18 Burst results for "Myocardial Infarction"

"myocardial infarction" Discussed on The Skeptics' Guide to the Universe

The Skeptics' Guide to the Universe

07:18 min | 5 months ago

"myocardial infarction" Discussed on The Skeptics' Guide to the Universe

"Bombas dot com slash skeptics. All right guys, let's get back to the show. All right, bob, I know that we've been talking a lot about the James web. Telescope. But there's some actual updates for us to tell us what's going on. So yeah, James Webb space telescope in the news, of course, because it hasn't been that long. Since it launched, so the $10 billion USD James Webb space telescope has officially officially prevented me from having a heart attack by finally becoming structurally deployed in space, fully structurally deployed. So what's next and what are some cool aspects of this mission that you may not have heard about? So most recently, as we know it launched December 25th, the secondary mirror tripod and both the primary mirror wings are in place. So essentially what has happened at this point Wednesday, January 12th, is that the origami shape that it was in for launch has been completely undone. It's unfolded. And but there's still a lot to do, but nothing that's nearly as high risk as it's already been done hence my lack of a heart attack. And some major milestones included that are coming up are there's a three month process of aligning all the web's telescope optics. This also insertion into its final orbit around January 23rd, among many other many other steps that need to be need to be done. I've been so nervous though, partly, though, because I remember Hubble, I was around. I was alive when Hubble was going through. It's birthing pains. If you remember, yes, they discovered that its mirror had a spiritual aberration. And yeah, because they didn't want to do the $1 million test on the earth because they figured, ah, we got it. It's flat enough. And it wasn't huge. And the company, the company that made that mirror is in Danbury, Connecticut. We grew up, yeah. It was actually local news for us, you know? And I remember it was a butt of jokes, all the late night TV shows were making fun of NASA and Hubble. It was bad. And very extremely disappointing because, of course, you know, we were so into it and so disappointed at the major screw up. But it's huge. Oh my God. The build up was like what it's been for James Webb. It was gargantuan. This was the first really the first to really ever it's kind, at least I guess an optical wavelength. But luckily, Hubble was in low earth orbit, and they had an amazing. Oh my God, an amazing mission that was able to repair it. But this repair can not happen for web, because, you know, its orbit is literally a freaking million miles away. If just one of the many complex mission critical steps failed, you'd have a very expensive piece of space junk. You'd have scientific careers in a shambles essentially. And you'd have crushed ASTRO enthusiasts all over the world, especially me, most importantly. So many, many cool future scientific discoveries would then be pushed much farther in the future. Sure, we'd eventually discover them, but how long would that take? I'd probably be dead. And I've had enough of that, you know, I've had enough of that delayed scientific discovery awesomeness in my life. Thank you very much. So why then? Why? Why risk giving me an acute myocardial infarction and put the space telescope so far away from us that repairs are basically impossible. When I first learned of this, I was like, wait, why are we doing this? That makes no sense at all. But of course, it makes a lot of sense. And it has to do with feeble infrared light that minute heat signals that Webb is designed was built to detect are easily overwhelmed. So you have to keep the earth moon and sun behind it. 24/7, it's gotta be behind it and basically invisible, that would be ideal. And that is what the earth's sun Lagrange .2 or L two allows us to do. So L two is a point a million miles or 1.5 million kilometers away on the far side of the earth directly opposite from the sun, right? Now Lagrange points of obviously I've done some reading today about this and yesterday and of course I've been reading about that for years. And oh boy, they've got some onion layers, the Grange points, fascinating stuff, but let's see what NASA said about it. Lagrange points are positions in space where objects sent there tend to stay put Lagrange points, Lagrange points, the gravitational pull of two large masses, precisely equals the centripetal force required for a small object to move with them. So essentially, the gravity of the sun and the earth and the Coriolis and centrifugal forces are interacting such that a third far smaller object can basically hang out, and it's in a parking spot. Once you're there, little or no efforts required to stay there relative to the primary bodies, right? That's the Lagrange point. So this is where the James Webb space telescope will spend the rest of its life until it's collected in a hundred years to be put in a museum, of course, a hundred years. You know, yeah, I'll predict a hundred years. It depends, you know, how the singularity goes. Isn't the mission only like a four or 5 year mission? Oh boy, we will get there dude. We will get there. All right. But did you know that Webb won't be exactly at the Lagrange point? Did you know that? Till July or something. No, no, it will never be at the Lagrange point. Oh, never. Always be kind of inching towards it. No, no, not even that. And this was a little bit of a surprise to me as well. It will be orbiting around it at a distance greater than the moon, the moon's orbit around the earth. Interesting. So what's the compensation for something? Well, this is called the halo orbit. It's a very well-known type of orbit. And they exist simply because they're an integral part of all Lagrange points with their, you know, like I said, with their complex interplay of the two large gravitational fields and this interpreter force, that's just something that spontaneously allowed because of the very nature of a Lagrange point itself. So they're using this orbit. And one of the many one of the primary reasons why webs that web is using its specific halo orbit and of which there are many. There's lots of different halo orbits you can use. It's using it to keep it out of earth and the moon's shadow at all times, right? So a great reason. You want to have your back to all that heat and light and you also you want to stay out of the shadow. You don't want to be in the shadow. So all of this with the Lagrange point and the halo orbit and all that all of this is a web won't get fried by the infrared behind it. So to further and definitively isolate from that heat, it has its now famous tennis court size shields, right? Giving it essentially an SPF of 1 million. So I had analogy on this one. Webb is like that old failed McDonald's hamburger. Remember those? Kara, you probably don't, but basically, it was cold on one side and hot on the other side. And then you put it together and you put them together before you ate them. And I think what? Yes. And the cold stays cold, yeah. Yes, and we are totally showing our ages again, so we will stop it..

James Webb Lagrange heart attack NASA Hubble Danbury Webb bob acute myocardial infarction James Connecticut tennis Kara McDonald
"myocardial infarction" Discussed on The Evidence-to-Impact Collaborative Podcast

The Evidence-to-Impact Collaborative Podcast

04:34 min | 9 months ago

"myocardial infarction" Discussed on The Evidence-to-Impact Collaborative Podcast

"The insurance companies. We think about the health systems and the doctor's offices when really what's probably very key a lot of people's health is that social services that they get from nonprofits one of the things that we've tried to do here. We talked about these regional councils. We made sure that communities organizations and nonprofits are on these regional health counsels. The other thing is that when we talk about value based purchasing we had a new requirement starting this year that the the medicaid managed cures asians have to work with community based organizations to address the social in terms of as part of value based purchasing. And so we really see communities. Organizations is a key part of our healthcare system that hasn't been tapped into and so your point about helping these relationships we also Realized that the community organizations sometimes it's a different language healthcare and some of the social services. I remember just as a side anecdote. I went to a housing conference and someone said that they were talking about. Am i and i thought they were talking about an acute myocardial infarction and it turns out they were talking about area mediate incomes the language and bridging these gaps on between the social sector and the academic sector and government sector is really important and so you come out with four different trainings now for community organizations to play a much larger role. And sometimes you just need to bridge some of the language barriers and the the the the cultural barriers that exist across academia government social services. But i'm so glad that you brought that one to i completely understand. We have to get again the relationships in the language our traditions of our discipline i think are really important but those community based organizations are critical. They are often the first to spot trends in the community to pick up problems. The understand how things will sort of be seen by the community. What's possible in a community. There contextual wisdom and knowledge is just essential in innovation certainly seems like a theme is is expanding building maintaining relationships expanding touch points providing the fora for those touch points to grow and entering into partnerships with humility right.

medicaid acute myocardial infarction
"myocardial infarction" Discussed on NEJM This Week - Audio Summaries

