MedWorm Tags: aneurysm

The Importance Of Physicals For Young Athletes

Better Health — Sat, 27 Aug 2011 16:00:00 +0100

Increasing numbers of young people participate in outdoor activities, including strenuous competitive athletics. In so doing, they subject their bodies to stresses that are more intense and prolonged than those presented by a largely sedentary life. Every story of a sudden death in a young person is a tragedy, and usually accompanied by commentary pondering the role and utility of pre-activity screening. Could the death have been prevented? What was the physiological condition of the deceased? Could the collapse, often attributed to a heart problem, have been predicted? Was there an examination or evaluation that might have indicated that the deceased was at greater risk, or should have been held out of the activity? These are all important questions, with no simple answers. Sudden collaps...

Interesting Neuro Case Requires ER Doc To Recall Forgotten Med School Knowledge

Better Health — Fri, 12 Aug 2011 16:00:00 +0100

Yesterday, I presented the case of a woman with double vision and ptosis and challenged you all to a game of “spot the lesion.” To be honest, I found this stuff impenetrable as a medical student and it was only by sheer force of will that I was able to commit it to memory for exactly long enough to pass a test on it before immediately purging it from my memory. I did this several times for various board exams and such, but it never really “stuck.” Hated neuro beyond words, I did. As mind-numbing as I found it all in the abstract, I get excited about these cases in application. I may not remember where exactly the internal capsule is or what it does, but when I see someone with an interesting neuro deficit due to a lesion there, all of a sudden it makes so much more ...

Sonar for the Brain

MD Buyline — Thu, 11 Aug 2011 13:32:31 +0100

The world of first line stroke diagnosis may soon rely on a small portable device called the “brain sensing system” that uses a headset to diagnose strokes (hemorrhagic and ischemic), aneurysms, and concussions. These conditions affect over 800,000 Americans each year. Historically, a CT scan is utilized for diagnosing a stroke. The brain sensing system uses passive sonar signal detectors incorporated into a headset, allowing a test to be performed in minutes and in just about any setting. So, how good is brain sensing system? A pilot study performed on 40 patients showed that the system has 97.3% sensitivity and 98.8% specificity for the diagnosis of stroke (. In comparison, CT angiography has a sensitivity of 70% and specificity was 100%. When I asked Dr. Geoffrey S.F. Ling, ...

Waiting To Die

Better Health — Sat, 02 Apr 2011 15:00:00 +0100

Surgeons are not so good at standing back, yet sometimes doing nothing is exactly what needs to be done. I remember one time that this turned out to be slightly humorous in a morbid sort of way. I was in my vascular rotation which was not too much fun (except for a short moment). Generally if a patient came in in the late afternoon requiring an operation, your entire night would be destroyed. And there was pretty much nothing worse than an abdominal aorta aneurysm (AAA). Scratch that. A bleeding AAA was a lot worse than an AAA. So when casualties called and said they had a bleeding AAA my heart sank. The patient was pale and clammy and his heart was racing. But the thing that struck me the most was his age. The man was 89 years old. The casualty officer also mentioned that he had previousl...

Contraindications For Use of Aortic Endovascular Graft

Inside Surgery — Fri, 12 Nov 2010 06:45:01 +0100

To use an endovascular graft in abdominal aortic aneurysm repair the infrarenal diameter of the neck must be < 32 mm, length of the aneurysm neck must > 10 mm, and the degree of angulation must be < 60%. (Source: Inside Surgery)

Type 1 Endoleak

Inside Surgery — Thu, 11 Nov 2010 06:55:46 +0100

Type 1 endoleaks occur after endovascular repair of an aortic aneurysm and result from a failure of the distal or proximal edge of the endograft to completely seal. This causes the aneursym sac to be exposed to full systemic arterial pressure and to have a significant risk of rupture. Typically, type 1 leaks in young patients are fixed with an open procedure with either open or an additional endovascular technique used in older patients with a shorter life expectancy. (Source: Inside Surgery)

Free Aneurysm Screening: Just Another Kmart “Blue Light Special?”

Better Health — Sun, 31 Oct 2010 00:00:10 +0100

Kmart, Medtronic, and a bunch of specialty medical groups are sponsoring a campaign called “Find the AAAnswers” — the “AAA” standing for abdominal aortic aneurysm. It’s clever marketing for Kmart’s pharmacy business, since the screenings are being offered throughout the Fall at more than 900 Kmart pharmacies. And it’s not bad business for the specialty medical groups, either, as Larry Husten wrote on his Cardiobrief blog: …the expenses of the program and the coalition are entirely underwritten by Medtronic, which sells abdominal stent grafts used to repair AAAs, and the members of the coalition include organizations like the Peripheral Vascular Surgical Society, the Society for Vascular Surgery, and the Society for Vascular Ultrasound, ...

