Tuesday, January 10, 2023

EKG alternating between LBBB and non specific intraventricular conduction defect-Mechanism?

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 A 75 year old man sought medical attention from his internist because of a several week period of decreased exercise tolerance.EkGshowed si...

Is there a big voltage drop( pun intended) between skillful Pacemaker implantation and the follow up?

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 Current training for an Ep cardiologist following four years of medical school consists of three years of internal medicine residency,three...
Monday, January 09, 2023

The hematology literature seems unaware of the effect of strenuous exercise on blood iron related measurements

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 In their authoritative review in the Journal Blood (1) in January 2019 Drs. Weiss,Ganz and Goodnough discussed what is known about iron def...
Saturday, January 07, 2023

Can aerobic exercise reverse loss of compliance in early (Stage B) HFpEF

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 Can aerobic exercise reverse loss of left ventricular compliance in  early (Stage B ) heart failure with preserved ejection fraction (HFpEF...

So how does cardiac conduction system really work?

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 Using recording catheters in the left ventricle, Upadhyway et al (Circulation 2019) demonstrated that the location of the blockage or slowi...

Is the COVID Pandemic legacy simply more of the same.

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 Is the COVID pandemic legacy going to be more of the same? The is the picture painted by Ed Yong writing in The Atlantic  Sept 30,2022 Quot...

Exercise,hepcidin,glycogen depletion and iron deficiency

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 Hepcidin has been described as the master regulator of iron. Hepcidin impedes GI tract absorption of iron and decreases movement of iron fr...

Another cause of medical care voltage drop-medical assistants

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 Different commentators have used the term "voltage drop" to refer to various things related to medical care. One use is to refer ...

The physician physical examination-is it almost extinct?

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 The physical examination (PE) was for many years a routine fixture of a person's annual checkup. It seem it is much less so now. Three ...
Friday, January 06, 2023

Does Cha2ds2 Vasc really estimate risk of stroke due to Atrial fibrillation

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 Does Cha2ds2 Vasc (CDVS) score really estimate the risk of a patient with atrial fibrillation (AF)? Or does it estimate the risk of a strok...

"...experience fallacious,judgement difficult" especially in regard to observational trials

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 There are four reasons besides causality for an association: 1)chance aka random variation 2 Bias aka systematic variation 3)confounding 4)...

Runner's anemia well known to runners and sports medicine doctors, less so with internists

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 Having spent many years running far  beyond a reasonable amount to attempt to improve health my blood count profile was that of a typical e...

Replace RNs with Medical Assistants -what could go wrong?

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 Recent data from Houston Texas indicate that RN's at a large local hospital system earn $ 73  per hour while medical assistants earn  $...
Thursday, January 05, 2023

Of all the disturbing developments in medicine the worse has to be the entry of venture capital

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 One of the greatest fears that the elderly and the near elderly have is to be alone in a nursing home.There is one thing worse and that is ...

ARBs versus ACEi and the winner is ...

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 The amount of analysis done on the comparison of the safety and efficacy or ARBs versus ACE inhibitors for treatment of hypertension is imp...
Tuesday, December 20, 2022

Is the Annual Wellness Visit just a condescending waste of time or something worse?

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 Is the Annual Wellness Visit (AWV) merely a demeaning waste of time or something actually harmful.? I have endured an AWV for the past 4 ye...
Friday, July 22, 2022

Soluble serum transferrin receptor increases acutely after exercise but is not an " acute phase reactant" ?

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 At least two research projects in runners and rowers have demonstrated elevation of the soluble serum transferrin receptor after strenuous ...
Tuesday, May 10, 2022

Left bundle branch block- new paradigm brewing- echo plus ekg

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 Left bundle branch block (LBB) has been defined by various EKG criteria. The pattern of inter ventricular and intraventricular desynchrony ...
Sunday, May 08, 2022

The coivid pandemic and one million U.S.deaths have waned my anti progressive,public health antibodies just a bit

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 Many decades of reading libertarian and classical  liberal literature and at least semi serious reading of Austrian school economics mixed ...
2 comments:
Tuesday, May 03, 2022

Hemolysis is part of strenuous exercise - it is not a disease

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 The intravascular destruction of red blood cells (rbcs) is a normal part of strenuous exercise.It is a feature not a bug of strenuous exerc...