NEJM This Week - Audio Summaries

02:01 min | 11 months ago

"myocardial infarction" Discussed on NEJM This Week - Audio Summaries

"Cardiac genyk shock were randomly assigned to receive mill. Reknown or wtam in in a double blind fashion. The primary outcome was a composite of hospital. Death from any cause resuscitated cardiac arrest receipt of a cardiac transplant or mechanical circulatory support nonfatal myocardial infarction transient ischemic attack or stroke diagnosed by a neurologist or initiation of renal replacement therapy. The treatment groups did not differ significantly with respect to the primary outcome. A primary outcome event occurred in forty nine percent of participants in the miller known group and in fifty four percent of participants in the beauty group. There were also no significant differences between the groups with respect to secondary outcomes including in hospital death thirty seven percent and forty three percent of the participants respectively resuscitated cardiac arrest seven and nine percent receipt of mechanical circulatory support twelve and fifteen percent or initiation of renal replacement therapy twenty two and seventeen percent in patients with cardio genyk shock no significant difference between mill reknown and dopamine was found with respect to the primary composite outcome or important secondary outcomes decompression with or without fusion in degenerative lumbar spondylosis. Thesis by eve are still from haukeland university hospital. bergen norway. This norwegian randomized trial investigated whether decompression surgery was non inferior to decompression surgery performed with the use of instrumented fusion in patients who have spinal stenosis with degenerative spondylosis thesis approximately seventy five percent of the patients had leg pain for more than a year and more than eighty percent had back pain for more than a year.

mechanical circulatory support stroke cardiac arrest haukeland university hospital bergen norway spinal stenosis
"myocardial infarction" Discussed on NEJM This Week - Audio Summaries

NEJM This Week - Audio Summaries

08:46 min | 11 months ago

"myocardial infarction" Discussed on NEJM This Week - Audio Summaries

"Tova sydney impatience hospitalized with kovic nineteen pneumonia by patrizia. Gay marriage from the hospital. Israel lita albert einstein sao paulo brazil severe kovic nineteen is associated with an exaggerated immune response that has been termed side. Kind storm tova sit nib an oral janice kinase inhibitor indirectly suppresses cytokine production but whether it improves outcomes in kovic nineteen. Pneumonia is unclear in this study. Two hundred eighty nine patients in brazil with kovic nineteen. Pneumonia who had been hospitalized for less than seventy. Two hours were randomly assigned to receive tova sip or placebo twice daily for up to fourteen days or until hospital discharge the cumulative incidents of death or respiratory failure through day twenty eight was eighteen point one percent in the tofa sydney group and twenty nine percent in the placebo group death from any cause through day. Twenty eight occurred in two point. Eight percent of the patients in the sydney group and in five point five percent of those in the placebo group of note overall eighty nine point. Three percent of the patients received glucocorticoid during hospitalization. Serious adverse events occurred in fourteen point one percent of the tofu nip group and twelve percent of the placebo group. There was one case. Each of deep-vein thrombosis acute myocardial infarction ventricular tax cardia and myocarditis in the tofa sydney group and hemorrhagic stroke and cardio genyk shock in the placebo group in patients hospitalized with covert nineteen monja tova. Sydney was superior to placebo in reducing the incidence of death or respiratory failure through twenty eight days of follow up justin stabbing from imperial college. London writes in an editorial that most persons who are infected with sars covy to our ase symptomatic or have only mild to moderate symptoms whereas others have progression to severe disease characterized by acute respiratory distress encompassing pulmonary. Hyper inflammation and endothelial and broad multi-system dysfunction. A number of drugs have been developed or repurpose to prevent clinical deterioration immunomodulators treatments such as decks and medicine have shown promise in reducing mortality among patients with covert nineteen janice highness jack inhibitors constitute further weapons in the armaments barium. The data from gay marriage and colleagues combined with data from other recent trials indicate that anti inflammatory therapy in hospitalized patients with cova nineteen who are receiving supplemental oxygen therapy or ventilation results. In reduced overall mortality and that treatment with glucocorticoid and mechanistically distinct anti inflammatory agents notably jack inhibitors at perhaps interleukin. Six receptor antagonists provides additive benefits among the anti inflammatory agents. Jack inhibitors have the distinctive vantage. That they're low. Cost and oral administration allows for scalable use in low and middle income countries in regimens with or without concomitant glucocorticoid. 's furthermore some jack. Inhibitors provide dosing flexibility with an absence of drug to drug interactions usefulness at lower glamorous filtration rates a short half life and an established safety profile in highly vulnerable populations notably the elderly long term complications in youth onset. Type two diabetes. By the today study group the prevalence of type two diabetes in youth is increasing but little is known regarding the occurrence of related complications as these youths transition to adulthood in a previous trial the investigators evaluated the effects of one of three treatments. Metformin metformin plus rosa glitter zone or metformin plus an intensive lifestyle intervention on the time to loss of glycemic control in participants who had onset of type two diabetes in youth after completion of the trial. Participants were transitioned to metformin insulin or both and were enrolled in the observational followup. Study reported now at the end of the follow up. Study january twenty twenty. The mean age of the five hundred participants was twenty six point four years in the meantime since the diagnosis of diabetes was thirteen point three years. The cumulative incidence of hypertension was sixty seven point. Five percent. the incidents of dislocated -demia was fifty one point six percent. The incidents of diabetic kidney disease was fifty four point eight percent and the incidence of nerve disease was thirty. Two point four percent the prevalence of retinal disease including more advanced ages was thirteen point. Seven percent in the period from twenty ten to twenty eleven and fifty one percent in the period from twenty seventeen to twenty eighteen. At least one complication occurred in sixty point. One percent of the participants and at least two complications occurred in twenty eight point. Four percent risk factors for the development of complications included minority race or ethnic group hyperglycemia hypertension and dislocated -demia no adverse events were recorded during follow-up among participants who had onset of type two diabetes in youth the risk of complications including micro vascular complications increased steadily over time and most participants by the time of young adulthood complications were more common among participants of minority race and ethnic group and among those with hyperglycemia hypertension and dislocated -demia risdon plan treated infants with type one spinal muscular atrophy versus historical controls by basil darris from boston children's hospital type. One spinal. Muscular atrophy is a progressive neuromuscular disease characterized by an onset at six months of age or younger. An inability to sit without support and deficient levels of survival of motor neuron. Sm n protein risdon plan is an orally administered. Small molecule that modifies sm and to pre messenger. Rna splicing and increases levels of functional. Sem and protein in blood. The investigators conducted an open label. Study of risdon plan in infants with type one spinal muscular atrophy who were one to seven months of age at enrollment in the dose. Finding part one of the study reported previously in the journal risdon plan led to increased expression of sm in protein now the authors present the results from part two on the clinical efficacy and safety of risk lamb in forty one infants with type one spinal muscular atrophy as compared with historical controls after twelve months of treatment. Twelve infants twenty nine percent. Were able to sit without support for at least five seconds. A milestone generally not attained in this disorder orel risdon plan treatment resulted in higher percentages of infants who met motor milestones survived without need for ventilation and showed improvements in motor function than the percentages in natural history. Cohorts the most common serious adverse events were pneumonia bronchiolitis hypo tonia and respiratory failure. Longer and larger trials are required to determine the long-term safety and efficacy of wisdom plan in infants with type.

tofa sydney Tova sydney kovic lita albert einstein Pneumonia thrombosis acute myocardial in monja tova diabetes severe disease acute respiratory distress enc brazil patrizia Jack inhibitors
"myocardial infarction" Discussed on Cardionerds