Berry Aneurysm – Signs and Symptoms

Inside Surgery — Tue, 05 Oct 2010 06:06:09 +0100

“Worst headache of my life.” (Source: Inside Surgery)

Endovascular repair for Abdominal Aortic Aneurysm

Malaysian Medical Resources — Tue, 13 Apr 2010 23:00:00 +0100

Abdominal Aortic Aneurysm is probably under recognised in Malaysia and ultrasound screening for AAA in Malaysia I dare say is not commonly practiced as it is in the US for men age 65-75 years. Nevertheless we do encounter this from time to time, and one might be interested to know that recently in the NEJM the results of clinical studies on endovascular repair (as compared with conservative management or open surgical reoair) have been published. The results are not great and it seems endovascular repair does not improve long term survival. Here’s an excerpt from the First Watch summary In EVAR-1, nearly 1300 adults with large AAAs were randomized to undergo endovascular or open repair. While 30-day mortality was lower with the endovascular approach (2%, vs. 4% with open repair), aft...

Diagnosed — A Case-Based Post

The Angriest Pharmacist — Thu, 14 Jan 2010 05:34:17 +0100

Older lady (50-something) calls in today….really…today January 13, 2010. “I have a pretty bad stomach ache. I’ve tried everything.” After a lengthy discussion with a lady that was pretty sharp when it came to OTC meds and taking care of herself, here were the facts: - Epigastric pain above the belly button, beneath the sternum. - Rarely radiated. Sometimes pulsated. Sometimes had back pain, but figured it was due to her job as a cashier. - Patient has (un)controlled hypertension. Her BP is high, but she is finally under treatment after years and years of uncontrolled HTN. It’s on the way down, but not to goal yet. - Has tried the following meds: Rolaids, Gaviscon, Milk of Magnesia, Fibercon, Colace, Zantac/Pepcid, Omeprazole, Protonix, and Tylenol/Ibupro...

Journal of the American Medical Association 2009 (Vol. 302 No. 18)

Fade Library — Tue, 24 Nov 2009 09:21:36 +0100

This article discusses the issues surrounding treatment and monitoring of AAA in a 66 year-old man. An NHS Athens password is required to access this article online. Posted in Current Awareness, Journals Tagged: Abdominal Aortic Aneurysm, Males, Older People, Risk Factors, Screening (Source: Fade Library)

"Gentlemen, I Have The Pleasure Of Informing You..."

The KnifeMan — Fri, 08 May 2009 11:24:00 +0100

**For reasons that will become apparent to her, I would sugest LBF doesn't bother with this post. Her character isn't in it. I also know that now I've written this, she'll read on...**The aortic aneurysm is a pathological entity to be feared. A weakening of the walls of the aorta, the body's main artery, the original big red, if you will, allows it to stretch and swell, to bulge. Think of old school Tom and Jerry cartoons where Tom stands on a hose, and the hose swells comically behind him.Except it's less funny.I shan't bore you with the details - you'll either know them already, or not want to. But the only curative therapy is surgical, and that carries significant risk. Some cases are felt 'inoperable', or carry such high risks as to be felt inadvisable.Of course, the risk is that, like...

Endovascular stent - grafts for the treatment of abdominal aortic aneurysms

Fade Library — Wed, 15 Apr 2009 09:30:08 +0100

Title: Endovascular stent - grafts for the treatment of abdominal aortic aneurysms Source: NICE The Skinny: Endovascular stent-grafts are recommended as a possible treatment for people with abdominal aortic aneurysms if: the aneurysm is below their kidney and has not burst, surgery is appropriate, and the person and their specialist have discussed the risks and benefits of this and other procedures and decided that endovascular stent–grafts are appropriate. Aneurysm repair using endovascular stent–grafts should only be carried out in specialist centres by staff experienced in treating people with abdominal aortic aneurysms. Endovascular stent–grafts are not recommended for people whose abdominal aortic aneurysm has burst unless they are taking part in research with the data collect...

