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Statistical Certainty: Less is More
By ANISH KOKA MD  The day after NBC releases a story on a ‘ground-breaking’ observational study demonstrating caramel macchiatas reduce the risk of death, everyone expects physicians to be experts on the subject. The truth is that most of us hope John Mandrola has written a smart blog on the topic so we know intelligent things to tell patients and family members. A minority of physicians actually read the original study, and of those who read the study, even fewer have any real idea of the statistical ingredients used to make the study. Imagine not knowing whether the sausage you just ate contained rat droppings. At...
Source: The Health Care Blog - December 26, 2018 Category: Consumer Health News Authors: matthew holt Tags: Data Health Policy Anish Koka Brian Nosek data analysis HRRP randomized controlled trials statistics Source Type: blogs

Heart failure and salt: The great debate
“Let there be work, bread, water, and salt for all.” — Nelson Mandela Salt: without it, food can seem tasteless. It is the reason sea water burns our eyes and skin. Some people enjoy salt water baths. Is it good for us? Is it not? Do we really know? In modern medicine, we tend to have a generally negative feeling about sodium, the element found in salt. Excessive sodium intake is linked to water retention, and it is also a risk factor for high blood pressure. Both excessive sodium intake and high blood pressure are major risk factors for developing heart failure, and for causing complications in those with existing h...
Source: Harvard Health Blog - December 18, 2018 Category: Consumer Health News Authors: James Januzzi, MD Tags: Diet and Weight Loss Health Healthy Eating Heart Health Source Type: blogs

CXR Essentials: The Failing Heart
Medmastery video helps identify the features of cardiac failure on the chest X-ray. Evaluation of the three stages of failure including vascular redistribution; interstitial oedema and alveolar oedema The post CXR Essentials: The Failing Heart appeared first on Life in the Fast Lane.
Source: Life in the Fast Lane - December 16, 2018 Category: Emergency Medicine Authors: Sabrine Elkhodr Tags: Cardiology Medmastery Respiratory alveolar edema CXR Heart failure interstitial edema pulmonary oedema Source Type: blogs

Locomotor brachii or locomotor brachialis
Locomotor brachii or locomotor brachialis is often described as a peripheral sign in severe aortic regurgitation or other causes of aortic runoff. It is the prominent pulsation of a usually tortuous brachial artery seen in severe aortic regurgitation. Sometimes it is called a dancing brachial artery as well. Though taken as a peripheral sign of aortic regurgitation, it is not uncommon to see a prominently pulsating tortuous brachial artery in the elderly with arteriosclerosis. In this case it is a stiffened blood vessel wall which makes the pulsation visible and more prominent. Added to this there will be isolated systoli...
Source: Cardiophile MD - December 13, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology locomotor brachialis Locomotor brachii Osler's sign Source Type: blogs

MedPAC ’s Proposed “Reforms” Should Be Tested Before They’re Implemented: CMS’s Hospital Readmissions Reduction Program Is Exhibit A | Part II
Conclusions reached by Gupta et al. and MedPAC In November of 2017 Ankur Gupta and 10 other experts in cardiovascular medicine published an article in JAMA Cardiology entitled, “Association of the Hospital Readmissions Reduction Program implementation with readmission and mortality outcomes in heart failure.” The authors were affiliated with well-known universities, and three of them were also editors of JAMA Cardiology [4]. Their research was financed by grants from the NIH and Get With the Guidelines-Heart Failure (GWTG-HF), a “voluntary quality improvement program” sponsored by the American Heart Association. ...
Source: The Health Care Blog - December 7, 2018 Category: Consumer Health News Authors: matthew holt Tags: Medicare Politics CMS Congress hospital readmissions HRRP Kip Sullivan MedPAC P4P Pay for Performance Source Type: blogs

Part II | MedPAC ’s Proposed “Reforms” Should Be Tested Before They’re Implemented: CMS’s Hospital Readmissions Reduction Program Is Exhibit A
Conclusions reached by Gupta et al. and MedPAC In November of 2017 Ankur Gupta and 10 other experts in cardiovascular medicine published an article in JAMA Cardiology entitled, “Association of the Hospital Readmissions Reduction Program implementation with readmission and mortality outcomes in heart failure.” The authors were affiliated with well-known universities, and three of them were also editors of JAMA Cardiology [4]. Their research was financed by grants from the NIH and Get With the Guidelines-Heart Failure (GWTG-HF), a “voluntary quality improvement program” sponsored by the American Heart Association. ...
Source: The Health Care Blog - December 7, 2018 Category: Consumer Health News Authors: matthew holt Tags: Medicare Politics CMS Congress hospital readmissions HRRP Kip Sullivan MedPAC P4P Pay for Performance Source Type: blogs

Ignorance based cardiology : How common is “ myocardial congestion ” in cardiac failure ?
We learn from basic physiology  lessons that human body is made up of 60 % water. What about heart ? There is no reason for the heart should behave differently from rest of the body . If my  assumptions are correct when the normal heart weighs 300g  , 180g of which should be  be water. The same thing could be applicable for LV mass( * Reference requested) Is there myocardial congestion in cardiac failure ? Genesis of edema in any tissue depends on local hydrostatic pressures, tissue resistive forces, osmotic balance, and cell membrane permeability. In the myocardium individual contribution of above factors are not ...
Source: Dr.S.Venkatesan MD - November 27, 2018 Category: Cardiology Authors: dr s venkatesan Tags: cardiac failure Cardiac MRI Cardio Nephrology effect of dialysis on myocardial water content lv amss and myocardial edema myocardial edema and ckd chronic kidney failure myocardial interstitial edema myocardial water imaging water logging Source Type: blogs

