Covid19-08/22/2021
Useful links Useful links & synopsis NY Times Latest map and case counts CNN Cases and deaths per 100K residents by county click you check your county Synopsis: US Vaccination: Fully vaccinated: 51% At least 1 dose: 60% New reported cases, 7 day average: Jan 10, 2020: peaked at...
AIS Carotid Stenosis
Symptomatic Internal carotid artery stenosis Risk of stroke Cause of 10% of all ischemic stroke A Transient Ischemic Attack is associated with higher risk of stroke Risk is related to age, sex, degree of stenosis, presenting symptom, time since last event, smooth vs irregular plaque Carotid stenosis tool to...
AIS Antithrombotic treatment
Acute ischemic stroke (AIS) & Transient ischemic attack (TIA) Low risk TIA ABCD2 score < 4 Aspirin 325 mg now and qd High risk TIA ABCD2 score > or = 4 Use dual antiplatelet therapy (DAPT) Aspirin 325 mg + Clopidogrel 300 mg loading dose then Aspirin 81 mg...
MS disease modifying Rx
Who should be treated Clinically definite relapsing remitting MSD (RRMS) Some patients with Clinically isolated syndrome (CIS) secondary progressive MS (SPMS) Choice of therapy depends on: age, severity of disease, patient choice, risk of side effects Highest efficacy High to low efficacy is based on limited randomized trials All...
MS Acute Treatment
Multiple Sclerosis review Acute exacerbation IV methylprednisolone: 1000 mg iv daily for 5 days (3 to 7 days) with or without short taper Oral prednisone: 50 mg tab x 20 tab daily for 5 days without taper some previous study suggested iv more effective for optic neuritis ACTH (corticotropin)...
Aphasia
Dominant hemisphere Right handed: over 90% has language center at left hemisphere Left handed: 30-70% has language center at left hemisphere Right brain dominant: when right brain injured, less severe symptom, some function are on left brain Syndromes Expressive (Broca’s): problem talking Broca’s area affected Receptive (Wernicke): problem comprehending...
Aducanumab
approved by FDA for mild Alzheimer’s disease: uncertain as to which patients may benefit A recombinant monoclonal antibody reduce amyloid plaque on pet imaging Coverage: not covered by public & private payers Cost: about $60,000 per year, depends on weight inconsistant clinical effects on rating scales Dosing MRI brain...
Sandbox
Link to testEmbed...
COVID-19 VACCINE
...
Endocarditis
Overview Inflammation of endocardium Non infective endocarditis Lieman Sacks Endocarditis from SLE, from autoimmune disease Bacterial endocarditis – bacterial enters blood stream Skin: iv catheter, iv drug – Staph Gums: dental procedure, V Strep Guts: colon cancer, ulcerative colitis – Enterococcus Most commonly affected Mitral valve Aortic valve Risk...