., Case, J., Thompson, R., Chan, P., Bateman, T. Tags: Cardiovascular Clinical Science Poster Session Source Type: research

Fool Me Once: An Uncommon Presentation of PE
​BY FREDDIE IRIZARRY-DELGADO; VAROON KAKAIYA; & AHMED RAZIUDDIN, MDAn 86-year-old African-American woman was brought to the ED by her daughter after two days of nutritional neglect, abdominal pain, and altered mental status. Her daughter said her mother felt lightheaded, appeared dehydrated, and vomited nonbilious watery fluid once. The patient had a history of diabetes mellitus type 2, DVT/PE, dementia, and early signs of parkinsonism.Her vital signs were remarkable only for tachypnea (24 bpm). Her troponin I was markedly elevated at 1.7 ng/mL. A D-dimer was ordered because of her history of unprovoked DVT/PE, and i...
Source: The Case Files - November 27, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research