Cardionerds

04:28 min | 1 year ago

"myocardial infarction" Discussed on Cardionerds

"And i think last forward. So yes i did. A lot of education and research but certainly the association and the recognition which came out of women heart of spontaneous coronary artery dissection or being completely different than we were taught in terms of prevalence in terms of diagnostic phase. And being able to be ready at that time to launch an area of inquiry that inspires me today. Both the patients and the research will again. We're seeing some new syndromes ammo. I think about what. I learned in medical school and what i do in practice. Today there is relatively modest overlap and again just as we're seeing the scab predominantly in younger and middle aged laments. We're seeing the takasu bio in the older women and again. In retrospect i realized that many of the women that i saw. Who were named myocardial infarction and who did amazingly well subsequently possibly probably were takasu. Bow but i expect that the khadijeh nerds. You're almost on the edge of a new era. Because when i started they will almost no diagnostic tests so we honed our skills on the history the physical examination and of course there we had the electrocardiogram and we will good electrical workers and the chest x-ray and then it took a while onto the. We began to get the exercise testing in the echo seven. But today i see the imaging just exploding and almost every one of the diseases disorders has something new that is added from an imaging. Study and from multi parametric imaging the fact that i never learned imaging except as a faculty member and now i have a number of fellows spending a year or two doing advanced imaging. Fortunately in many institutions cardiologists are now redundant in the imaging area and because we know the clinical we know the clo- correlation and we have the patients. So i think that so. Many of the new imaging techniques are wonderful horizon and the fascinating part as i see them being reported in the literature. Is that the message of sex-specific biology as come across..

takasu myocardial infarction
"myocardial infarction" Discussed on Sandy K Nutrition

Sandy K Nutrition

03:28 min | 1 year ago

"myocardial infarction" Discussed on Sandy K Nutrition

"Higher one. Welcome to sandy kane nutrition health and lifestyle queen today with me. I have dr bill lawrence and dr lawrence actually has a degree in law however he is a master of science and psychology and a phd in nutrition and since nineteen ninety. His focus has been on slowing and reversing human biological aging. He has developed. Numerous science based protocols focused on optimal aging for health professionals and individual clients and currently doctor lawrence is the administrator of two clinical studies to determine if human biological age can be reversed. Welcome dr lawrence. I saw excited to have you today. Thank you sandy. It's great to be here actress. Just great to be anywhere. Well yeah exactly these days. That's just the case. But i'm i'm really excited to talk to you because what you're doing is truly in my opinion cutting edge and it's based in science so it's not just techniques that people can use and maybe it's going to help them age. Well maybe not. This is truly science that you're doing and you have these two clinical studies that i really want to introduce to my listeners. Because i feel like it's really going to be of interest to many people in midlife so you know maybe i guess we can 'cause you're actually doing quite a few things yourself aren't you. Oh yes Let's let me give the yeah some background and soon you all of us have our personal stories as to why were in the health field and so forth and i have one of those When i said. I'm glad to be anywhere literally. I i truly mean that of i was raised in the mormon church. And we do a lot of genealogy work there i knew growing up that We did not have genes for longevity certainly among the males in my family and my uncles grandfather uncles and so forth the all died in their fifties all of them from heart disease My father had his first heart attack. Myocardial infarction at fifty seven and then his fatal one at sixty five Looking back through the genealogy there was only one man one male over a period of two hundred years where we had both birth and death information Only one male made it to seventy in all those years. he was a wonderful manuals. An uncle of mine He was a nondenominational preacher Just the most ethical honest good human being it was interesting. Because he preached all the time And he would refer oftentimes to a section of of psalms in the bible where it says that Mankind should live for three score and ten years. Well that's seventy years of interest in his seventieth year about three months he turns seventy. he was diagnosed with cancer and.

dr lawrence sandy kane dr bill lawrence lawrence Myocardial infarction mormon church heart disease cancer
"myocardial infarction" Discussed on Mayo Clinic Q&A

Mayo Clinic Q&A

04:08 min | 1 year ago

"myocardial infarction" Discussed on Mayo Clinic Q&A

"That our listeners have a little more comfort with this topic. The first is your specialty really. But what is a cardiac arrhythmia so cardiac arrhythmias anything that we could capture on record either with an ekg and that's something where we take a snapshot of the heart a ten second snapshot or on longer term monitoring where we're monitoring the rhythm of the heart of someone's in you'd see on television or if someone's in the hospital there on a heart monitored in an arrhythmias anything we find. That's from what we call normal. Sinus rhythm just normal rhythm sewn arrhythmias some of them could be benign and some could be not to worry about but with nece such as ones especially that down to the bottom of chamber of the heart make the bottom chamber the heart go very very fast. Those could cause severe symptoms and severe science in. Maybe a warning sign of someone about to have a cardiac arrest or something. We call sudden cardiac death where the heart stops and it doesn't pump blood which leads me to my next question. What is a heart attack. So a heart attack is when the heart muscle itself has not or is not getting enough blood flow at needs deform its proper function so some of these are based on the flow ability in the coronary arteries. So the blood flow. That's bringing blood to the heart is either blocked. Or it's limited if it's limited you still at certain times such as exercise or if the heart rate's going fast the heart needs to pump and it doesn't match the oxygen an intrusion that the heart needs the heart muscle dies off calling it a heart attack some of these other ones where you hear patients going in and they need emergent blockage and merging opening of their heart. Arteries is what we call in stem and people might have heard that word. St elevation myocardial infarction again. It just means that acutely the inside of the walls of that coronary already have clogged up..

cardiac arrhythmia myocardial infarction
"myocardial infarction" Discussed on Cardionerds

Cardionerds

05:09 min | 1 year ago

"myocardial infarction" Discussed on Cardionerds

"You heard in our first annual prevention rules, FOR CARDIO-METABOLIC DISEASES CME conference, we are starting to develop peace to take care of elevated LP literally intruding work that's going on right now at Baylor College of Medicine and these are things that it's an interesting space as we look forward to. Now before we moved from there, I must. Fellows didn't such an outstanding job moderating the sessions. It was really a remarkable job. Well, done guys. So the next thing that we have to understand is once we looked at all the potential risk factors is take a step back and understand the pathophysiology of actress grossest genesis and myocardial infarction. Itself Goes Your Talk About Clark rupture inciting event, and that's an important aspect often now, the thing is don't forget though that atherosclerosis is a lifelong event right in other words only process about the scores has been identified even before the age of. Fatty speaks have been noted by the age of thirty through international studies. We've noted that about eighty percent of men and the majority of women have some block develop into the coronary arteries. We've done some work with ultrasound of the characters using a candidate intermediate thickness prevalence of plock in predicting cardiovascular disease, and again, I can tell you the prevalent off atlas crisis is so high that presents the plug tells you that the process is going on..

Baylor College of Medicine atherosclerosis myocardial infarction Fatty Clark
"myocardial infarction" Discussed on Cardionerds

