21 Nov 2013

November 21, 2013

Written by REBEL EM
Gallbladder cancer (GBC) incidence ranges from 12 - 62% when porcelain gallbladder (PGB) is seen.  You ever wonder where these numbers come from?  Well, these are the quoted numbers from two studies done in 1959 and 1966.  These studies also indicated that if porcelain gallbladder was seen, that a prophylactic cholecystectomy should be performed. Is this the best evidence we have?  Is there nothing more recent?  Well, it turns out there is.
Medical Categories: Abdominal and Gastroinstestinal
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19 Nov 2013

November 19, 2013

Written by REBEL EM
In 2011, Azithromycin was the 7th most prescribed (55.3 million prescriptions) medication according to IMS Health.  There have been several publications indicating that the use of macrolide antibiotics, increase risk of serious ventricular arrhythmias and sudden cardiac death (FDA Adverse Event Reporting System). Specifically, 2 recent studies in the NEJM were published looking at the risk of Azithromycin with cardiovascular death and received lots of press.
Medical Categories: Thoracic and Respiratory
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18 Nov 2013

November 18, 2013

Written by REBEL EM
The subject of this ECG of the Week is a 47 y/o hispanic female with a past medical history of type 2 diabetes mellitus, hypertension, hyperlipidemia, and morbid obesity with a chief complaint of weakness.  Per the patient she cleans houses for a living and for the past 2 weeks she gets weak and short of breath earlier in the day while cleaning houses.  She used to be able to clean all day without issues, but for the past 2 weeks this has been getting less and less.  No chest pain, vomiting, diaphoresis, or syncope.  She has never had anything like this before.  She comes to the ER today because this is her only day off.  She has not had any symptoms today. BP 156/94  HR 68 RR 14 O2 sat 100% on RA   Temp 98.7 ECG from triage is shown...

Medical Categories: Cardiovascular
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11 Nov 2013

November 11, 2013

Written by REBEL EM
58 year old female with chief complaint of chest pain x2hours with PMH of type 2 diabetes mellitus, Hyperlipidemia, and hypertension.    She is brought in via EMS still having active chest pain. BP: 102/88  HR: 82  RR: 24  O2 Sat on 2L: 99%  Temp 99.0 ECG obtained at arrival is shown...

Medical Categories: Cardiovascular
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8 Nov 2013

November 8, 2013

Written by REBEL EM
68 year old hispanic female with a chief complaint of weakness/syncope.  PMH of type 2 diabetes mellitus and hypertension.  She was brought in via EMS due to the family calling 911 as she had an episode of syncope while at the dinner table.  At the time of arrival: VS: 96/48   43     18     99% on RA  98.7 ECG obtained at arrival is shown...
Medical Categories: Cardiovascular
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