Archive for August, 2009

Impact Ratings of Cardiovascular Journals

Monday, August 31st, 2009

Here is the list of Impact Ratings of some the cardiovascular and medical
journals

                        IMPACT
New Eng J               23.200
Ann Int Med              9.211
JAMA                     5.168
Arch Int Med     2.758
Am J Med                 2.672

Circulation              9.038
JACC                     6.114
Am J Cardiol     2.286
Am Heart J               1.762

Does anyone know if this list available online somewhere?

Also, I have a great idea for judging someone’s CV.  
So often you see a CV with 15 pages of bibliography
and don’t know what it means.  My idea is:

First author article you get 3 points multiplied by the impact rating
second authorship 1 point multiplied by impact rating
Senior (last) authorship 2 points multiplied by impact rating
    Anything but 1st 2nd or senior authorship won’t count
The final score is add all the points from each article.  

Cause(s) of "Missed" Heartbeats ?

Monday, August 31st, 2009

Every few months, I have a few consecutive days when
I suffer from "missed" heartbeats – maybe half a dozen
or so times a day. This does not cause me trouble other
than the annoying sensation when it happens. I had an
EKG strip done but everything seemed normal (of course,
like that pinging noise in your car, the old ticker
did not do its thing during the test). I have never
been able to correlate the episodes with any specific
cause – stress/excercise/diet etc..

Any clues or words of wisdom ? I am a 38yr old anglo male.

–jim

Staff Infection during Surgery at Saint Lukes in Kansas City.

Monday, August 31st, 2009

My Dad had a quadruple bypass surgery at Saint Lukes hospital in Kansas City
last Nov.  He was released on the 5th day after surgery and was told to
expect pain for awhile.  He endured pain alright, but after several days the
incision started to ooze.  He had to go back to Saint Lukes and was operated
on again immediately.  He had a raging staff infection and part of his
sternum was infected and had to be removed.  He took up residence in the
CVICU area and was placed on some powerful antibiotics.  He had to be fed
intravenously.

After a few days he developed intense stomach and lower back pain.  They
thought he might have peritonitis and did an emergency stomach surgery (really
big incision).  Once inside, they could’nt see any problems.  The surgery
was just another source of stress for my dad.  A couple of days after this,
he had a stroke that paralyzed his left arm and leg.  A couple of days later
they did a CAT scan that showed a collection of fluid walled off behind the
stomach.  They put a drain in there and sampled some of the fluid.  It had a
high amount of enzymes.  They thought it could be a perforated ulser or
pancreatitis.  They shot dye into this fluid area via the drain they had
installed and checked to see if the dye made its way into the stomach (which
would have pointed to an ulcer).  The dye was not found in the stomach so they
were thinking it was a pancreas problem.  

Well, they finally decided to get a GI team in there to scope him and they
saw the ULCER with the scope.  So they have to go back in through that same
incision they had made a week or so earlier.  The doctor was able to find the
ulcer and sow it closed.  The tissues were to inflamed to excise the ulcer
area and sow the surrounding tissues together.  He even wanted to do a bypass
on that part of the stomach but he at least had the sense not to do it.

Anyway, I thought my dad might start to improve after that, but two days after
the surgery, he was really agitated about something but since he was on a
ventilater and had been most of this time I could’nt read his lips to determine
what he was saying.  Later that day he became unresponsive and his temperature
rose to 39.6c.  His blood pressure dropped and he required two units of blood.
It turns out that he had another stroke that paralyzed his right arm and leg.
Also he was not able to see after this stroke.  He did wake up at one point
and was able to hear us and smile in response to stories.  However he had made
out a living will that made it clear he did not want to be on any type of life
support.  We decided to withdraw support and they gave him an IV of morphine.
He died about 8 hours after that.

I believe that all of this happened because he was exposed to something in the
initial heart surgery that gave him the staff infection.  Then the hospital
released him with a raging staff infection that caused this tragic chain of
events to take place.  He has to go back in for surgery, developes a stress
ulcer, suffers a series of strokes and is subjected to a stomach surgery
before the ulcer was found.  

On top of this, another man from our hometown about the same age as my dad
(71) went in for heart surgery a week after my dads initial surgery.  He also
developed a staff infection and had to come back for a second surgery.  He
developed a stress ulcer just like my dad and died a week after my dad died
from complications.  