Cardionerds

07:44 min | 1 year ago

"myocardial infarction" Discussed on Cardionerds

"The second, just a number of years later was the first presentation about a heart healthy diet given by the American Heart Association and this was titled. The way to a man's heart, a fat control, low cholesterol meal plan to reduce risk of a heart attack and the third was a comic from. Nineteen. ninety-one picturing a doctor talking to a female patient and I quote he's saying to her we have said for fruit flies, mice, hamsters, frogs, monkeys, and men with this condition. But medical research using women as subjects just never occurred to anybody. So with this in mind docu anger having trained during this time, and as the foremost became for advancing our recognition and understanding of women's cardiovascular health can you tell us more about the past when only men had heart disease? What is your learned when you were a Harvard medical student in the nineteen fifties and how did this evolve in your early career will let me go back to that cartoon which says using women as research subjects never occurred to anybody fortunately subsequent to that it did occur to many many people and most of us are very familiar with the graphs on cardiovascular mortality in the US. And really until the year two, thousand, the decline in cardiovascular mortality in the US was solely in populations of men and women's cardiovascular mortality remained unchanged, and in the year two thousand, which was at the time we began to see sex specific issues in terms of prevention, diagnosis management, etc. there was a sharp decline in women's cardiovascular mortality, much more abrupt than that for men and actually in twenty fourteen for the first time. The annual cardiovascular mortality for women was lower than that met, and as I said on a number of podiums previously, we are delighted to be in second place and we hope to say there. Let. Let me go back to the Harvard Medical School in the teaching hospitals. Remember that are major cause for hospitalization was myocardial infarction, and this was Q. Wave Mark Cardio infarction diagnosed only by the electric Graham. We had no enzymes. We had no imaging studies. There was nothing else there. And the concern was that this entailed mortality a forty to sixty percent. So this was really serious an as we learned in the years of Framingham myocardial infarction occurred predominantly admit, and this was the focus on men and heart disease because men were dying. Now you must remember we had used populations of men in hospital. Simply. Because the typical hospitalization was three to six months for acute myocardial infarction with probably the first two or three months at strict bedrest. But even in the time of Framingham, if you go back to the old data, the women had predominance of Angela. But Angelina wasn't facial and therefore was essentially disregarded. It was tabulated. As we've come to realize in subsequent years, women essentially have a warning system, which is why it is important to recognize Nevada anyway chest pain and of course, cardiac pain was considered to be central sub stern will pain and as you have in your case of the woman from India, the radiation of pain into the jaws neck arms back shoulders was not even discussed. It was oppressive substantal pain that was the. Her. But. We actually did see women with heart disease but it was predominantly rheumatic heart disease and we saw women who had Is the predominant problem often complicated by atrial fibrillation many of these women died in pregnancy. Had No way to recognize that at the time we were excellent at the physical examination men had rheumatic heart disease but the predominant population of women that we saw will women, with Mitral, stenosis and in terms of other features remember we had no good therapy for hypertension and definition of hypertension at the time was one hundred and twenty systolic plus your age. These were the days of Franklin Delano Roosevelt dying with severe hypertension untreated we never managed hypertension is a problem. And heart failure was documented but we had no therapies that was a fatal diagnosis. So when we look at the predominance in men, it really was the men with myocardial infarction. Out, say hypertension was one, hundred twenty plus your age. Thank goodness for the sprint trial for audience. DACA Ranga, wrote a beautiful state of the Art Review in Jack Twenty eighteen titled Hypertension across a women's life cycle is absolutely incredible. I will put the link to that article in the episode description I. Think it's so important to realize that women have heart disease and we'll talk about that as some of the discussion goes on because the emphasis really because of my cardio infarction and it's enormous mortality was that this was a man's Z's. Absolutely, and it's so interesting I think we ask trainees take for granted all of the different testing that's at our fingertips. Are often probably testing too much constantly innovating and looking for new things but it's really amazing to think about what was able to be accomplished with just the basics of history and physical exam and an electrocardiogram. So I'd like to now move onto women's cardiovascular health the present July twenty third nineteen ninety-three marked a major turning point in the story of women's cardiovascular health. This was when doctors. Ninette. Net Winger Leon spare off and Barbara Packard published a revolutionary article in the New England Journal entitled Cardiovascular Health and Disease In women, and this recognize that coronary heart disease was the most common cause of death among US women as you mentioned and that women with coronary disease actually did worse than men with coronary disease. Now, all of a sudden heart disease was no longer just a man's. Problem following impactful work from trailblazers like Dr Wenger. Advocacy from three major organizations which brought in recognition that heart disease also affected women nine, thousand, nine, hundred, nine women's heart. The National Coalition for women with heart disease was founded by women with heart disease to support other women and for political advocacy in two, thousand and four the NHLBI's heart truth campaign titled Heart Disease Doesn't Care what you wear. And in two thousand and four H. as go red for women program, which really catapulted the readdress symbol of heart disease in women. So Dr Wang or where are we now in the story of women's cardiovascular health and what is the.

infarction hypertension acute myocardial infarction American Heart Association coronary disease US Framingham Harvard Medical School Harvard stenosis Dr Wenger NHLBI Dr Wang DACA Ranga Angelina Nevada Franklin Delano Roosevelt India National Coalition
"myocardial infarction" Discussed on 77WABC Radio

77WABC Radio

03:50 min | 1 year ago

"myocardial infarction" Discussed on 77WABC Radio

"Inhuman clinical trials as call cognitive deserve a cognitive reserve, which you deserve. On the bike. Rickman five election can hope you create that now. The other thing with my equipment five blocks in well, it's not dangerous. And it's really good for arthritic pain. So here's a study that just came out. All the people that even take a low dose aspirin and increases the risk of intestinal bleeding by 60%. And it was in terror coded to boot, which makes it even safer. All the people even and terracotta, low dose aspirin and increases the risk of bleeding by 60% bleeding in the brain and bleeding in the stomach and intestines. So that came out. That report came out August 6th. That came out August 6th. It was a big study. It's in the journal Gut. Um, here. Here's another one. This just came out this present at the pharmacist, doctors and nurses. This was sent out to all doctors, pharmacists, nurses Podiatrists and dentist. It went out August 3rd from Medscape. All ends age race, post myocardial infarction risk. All in change. What they say. It's in the Journal of the American College of Cardiology, The Journal of the American College of Cardiology. They looked at 100,000 Americans after they had AH heart attack. Two or three years after they had a heart attack. If they used any ends. Aid aspirin, Advil believe Celebrex diclofenac any of them and increased risk of a stroke and increased risk of a heart attack and then increased ever is completed. Any of them increase terrorist, a stroke and heart attack. Ah, listen to this the risk of bleeding. For Mahalakshmi Cam and selling Celebrex. Now they say, Celebrex isn't cause bleeding. Right? The risk of bleeding from Mahalakshmi Cam or Celebrex was a 300% increased risk of bleeding like a bleeding stroke. On the risk for a nap person, which is supposed to be safe was 600% increased risk of stroke or bleeding. So if you take the bike, Rickman five election it's not going to cause a bleeding stroke. That's not going to cause a bleeding ulcer in your stomach or intestines. It doesn't trigger ah heart attack or a stroke or heart failure or swollen legs or kidney damage or cataracts or damage to your hearing or trigger an asthma. Attack all the other drugs to all those rusty aspirin, the Advil they believe they can all damage your kidneys. That can all closed heart failure, Dick and will trigger a stroke or a heart attack. They couldn't make your legs. Well, they can always raise your blood pressure taken will contribute to cataracts. Postures of capsule of cataract formation on they're all toxic to your hearing. You're not supposed to stay in those drugs forever. You're supposed to use it for like 3 to 5 days. I don't know where that message got screwed up. When I was in pharmacy school in the 19 seventies, these drugs were used for 3 to 5 days, but somehow and the 19 eighties, the drug companies weasel their way into saying, Hey, you use our drug every day for your arthritis and watch happening. People are getting heart failure, people getting cataracts. People are getting tonight. It's ringing in the years, people getting kidney damage and kidney failure, But this is not I'm not making this up. I was the pharmacist of the air twice in the United States. I know what I'm talking about. So when you use those drug user when you're really in pain, but otherwise you're better off with something natural. Like bio Kirkman. Five lakhs in Bio Kirkman five auction. They're great for pain. They're great. Oh, by the way to bio Kirkman's even good for nerve pain..

aspirin kidney damage Bio Kirkman Rickman Advil Mahalakshmi Cam Journal of the American Colleg infarction swollen legs United States Dick diclofenac
Eerie Emptiness Of ERs Worries Doctors: Where Are The Heart Attacks And Strokes?

Erin Burnett OutFront

05:10 min | 2 years ago

Eerie Emptiness Of ERs Worries Doctors: Where Are The Heart Attacks And Strokes?

