December, 2023

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ECG Blog #409 — Every-Other-Beat.

Ken Grauer, MD

The ECG in Figure-1 — was obtained from a patient with palpitations. The patient was hemodynamically stable in association with this rhythm. QUESTIONS: What is the rhythm in Figure-1 ? — How certain are you of your answer? — Why is QRS morphology changing ? Figure-1: The initial ECG in today's case. My Interpretation of the ECG in Figure-1: Since the patient is hemodynamically stable — there is time for systematic assessment of the rhythm.

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Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis

Cardiovascular Diabetology

Elevated glycated hemoglobin (HbA1c) is associated with a higher burden of subclinical atherosclerosis (SA). However, the association with SA of earlier insulin resistance markers is poorly understood. The stu.

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Very high LDL no impact on plaque progression

Dr. Malcolm Kendrick

10th December 2023 A very important study – please watch Very high low density lipoprotein levels with no impact on plaque progression I interrupt my series on what is wrong with the health service to bring you breaking news. I was sent the e-mail below, directing me to a short YouTube presentation by Dr Shawn Baker. It highlights a study which provides very strong evidence that a very high LDL (as seen in some people who go on a keto diet), has no impact on coronary artery plaque progression.

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Cardiac imaging in athlete’s heart: current status and future prospects

Cardiovascular Ultrasound

Physical activity contributes to changes in cardiac morphology, which are known as “athlete’s heart”. Therefore, these modifications can be characterized using different imaging modalities such as echocardiogr.

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Young-Onset Dementia Tied to New Risk Factors

Med Page Today

(MedPage Today) -- Four new risk factors for young-onset dementia were identified in the prospective U.K. Biobank study. Orthostatic hypotension, vitamin D deficiency, high C-reactive protein (CRP) levels, and social isolation emerged as new risk.

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A study of genetics of pericarditis increases understanding of newly approved drug treatment

Medical Xpress - Cardiology

Sequence variants that protect against pericarditis have been discovered at a genomic locus encoding interleukin-1 immune cytokines. A newly approved drug treatment for pericarditis inhibits these cytokines, according to a new study.

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ECG Blog #410 — How Tall are the T Waves?

Ken Grauer, MD

QUESTION: HOW would YOU interpret the ECG in Figure-1 — if no clinical information was provided? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). = The H ISTORY in T oday's C ASE: The patient in today's case is a teenager who presented to the ED ( E mergency D epartment ) in cardiac arrest after electrocution.

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More Trending

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Clinical characteristics, treatment, and blood pressure control in patients with hypertension seen by primary care physicians in Spain: the IBERICAN study

Frontiers in Cardiovascular Medicine

Objectives To determine the clinical profile, according to the history of hypertension, the risk of developing hypertension, current antihypertensive treatment and BP control rates in patients with hypertension from the IBERICAN cohort. Methods IBERICAN is an ongoing prospective cohort study, whose primary objective is to determine the frequency, incidence, and distribution of CVRF in the adult Spanish population seen in primary care settings.

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Metixene is an incomplete autophagy inducer in preclinical models of metastatic cancer and brain metastases

Journal of Clinical Investigation - Cardiology

A paucity of chemotherapeutic options for metastatic brain cancer limits patient survival and portends poor clinical outcomes. Using a CNS small-molecule inhibitor library of 320 agents known to be blood-brain barrier permeable and approved by the FDA, we interrogated breast cancer brain metastasis vulnerabilities to identify an effective agent. Metixene, an antiparkinsonian drug, was identified as a top therapeutic agent that was capable of decreasing cellular viability and inducing cell death

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Blood Test May Be Able to Tell Which Organs Have Accelerated Aging

Med Page Today

(MedPage Today) -- About one in five healthy people ages 50 and older had an organ that was aging at an accelerated rate, which may increase mortality and signal organ-specific disease, a study of nearly 5,700 people suggested. In an analysis.

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Research offers new insights into how breakdown of omega-6 fatty acids influences metabolism

Medical Xpress - Cardiology

What role do omega-6 fatty acids play in cardiovascular disease and diabetes? Scientists from Mannheim, together with researchers from Heidelberg, Frankfurt, and Hangzhou in China, have investigated the breakdown of omega-6 fatty acids and gained new insights into how their oxidation products influence the metabolism.

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ECG Blog #406 — To Do Additional Leads?

Ken Grauer, MD

== CLICK HERE — for a V ideo presentation of this case! ( 19:40 min. ) Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #351 — == The ECG in Figure-1 — was obtained from a previously healthy older man who contacted EMS ( E mergency M edical S ervices ) because of "chest tightness" that began ~1 hour earlier.

