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Time your next heart attack to conincide with national cardiology meetings
Surprisingly,high-risk patients with heart failure and cardiac arrest admitted to US teaching hospitals during dates of national cardiology meetings had lower 30-day mortality rates. The surprise is that outcomes improved despite the absence of the cardiologists who attended the meetings. While the cause of this correlation and the generalizability of the methodology are unclear, the finding is very significant.A Freakonomics podcast covering this study expressed the magnitude of this effect in a powerful comparison. While the combination of common interventions (beta-blockers, statins, aspirin, and blood thinners) reduce ...
Source: Bayblab - April 13, 2015 Category: International Medicine & Public Health Authors: Rob Source Type: blogs
ED Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.....
Conclusions: Many unnecessary tests are obtained to evaluate syncope. Selecting tests based on history and examination and prioritizing less expensive and higher yield tests would ensure a more informed and cost-effective approach to evaluating older patients with syncope._____________________________________________________________________________4) Reed MJ. The ROSE (Risk Stratification of syncope in the emergency department) Study. J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049 Objectives: The aim of this study was to develop and validate a clinical deci...
Source: Dr. Smith's ECG Blog - April 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.....
Conclusions: Many unnecessary tests are obtained to evaluate syncope. Selecting tests based on history and examination and prioritizing less expensive and higher yield tests would ensure a more informed and cost-effective approach to evaluating older patients with syncope._____________________________________________________________________________4) Reed MJ. The ROSE (Risk Stratification of syncope in the emergency department) Study. J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049 Objectives: The aim of this study was to develop and validate a clinical deci...
Source: Dr. Smith's ECG Blog - April 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
The Troubles at Cooper Continue, Lately Gruesomely, But Will Its Leadership and Governance Change This Time? - Part I: Historical Background
Allegations of Murder-Suicide by a Hospital System CEO This will be a hard series of posts to write. It wa triggered by the latest, and perhaps most gruesome chapter in the troubled history of the leadership of Cooper Health, the largest hospital system in southern New Jersey (known locally as South Jersey). As reported by the Philadelphia Inquirer on March 28, 2015,Cooper University Health System CEO John P. Sheridan Jr. stabbed his wife to death, set their bedroom on fire, and then took his own life, authorities have concluded, closing a six-month investigation into the deaths that shocked New Jersey's political an...
Source: Health Care Renewal - April 1, 2015 Category: Health Management Tags: anechoic effect boards of trustees conflicts of interest Cooper Hospital/ UMC crime governance health care corruption hospital systems leadership Source Type: blogs
Atrial fibrillation during STEMI : Don’t get alarmed
Atrial fibrillation is the most common arrhythmia we encounter in clinical cardiology .Ironically it is uncommon during ACS and extremely rare in association with UA/NSTEMI. Surprisingly , an entity ” Ischemic AF” is not to be found in cardiology literature.
The incidence of AF in STEMI is less than 5%. Occurs more often due to factors other than primary ischemia of atrial musculature. Of-course , AF in association with Infero posterio MI and RVMI is an important trigger for AF.LCX disease is more often associated with AF as it gives up a consistent branch to left atrium.
Though it is tempting to implicate ...
Source: Dr.S.Venkatesan MD - February 25, 2015 Category: Cardiology Authors: dr s venkatesan Tags: Atrial fibrillation Infrequently asked questions in cardiology (iFAQs) atrial fibrillation in stemi management of atrial fibrillation during stemi Source Type: blogs
Introducing Dr. Staci Mandrola — @DrStaciM
It took me four years to convince my wife, Dr. Staci Mandrola, to join Twitter. Like many (previously) analog docs, Staci was resistant. “I don’t need another distraction,” went one of the arguments.
Yet I knew if she tried Twitter, she would love the medium. If you care about a topic, if you are curious, and if you are comfortable in your own skin, Twitter works. This is why I predict Staci will do well in the digital realm.
The one bad thing about @DrStaciM being online is that one of my secrets is out. All these years, I have had an advantage–sort of like cheating. How does a cardiologist know th...
Source: Dr John M - February 25, 2015 Category: Cardiology Authors: Dr John Source Type: blogs
Research and Reviews in the Fastlane 065
This study looked at how patients and doctors can use shared decision making to reduce in patient work ups for low risk chest pain. Using a chest pain decision aid, they reduced in patient work ups by 19%. The brilliance here is in the application of the theory of shared decision making and the knowledge transfer to patients using this system.Recommended by: Anand SwaminathanThe Best of the RestCardiology, Emergency MedicineBangalore S et al. Clinical outcomes with β-blockers for myocardial infarction: a meta-analysis of randomized trials. Am J Med. 2014;127(10):939-53. PMID: 24927909The pendulum for beta blockers in MI k...
