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Recannalised IRA : When God’s hand is natural aspiration catheter . . . better show restraint .
“Oh , it’s a well recannalised IRA and its flowing TIMI 3 as well. Now, what shall we do sir” ?, An apparently worried senior resident queried after a second look at the images from a 8 hour old STMEI .Why you sound unhappy man ? As if recanalisation is an untoward event” ! I teased my resident !
and went on to ask . . .
What we mean by recannalised IRA ? (Recan-IRA)
It is akin to natural or pharmacological angioplasty (or combination of the two )
It can be complete or incomplete from the IRA perspective.
It can either result in partial or fully salvaged myocardium.
It should be unde...
Source: Dr.S.Venkatesan MD - October 2, 2015 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
Cambridge University Hospitals Trust IT Failures: An Open Letter to Queen Elizabeth II on Repeated EHR Failures, Even After £12.7bn Wasted in Failed NHS National IT Programme
In conclusion, Your Highness, it might benefit your citizens (and those of the U.S.) if a national re-education programme were instituted to de-condition your leaders from unfettered belief in cybernetic miracles in medicine, a mental state they attain in large part due to mass EHR vendor and pundit propaganda.A more sober mindset is recommended by your subject Shaun Goldfinch in "Pessimism, Computer Failure, and Information Systems Development in the Public Sector" (Public Administration Review 67;5:917-929, Sept/Oct. 2007, then at the University of Otago, New Zealand): The majority of information systems developmen...
Source: Health Care Renewal - September 24, 2015 Category: Health Management Tags: Addenbrooke Hospital Cambridge University Hospitals healthcare IT dangers healthcare IT risks Mismanagement NPfIT Patient care has not been compromised Rosie hospital Source Type: blogs
Turn That Door Around - A Physician Substantially Tied to the Pharmaceutical Industry Nominated to Run the FDA
It seems to be the season of the revolving door in health care. The latest version got some media attention, because it involves one of the most important health care leadership positions in the US government, the Director of the Food and Drug Administration (FDA). However, the case actually seems much more serious than what the media has recently reported.The BasicsFor an introduction, we turn to the Wall Street Journal from September 15, 2015:President Barack Obama plans to nominate the prominent cardiologist and medical researcher Robert Califf as the next commissioner of the Food and Drug Administration, th...
Source: Health Care Renewal - September 24, 2015 Category: Health Management Tags: boards of directors CME conflicts of interest FDA key opinion leaders logical fallacies revolving doors Source Type: blogs
White House Nominates Robert Califf As The Next FDA Commissioner
This article lists a wide range of health policy and cardiology experts who weighed in very positively on Califf’s nomination. For example, MedPage Today quotes Sanjay Kaul, MD, MPH, of Cedars-Sinai Heart Institute in Los Angeles, who wrote: "I can't think of a more qualified person than Dr. Califf to lead the FDA at the present time…He is an accomplished leader in cardiovascular disease research whose work has resulted in therapies that save lives and improve the quality of life for millions of patients."
In terms of how much change Califf would bring to the agency, the article quoted Steve Nissen, MD, chair of cardio...
Source: Policy and Medicine - September 18, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
The Wheat Belly lifestyle BEGAN with heart health
Debbie posted this comment on the Wheat Belly Facebook page:
“I posted a few weeks back about our scare from our primary care doctor. My husband had a calcium score of 1200. We panicked! Messaged Dr. Davis and went the next day to a cardio doctor and had a stress test, ultrasound, and blood test (inflammatory markers). Got him on recommended supplements per Dr Davis.
“Latest update: Cardio doctor says, being as you started ‘Wheat Belly’ back in October, 2014, your score could have been higher and already started to improve, we don’t know. What we DO know is, because of this new way of eating,...
Source: Wheat Belly Blog - September 15, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle calcium score cholesterol fish oil gluten grains heart disease iodine Thyroid vitamin D Weight Loss Source Type: blogs
The Atlanta Declaration: A 21st Century Vision For US-Based Global Noncommunicable Disease Research
The United States has been synonymous with innovation. Conducting research to better understand the world and to experiment with new ideas has been an important part of this country’s progress. However, at this critical juncture in history, when chronic noncommunicable diseases (NCDs) (e.g., cancers, diabetes, cardiovascular disease, and mental health disorders) are rapidly becoming the largest global health burdens, affecting human welfare and productivity worldwide, US institutions must better align opportunities, pathways, and resources for 21st century scientists and future leaders in health policy.
To this end, we ...
Source: Health Affairs Blog - September 9, 2015 Category: Health Management Authors: Sandeep Kishore, John Bartlett, Gerald Bloomfield, Douglas Heimburger, Lindsay Jaacks, Kasia Lipska, Christine Ngaruiya, Robert Peck, Melissa Burroughs Peña, Karen Siegel, Olivia Manders, K.M. Venkat Narayan and Mohammed K. Ali Tags: Costs and Spending Equity and Disparities Featured Global Health Health Professionals Organization and Delivery Population Health Public Health Google HIV/AIDS NCDs Research Source Type: blogs
Entresto: Blockbuster, or Just Over Hyped? - Whatever, It Will Cost $4500 a Year
The newest drug for congestive heart failure, Entresto, a fixed combination of valsartan and sacubitril, has just hit the market at an elevated price. Like other drugs recently introduced as blockbusters, the high price does not seem clearly justified by clinical evidence about the drug's benefits and harms. Questions Raised by the One Big Published Controlled Trial Last year, we discussed the hoopla around a study of a new drug for congestive heart failure (CHF),(1) a fixed combination of valsartan and sacubitril. Also, on the now defunct CardioExchange blog, Dr Vinay Prasad discussed the same study (look her...