I would like to hear from anyone else out there who has heard of any similar
scenarios:

          Heart Surgery
               |__________Infection
                            |_______Stress Ulcer
                                        |_________More Surgery
                                                      |_____Strokes
                                                              |______DEATH

If you have not heard of this before, then I would recommend staying away
from SAINT LUKES HOSPITAL in Kansas City, Mo

By the way, as far as their statistics go, my dad had a successful heart
operation.  The cause of death was listed as an ulcer.  They are padding
their statistics with this case.

wazz

newsletter

Monday, August 31st, 2009

Are there any newsletters available that speak/write specifically about
heart related problems?
Thanking you in advance,
Ronnie Schultz

Ronnie J Schultz
City Sitters, Inc.
ron…@citysitters.com
visit my homepage:  http://www.panix.com/~ron

Medical books,info,software,free catalogs

Monday, August 31st, 2009

If you are in need of medical information and don’t know the author,
publisher or ISBN, a new service is available to locate your need,
MedSmart.
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free.  There is a small charge for shipping and handling.  Visit MedSmart
at http://www.lo.com/medsmart.

Myocarditis: treatment options?

Monday, August 31st, 2009

A close family friend, w/m, age 38, good health history, is in hospital
in Chattanooga, Tn.  Attending card. diagnosed Myocarditis, transplant is
only chance.  Blood clot has developed in heart, drugs are being used to
try to dissolve it.  Patient is not stable enough to be moved, and no
local hospital does transplants.
Myocarditis is relatively unknown to local physicans.  Is transplant the
only option?
Any information/suggestions you can e-mail me will be greatly
appreciated, but time is of the essence.  Also, information on  hospitals
with a history of treating Myocarditis with positive results would also
be appreciated.
                                             Joe Kirkpatrick

trist…@chatt.mindspring.com

Recent angioplasties

Monday, August 31st, 2009

        I’ve just returned home from having some angioplasties and stents
"installed" in the circumflex. I did have single IMA graft in the LAD
in 1982, at 33 years old.  I have NO family history, all parents and
their brothers and sisters are still alive or died at ripe old ages.
The cath of the IMA and LAD  looked REAL GOOD  !!Whew.
        Recently I’ve been having these funny pains in the back of my throat.
These pains occurred most intensely and freqently after
eating…generally larger meals effected greater pain.  After a
cardiac evaluation, the pain was diagnosed by the GP and cardiologist
as likely being of GI etiology.  A cardiolyte scan and stress test
showed nothing extremely abnormal save for a spot on the apical
anterior that did not take up dye at rest or exercise (See..Error in
cardiolyte scans in this newsgroup). An endoscopy was negative.
However, Prevacid seemed to alleviate the problem, and so we all
thought that the problem was GI related (save for the
gastroenterologists).  The angiogram showed otherwise. I had some
pretty severe blockages that were resolved as I stated.
        So here’s the question.  Why did the stress stress test and cardiolyte
scan  NOT show these severe abnormalities, and why did I have no pain
during the stress test, but severe pain after eating?  The pain in my
throat was not like my previous angina in 1982. That previous angina
was in my chest, neck, jaws, left arm, and left a metallic tatse in my
mouth.  During the installation of the stent, the pain was reproduced,
so clearly, these blockages were causing the problem.

        One last comment…I was really impressed with the staff and
facilities att he Iowa Heart Center.  The cath lab reminded me of the
Enterprise sick bay. Since I’m a research scientist I really got off
on this. The staff  let me walk around a bit to took at the equipment
before the procedure. It looked like they had about 5 cath bays there.
The cath, through the femoral,  went without much pain, but I suffered
from extreme anxiety. The staff handled my concerns with dispatch and
professionalism. What a trip!

        I’ll have more comments on this later.

Jerry Ranch
ranc…@dsmnet.com

Effect of Asprin on Heart Attack

Monday, August 31st, 2009

How long does it take for an Asprin (bought over the counter)
that has been chewed to have a significant affect on an adult
suffering a heart attack.

Christine Summers

ECG strip – rhythm2.gif [01/01]

Monday, August 31st, 2009

This is a 10 second recording of standard lead II showing a rather odd rhythm.
There is AV dissociation with alternating morphologies of the (apparent)
escape rhythm. Anyone have any suggestions?

Dean Jenkins
Waikato Hospital
Hamilton           <——  very warm and humid today.
New Zealand

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ECG strip – rhythm2.gif [

Monday, August 31st, 2009

To: DJENK…@MIDLAND.CO.NZ

d>From: djenk…@midland.co.nz (Dean Jenkins)
d>
d>This is a 10 second recording of standard lead II showing a rather odd
d>rhythm. There is AV dissociation with alternating morphologies of the
d>(apparent) escape rhythm. Anyone have any suggestions?
d>
d>Dean Jenkins
d>Waikato Hospital
d>Hamilton           <——  very warm and humid today.
d>New Zealand
d>

Hi Dean,

Based on what I can see, you’re looking at a 3rd degree block with a
superimposing junctional escape rhythm. If you ignore the bigeminal
junctionals and just march out the P’s on the baseline, it all fits
together. -Rod-

Rod & Susan Venger, Venger’s Orchids
Homepage address http://www.usa.net/venger/
Listings Available – Email us for your copies
Order Line 1-800-483-6437