Why COVID PCR tests aren ’t as accurate as you think
Recently, I started suspecting that RT-PCR testing was not foolproof at ruling out COVID disease after seeing a fair number of patients with typical signs and symptoms but a negative PCR. I have encountered some patients hospitalized with typical COVID pattern pneumonia, thromboembolism with multiple negative PCR tests. Some of these folks even had exposure […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - January 4, 2021 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/balram-khehra" rel="tag" > Balram Khehra, MD < /a > < /span > Tags: Conditions COVID-19 coronavirus Infectious Disease Source Type: blogs
Fight Aging! Newsletter, January 4th 2021
The objective of this study is to quantify the overall and cancer type-specific risks of subsequent primary cancers (SPCs) among adult-onset cancer survivors by first primary cancer (FPC) types and sex. Among 1,537,101 survivors (mean age, 60.4 years; 48.8% women), 156,442 SPC cases and 88,818 SPC deaths occurred during 11,197,890 person-years of follow-up (mean, 7.3 years). Among men, the overall risk of developing any SPCs was statistically significantly higher for 18 of the 30 FPC types, and risk of dying from any SPCs was statistically significantly higher for 27 of 30 FPC types as compared with risks in the general po...
Source: Fight Aging! - January 3, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
The Health Improving Effects of Aspirin Depend on Autophagy
Many groups are attempting to develop calorie restriction mimetic drugs that produce benefits to health - and slow the progression of aging - by triggering some fraction of the stress response mechanisms engaged by the practice of calorie restriction. The most notable such mechanism is autophagy, a collection of cellular housekeeping processes that recycle damaged proteins and structures in the cell. Greater efficiency or activation of autophagy is a feature of a great many interventions known to slow aging in laboratory species.
Based on existing data, we should not expect any of these therapies to move the needle ...
Source: Fight Aging! - December 30, 2020 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
ECMO – Extracorporeal membrane oxygenation
ECMO – extracorporeal membrane oxygenation
ECMO – Extracorporeal membrane oxygenation – has been in use for the past four decades to support persons who are unlikely to survive with mechanical ventilation. ECMO is used in both adult and pediatric practice, though in the initial years, use of ECMO was restricted to pediatric intensive care. The enthusiasm for use of ECMO in adults have been triggered by the beneficial effect noted during the last H1N1 influenza pandemic [1]. In contrast from cardiopulmonary bypass which is used for a short period during cardiac surgery, ECMO is used to support for a ...
Source: Cardiophile MD - December 26, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiac Surgery Source Type: blogs
A 50 year old man with sudden altered mental status and inferior STE. Would you give lytics? Yes, but not because of the ECG!
DiscussionFlutter waves are well known to mimic ST deviations, as well as to hide true ischemic ST deviations from the interpreter. In many cases of flutter waves mimicking ST deviations, the expert electrocardiographer can see the morphology of the flutter waves as the cause of apparent STE or STD. Likewise, in some cases of ischemia concealed by flutter waves, the ischemia can be seen despite the flutter waves, whereas in other cases the dysrhythmia must be terminated before the ischemia can be clearly distinguished. Even when flutter waves conceal true ST segment deviations, the cause and effect relationship may be...
Source: Dr. Smith's ECG Blog - December 26, 2020 Category: Cardiology Authors: Pendell Source Type: blogs
Modified Blalock – Taussig shunt
The original Blalock – Taussig (BT) shunt was designed by Helen B Taussig (physician) and Alfred Blalock (surgeon) at the John Hopkins Hospital. This was based on the observation by Helen B Taussig that infants with severe pulmonary stenosis or pulmonary atresia had worsening of cyanosis after spontaneous closure of ductus arteriosus. The BT shunt was an anastomosis between subclavian artery and pulmonary artery, to enhance pulmonary blood flow those infants with severe cyanotic congenital heart disease with low pulmonary blood flow.
Different techniques have been used to modify a BT shunt when it is not technically fea...
Source: Cardiophile MD - December 23, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiac Surgery Blalock – Taussig shunt BT shunt classic Blalock – Taussig shunt Modified Blalock – Taussig shunt modified BT shunt Source Type: blogs
" Pay me now, or pay me later "
This patient presented with acute pulmonary edema without chest pain.A bit of history prior to showing the ECG:The patient had been hospitalized at a different hospital for pneumonia and NonSTEMI for a week. The troponin I had peaked at 40 ng/mL, and echo showed multiple wall motion abnormalities and EF of 35%. The patient suffered third degree heart block with bradycardia and required permanent pacemaker placement. A troponin that high is usually associated with Occlusion.I reviewed the ECGs from that hospital and they donot show OMI. But many ECGs in patients with OMI do not reveal the OMI, even when I ...
Source: Dr. Smith's ECG Blog - December 10, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
Why AF is often well tolerated in Hypertrophic cardiomyopathy ?
Up to 25 % of LV filling is done by atrial contraction. Atrial booster function is important in LV outflow lesions. This can be critical in patients who have diastolic deformities of LV. ( an audible or even palpable S4 confirms the atrial kick in these situations ) This is how we were taught for decades right. Still, it may hold good in many left-sided condtions, but in HCM it definitely seems to be not true.
A succinct review of this topic makes a good read.