A visit from Dave

NHS Blog Doctor — Mon, 16 Feb 2009 17:49:00 +0100

Barbara is 75 years old. She has lived alone since Bob, her husband, died a few years ago. She is still quietly grieving. Bob did all the household accounts. He paid the bills, and was a dab hand at D.I.Y. Barbara does it all now. Apart from the D.I.Y., which her son, Tom, has taken over. She is managing very well, thank you. Except when the central heating boiler makes that clunking noise. It worries her. It clunked when Bob was alive but he said it was nothing serious, just the pipes expanding. Barbara understands that, but she still worries. So when that nice young man in the white van, with "Plumber" written on his smart overalls, knocked on her door and said he was in her area, and would she like her boiler checked before the onset of winter, Barbara accepted the offer. Dave was fri...

Kawasaki Disease

MRI LINKS AND OTHER COOL THINGS — Mon, 05 Jan 2009 17:20:00 +0100

According to the American Heart Association, more than 4,000 cases of the disease are diagnosed annually in the United States. It occurs more often in boys of Japanese and Korean descent, but has been identified in children of all ethnicities and races, Alenick said. The danger of Kawasaki syndrome is that it can cause large aneurysms in the blood vessels that feed blood to the heart, said Alenick.“Kawasaki doesn’t come in degrees of severity, but it varies in that it may cause no aneurysms, small aneurysms, moderate aneurysms or giant aneurysms,” he said. “Giant aneurysms are more common in babies. But it’s the aneurysms that form in the vessels and the arteries that feed the heart that have the potential to cause a fatal heart attack.”The disease was first identified in Jap...

Dream a Little Bigger

Donna Trussell — Mon, 22 Dec 2008 17:00:33 +0100

Yesterday I saw open grief at a memorial service for a friend. I can’t tell you how refreshing that was. Photographer and Kansas City Star restaurant critic Lauren Chapin had just turned 50 when she basically dropped dead at the gym. Lauren was a trim, energetic, happy wife and mother of two teenaged daughters she adored. She was in perfect health, everyone thought. But she had a previously undiagnosed condition, an aneurysm/AVM. The first symptom proved fatal. At Lauren’s 100-percent no-BS memorial service, I saw tears, confusion and longing. A little regret that there was no time to say goodbye, no time to at least try to express the inexpressible. Because of the family’s generosity and the quick action of doctors, Lauren’s organs went to desperate patients so...

Radiology Grand Rounds XVII

Sumer's Radiology Site — Sun, 28 Oct 2007 03:26:00 +0100

Here is a case of Pediatric Aneurysm for the Radiology Grand Rounds submitted by Dr MGK Murthy, Dr Sumer Sethi of Teleradiology Providers. Concept and Archive of the Radiology Grand Rounds is available at- Radiology Grand Rounds.The incidence of congenital aneurysms in the general population is about 1-2%. Clinically, a ruptured aneurysm presents as sudden onset of severe headache. In cases of subarachnoid hemorrhages, the most common aneurysms are posterior communicating, 38%; anterior communicating, 36%; middle cerebral, 21%. These three locations account for 95% of all ruptured aneurysms. The basilar artery accounts for only 2.8% and posterior fossa aneurysms are even less common. Posterior fossa aneurysms are as such uncommon. PICA (Posterior inferior cerebellar artery) aneurysms are e...

Supraclinoid Internal Carotid Artery Aneurysm--MRI

Sumer's Radiology Site — Tue, 18 Sep 2007 14:25:00 +0100

Here are images of a case of supraclinoid ICA aneurysm on MRI sent by Dr MK Murthy, Dr Sumer Sethi, Dr David, Dr Padamaja Teleradiology ProvidersFrom Sumer's Radiology Site http://www.sumerdoc.blogspot.com -The Top Radiology Magazine (Source: Sumer's Radiology Site)

WikiPedia Meets Genetics

Gene Sherpas: Personalized Medicine and You — Tue, 24 Jul 2007 23:03:00 +0100

I just received an email from one of my readers today. Trip said " am med student at Univ of KY, interested in medical genetics and have been reading your blog.........I am recommending http://www.snpedia.com/ for a blog post on the gene sherpa" Well Trip....You Asked for it, You got it..... As they say on that old Toyota commercial....First I would like to mention that my friend Bertalan over at ScienceRoll commented on this Yesterday. He did an excellent job. Also SNPedia has their own blog although there are only 2 posts so far.....So Single Nucleotide Polymorphisms (SNPs) are little genetic changes, much like letters in a word. There is some data out there which shows taht when readign a senetnce letters in the middle of a word do not alter the readers undertsanding. This could be the ...