Source: Health Care Renewal - July 30, 2015 Category: Health Management Tags: CHF clinical trials Entresto evidence-based medicine manipulating clinical research Novartis sacubitril Source Type: blogs
Assuring Hospital Emergency Care Without Crippling Competition
Hospital emergency departments (EDs) occupy a critical position in the American health care system, bearing responsibility for the most urgent acute care cases, while serving as a provider of last resort for many without insurance coverage. Emergency health care also functions as a conspicuous exception to the general principle of market exchange, whereby services are voluntarily bought and sold.
The urgent need for treatment makes it difficult for patients to shop around, while hospitals are required to treat patients regardless of ability to pay. The obligation to treat patients whose medical needs exceed their financial...
Source: Health Affairs Blog - July 6, 2015 Category: Health Management Authors: Christopher Pope Tags: Costs and Spending Equity and Disparities Featured Hospitals Insurance and Coverage Organization and Delivery Payment Policy Population Health Quality ACA Community Health Emergency Medicine EMTALA Medicaid Nonprofit Uncompen Source Type: blogs
A Declaration of Data Independence Through the Lens of the Patient
By BRIAN AHIER
This weekend is not only independence day in the US, it’s the culmination of a patient-led uprising to demand that providers hand over their medical data. To that end I & THCB are supporting Health Data Independence Day. Sign the petition at GetMyHealthData.org and please use and encourage others to use the free tool from the associated Vocatus Project to request your data from your doctors and hospitals. I’ll be taking up the cudgels in the continuing story of my son’s “Search for Intr-Aero-Bili-Ty” but for now we’re thrilled to publish this amazing piece from Health...
Source: The Health Care Blog - July 3, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs
The ABIM Controversy: A Brief History of Board Certification and MOC
By ROBERT WACHTER, MD
What’s up with the ABIM?” “I just got a note about an alternative board. Should I join it?” “Aren’t you glad to be off the Board?”
These days, I get these questions from friends and colleagues regularly. When I first joined the board of directors of the American Board of Internal Medicine (ABIM) in 2004, the organization was a well-respected pillar of American medicine. Today the organization finds itself in a fight for its life, being painted as everything from out of touch to money-hungry to, more recently, corrupt.
I just completed my decade-long service to the ABIM and, more recentl...
Source: The Health Care Blog - July 2, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB ABIM Source Type: blogs
The Digital Doctor: Is Natural Language Processing the Breakthrough We’ve Been Waiting For?
By BOB WACHTER, MD
Natural language processing might seem a bit arcane andtechnical – the type of thing that software engineers talk about deep into the night, but of limited usefulness for practicing docs and their patients.
Yet software that can “read” physicians’ and nurses’ notes may prove to be one of the seminal breakthroughs in digital medicine. Exhibit A, from the world of medical research: a recent studylinked the use of proton pump inhibitors to subsequent heart attacks. It did this by plowing through 16 million notes in electronic health records. While legitimate epidemiologic questions can be raised a...
Source: The Health Care Blog - June 23, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs
Can You Test A Drug And Also Say Negative Things About It?
In my last post I raised the possibility that Steve Nissen, a highly influential cardiologist who has been an outspoken critic of industry influence in medicine, might have his own conflict of interest (COI) problem. In response, another cardiologist, James Stein, said that my post was unfair in its treatment of Nissen and failed to consider important distinctions and subtleties in the academic literature about conflict of interest. Let me first of all confess that Stein– for whom I have the highest possible regard– makes some excellent points. And I further admit that my piece More…
Source: CardioBrief - June 15, 2015 Category: Cardiology Authors: Larry Husten Tags: People Policy & Ethics CME conflict of interest PCSK9 steve nissen Source Type: blogs
LITFL Review 183
Welcome to the 183rd LITFL Review. Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
The Emergency Medicine Educator’s Conference (EMEC) posted the first of its conference videos. Dan Boden shares Derby’s ideas and success on teaching the whole department. Plenty of food for thought….. [SL]
The Best of #FOAMed Emer...
Source: Life in the Fast Lane - May 24, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Prominent Harvard Cardiologist Moves To Google X To Head Large Study
Here’s a clear sign of the ascending role of digital/precision/personalized medicine: a prominent cardiologist has left a top academic and clinical position in Boston to run a large, innovative study in Silicon Valley. Jessica Mega was widely perceived as a rising star at Harvard Medical School and the Brigham and Women’s Hospital. She has now joined Google X, Google’s research arm, where she will head up the much publicized Baseline Study. “I’m jealous,” said one academic cardiologist at a top hospital, upon hearing the news. Baseline is one of the ambitious projects undertaken ...
Source: CardioBrief - May 11, 2015 Category: Cardiology Authors: Larry Husten Tags: People, Places & Events Policy & Ethics Prevention, Epidemiology & Outcomes Baseline Study genetics Google precision medicine Source Type: blogs