Incidence if AF in HCM is about 20% (Mostly paroxysmal 70 % , Persistent /Permanent 30 %)
Mechanism of AF IN HCM
Incre...
Source: Dr.S.Venkatesan MD - November 29, 2020 Category: Cardiology Authors: dr s venkatesan Tags: Atrial fibrillation af in hocm affirm study atrial fibrillation in hypertrophic cardiomyopathy current guidelines in hcm hcm hocm mechansim of af in hcm pathophysiologyof hcm Source Type: blogs
TWiV 683: Two COVID-19 mRNA vaccines
On this episode of TWiV, mRNA vaccines from Moderna and Pfizer show over 90% efficacy, prothrombotic auto-antibodies in serum of COVID-19 patients, and the whereabouts of SARS-CoV-2 in the human body. Click arrow to playDownload TWiV 683 (72 MB .mp3, 119 min)Subscribe (free): iTunes, Google Podcasts, RSS, email Become a patron of TWiV! Show notes at microbe.tv/twiv (Source: virology blog)
Source: virology blog - November 19, 2020 Category: Virology Authors: Vincent Racaniello Tags: This Week in Virology autoantibodies blood clots coronavirus COVID-19 mRNA vaccine pandemic phospholipid SARS-CoV-2 thrombosis tissue tropism viral viruses Source Type: blogs
Fascinating case of dynamic shark fin morphology - what is going on?
Case submitted by Magnus Nossen MD from Norway, written by Pendell MeyersA man in his 50s with no pertinent medical history suffered a witnessed cardiac arrest. EMS found the patient in VFib and performed ACLS for 26 minutes then obtained ROSC. 12 minutes later, the patient went back into VFib arrest and underwent another 15 minutes of resuscitation followed by successful defibrillation and sustained ROSC. In total, he received approximately 40 minutes of CPR and 7 defibrillation attempts. Here is his first ECG recorded after stable ROSC:Originally recorded in 50 mm/s (the standard in Norway), here converted to ...
Source: Dr. Smith's ECG Blog - October 26, 2020 Category: Cardiology Authors: Pendell Source Type: blogs
DAPT blues in ACS : Does Prasugrel really bother to know about the coronary anatomy before it acts ?
It appears,antiplatelet agents are waging a turf war on the CAD battlefield. It is no secret either, the fight often goes beyond academic reasons. Though NSTEMI connotes a true cardiac emergency, it consists of a highly heterogeneous population. A patient with UA can be treated even at home (Low-grade angina with little ECG changes, when it’s due to Increase demand situation). While, in the other extreme of NSTEMI, a patient with a GRACE score >200, in Ischemic LVF, might need an emergency multivessel angioplasty along with Mitra clip ± ECMO support.
Antiplatelet agents along with heparin will re...
Source: Dr.S.Venkatesan MD - October 19, 2020 Category: Cardiology Authors: dr s venkatesan Tags: acute coronary syndrome oral anticoagulants warfarin acitrom prasugrel 2b3a vs prasugrel coronary anatomy in nsteacs dapt mapt NSTEMI guidelines esc acc 2020 prasugrel vs aspirin vs ticagrelor reopro vs prasugrel themis twilight study Source Type: blogs
Elevated White Blood Cell Count (WBC) Linked With Cardiovascular Disease
A growing body of evidence suggests that low grade inflammation contributes to the development of cardiovascular disease and, specifically, coronary artery disease (CAD). WBC-derived macrophages and other phagocytes are believed to contribute to vascular injury and atherosclerotic progression. Multiple markers of inflammation have been tested as potential risk factors for the development of CAD such as IL-6, E-selectin and CRP.Elevated white blood cell count (WBC) that is well within the normal range was associated with an increased risk for developing CAD in multiple studies. A large-scale study demonstrated that a s...
Source: Clinical Cases and Images - Blog - October 15, 2020 Category: Universities & Medical Training Tags: Cardiology Source Type: blogs
Rheumatic tricuspid stenosis
Rheumatic tricuspid stenosis is often associated with mitral valve disease. As in rheumatic mitral stenosis, there is commissural fusion in rheumatic tricuspid stenosis. Anteroseptal commissure between the anterior and septal leaflets of the tricuspid valve is the one which is most commonly involved. Tricuspid valve being the largest valve in the body, a gradient of 2 mm Hg across it will qualify for tricuspid stenosis. A gradient of 5 mm Hg would mean severe tricuspid stenosis where as the corresponding gradient in severe mitral stenosis is 20 mm Hg.
Severe tricuspid stenosis causes right atrial hypertrophy and prominent...
Source: Cardiophile MD - October 9, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: HBC Ascites precox giant a waves Slow y descent Source Type: blogs
Cardiologists need to keep an open mind and be capable of listening to, and learning from, the Emergency Physician
Conclusion: This represents the largest study of patients with VPR and angiographically-proven ACO. The MSC were highly sensitive and specific for the diagnosis of ACO in patients presenting to the ED with VPR and symptoms of acute coronary syndrome.===================================MY Comment by KEN GRAUER, MD (10/4/2020):===================================Today ’s case provides a superb example of how acute OMI can sometimes be definitively recognized even in the presence ofpacing. Unfortunately, this was not recognized by the cardiology team despite&nbs...
Source: Dr. Smith's ECG Blog - October 4, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