Source: Life in the Fast Lane - January 7, 2015 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Cardiology Education Emergency Medicine Intensive Care Pre-hospital / Retrieval Respiratory Resuscitation airway critical care R&R in the FASTLANE recommendations Review Trauma Source Type: blogs
S3 and left ventricular dysfunction in AR vs MR
S3 and left ventricular dysfunction in AR vs MR
Short Notes
Abstract: S3 can occur in mitral regurgitation without left ventricular dysfunction while presence of S3 in aortic regurgitation indicates left ventricular dysfunction.
Conventional teaching is that an S3 can occur in mitral regurgitation without left ventricular dysfunction while presence of S3 in aortic regurgitation indicates left ventricular dysfunction. Horn RA and colleagues explored this aspect using quantitative Doppler echocardiography and the data was published as an abstract in the Journal of American College of Cardiology in 1996.1 They evaluated thr...
Source: Cardiophile MD - January 4, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Aortic regurgitation mitral regurgitation S3 and left ventricular dysfunction Source Type: blogs
A new “Null Hypothesis” in medical research !
After nearly three decades of , treating patients , teaching students and little involvement in research , I have consciously created a new null hypothesis in medical research !
Source: Dr.S.Venkatesan MD - December 21, 2014 Category: Cardiology Authors: dr s venkatesan Tags: bio ethics medical quotes Two line sermons in cardiology evidence based medicine flawed drug trials medical ethics randomised drug trials rct statistical gimmicks Source Type: blogs
Viva La Evidence
Hi All,
It’s been a while.
The hospital is abuzz with electrophysiology problems. I’ve been unleashing some serious medical fury in the past weeks. It has been fun, though it gets in the way of writing and training.
James McCormack (@medmyths) is a “Pharmacist, Professor, Medication Mythbuster, and Healthy Skeptic at the Faculty of Pharmaceutical Sciences at UBC.”
I have recently subscribed to his You Tube Channel.
Here is his latest four-minute gem on using clinical evidence as a therapeutic tool. I don’t think clinical evidence is just for doctors. Now that the playing field of medical infor...
Source: Dr John M - December 5, 2014 Category: Cardiology Authors: Dr John Source Type: blogs
Take Heart Australia
Guest Post by Professor Paul Middleton, emergency physician and founder of Take Heart Australia
I have spent the last 20 years practicing emergency medicine on the ground and in the air. I have attended countless cardiac arrests both in hospital and the pre-hospital setting; performed compressions on hundreds of chests; sent countless joules of energy through wobbling hearts, and squirted buckets of adrenaline into cannulae, IO needles and ET tubes…but I still have an empty feeling inside – I know we can do better.
We hear about cardiac arrest all the time, and as clinicians working in emergency medicine and cr...
Source: Life in the Fast Lane - November 18, 2014 Category: Emergency Medicine Authors: Mike Cadogan Tags: Cardiology Pre-hospital / Retrieval Website Chain of survival OOHCA Paul Middleton Professor Paul Middleton Take Heart Take Heart Australia Source Type: blogs
Staying Alive — Start The Heart Foundation taking off in Louisville
My friend and colleague William Dillon (@wmdillon) is an interventional cardiologist. He and his wife Sally have started a non-profit foundation called Start the Heart Foundation. Their goal is to improve survival of patients who suffer cardiac arrest in Louisville Kentucky. The odds of surviving cardiac arrest here in Louisville are dismal: more than 90% die.
Start the Heart Foundation uses a novel means to achieve their goal. They send premedical student interns to the community to teach hands-only CPR. The youngsters go to schools, corporations and community centers. They teach and teach and teach.
The local TV station ...
Source: Dr John M - November 13, 2014 Category: Cardiology Authors: Dr John Source Type: blogs
Research and Reviews in the Fastlane 057
This study compared bivalirudin to unfractionated heparin with the primary combined endpoint of death, CVA, reinfarction and target lesion revascularization. In spite of the fact that the trial was designed to favor bivalirudin (open-label), the authors found an increased rate in the primary outcome in the bivalirudin group (8.7% vs. 5.7%). Further proof that just because a drug is new, doesn’t mean it’s better.
Recommended by: Anand Swaminathan
Trauma, PediatricsAltgärde J, Redéen S, Hilding N, Drott P. Horse-related trauma in children and adults during a two year period. Scand J Trauma Resusc Emerg Med. 2...
Source: Life in the Fast Lane - November 10, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Cardiology Education Emergency Medicine Pediatrics Resuscitation Trauma Wilderness Medicine airway brain failure critical care General Surgery hypothermia Intensive Care prehospital recommendations Review Source Type: blogs
Top 10 List of Social Admits Defined!
What is a social admit to the hospital? A social admission is generally accepted by healthcare professionals to be a patient with no acute medical needs that is brought into a hospital because no safe discharge arrangements could be made at the time they presented. Most social admits involve elderly patients who present to an emergency room with weakness, have a thorough negative workup and are too weak to go home but have no where else to go. They might have a non surgical fracture limiting their mobility or a family refusing to take them home. Most social admissions occur after-hours when community services are un...
Source: The Happy Hospitalist - November 9, 2014 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