"Across the United States doctors are seeing a drop off in cardiovascular emergencies during the corona virus pandemic and they're calling the drop staggering unlike anything they've seen before Dr. Jonathan Reiner joins me now. He advised the White House medical team under president. George W Bush and he is the currently the director of the Cardiac Cath Lab at George Washington University Hospital. So honor your cardiologists. You're you've been you know in with patients doing surgeries as I know daily. What are you saying? Yeah this is really fascinating soon. After they stay at home measures were begun. Almost two months ago cardiologists around the country and around the world started to notice something really unexpected. Which was there almost daily cases of acute myocardial infarction heart attacks stopped coming and all over the world. Physicians noted a decrease about forty percent in patients presenting with heart. Attacks was really very hard to explain. Some people suggest that maybe there was something about you. Know Our our new daily routine. The lack of commute maybe the cleaner air more sleep that was reducing heart attacks. But I think what we've really come to understand is something much worse. Which is we think. Many people just aren't coming to the hospital and people are staying home. Places like New York have seen up to five six or seven fold increase in out of hospital deaths and we think many of these patients are simply not coming to the hospital for fear of contracting copay nineteen so they're dying just dying outside the hospital and maybe they wouldn't have died if they were able to if they came to the hospital where you could help them. That's right and the New York. Times recently published an analysis of all cause mortality data from the CDC and if you compare basically mortality in places like New York since mid-march. There's been this huge success. Death Twenty three thousand more people have died during that period than last year. But only some of that can be accounted for by cove in one thousand nine hundred so either undercounted covert nineteen which is which is possible. But also just as likely other things are happening cigna published utilization data from their members and they've noted similar decreases in hospitalization for things like appendicitis and Ti mini strokes and guess for tests no bleed to neutral fibrillation. So we think what's happened and this is going to be. Collateral damage to the actual viral infections. Is that people haven't sought medical help for for serious illnesses over the last two months. Which is which is pretty an an incredible statement because I mean I suppose you could be both under counting. Covert nineteen and having the the. The access is is so enormous that both things could be true. I I realize that But but you do believe it. The bottom line is that is it possible that you have more people and I would presume the answer to this is yes because people are going to the hospital you would save. Some of these lives is possible. You have more people dying of heart attacks now than you had then you had before just we just aren't just aren't categorizing them that way. We're seeing this New York where it used to be in New York City. There would be thirty five out of hospital deaths now. They're seeing two hundred out of hospital deaths per day now. Some of that may be Cova deaths but a lot of that is also probably other illness. Not Treated in the hospital's so earlier this week. A Doctor Reiner you and I were talking about Brazil. You trying to understand what's happening in the warmer countries and what that means for the United States in the summer in Brazil Where obviously The YEARBOOK SCENARIO. The president has called this a little flu. He's been going to massive rallies against social distancing. Right he has he has done this at a level that that perhaps We had a huge spike in the past twenty four hours. I don't know if you just saw these numbers. They just came out ten thousand five hundred and three known new infections. No I should emphasize in just twenty four hours in Brazil. I mean it's huge surge. What is the significance? Here I in terms of it's clearly not control there and there's very little effort to control. It was obviously cautionary tale. A very ominous cautionary tale. Both scenarios been a president who has a denied the significance of the undoubted the significance of the corona virus. He's gone to a rally and has shake the hand hands of protesters. He's called the virus a little flu and that resonates through the population. Look what we know. Works is mitigation strategies. Such a stay at home and social distancing and when people start to move away from that the virus spread and you see you seeing that happen in Brazil now. We need to think about that as we start to open up the United States economy. We need to. We need to use it. As an example of what happens if we lessen our guard and we open too quickly or imprudently dot Reiner thank you

George Washington University H Brazil United States President Trump New York Dr. Jonathan Reiner George W Bush FLU Acute Myocardial Infarction New York City Appendicitis Cardiac Cath Lab White House CDC
"myocardial infarction" Discussed on Cardionerds

Cardionerds

01:30 min | 2 years ago

"myocardial infarction" Discussed on Cardionerds

"Gotten trained in outer put on your personal protective equipment when we have a patient under investigation in or corner curious and we said five. During my two weeks there who had heart failure and transplantation and sern for infection we had Someone from infection control a watch us as we donned a protective equipment to make sure that we did it correctly. We have two rooms with negative pressure. That are where omitting or patience to who are under investigation who also helping out or medical intensive care unit colleagues taking routine omit you patients into our units since Mick you as a turn it into a bio containment unit. I think it takes full team. Effort by nurse says infection control how staff fellows and attending alike to help each other and to get through this crisis credible. Thanks thanks for sharing that and we really appreciate your time in this really just crazy time. When you're not gonNA have enough time to talk dozen yet. You make your way and talk to us which is just We're overwhelmed with gratitude. Pleasure thank you card..

