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Top Ten Medical Uses of the iPhone
1. The iPhone as Otoscope
2. AliveCor as Portable EKG
Just recently approved by the FDA (December 2012) the iPhone ECG is a single-lead electrocardiogram reader that attaches to the back of an iPhone and displays heart rate info via an app. (An Android version is in the works.) The creator, Dr. David Albert, is an Oklahoma Cardiologist, who likes to be called an “Inventor”. Son of former Speaker of the House, Carl Albert, David believes the iPhone ECG could be used in intensive care units and used by EMTs. His team is recently compiled data in June 2012, after which his company received more funding from the powerful Qualcomm, a big company in the wireless industry.
4) The iPhone as a GLUCOMETER : IBGStar
5) iPhone as a Skin Scanner: THE DERMATOSCOPE
6) The Smartphone Ultrasound
8) The iPhone to Aid Slit Lamp: Eyepiece Digital Adapter
Mas información en este link: http://www.imedicalapps.com/2010/12/bes-free-iphone-medical-apps-doctors-health-care-professionals/4/
Top 10 Free iPhone Medical Apps for Health care Professionals
Editors note: We now have an updated “Top 20 Free iPhone Medical Apps List”. It can be found at this link.
If you’re a physician, medical student, or in any other health care related field, trying to find the best free medical apps for the iPhone is a hassle. Apps such as “Dream Meanings”, “Relax Ocean waves”, and “Stool Scanner Lite” dominate the Top Free Medical Apps list in the App Store.
Our top 10 iPhone medical apps list contains no such app, and this isn’t a re-hash of the top downloaded free medical apps either. Rather, this list contains the top 10 free iPhone medical apps health care professionals and students can actually use on a day to day basis.
If you want free apps, make sure to “Like” us on our Facebook fan page and follow us on Twitter. We give out tons of free medical apps on our Facebook wall and our Twitter feed – you can find interesting commentary on these platforms and it’s where we interact with our readers frequently as well: http://www.facebook.com/iMedicalApps ;http://twitter.com/imedicalapps
1) Medscape
We mentioned this app when it was released in the summer of 2009. At the time I doubt many thought it would ever eclipse Epocrates in the top free medical apps section of the App Store, but with significant recent updates it’s accomplished this feat.
This app always had a great drug reference section, with over 6,000 generic, brand, and OTC drugs, along with a drug interaction checker. But with recent updates, Medscape now has a Diseases and Conditions section, along with a Clinical Procedures section. These added sections aren’t just fluff, they actually contain concise and useful information, with videos and pictures to boot. We plan on doing a full review in the near future.
This app always had a great drug reference section, with over 6,000 generic, brand, and OTC drugs, along with a drug interaction checker. But with recent updates, Medscape now has a Diseases and Conditions section, along with a Clinical Procedures section. These added sections aren’t just fluff, they actually contain concise and useful information, with videos and pictures to boot. We plan on doing a full review in the near future.
2. Micromedex
This might come as a surprise to many, but after you use this prescription medical reference app you’ll understand why it ranks so high. The overall user interface of the app is simple and quick. There is minimal clutter — another reason for such a high ranking. If you need to look up a dose or some quick reference information about a drug you can accomplish this with ease, as shown in the below pictures.
There are no prompts to register your e-mail address, no CME activities, no icon badges, no notifications, or any other distractions. The one knock on this app is it doesn’t have a robust drug interaction checker, something Medscape and Epocrates provide. On the flip side, for residents and medical students, the app does a better job than other drug reference apps when it comes to mechanism of action information and patient teaching information. Another plus is it’s available for the iPad — which is not true of Epocrates and Medscape.
The application is a production of Thomson Reuters, a legitimate name in Healthcare.
3. New England Journal of Medicine
The NEJM app is clearly a must have for all health care professionals. The caveat is that when this app was released the NEJM stated it would be free for a “limited time” in the iTunes description — that was more than 5 months ago and the app still remains free, allowing you to access fantastic NEJM content customized for the mobile format. The app allows you to access the last 7 days worth of published articles, along with images of various medical conditions and videos on how to perform procedures such as LPs and chest tubes.
Where this app is essential though is with the weekly audio summaries and the selection of four full text audio reads of clinical practice articles. Note, you can access the weekly audio summaries via podcast format as well. This type of content access in mobile form is great for keeping abreast of changing clinical practices while driving back and forth to work or when having downtime in the wards.
Quien da el diagnóstico?
A Curious Case of Chest Pain
A 67-year-old man presented to the emergency department with chest pain, reporting
that he had felt well until 10 days before presentation, when nausea, nonbloody emesis,
bloating, and epigastric pain developed. At that time, he was evaluated at another
hospital, where the results of computed tomography (CT) of the abdomen and pelvis,
performed after the administration of intravenous contrast material, and laboratory
tests were normal except for an elevated platelet count (491,000 per cubic millimeter).
A presumptive diagnosis of gastroesophageal reflux was made, and omeprazole was
prescribed but provided no relief of symptoms. Over the course of several hours on the
day of presentation, heaviness of the chest developed on exertion and progressed to
pain at rest accompanied by diaphoresis and dyspnea. The pain was substernal and
nonradiating, and it did not change with a change in position or with food intake. The
patient rated the pain at 8 on a scale of 1 to 10, with 10 indicating the most severe pain.
