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Calculate risk of stroke on Apple Watch

Read a review of our stroke app on iMedicalApps! via iMedicalApps.

New version of MedCalc for Apple Watch

We just released a new version of our Medical for Apple Watch application!

Version 2.2 introduces new scores and tools:

  • Ideal body weight calculation is now included with BMI and BSA
  • Corticosteroid equivalence calculator
  • CAGE questionnaire (screening of alcoholism)
  • Centor Score (probability of strep pharyngitis)

Medical for Apple Watch is a great tool for physicians and medical students. Previous versions already contained several tools including:

  • BMI, BSA calculation
  • eGFR
  • Cardiovascular scores:
    ABCD2, CHA2DS2 VASc, corrected QT, HEART Score, PE probability

It is fully optimized for Watch OS2!

The price ($0.99) remains unchanged! So don’t hesitate to take a look and try by yourself by clicking here

 

 

Emergency medicine and internal medicine trainees’ smartphone use in clinical settings in the United States

Purpose:
Smartphone technology offers a multitude of applications (apps) that provide a wide range of functions for healthcare professionals. Medical trainees are early adopters of this technology, but how they use smartphones in clinical care remains unclear. Our objective was to further characterize smartphone use by medical trainees at two US academic institutions, as well as their prior training in the clinical use of smartphones.
Methods:
In 2014, we surveyed 347 internal medicine and emergency medicine resident physicians at the University of Utah and Brigham and Women’s Hospital about their smartphone use and prior training experiences. Scores (0%–100%) were calculated to assess the frequency of their use of general features (email, text) and patient-specific apps, and the results were compared according to resident level and program using the Mann-Whitney U test.
Results:
A total of 184 residents responded (response rate, 53.0%). The average score for using general features, 14.4/20 (72.2%) was significantly higher than the average score for using patient-specific features and apps, 14.1/44(33.0%; P < 0.001). The average scores for the use of general features, were significantly higher for year 3–4 residents, 15.0/20 (75.1%) than year 1–2 residents, 14.1/20 (70.5%; P=0.035), and for internal medicine residents, 14.9/20 (74.6%) in comparison to emergency medicine residents, 12.9/20 (64.3%; P = 0.001). The average score reflecting the use of patient-specific apps was significantly higher for year 3–4 residents, 16.1/44 (36.5%) than for year 1–2 residents, 13.7/44 (31.1%; P = 0.044). Only 21.7% of respondents had received prior training in clinical smartphone use.
Conclusions:
Residents used smartphones for general features more frequently than for patient-specific features, but patient-specific use increased with training. Few residents have received prior training in the clinical use of smartphones.

via J Educ Eval Health Prof

HCV-Related Central and Peripheral Nervous System Demyelinating Disorders

Chronic infection with hepatitis C virus (HCV) is associated with a large spectrum of extrahepatic manifestations (EHMs), mostly immunologic/rheumatologic in nature owing to B-cell proliferation and clonal expansion. Neurological complications are thought to be immune-mediated or secondary to invasion of neural tissues by HCV, as postulated in transverse myelitis and encephalopathic forms. Primarily axonal neuropathies, including sensorimotor polyneuropathy, large or small fiber sensory neuropathy, motor polyneuropathy, mononeuritis, mononeuritis multiplex, or overlapping syndrome, represent the most common neurological complications of chronic HCV infection. In addition, a number of peripheral demyelinating disorders are encountered, such as chronic inflammatory demyelinating polyneuropathy, the Lewis-Sumner syndrome, and cryoglobulin-associated polyneuropathy with demyelinating features. The spectrum of demyelinating forms also includes rare cases of iatrogenic central and peripheral nervous system disorders, occurring during treatment with pegylated interferon. Herein, we review HCV-related demyelinating conditions, and disclose the novel observation on the significantly increased frequency of chronic demyelinating neuropathy with anti-myelin-associated glycoprotein antibodies in a cohort of 59 consecutive patients recruited at our institution. We also report a second case of neuromyelitis optica with serum IgG autoantibody against the water channel aquaporin-4. The prompt recognition of these atypical and underestimated complications of HCV infection is of crucial importance in deciding which treatment option a patient should be offered.

via Inflamm Allergy Drug Targets

Use of Accelerometers to Measure Real-Life Physical Activity in Ambulatory Individuals with Multiple Sclerosis

Background: Multiple sclerosis (MS) may negatively affect individuals’ participation in physical activity (PA). We used accelerometers to determine PA level in individuals with MS with varying degrees of disability as measured by the Expanded Disability Status Scale (EDSS) during regular daily activities.

Methods: Participants wore an accelerometer from 8 a.m. to 9 p.m. for 7 consecutive days. Activity counts recorded during this period were analyzed in 1-minute epochs and categorized into one of four PA levels: light, moderate, hard, and very hard.

Results: The study cohort comprised 13 patients with MS and 12 controls. There were significant negative correlations for minutes spent in PA and EDSS measures on weekdays (r = −0.61), weekend (r = −0.64), and full week (r = −0.61) and number of steps taken on weekdays (r = −0.56), weekend (r = −0.80), and full-week average (r = −0.68). Significant positive correlations were found for minutes spent in light PA and EDSS score (r = 0.69). Significant negative correlations were found for minutes spent in moderate and hard PA and EDSS score. No significant difference was seen between the MS group and controls on any parameters (P > .05).

Conclusions: This study showed that accelerometers can be used to objectively quantify PA levels in individuals with MS with different disability levels. This cohort demonstrated that the amount of PA is inversely proportional to the degree of physical disability. Collected data revealed not only the amount but also the intensity of PA performed in real-life circumstances.

via International Journal of MS Care

Use of quantitative susceptibility mapping (QSM) in progressive multifocal leukoencephalopathy

Background

Progressive multifocal leukoencephalopathy (PML) is an opportunistic demyelinating encephalopathy related to JC virus. Its characteristics on conventional brain MRI are well known and are important for the diagnosis.

Objective

To analyze SWI hypointensities recently described in U-fibers and cortex adjacent to the white matter lesions of PML.

Methods

Prospective study including four patients with an history of definite diagnosis of PML. Clinical data were collected retrospectively. Brain MRI exams were done on a 3T magnet, including FLAIR, T2 GRE sequences and SWI.

Results

Four males were included (mean age: 47 years, mean PML duration: 24.2 months). Immunosuppression was related to AIDS (n=2), natalizumab for multiple sclerosis (n=1), B-cell lymphoma treated by chemotherapeutic agents and rituximab (n=1). All patients had SWI hypointensities in cortex and/or U-fibers adjacent to the white matter lesions. QSM always suggested a paramagnetic effect.

Conclusion

SWI and T2 GRE hypointensities in cortex and U-fibers adjacent to the white matter lesions seem highly prevalent in PML, irrespective of the delay between PML onset and the MRI. QSM data suggest a paramagnetic effect.

via Journal of Neuroradiology