Mick
"myocardial infarction" Discussed on Cardionerds

Cardionerds

15:31 min | 2 years ago

"myocardial infarction" Discussed on Cardionerds

"Jcc guideline therapies type. Two events we just tryin decreased demand and so the distinguishing type. One in demands advancer very important and often very very challenging at thank the influenza in viral illness patient. Many of these patients are GONNA have type two demands events where treating light granderson said tweeting. The POXY MIA treating the fever tweeting. A inflammatory state at driving. The demand is what's best for the heart tweeting dehydration on the like. And we have to also be ready to pick out that plaque rupture of that which Gem Lay as Someone who will have symptoms of Mike corless Schema where the demand eventless likely symptoms of Michael Schema and With in the rare event that there's Seo allegation will that is In my experience always a plaque rupture plaque fisher Definitely a challenging and we know that patients come in with this mixed picture especially in these cases and so it could be very challenging to suss out even sometimes after they go to the Cath lab and they do have underlying coronary disease as they very likely. Do you know even then. It's hard to know if it's a plaque rupture unless you see like a large lesion calf agreed in. I don't think tripling in helps them much. Asians with very large proponent elevations with a type two event and smaller elevations with a type one events. So that is not very helpful in the challenge with studying type two events is. It's such a mixed bag. Patients that the exact treatment except treating what's driving it has not been readily elucidated in Well-studied given the diverse population that develops as we do know is bad noces has type one event and these patients have to be evaluated and watch. We recently talked to an Italian cardiologists in Milan and he was saying that in addition to Kobe. hid presentations like myocarditis. He was seeing a lot of late. Presentations of 'em is in patients without coated. Who were kind of staying at home? Because they didn't want to leave and get infected into their presenting pretty late in their course. Have you seen this yet in the new Baltimore were still early in this pandemic? Uh certainly emotional. Stress is well associated with the onset of q Mike Cohen Fortune and we have to not only people infected but love lunches and people not infected with the stressors of what's going on may be at Risk for two Mike. I WANNA move onto our next topic but before I do I I was telling the group earlier. I interviewed a cardiologists in Spain today. And they're like just really trying to stay afloat they're dealing with. It's like a crazy crisis over there. But he actually mentioned. They've seen a huge draw in a my presentations as well. Probably for the same reason he didn't he didn't elaborate but I think it'll be really interesting to see over the course of this pandemic how things sort of shift around I also worry Patients are afraid to come ospel. Yeah no exactly Dr Shamma. What are your thoughts on Coronary CPA for some of these patients season as you're trying to sort out it's really a type. One or type chew event or even myocarditis into acute setting and especially as our our technique gets better able to image patients with a higher heart rate and also thinking about protecting the Cath lab personnel. What do you think about? Cpa in some of these settings sorry city could be a very useful tool we are in the covert nineteen patients in those under investigation. We are trying to limit moving them in and out of their rooms. Any evaluation would have to wait. 'til things have stabilized. You really interesting randomly. You brought up that point because docker Gianluca on donating or Italy. Experience episode did mention that they were trying to use her French Lee more. Cpa to help. Triage Cath Lab us. By as a way of trying to minimize exposure but even going to the Cath Lab of course presents problems sternly does we're also being judicious Catholic abuse and we are getting circum sat in all our tests and isolate. What's best for the patient and best for caregivers soon to get the best outcomes for everyone? Okay so back to our patient. Gavin Flu Enza. Clearly stem is suspected and with proper droplet precautions. The patient is brought to the Cath Lab. Where a proximal. Led inclusion is identified and successfully balloon treated with drug alluding stent once am. I is suspected or identified doctor. Shulman is there a difference in management in these patients so unaware of increased risk of stent thrombosis though concerned that they're a pro thromboembolic? State and platelets are activated with a viral syndromes as render sin stated in so when one thinks about dual anti platelet therapy Consider weighing clotting and bleeding risk but a more potent one of the more potent platelet antagonists. In addition the aspirin would probably be a reasonable treatment. Definitely makes sense. And then you know we. We've already touched on this a bit but particularly in the Cova era. What are your impressions in terms of Protective Management? How we can sort of best handle that. While taking patients to the Cath Lab. We've had a few patients. Taken the Cath lab with ESI signal vision in mind and or patients under investigation known Begovic positive emphasis is on safety of the patient and safety of the staff and less emphasis on door to balloon. Time of ninety minutes so all protective equipment has to be in place we have designated a specific Cath lab suite for care of these patients and share be given to safely getting this patient to the kappa in safely performing the procedure. Incredible and I think that judicious use of the Cath. Lab is going to be really important. Moving forward returning to our patient. Korean awesome job opening up that led really happy to see Mr Flu Enza back on its feet doing laps around the unit. Getting good physical therapy without any difficulty by day. Three of his event he is tolerating his awesome regimen of Aspirin Keg or high-intensity Staten and mature Polo and an echocardiogram sheild ethical hypoc nieces but the Egyptian fraction overall preserved turning now to how long term outcomes are different in these patients from those observant types of m. i. that are not confounded by viral infections. Ron Johnson really enjoyed reading your paper in the American Journal. Cardiology examined the short term prognosis and management of patients with my cardio fortune but competent influenza. You mind walking us through the steady what you found and what that may mean for the clinicians taking care of patients absolutely on it before I get into the details of the city also want to acknowledge too hard work if all my co-authors involved especially my friend Dr Manuel Rivera. He's a cardiology fellow at the Washington University in St Louis and also Dr Mad Sarin. You WanNa far interventional cardiologists who are really instrumental in disfavor. The study was actually motivated by patient. That I cared for very similar. Mr Flu Enza. We reviewed the literature at the time and found many reports on dissociation of influenza and other viral respiratory illnesses with acuity my very little data on the outcome of these spacious. So we set out to examine this question in the national inpatient sample. This is the largest database of inpatient care in the United States in the period that we interrogated the database. We've found four point. Two million acute him is an off does about thirteen. Thousand patients had a concomitant diagnosis of influenza on the same admission so we did chew things into study. I wanted to report the descriptive outcomes of these patients with influenza and accused him. I and second compared the outcomes in these patients true controls with acute am I and no influenza. So what did we find I to fall the patients with acute on my end influenza there were older and they had a higher burden of some commodities like heart failure diabetes but a lower rate of atherosclerotic risk factors like tobacco smoke in hypoglycemia compared to patients with acute. Am I in no influenza? What about how the the spacious STU? What were there in hospital outcomes? What about the descriptive outcomes of these patients so it turns out that? About ninety percent of this population had honesty elevations myocardial infarctions in only ten percent had stems about a quarter of them had coronary geography. An eleven percent underwent some type of coronary vascular ization most commonly now. This is a really important point. The in hospital mortality of these patients was very high was about fourteen percent and one third of these patients with acute M. I. N. Influenza had multi organ failure moving on to the second objective which was to compare. The outcomes of these patients should those without influenza. You can't imagine that there's a lot of confounds this comparison because these populations are different in many levels. Not just with regards to influence the diagnosis to minimize confounding with did a propensity score matched analysis and we were very strict are matching criteria Indiana. We compared almost twelve thousand patients with acute in my who had influence A to an equal number. We've found influenza so even with propensity matching. We've found that. The patients with influenza had a higher in hospital Mortality Acute Kidney Injury Multi Organ Failure Live for stay compared to those acute in my and without influenza. So what this data really highlights is really that did first outcome and prognosis of patients with acute in my influenza. And yes there's an an important limitation is that we're not able to differentiate type one or type two. Mi's based on this data alone but like Doctor Schumann eluded chewed these patients. Really even with type. Chew Him I have a poor prognosis and it's important to recognize that and I also want to say that all those studies that reported association of acute in my and influenza they really didn't differentiate those type of myocardial infarctions. Because it's often hard to do that without doing routine Korean geography and all the patients. So this data really highlights adverse outcomes in these patients and how they're currently manage. Wow Anderson thank you so much and thank you for all your work on this subject and that was really a stellar explanation. So what Next Steps in research so we can maybe make a dent in the poor outcomes that we're seeing with patients who are presenting with both flu. And am I so I think an important aspect of the treatment of these patients will be finding better ways to phenotype these patients. Ideally we would do that. Noninvasive Lee because we can't the routine coordinating geography or intra coronary imaging in all patients. As our noninvasive imaging tools get better. I think it's really an area that deserves more attention and research on how we can better manage these patients with a virus. Pretoria illnesses or other situations that can lead to a type shoe am I but also. There is a significant portion of these patients. Who HAVE BLACK RUPTURE IN HAVE TYPE? One event and another potential area for research would be to develop the ideal therapies for these patients. I think that despite widespread knowledge that type two events are common in associated with an adverse prognosis. There's such a heterogeneous population that we really haven't figured out exactly how to treat them effectively. And I think it all starts first with fina typing population better so we can ultimately come up with better treatment strategies while rendered. I'm so glad that smart people like you are looking into things like this and I can imagine only become more relevant in a covert era. I'm wondering Doctor Shulman. What parallels do you see or anticipate with the Kobe? Nineteen affected patients. And do you have any thoughts in terms of what will be encountering moving forward so given a random person so wonderful article in explanation? It strikes me that When only twenty three percents of flu when my patients are going that a Cath? Lab was such a POOR PROGNOSIS. Just raises the alarm. That in this high risk group of patients with flu and I'm sure with cove in nineteen at as Corday August. We have to be on the lookout for more aggressive therapies and figure out who should be in the GAFF lot and it strikes me a much higher percentage in ten percent to look at their anatomy. Figure OUT WHO said a plaque rupture type one of that too. Vast grows of those patients and in those. We don't leave Astros at least better. Risks Ratify as so. We could figure out who needs more aggressive therapies. I think we'll be saying a whole host of Mike Complications. Mike nation's third complications in Cove in nineteen population and ongoing. Research will help us figure out who needs a Catholic who needs a mechanical support and noninvasive evaluation and we have to get better or a restaurant find these patients to decrease future rest. That's absolutely wonderful. Show tonight I agree you know as terrifying an uncertain as this pandemic is. I think the one thing that remains true is that there is definitely going to be a lot to learn from this. You know from a cardiovascular standpoint from a medicine standpoint and so they'll be a lot of potential for research moving forward Doctor Shulman Dr Cardozo. We WanNa thank you from the bottom of our hearts for taking the time to teach us more about this important topic. Not only. Are we still in flu season. But as we've discussed at many points in this interview were going to undoubtedly be facing several unanticipated cardiovascular complications such as Acute Coronary Syndrome Maya Card itis a heart failure like doctor Shulman met me mentioned in patients infected with cove in nineteen and it will be so important for us. Cardio nerds to be on the lookout for these potential complications. Moving forward there are a lot of units that are trying to learn how to plan for the surge and just logistics doctor Shulman as the director of the Johns Hopkins. Ccu I think many are wondering. What are the steps? You're taking to prepare for the surge of Kobe. Patients thanks mid. It's certainly a stressful time for patients nursing staff antlers staff how staff fellows in attempting alike. Everyone has.