When will the stigma of mental health end in medicine?
Imagine being a cancer patient afraid of seeing an oncologist because they would likely need to discuss chemotherapy and all the lifestyle changes that it entails. Imagine being a patient with heart failure afraid of seeing the cardiologist because they may be prescribed a diuretic to remove excess fluid from their body and may need […]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 - November 15, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Physician Psychiatry Source Type: blogs

HeartMate 3 Heart Pump Approved for Patients Not Eligible for Transplant
Abbott‘s HeartMate 3 left ventricular assist device (LVAD) won FDA approval to be used as a destination therapy for advanced heart failure patients who are not eligible for a transplant. Previously, the device has been indicated for patients el...
Source: Medgadget - October 23, 2018 Category: Medical Devices Authors: Editors Tags: Cardiac Surgery Cardiology Source Type: blogs

Anterior STEMI and multiform PVCs with Narrow Coupling Interval. When to give beta blockers in acute MI?
Conclusion of first report:In patients with anterior Killip class II or less ST-segment –elevation myocardial infarction undergoing primary percutaneous coronary intervention, early intravenous metoprolol before reperfusion reduced infarct size and increased left ventricular ejection fraction with no excess of adverse events during the first 24 hours after STEMI.Conclusion of 2nd report: In patients with anterior Killip class  ≤II STEMI undergoing pPCI, early IV metoprolol before reperfusion resulted in higher long-term LVEF, reduced incidence of severe LV systolic dysfunction and ICD indications, and fewer h...
Source: Dr. Smith's ECG Blog - October 19, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs

Behold the power of clinical triads
A few weeks ago, I saw a patient with shortness of breath during my Saturday clinic. He had been short of breath for a few weeks, and on a couple of occasions, he had also experienced mild chest pain. He has known aortic stenosis, moderate according to his last echocardiogram two years ago. My brain kicked into autopilot, and I asked: “Have you fainted or passed out recently?” It was a flashback to medical school, where it seemed we were inundated with lists of threes. For aortic stenosis, the triad of surgical indications for critical degrees was: angina, synkope (remember I’m Swedish) and svikt, which is Swedish fo...
Source: Kevin, M.D. - Medical Weblog - September 18, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/a-country-doctor" rel="tag" > A Country Doctor, MD < /a > Tags: Conditions Cardiology Endocrinology Source Type: blogs

Heart failure with preserved ejection fraction (HFpEF) – Cardiology MCQ – Answer
Heart failure with preserved ejection fraction (HFpEF) – Cardiology MCQ – Answer Heart failure with preserved ejection fraction (HFpEF) is defined as heart failure with left ventricular ejection fraction (LVEF) more than: Correct answer: b) 50% Heart failure with preserved ejection fraction was also known as diastolic heart failure. HFpEF is as common as heart failure with reduced ejection fraction (HFrEF) or systolic heart failure. As the population ages, HFpEF is becoming more common. Prognosis of both types are equivalent, but guideline directed medical therapy (GDMT) options are limited for HFpEF, compared...
Source: Cardiophile MD - September 14, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Idiopathic Ventricular Tachycardias for the EM Physician
Written by Pendell Meyers, reviewed by Steve Smith and Scott Weingart“Idiopathic ventricular tachycardias” refer to a group of tachydysrhythmias originating below the AV node and bundle of His but differing in etiology, prognosis, and treatment compared to classic ventricular tachycardia (VT). The name “idiopathic” is becoming more and more inappropriate, as various specific subgroups and specific etiologies are being discovered, including right ventricular outflow tract VT, fascicular VT, and bundle branch reentrant VT. To understand these entities one must first understand the differences between classic VT and i...
Source: Dr. Smith's ECG Blog - September 14, 2018 Category: Cardiology Authors: Pendell Source Type: blogs

Heart failure with preserved ejection fraction (HFpEF) – Cardiology MCQ
Heart failure with preserved ejection fraction (HFpEF) – Cardiology MCQ Heart failure with preserved ejection fraction (HFpEF) is defined as heart failure with left ventricular ejection fraction (LVEF) more than: a) 40% b) 50% c) 60% d) 70% Post your answer as a comment below. Correct answer will be published on: Sep 15, 2018 @ 02:03
Source: Cardiophile MD - September 13, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Myocardial injury vs Myocardial infarction
Elevated cardiac troponin levels indicate myocardial injury. But all cases of troponin elevation are not due to myocardial ischemia. If there is clinical evidence of myocardial ischemia or ECG changes consistent with myocardial ischemia, associated with rise in troponin followed by a fall or a fall from initially elevated levels, then a diagnosis of myocardial infarction can be considered. Ischemic discomfort can be in the chest, upper limbs, mandible or epigastrium. This can occur at rest or with exertion. The discomfort is diffuse and not localised like a pricking pain at one point. Usually there is no change with posit...
Source: Cardiophile MD - August 29, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Uncategorized Source Type: blogs