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Keys to Diagnosing Broken Heart Syndrome (Takotsubo Cardiomyopathy) Mark P. Brady, PA-C   |  February 17, 2016 Electrocardiography The most common ECG finding in acute TCM is ST-segment elevation in the precordial leads (usually V2-V3),[1,3,20] although an initially normal or nonspecific ECG finding is seen in 20%-30% of affected patients.[1] The ST-segment elevation is then followed by diffuse T-wave inversions (as the ST segments normalize) along with QT prolongation. T...
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Keys to Diagnosing Broken Heart Syndrome (Takotsubo Cardiomyopathy) Mark P. Brady, PA-C   |  February 17, 2016 Takotsubo cardiomyopathy (TCM), first described in 1990 by Sato et al,[1,2] is a transient cardiac syndrome that involves left ventricular (LV) apical akinesis and basal hypercontraction that may symptomatically mimic acute coronary syndrome (ACS).[1,3] A significant emotional (eg, an unexpected death of a loved one, a divorce, bad financial news) or physical ...
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The 50 Most Influential Physicians in History, Part 1: #50-#36 Steven Rourke  |  February 5, 2016 Compiling a ranking of the most influential physicians throughout history is a perilous undertaking that has fueled animated discussions between Medscape editors and advisors. Influence is a tricky thing to gauge, after all, and depends entirely on one's viewpoint, background, location, and specialty. And "history" is a rather long timeframe. Some prickly questions were raised...
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Physical Manifestations of 8 Drugs of Abuse Michael J. Payette, MD, MBA  |  February 2, 2016 Anabolic Steroids Anabolic steroids, also referred to as "Arnolds," "juice," and "roids," are synthetically produced variants of testosterone.[1,3] Their clinical use has been for hormone replacement therapy and for illness-related cachexia.[22] As drugs of abuse, anabolic steroids are used as performance enhancing agents—for promoting muscle growth, enhancing athletic and/or sexu...
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Physical Manifestations of 8 Drugs of Abuse Michael J. Payette, MD, MBA  |  February 2, 2016 Discussion of substance abuse generally revolves around addiction, with a focus on the neurologic, psychosocial, and medicolegal consequences of this disorder. It is known that most drugs of abuse can alter a person's thinking and judgment, as well as lead to health risks that include addiction, drugged driving, and infectious disease.[1,2] One important issue that may not be cons...
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大连医科大学重症医学研究所/附属一院重症医学科(116011)李文雯 万献尧   急性呼吸窘迫综合征(ARDS)是严重威胁患者生命的危重症,其临床发病率和病死率均较高。尽管近年来对其发病机制、治疗策略等研究有了很大的进展,但其病死率仍居高不下,可达36%~45%[1],甚至更高。因此,及时正确的诊断与治疗,在临床工作中起着极其重要的作用。 自1967年Ashbaugh等[2]报告了ARDS的病例以来,ARDS便成了基础和临床的研究热点,但尚缺乏统一的临床诊断标准。直至1994年,欧美联席会议(AECC)提出了急性肺损伤(ALI...
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首都医科大学附属北京朝阳医院-北京呼吸疾病研究所   李洁 詹庆元 (CSCCM原创,转载请注明) 一、基础篇: 1. 首先,从呼吸机如何送气说起:一般而言,呼吸机的功能是将一口气吹进患者肺内,至于其如何呼出,与呼吸机无关。因此,呼吸机的工作原理即吸气相的送气原理,而送气原理有三要素: 1) 触发: 何时送气:这主要由呼吸机设置的触发灵敏度和患者自主呼吸强度决定,一旦患者自主呼吸强度达到预设值,呼吸机开始送气,称为自主触发;如果患者自主呼吸达不到或...
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[专家课件] 动脉血气分析及高乳酸血症-杜斌已关闭评论
动脉血气分析及高乳酸血症 杜斌 // < ![CDATA[ // < ![CDATA[ AC_FL_RunContent( 'codebase','http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=9,0,28,0','width','630','height','504','src',http://www.csccm.org.cn/Slideshow/lactic/LacticAcidosis.swf','quality','high','pluginspage','http://www.adobe.com/shockwave/download/download.cgi?P1_Prod_Version=ShockwaveFlash','movie','http://sunwardmedical.gicp.net/video/10Anniv/21n_12' ); //end AC c...
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6-step Approach in ABGs 整理及讲解:杜斌 摘录并翻译自:http://www.thoracic.org/sections/clinical-information/critical-care/abgs.html (CSCCM原创,转载请注明) [ 第一步 ] 根据 Henderseon-Hasselbach 公式评估血气数值的内在一致性 [ H+ ]  = 24 x ( PaCO2 ) / [ HCO3- ] o 如果 pH 和 [ H+ ] 数值不一致, 该血气结果可能是错误的 pH 估测 [H+]                           (mmol/L) 7.00 100 7.05 89 7.10 79 7.15 71 7.20 63...
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