influenza Cath lab Gavin Flu Enza Doctor Shulman flu Cath Acute Coronary Syndrome Kobe aspirin fever Lee Doctor Shulman Dr Cardozo Cove Mike corless granderson Dr Manuel Rivera Spain Milan Mike Cohen Fortune
"myocardial infarction" Discussed on Cardionerds

Cardionerds

04:03 min | 2 years ago

"myocardial infarction" Discussed on Cardionerds

"Michael in fortune indeed the majority of patients we see are type. Two non stemming events the patient described today with an se segment elevation at my is somewhat atypical in our most recent and DEMOC with covert nineteen. There's a another potential mechanism of Michael Injury. The source corona virus to virus of binds to humid injured tense in converting enzyme two receptor which is highly expressed in the respiratory tract in as well as the heart in itself out seven percent of current covet a nineteen patients admitted to the hospital at positive components and about one in four patients who are critically. Oh what cove. In nineteen will have positive proponent ovations. I wanted to sort of Digress. A Little Bit. Since you brought up cove in nineteen and the proponent elevation. I know you recently completed a stint in the C. C. You when you see the proponent elevation how were you distinguishing between acute coronary syndrome and another possible reason like Myocarditis in these patients? Oh that's a great question. Renew one of the challenges and Asians infected and non infected is distinguishing Mike Coral injury from my coralline fortune. And so we're certainly looking for beyond the enzyme elevation evidence of Schema via symptoms he. Cg Wall motion add the Molly at would let us define this. As a micro and fortune nonetheless. The prognosis whether it's injury or micro fortune both adds significantly to the disease process in an adverse way M. I usually present differently in these patients or is it. Is there a difference in the severity. The presentation depends on the context in my experience and in the Lurch. Mr Does present differently so in contrast the primary reason a patient comes to the corner carrying with acute my com fortune. These patients arrived at the hospital with their viral syndrome. And then through evaluation either worsening shortness of breath E C g changes are full motion. Add the molly gives us a hint. That the Horta's involved with this Processes well and so we have to have a very high index of suspicion particularly in patients the elderly those with pre existing corners easing multiple risk. Factors at this. Is that risk population in that? The heart may ultimately be involved in the process. And you said at n stem is usually the more common presentation compared to stem. -I absolutely soon In the literature and in Randy Johnson study. He didn't ninety percent of patients will have anonymously segment. Elevation of that is sorry guys. This is I may have been quiet so far. But I've just been so mesmerized by this discussion and I have to say house specialises for me. Dark Schulman running with you and learning from you remains a among my favorite memories from residency. And it's a it's so awesome. Learn from you again right. Now when we're talking about the Michael Injury in the within the context of a viral infection jetting is relevant for influence and cove. Ed How are you teasing out in? Acs Presentation from Microsoft is. Can you walk us through your steps in terms of are there differences in the clinical history or proponent trend or ekg? And I asked. Because ideally we would try to minimize trips to imaging testing or the Cath lab to try to prevent exposure to healthcare workers. Just so in the Kovic. Nineteen Pandemic News Ben to patterns of Michael Injury Pattern is a progressive rise in proponent associated with other inflammatory Markers d diner Feridan. I'll six in that likely reflects Cited kind storm of that of shoe patients..

Michael Injury Horta Molly Michael Michael Injury Pattern acute coronary syndrome respiratory tract viral syndrome Cath lab Mike Coral Kovic Microsoft Dark Schulman Randy Johnson Mr
"myocardial infarction" Discussed on Cardionerds

Cardionerds

06:53 min | 2 years ago

"myocardial infarction" Discussed on Cardionerds

"Affects the lives of hundreds of millions dedicated cardio nerds everywhere are working hard to fight this global epidemic. These are their stories. Welcome back Carter nerds. We are continuing our series on cardiovascular implications of Cova nineteen given that there is still so much that is unknown about the cardiovascular consequences of Kobe. Nineteen today we are going to focus on another respiratory virus influenza and one of its unfortunate cardiac complications myocardial. Infarction we are super thrilled to be joined today by our fellowship director and director of the C. C. You at Hopkins Dr Steven Schulman as well as one of our star Co fellows Dr Anderson Cardozo and friends before we dive into this treasure of discussion. Please be sure to subscribe to the Cardio Nurse to channel ringing high yield bite-size education directly to your screens this week. We are just thrilled to feature a phenomenal ten minute video about all things. Cutie interval related by Dr Dino as Kudsy cardiology fellow at the Johns Hopkins Hospital to Cutie is one of our favorite intervals but is especially important. Now as you consider the impact of drugs like hydroxy chloroquine in the era of covered. Nineteen four we get started friends. Just remember this. Podcast is not meant to be used for medical advice. Views expressed here do not necessarily reflect the opinions or policies of our employers. The goal is simply to enjoy learning more cardiology in Kupwara directly from expert. Cardi nerds. Dr Steven Shellman graduated from Johns Hopkins University School of Medicine. He fulfilled his training in internal medicine and chief residency as well as completing his cardiology fellowship at Hopkins Capture. Shulman is the director of the coronary care unit as well as the cardiology fellowship program director at Johns Hopkins. His mean research interests include acute myocardial. Infarction he has won numerous teaching awards from Hopkins residents and fellows over the years while attending in the see. Cu Doctor Shulman teaches and guides the next generation of residents and fellows about acute cardiac care. Dr Ryan Anderson Cardoza Graduated Medical School at the University of go. Yes in his home country. Brazil he then completed internal medicine residency and chief year at the University of Miami Jackson. Memorial hospital has diverse interests in cardiovascular diseases including electrophysiology imaging and prevention. He is especially passionate about teaching and hopes to have a career and he will have a career in. Academic Medicine is currently earning a master's degree in cardiovascular epidemiology at Hopkins Bloomberg School of Public Health and Planning on pursuing additional imaging training at Brigham and women's Hospital in the upcoming academic year. Definitely if everybody could feel free jumping but I have to just comment a few things first of all doctor Shulman. You are just such a leader in this era you have really just lifted up the entire program and all the fellows and faculty feel like you have our back and we feel confident as we face. This endemic in really big crisis. That's coming our way and Randy. Johnson I just as a friend and as a CO fellow. We have just had the best of times together. We teach each other. That's actually more you teaching me. We I definitely could not have passed. Echo boards that use. I just wanted to say this is a real treat to have you both here. Should I just say like thank you for the introduction yet? What everyone thinks. Please please thank us? Thanks a lot for decayed words of introduction. Dan and it's really such an honor to be of Carter nerds. Thanks very much for having me on the show as I pleasure to have. You here still excited that you're here cardio nerds and that's a real treat doctor. Shulman okay. Why don't you take it away okay? So let's start off by introducing patient. Mr Gavin Flu Enza a lovely Italian pizza parlor owner in his mid fifties. He has a history of hypertension and he was in his usual state of health until a week ago when he developed a runny nose. Cough increased sputum production with Associated Malays in myalgia initially wanted to finish it out at home but ultimately he decided to come to the emergency department because he developed chest and shoulder pain developed earlier on the day of presentation his initial vital signs were remarkable for a blood pressure of one hundred sixty three over ninety eight. His heart rate was seventy one respiration at fifteen and he's saying about eighty eight percent on room air and then would bumped up to ninety six percent after being put onto leaders of nasal Kenya his initial. Ekg showed normal sinus rhythm with anterior t wave inversions but a repeat ekg five minutes later demonstrated st elevations in the anterior elites as he's being whisked away to the cath lab the charge nurse in that emergency room hands out masks and gowns to the team because rapid flu senate. The emergency room triage returned positive for influenza A. Wow Heather this definitely sounds like a full blown. Mida me in the setting of the flu. In general there has been a proposed link between acute respiratory virus infections such as influenza and myocardial infarction and this has been reported since the early nineteen. Thirty's a two thousand eighteen study in the New England Journal by Quang. All the link to which will include on our website found that the incidence of admissions for acute am. I was six times as high during the seven days after laboratory confirmation of influenza infection as during the control interval Ron Johnson. What do you think is the mechanism whereby acute respiratory infections might make individuals more susceptible to myocardial infarction? That's a really great question. Korean the mechanism by which influenza and other viral illnesses including right now. Cova nineteen can lead to acute coronary syndrome are several fold. First of all acute him. I can be a type one mechanism because the systemic inflammatory and immune response off of the illness is pro through botox. So there's include increased platelet activity abnormal window telea function and decreased license creating a Milieu second the. Systemic inflammation can also increased activity of inflammatory cells produce Olympic enzymes contributing potentially to an unstable black. These mechanisms can lead to a type. One Am I. But there's also many different ways in which an influenza or other viral upper respiratory infection can cause a type chew in my by either increasing demand or decrease in supply a fox in profusion tomorrow Carter Tissues so those mechanisms include tack Ikaria Hypoc Sena increased systemic metabolic demand hypertension and so many other mechanisms house. Wonderful Render. Send you really create a picture of all the different reasons for for. Why am I can present in these patients? I want to turn now to Dr Shulman in caring for patients in the.

