Clinical Medicine

August 18, 2023

SNM Updates Guidelines for Breast Scintigraphy Imaging

The Society of Nuclear Medicine has published updated guidelines for breast scintigraphy using dedicated gamma cameras and 99mTc-sestamibi. The guidelines provide best practices on patient selection, radiotracer dosing, imaging protocols, interpretation, and reporting. They outline specific clinical indications like cancer staging, high-risk screening, and monitoring therapy response. Details on personnel qualifications, techniques, radiation safety, and…

August 9, 2023

Do Emergency Physicians Follow the American College of Emergency Physicians’ Policy Regarding the Evaluation of Nontraumatic Chest Pain in the ED?

Lewis, Lawrence M. and Heston, Thomas F. and Mecker, R and Lasater L and Rush C. Abstract. This study looked at 718 patients evaluated by 97 physicians in 10 regional hospitals. The correctness of the ED diagnosis was correlated to the cumulative score for adherence to ACEP rules (p = 0.0003). Keywords: ACEP, acute chest…

A Comparison of Care Rendered by ED Physicians With Varying Medical Backgrounds

This prospective study compared the quality of the history (Hx), physical examination (PE), diagnosis, and treatment (Tx) of patients with hand injuries as performed by emergency department (ED) physicians with varying training backgrounds. There were 465 cases reported by 93 physicians. No differences between residency-trained and legacy practice-track EM board-certified physicians were found. Physicians of…

August 6, 2023

Assessing Illness and Recovery With the Clean Plate Sign

Hospitalized patients, upon admission, often have a degree of anorexia which gradually resolves as their medical condition improves. Thus, a quick way to assess the overall improvement of hospitalized patients is to look at their plate after breakfast when rounding. Patients with a clean plate after eating their full meal often are close to or…

August 5, 2023

Gender-specific differences in the evaluation and management of chest pain

This study examined 199 men and 246 women presenting to the emergency department with acute, nontraumatic chest pain and found significant differences between men and women. The time to first contact with a physician was 17.3 minutes for women and 13.2 minutes for men. 92% of men had their initial EKG within 30 minutes, but…

August 3, 2023

Fragile Data Requires High Statistical Caution

It is important to address fragility on clinical trials. When a study’s fragility is addressed, it frequently changes the conclusion. Heston, Thomas F. (2019). Fragile Data Requires High Statistical Caution. https://doi.org/10.5281/zenodo.8122528

August 2, 2023

Sauna Bathing and the Cardiovascular System

Sauna bathing is not only enjoyable but potentially greatly beneficial to your health. In this review article, I look at the evidence. Citation: Heston, Thomas F. (2017). Sauna Bathing and the Cardiovascular System. International Journal of Scientific Research, 6(11), 569–570. https://doi.org/10.5281/zenodo.8106462

Pharmacologic stress testing in nuclear cardiology

Pharmacologic stress testing is common in nuclear cardiology. Estimates have suggested that about 30% of all stress tests done in nuclear laboratories utilize pharmacologic stress. Citation: Heston, Thomas F. (2007). Pharmacologic stress testing. Southern Medical Journal, 100(10), 969–970. https://doi.org/10.5281/zenodo.8126709

August 1, 2023

Cardiac Risk Stratification in Renal Transplantation Using a Form of Artificial Intelligence.

Abstract. The purpose of this study was to determine if an expert network, a form of artificial intelligence, could effectively stratify cardiac risk in candidates for renal transplant. Input into the expert network consisted of clinical risk factors and thallium-201 stress test data. Clinical risk factor screening alone identified 95 of 189 patients as high…

Myocardial Infarction

“In their study, a man admitted for suspected myocardial infarction was 1.53 times more likely than a woman to be placed in an intensive care unit instead of a telemetry floor. Our study of patients with suspected myocardial infarction or unstable angina came up with remarkably similar results. We found that men were 1.48 times…