Therapeutic Hypothermia After Cardiac Arrest Protocol
Therapeutic hypothermia after cardiac arrest is an increasingly used strategy to improve outcomes after myocardial infarction. Most medical centers have developed protocols to be used by the emergency medicine, ICU, and nursing staffs. One representative protocol that is similar to the one used at the University of Chicago Medical Center is outlined below.
Eligibility
1. status post cardiac arrest
2. return of spontaneous circulation within previous 6 hours
3. presence of coma (patient does not follow commands or open eyes to pain)
4. check pregnancy status in women < 50 and if positive contact Obgyn
Exclusion Criteria
1. ...
Source: Inside Surgery - February 17, 2013 Category: Surgeons Authors: Editor Tags: Cardiology Critical Care Source Type: blogs
Endometriosis
Pathophysiology of Endometriosis
1) presence of benign endometrial tissue outside of uterine cavity
2) most commonly found in posterior cul-de-sac (pouch of Douglas)
3) also found on ovaries, rectosigmoid, bladder, uterosacral ligaments and very occasionally at distant sites such as
lungs, bones, umbilicus
4) pathogenesis is uncertain
Signs and Symptoms
1) pelvic pain
2) dysmenorrhea (esp. before onset of menstrual flow)
3) dyspareunia
The post Endometriosis appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - February 11, 2013 Category: Surgeons Authors: Editor Tags: Surgpedia chocolate cysts endometrial tissue pelvic pain powder burns Source Type: blogs
IBM Supercomputer Watson to Aid in Cancer Diagnosis
IBM Supercomputer Watson is being used to aid the diagnosis of cancer.
The post IBM Supercomputer Watson to Aid in Cancer Diagnosis appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - February 11, 2013 Category: Surgeons Authors: Editor Tags: Oncology Source Type: blogs
Hypertonic Saline for Fluid Resuscitation
Hypertonic saline for fluid resuscitation is best performed with an institution-approved protocol. One such protocol which closely follows the protocol used in the surgical ICUs at Johns Hopkins Hospital is described below:
Indications
To resuscitate patients with any of the following:
The post Hypertonic Saline for Fluid Resuscitation appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - February 9, 2013 Category: Surgeons Authors: Editor Tags: Critical Care fluid resuscitation hypertonic saline ICU Johns Hopkins Source Type: blogs
Chris Christie Weight Causes Testy Reply
Chris Christie, Republican governor of New Jersey, yesterday grew testy in a press conference when he spoke about a physician whom he had never met or consulted making remarks about his health and mortality risk.
Dr. Connie Mariano, a former rear Admiral in the Navy and also former White House physician, in an interview about Chris Christie weight related mortality risk, said she would be concerned about Christie’s prospects for completing a full term as President because of his increased risk secondary to his morbid obesity. Christie responded by calling her a “hack” and telling her to “shut up....
Source: Inside Surgery - February 7, 2013 Category: Surgeons Authors: Editor Tags: Medical News Wire Chris Christie Connie Mariano problems shut up weight Source Type: blogs
Obamacare Loophole Puts Caps on Some Student Health Insurance
Obamacare was supposed to end lifetime caps on insurance payments, but a loophole is allowing some universities that administer a self-funded insurance plan to place lifetime caps on care. University of California student Micha Rahder is learning this the hard way as she has been cut off from the insurance plan that allows her to receive medication she needs to walk. She is afflicted with a rare neurological disorder that causes chronic demyelination of her nerves.
Colleges that offer this type of insurance and in fact require students to have insurance are located largely in the Ivy League and in the University of Califor...
Source: Inside Surgery - February 1, 2013 Category: Surgeons Authors: Editor Tags: Medical News Wire caps lifetime loophole micha rahder Obamacare student insurance Source Type: blogs
Doctor Murdered in Exam Room, Patient Held as Suspect
Dr. Ronald Gilbert, a urologist by training, was shot to death in a patient exam room as he worked through his daily office hours at the Hoag Health Center in Newport Beach, Califorina. Patient Stanwood Elkus was arrested and is being held without bail as the investigation unfolds.
The post Doctor Murdered in Exam Room, Patient Held as Suspect appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - January 30, 2013 Category: Surgeons Authors: Editor Tags: Medical News Wire Hoag Health Center murdered Ronald Gilber shot Stanwood Elkus urologist Source Type: blogs
Stem Cell Transplant Increasingly Sought by Patients
Stem cell transplant and treatment is offered in hundreds of clinics outside of the United States for conditions ranging from cancer to arthritis to autism, but American physicians warn patients of potential dangers, saying clinics like to use the term autologous and FDA approved to mislead people.