doctor Shulman Infarction influenza Doctor Shulman Johns Hopkins University Schoo Carter Johns Hopkins Hospital myocardial infarction director Ron Johnson Hopkins Capture acute coronary syndrome Dr Dino Cova Dr Steven Schulman Johns Hopkins Dr Anderson Cardozo Hopkins Bloomberg School of Pu Dr Steven Shellman Dr Ryan Anderson Cardoza
"myocardial infarction" Discussed on WBZ NewsRadio 1030

WBZ NewsRadio 1030

02:40 min | 2 years ago

"myocardial infarction" Discussed on WBZ NewsRadio 1030

"Another attack on the U. S. presidential campaign this time linked to over on Microsoft's as a hacker bling to that country a lease to cyber attacks on a campaign on government officials and even on journalists correspondent Jeff Begay he says the tack appears to be significant but relatively low tech operation much like the one that successfully stole the emails of Hillary Clinton's campaign chairman in two thousand sixteen Microsoft says the hackers when after two hundred forty one email accounts of campaigning government officials journalist and others. it was for personal accounts were compromised Microsoft is not saying which presidential candidate was hacked a house committee is set to subpoena to the White House demanding documents that could provide details on president trump's effort to push you crazy to produce information that could damage Joe Biden's presidential run the subpoena was issued by the house oversight and reform committee as part of Democrats and peach with investigation of Mr trump house foreign relations committee member congressman Eliot Engel on CNN I believe where there's smoke there's fire and I think the American people believe that too and as we have more and more people as witnesses and more and more people coming to to talk to us I suspect they'll be a lot more smoking a lot more fire a senior White House official tells CBS news that there are discussions with in white the White House about the upsides of impeachment Bernie Sanders campaign confirms that the senator suffered a heart attack when he was taken to the hospital in Las Vegas this week democratic presidential candidate had two stents placed into a blocked artery CBS news chief medical correspondent Dr John the poop says there are still questions the devil's in the details here okay he had a myocardial infarction but how big of a myocardial infarction or heart attack we don't know that yet we don't know what other tests were done we don't know if he has any other medical condition but having had a heart attack in and of itself should not prevent him from continuing to run for president or being prepped the seventy eight year old was released from the hospital today. or bad vaping news Pennsylvania and Michigan now reporting dazzling to vaping and many more illnesses are coming in daily the CDC's Dr and shook it I cannot stress enough the seriousness of these long injuries associated with a cigarette you survey thing federal health officials are working around the clock to try and find the culprit is the emergency operations center at the CDC here in Atlanta has been open since last month CDC recommends right now people stay away from vaping as the investigation continues Sabrina cubic CBS news Atlanta there have been nearly eleven hundred illnesses related to vaping this is CBS news..

infarction CBS vaping Pennsylvania Bernie Sanders Mr trump Atlanta CDC Michigan president heart attack Dr John Las Vegas senator official CNN congressman Eliot Engel
"myocardial infarction" Discussed on 77WABC Radio

77WABC Radio

01:32 min | 2 years ago

"myocardial infarction" Discussed on 77WABC Radio

"A myocardial infarction otherwise known as a heart attack the seventy eight year old was hospitalized on Tuesday after he experienced chest pain during a campaign event Sanders left a Las Vegas area hospital on Friday after having two stents place in a blocked artery Sanders says he's ready to return to work I'm Kerry she maker the house oversight committee sending a subpoena directly to the White House the latest effort to obtain documents to the impeachment probe correspond with the Kenyan has a story opinion demands documents after committee chairman Elijah Cummings says the White House ignore two letters in September seeking the documents the subpoena escalates the ongoing clash between the legislative and executive branches of government as the impeachment inquiry picks up speed the inquiry began after a whistleblower reported a phone call in which the president reportedly was withholding military aid to Ukraine to pressure that leader to investigate political rival Joe Biden and reaction from Joe Biden he's corrupted the agencies of government from the defense department from the state department from the justice department all about making sure that he in fact allow somebody else to pick his opponent for him. that's what this is about police around the city and across the country patrolling movie theaters showing the film joker this weekend there been no specific threats but it's feared that the film could glorify violence and inspire those who sympathize with the character to mimic him some fans with tickets to see the flick though say they're not worried little scary but I think.

infarction Sanders house oversight committee White House Elijah Cummings president Ukraine Joe Biden justice department Las Vegas chairman executive seventy eight year
"myocardial infarction" Discussed on NEJM This Week - Audio Summaries

NEJM This Week - Audio Summaries

02:00 min | 3 years ago

"myocardial infarction" Discussed on NEJM This Week - Audio Summaries

"A recent study showed an increase in the risk of myocardial infarction during the week after laboratory confirmed infection with influenza virus respiratory Sincil virus or other respiratory viruses to a risk that was six four and three times higher respectively than the risk during the year before or after the onset of infection the association between acute infections and an increased risk of myocardial infarction persists beyond the short-term post infection period. Among patients with mild respiratory infection. Or urinary tract infection? The risk of myocardial infarction returns to baseline within a few months after resolution of the infection among patients with pneumonia. The risk also decreases with time, but still exceeds the baseline risk up to ten years after the infection the increase in the risk of myocardial infarction both in the short term. And the long term is more pronounced when the infection is more severe the strength and temporal pattern of the association between acute infections, and an increased risk of myocardial infarction suggest a causal relationship the authors review, the evidence that acute bacterial and viral infections are associated with an increased risk of myocardial infarction in the short intermediate and long term. And they then discuss mechanisms that might explain this assoc-. A thirty four year old veteran with multiple somatic symptoms. A case record of the Massachusetts General Hospital by Abigail Donovan and colleagues a thirty four year old male war veteran was evaluated for headaches cognitive changes mood symptoms. Flashbacks? Chest pain, armed tingling and gastrointestinal symptoms..

urinary tract infection infarction Massachusetts General Hospital Abigail Donovan pneumonia thirty four year ten years