Friday, September 28, 2007
This farm is set on a steep, rocky hillside overlooking a forested valley. Just beyond the farmhouse, the ground falls away steeply and you can barely see to the bottom of the ravine, where another mountain rises just as severely, filling up the horizon.
Okay, it’s not the Himalayas, but it’s an incredibly beautiful, secluded corner of western Massachusetts. The hill above the road is figured with large stone terraces. At the edge of the rise stands a tall stupa (Tibetan prayer shrine).
In large wire pens, or roaming about free, are animals such as Bactrian camels, Royal Pinto Yaks and Icelandic sheep and rams. Plus pigs, sheep and chickens, and a pet duck who swims around in a spectacular hand-laid slate fountain the size of a small pond.
Wednesday, September 19, 2007
Amidst the crowd of articles on medical therapeutics in the journals every week (it’s where the money is), I’m always pleased to find a good study on the pathophysiology of disease.
Here’s one from the American Heart Journal, Progression of paroxysmal atrial fibrillation to persistent atrial fibrillation in patients with bradyarrhythmias.
We know that some patients can have paroxysmal atrial fibrillation for decades, and others progress gradually to persistent atrial fibrillation.
The authors studies recordings from implantable devices for a bit over a year, looking at the “cumulative daily AT/AF burden.” The findings:
Seventy-eight patients (24%) progressed to persistent AT/AF during the follow-up period with a mean interval of 147 ± 149 days. Mean AT/AF burden increased progressively (slope 14 s/d, P < .001) over 500 days after implant, and median AT/AF burden also increased (P < .01) in this subgroup of patients. This increase was highly correlated with the presence of structural heart disease (P < .001).
Friday, September 14, 2007
I’ve written here mostly about clinical medicine but I had other things on my mind this morning. Seeing as this is a blog, and I can post whatever I want, I thought I would put up this meditation on the origins of the idea of sin and redemption in the Jewish tradition. This [...]
Tuesday, September 11, 2007
Well, here’s an interesting approach to preventing vascular complications in type II diabetes.
In this Lancet article, the researchers tried putting all patients on a fixed dose combination of ACE inhibitor and diuretic.
Traditional strategies set arbitrary blood pressure levels at which treatment is initiated and arbitrary goals against which treatment should be titrated. This strategy neglects [...]