Blood containing stem cells for transplant
The post Stem Cell Transplant Increasingly Sought by Patients appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - January 27, 2013 Category: Surgeons Authors: Editor Tags: Oncology arthritis autologous bone marrow Cancer stem cell treatment Source Type: blogs
Sarcoma – Signs, Histology, and Treatment
Pathophysiology of Soft Tissue Sarcoma
1) sarcomas of the soft tissue are a family of neoplasms affecting the soft tissue of the body Causes 2) previous radiation 3) HIV 4) genetic predisposition such as L-Fraumeni syndrome 5) asbestosis 6) congenital immunodeficiences 7) dioxin exposure 8) Herpes virus
Signs and Symptoms
1) most common presentation is an enlarging mass 2) pain 3) neuralgia and neurologic deficits, if the tumor encases a nerve structure 4) metastases are usually via the blood system and most commonly go to the lungs
Characteristic Test Findings
Radiology – mass on MRI
Histology/Gross Pathology
1) m...
Source: Inside Surgery - January 27, 2013 Category: Surgeons Authors: Editor Tags: Oncology angiosarcoma leimyosarcoma malignant fibrous histiocytosis p53 Schwannoma tumor suppressor Source Type: blogs
Babesia Infection – Signs, Symptoms, and Treatment
Pathophysiology of Babesia Infection
1) Babesiosis is caused by the intracellular protozoan parasite Babesia microti and in Europe B. divergens 2) most severe symptoms occur in immunosuppressed, diabet6ic, splenectomized, and elderly 3) now clinically important in the USA and Candada as a coinfection of Lyme disease, ehrlichiosis, and Bartonella (which are all transmitted via the bite of the Ixodes tick)
Signs and Symptoms
1) acute flu-like symptoms – fever, chills, sweats, muscle pain, fatigue, arthralgias, and headache 2) petechiae 3) jaundice/dark urine 4) if occurs as coinfection with Lyme disease, the clinical ...
Source: Inside Surgery - January 27, 2013 Category: Surgeons Authors: Editor Tags: Infectious Disease atovaquone babesia babesiosis bartonella coinfection ixodes Lyme microti tick Source Type: blogs
Varicella-Zoster Virus Signs, Symptoms, and Treatment
Pathophysiology of Varicella-Zoster Virus
Varicella-Zoster causes two separate disease 2) initial disease is chickenpox 3) after a latency period (can be decades) patients can develop zoster (shingles)
Signs and Symptoms
Chickenpox – 1) fever 2) malaise 3) painful vesicular rash, starting on head and spreading to limbs, mouth, vagina, and trunk that ulcerates and crusts over in 3-5 days 4) vesicles appear in crops (different areas of body have lesions in different stages) 5) in older children and adults, causes life-threatening interstitial (as opposed to a bacterial intra-alveolar) pneumonia with lung hemorrhage, co...
Source: Inside Surgery - January 25, 2013 Category: Surgeons Authors: Editor Tags: Infectious Disease Source Type: blogs
Pulmonary Hypertension
Pathophysiology
1) increased arterial pressure in lungs 2) primary or idiopathic form occurs in absence of known precipitating causes 3) secondary form caused by – mitral stenosis, pulmonary venous occlusive disease, extreme obesity (Pickwickian syndrome), chronic hypoxemia, recurrent pulmonary embolism, kyphosis, infiltrative lung disease, chronic bronchitis, long periods at high altitude
Signs and Symptoms
1) insidious onset of dyspnea idiopathic form 2) right heart failure with venous distention of neck 3) peripheral cyanosis late in disease 4) palpable right ventricular heave (owing to cor pulmonale) 5) fatigue ...
Source: Inside Surgery - January 23, 2013 Category: Surgeons Authors: Editor Tags: Pulmonology arterial pressure cyanosis dyspnea high altitude lungs obesity right heart failure Source Type: blogs
Rheumatic Fever
Pathophysiology
1) caued by group A beta-hemolytic streptococci infection 2) this organism produces anti-M protein antibodies, which cross-react with human heart tissue 3) most important long-term sequelae (Source: Inside Surgery)
Source: Inside Surgery - January 19, 2013 Category: Surgeons Authors: Editor Tags: Infectious Disease Source Type: blogs
USMLE Questions – Characteristic Disease Findings
The United States Medical Licensing Examination (USMLE) is designed to emphasize knowledge of clinical scenarios and clinical pearls, even on Step I. Listed below are some commonly encountered disease findings and characteristics.
Feature
Disease
45, X chromosome
Turner’s syndrome
5-HIAA increased in urine
Carcinoid syndrome
Aganglionic rectum
Hirschsrpung’s disease
Apple-core sign on barium enema
Colon cancer
Arched back (opisthotonos)
Tetanus
Argyll-Robertson pupil
Syphilis
Ash leaf on forehead
Tuberous sclerosis
Auer rods
Acute myelogenous leukemia
Austin Flint murmur
Aortic regurgitation...
Source: Inside Surgery - January 18, 2013 Category: Surgeons Authors: Editor Tags: Surgpedia USMLE diseases findings VMA water hammer pulse Source Type: blogs
Nonabsorbable Sutures
Suture material can be classified as absorbable sutures or nonabsorbable sutures. Nonabsorbable sutures are used in many fascial closures of the abdomen and in skin closures and vessel ligation. The following are categories of nonabsorbable suture. (Source: Inside Surgery)
Source: Inside Surgery - January 5, 2013 Category: Surgeons Authors: Editor Tags: Tip of the Day Source Type: blogs