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Amal Mattu’s ECG Case of the Week – January 1, 2024

ECG Weekly Workout

HPI: A 50-year-old man decides to get “his life in order” for the new year. He quits smoking, decides to eat healthier and exercise more, and to be more compliant with his blood pressure medications. A week into the new year he wakes up feeling weak and achy with nausea and vomiting. He is lightheaded when sitting or standing and has trouble getting out of bed.

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Electronic 'Nudges' to Improve Influenza Vaccine Uptake May Be Less Effective in Patients with Diabetes

HCPLive

Analysis of the NUDGE-FLU study reveals electronic nudges designed to boost influenza vaccination were more effective in older adults without diabetes, highlighting the need for tailored approaches in diabetes populations.

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Rational design of a SOCS1-edited tumor-infiltrating lymphocyte therapy using CRISPR/Cas9 screens

Journal of Clinical Investigation - Cardiology

Cell therapies such as tumor-infiltrating lymphocyte (TIL) therapy have shown promise in the treatment of patients with refractory solid tumors, with improvement in response rates and durability of responses nevertheless sought. To identify targets capable of enhancing the antitumor activity of T cell therapies, large-scale in vitro and in vivo clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 screens were performed, with the SOCS1 gene identified as a top T cell–enhancing

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Beware of Fake Ozempic, FDA Warns

Med Page Today

(MedPage Today) -- The FDA continues its investigation into counterfeit semaglutide (Ozempic) products -- which may still be available for purchase -- and has already seized thousands of units, the agency announced Thursday. In its warning.

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Eating meals early could reduce cardiovascular risk

Medical Xpress - Cardiology

Cardiovascular diseases are the leading cause of death in the world according to the Global Burden of Disease study, with 18.6 million annual deaths in 2019, of which around 7.9 are attributable to diet. This means that diet plays a major role in the development and progression of these diseases.

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ECG Video Blog #407 (292): Why the Patient Died?

Ken Grauer, MD

== CLICK HERE — for a V ideo presentation of this case! (22:3 0 min. ) Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #292 — == The 2 ECGs shown in Figure-1 were obtained from a man in his 30s — who presented to the ED ( E mergency D epartment ) with chest pain that began several hours earlier. ECG #2 was recorded 1 hour after ECG #1.

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What’s wrong with the NHS? – Part 4

Dr. Malcolm Kendrick

8th December 2023 Nothing can simply be ‘good enough’. Before beginning this blog, I thought I would introduce you to the first two laws of regulation ‘ regulation-omics’ : I know that many of the things that are obliterating productivity in the NHS are happening in all health care services, everywhere. A couple of blogs back I mentioned a US study which looked at all the guidelines primary care practitioners (PCPs) are now required to follow.

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AFL WITH 2:1 CONDUCTION IN A PATIENT WITH PREEXISTING RBBB + LAFB

ECG Guru

If a wide complex tachycardia occurs, the probability is very high that it is a ventricular tachycardia (approx. 80%, in patients with a previous myocardial infarction (.) approx. 90%). Here we see a broad complex tachycardia that looks like an RBBB + LAFB, which is regular. In this constellation, 3 causes must be considered: 1. fascicular tachycardia from the left posterior fascicle of the left tawara fascicle (QRS width usually only around 130 ms, but sometimes significantly longer). 2.

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Laura Donlin, PhD: Study Discovers New Subtypes of Rheumatoid Arthritis

HCPLive

Laura Donlin, PhD, highlights the significance of identifying new subtypes of rheumatoid arthritis, emphasizing the potential for a paradigm shift in RA treatment toward personalized care and early interventions.

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Food as Diabetes Medicine? Maybe Not, Trial Suggests

Med Page Today

(MedPage Today) -- An intensive food-as-medicine program didn't improve glycemic control in adults with type 2 diabetes any better than usual care in a randomized clinical trial. After 6 months, both groups had a similar drop in HbA1c -- 1.5.

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New AI-powered algorithm could better assess people's risk of common heart condition

Medical Xpress - Cardiology

A new artificial intelligence (AI) model designed by Scripps Research scientists could help clinicians better screen patients for atrial fibrillation (or AFib)—an irregular, fast heartbeat that is associated with stroke and heart failure. The model picks up on tiny variations in a person's normal heartbeat that signify AFib risk, which standard screening tests cannot detect.

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Profilin1 is required for prevention of mitotic catastrophe in murine and human glomerular diseases

Journal of Clinical Investigation - Cardiology

The progression of proteinuric kidney diseases is associated with podocyte loss, but the mechanisms underlying this process remain unclear. Podocytes reenter the cell cycle to repair double-stranded DNA breaks. However, unsuccessful repair can result in podocytes crossing the G1/S checkpoint and undergoing abortive cytokinesis. In this study, we identified Pfn1 as indispensable in maintaining glomerular integrity — its tissue-specific loss in mouse podocytes resulted in severe proteinuria and ki

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A young woman with palpitations. What med is she on? With what medication is she non-compliant? What management?