The patient reported no fever, cough, or upper respiratory symptoms; no edema, redness,
or pain in the legs; and no weight change, diarrhea, jaundice, or joint pain. His
medical history included mild asthma and a hemicolectomy for dysplastic polyps
complicated by a ventral abdominal hernia. His medications included omeprazole,
inhaled glucocorticoids and bronchodilators, montelukast, and zolpidem as needed.
He had a remote smoking history of 20 pack-years, drank fewer than four alcoholic
beverages weekly, and reported no illicit drug use. The patient worked as a courier
and lived alone. He reported no known contacts with sick persons and no recent travel.
Owing to estrangement, his family history was unknown.
On examination, the patient was afebrile. The pulse was 125 beats per minute and regular, the blood pressure 84/62 mm Hg, the respiratory rate 22 breaths per minute, and the oxygen saturation
94% while he was breathing 6 liters of oxygen through a nasal cannula. The patient’s body-mass index (the weight in kilograms divided by the square of the height in meters) was 30. He appeared uncomfortable, pale, and diaphoretic, and he was using his accessory muscles to breathe. The jugular venous pressure was estimated at 18 cm of water. Cardiac examination revealed a regular tachycardia and a grade 2/6 holosystolic apical murmur, with no appreciable gallop, heave, or thrill. Examination of the lungs revealed rales at the left base. The abdomen was soft and nontender, without abdominojugular reflux. The liver
edge, which was palpable 4 cm below the costal margin, was not tender. The arms and legs were
cool and clammy, with no edema. Distal pulses were thready. There was no rash.
The hematocrit was 39.4%, the platelet count 465,000 per cubic millimeter, and the white-cell
count 12,730 per cubic millimeter, with a differential count of 83% neutrophils, 9% lymphocytes,
and 8% monocytes. The erythrocyte sedimentation rate was 40 mm per hour. The serum level of sodium was 130 mmol per liter, potassium 4.6 mmol per liter, chloride 97 mmol per liter, and bicarbonate 17 mmol per liter; levels of creatinine and urea were normal. The results of liverfunction tests were unremarkable. The lactic acid level was 2.8 mmol per liter (normal range, 0.5 to 2.2). The level of creatine kinase was 182 U per liter (normal range, 39 to 308), the creatine kinase MB (CK-MB) fraction 17.4 ng per milliliter (normal range, 0 to 6.6), troponin T 3.03 ng per milliliter (normal level, 0), N-terminal pro–B-type natriuretic peptide 40,843 pg per milliliter (normal range, 0 to 899), and C-reactive protein 64.5 mg per liter (normal range, 0 to 3.0).
An electrocardiogram (ECG) showed sinus tachycardia with premature atrial contractions, low
limb-lead voltage, left atrial enlargement, a vertical axis, septal Q waves, poor R-wave progression, and diffuse T-wave flattening (Fig. 1). A chest radiograph revealed mild cardiomegaly, small bilateral
pleural effusions, and mild-to-moderate pulmonary edema.
A transthoracic echocardiogram revealed mild left ventricular dilatation with mild concentric hypertrophy
and severely reduced global systolic function (ejection fraction, approximately 25%), with some regional variation (greater impairment of the anterolateral wall). The right ventricle was moderately dilated, with moderately reduced systolic function. There was moderate mitral regurgitation and mild-to-moderate tricuspid regurgitation. There was no pericardial effusion.
The patient underwent emergency coronary angiography for presumed non–ST-segment elevation
myocardial infarction. Angiography revealed a minor discrete lesion in the proximal left anterior descending coronary artery; the lesion obstructed 20% of the cross-sectional area of the artery. No other abnormalities were noted. Right heart catheterization confirmed elevated filling pressures (right atrial pressure, 15 mm Hg; pulmonarycapillary wedge pressure, 38 mm Hg) and low cardiac output (cardiac index, 2.0 liters per minute per square meter of body-surface area) despite intravenous administration of dopamine. During catheterization, the patient became progressively hypotensive, necessitating placement of an intraaortic balloon counterpulsation pump. Intubation was performed for worsening hypoxemia.
The patient underwent endomyocardial biopsy, and a transseptal continuous-flow PVAD was
placed to address the poor perfusion and ongoing hypotension. Filling pressures and cardiac output
improved substantially with PVAD support. Additional laboratory testing revealed a low serum iron level (30 μg per deciliter; normal range, 37 to 158) and reduced total iron-binding capacity (204 μg per deciliter; normal range, 220 to 460). The ferritin level was 6500 μg per liter (normal range, 20 to 400). Levels of thyrotropin, uric acid, carnitine, vitamin B12, and folate were normal. Antinuclear antibodies were not detected. Serum and urine toxicologic tests and serologic tests for the human immunodeficiency virus and Borrelia burgdorferi were negative.
Immunosuppressive therapy with intravenous methylprednisolone and cyclosporine was initiated,
and the patient was evaluated for heart transplantation and definitive mechanical support. Attempts to wean the patient from the PVAD were unsuccessful. On hospital day 5, fever developed and the white-cell count increased. A chest radiograph revealed new pulmonary infiltrates. The surgical risk associated with the introduction of definitive mechanical support was deemed too high, and the patient died from pneumonia.
http://www.nejm.org/doi/pdf/10.1056/NEJMcps1301819
Interesante artículo, disponible en NEJM.
Natural Disasters, Armed Conflict, and Public Health
http://www.nejm.org/doi/pdf/10.1056/NEJMra1109877
Natural Disasters, Armed Conflict, and Public Health
http://www.nejm.org/doi/pdf/10.1056/NEJMra1109877
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