Dr. Smith's ECG Blog

Written by Pendell Meyers A woman in her 20s with connective tissue disorder and history of aortic root and valve repair presented with palpitations. Here is her triage ECG: What do you think? Atrial flutter with 2:1 conduction. The atrial flutter rate is approximately 200 bpm, with 2:1 AV conduction resulting in ventricular rate almost exactly 100 bpm.

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What’s wrong with the NHS? – part five

Dr. Malcolm Kendrick

29th December 2023 The underlying forces In the last few blogs, I have been writing about the proliferation of guidelines, targets, and regulatory work in the NHS. Hopefully I have managed to give you a sense of how much time and effort these pile on to everyday work. Time and effort which eats away at clinical time, erodes morale and drives down productivity.

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1 in 6 Patients with Gout Experience Second Flare within 1 Year

HCPLive

Patients with gout who did not experience recurrent flares had a shorter mean time between diagnosis and the start of urate-lowering therapy compared with those who had ≥1 flare.

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Dementia-Sleep Link Has a New Twist

Med Page Today

(MedPage Today) -- Sleep regularity in midlife and at older ages may be a novel dementia risk factor, data from 88,000 people in Great Britain suggested. Day-to-day consistency in sleep-wake patterns showed a U-shaped association with incident.

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Artery calcification more common in night owls, shows study

Medical Xpress - Cardiology

Artery calcification is almost twice as common in night owls compared to early birds, according to a study from the University of Gothenburg, Sweden. Circadian rhythm appears to be particularly important for the heart and blood vessels during the early stages of the disease.

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Engineered hydrogel reveals contribution of matrix mechanics to esophageal adenocarcinoma and identifies matrix-activated therapeutic targets

Journal of Clinical Investigation - Cardiology

Increased extracellular matrix (ECM) stiffness has been implicated in esophageal adenocarcinoma (EAC) progression, metastasis, and resistance to therapy. However, the underlying protumorigenic pathways are yet to be defined. Additional work is needed to develop physiologically relevant in vitro 3D culture models that better recapitulate the human tumor microenvironment and can be used to dissect the contributions of matrix stiffness to EAC pathogenesis.

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Occlusion myocardial infarction is a clinical diagnosis

Dr. Smith's ECG Blog

Occlusion myocardial infarction is a clinical diagnosis Written by Willy Frick (@Willyhfrick). Willy is a cardiology fellow with a keen interest in the ECG in OMI. A woman in her late 70s presented with left arm pain. The arm pain started the day prior when she was at the dentist's office for a root canal. Her systolic blood pressure at the dentist was over 200 mm Hg.

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New study finds many couples around the world may share high blood pressure

American Heart News - Heart News

Research Highlights: A study of married or partnered, middle-aged and older heterosexual couples in the U.S., England, China and India found that in 20% to 47% of the couples, both spouses/partners had high blood pressure. The prevalence of both.

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Rheumatoid Arthritis Quiz: Anxiety and Depression in RA

HCPLive

It is common for patients with rheumatoid arthritis to have mental health conditions. Test your knowledge of the impact of anxiety and depression in rheumatoid arthritis with this quiz.

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Deep Flaws in FDA's Device Oversight, and Patient Harm, Exposed in Lawsuits, Records

Med Page Today

(MedPage Today) -- Living with diabetes, Carlton "PeeWee" Gautney Jr. relied on a digital device about the size of a deck of playing cards to pump insulin into his bloodstream. The pump, manufactured by device maker Medtronic, connected plastic.

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Blood group may predict risk of stroke when receiving COVID-19 Oxford-AstraZeneca vaccine

Medical Xpress - Cardiology

A large international research collaboration, led by an academic from Royal Holloway, University of London, found that blood groups could help predict the risk of venous strokes associated with the Oxford-AstraZeneca COVID-19 vaccine.

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ADORA2A-driven proline synthesis triggers epigenetic reprogramming in neuroendocrine prostate and lung cancers

Journal of Clinical Investigation - Cardiology

Cell lineage plasticity is one of the major causes for the failure of targeted therapies in various cancers. However, the driver and actionable drug targets in promoting cancer cell lineage plasticity are scarcely identified. Here, we found that a G protein-coupled receptor, ADORA2A, is specifically upregulated during neuroendocrine differentiation, a common form of lineage plasticity in prostate cancer and lung cancer following targeted therapies.

Cancer 116
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Concerning EKG with a Non-obstructive angiogram. What happened?

Dr. Smith's ECG Blog

This is written by Willy Frick, an amazing cardiology fellow in St. Louis. [link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain. He described it as "10/10" intensity, radiating across his chest from right to left. EMS obtained the following vital signs: pulse 50, respiratory rate 16, blood pressure 96/49.

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