Critical gaps in STEMI knowledge base : What is the relationship between “ Time window ” and “ Age ” of IRA thrombus ?

Cardiologists are grappling with at least  half a dozen time windows  in the management of STEMI. (It can be combinations of any of the following :Symptom – DAPT Loading – Door – Needle /Balloon-Sheath, wire crossing etc ) Time windows are Important in choosing the right (or no)modality of re-perfusion . Though superiority of  primary PCI  is thought to be established in academic community , it  may not be in real world. Published studies that suggest pPCI is superior to lysis at any time window  still lack good evidence. Why is this long drawn confusion  ?  One of the important determinant of outcome in STEMI , is the thrombus organisation (hardening )time . Some how we have assumed PCI can tackle hardened thrombus  much better than lysis (In fact the outcome in late PCI is as bad or good as lysis in terms of true myocardial reperfusion in this population.This fact will not be visible in scientific data that’s read superficially .One has  to  mine deep for the truth) (Claeys MJ,. . Arch Intern Med. 2011;171(6):544–549) Two more virtual pathological Time windows. While we are preoccupied with certain time windows in STEMI  ,may I suggest  two more  Invisible pathological windows. I don’t know , whether these are presumptive theoretical stuff ,  but understanding these time windows will sharpen our decision-making skills in STEM...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: cath lab tips and tricks PCI PTCA Hardware Primary -PCI STEMI STEMI -Managment STEMI-Primary PCI Thrombolysis how to estimate the age of thrombus in stemi acs soft vs hard thrombus in stemi thrombus hardening time thrombus organising t Source Type: blogs

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Publication date: Available online 31 May 2020Source: SteroidsAuthor(s): Fernando A.C. Seara, Emerson L. Olivares, Jose H. M. Nascimento
Source: Steroids - Category: Drugs & Pharmacology Source Type: research
Publication date: Available online 31 May 2020Source: Journal of EthnopharmacologyAuthor(s): Deng Zhihao, Weng Xiaogang, Zhao Yongjiao, Gao Jianen, Yu Dingrong
Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
CONCLUSION: We report the successful management of anesthesia without lethal arrhythmia in a patient with ARVC and an ICD. An adequate amount of analgesia should be administered during general anesthesia to maintain adequate anesthetic depth and to avoid stress and pain. PMID: 32473832 [PubMed - as supplied by publisher]
Source: Revista Brasileira de Anestesiologia - Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research
Resumo Fundamento M últiplos sistemas de pontuação têm sido elaborados para calcular o risco de eventos cardiovasculares adversos maiores (MACE) em pacientes com dor no peito. Não há dados que avaliem se o escore HEART tem um desempenho superior a TIMI e GRACE para a predição de MACE, especialmente na era de tr oponina I de alta sensibilidade e em uma população exclusivamente latino-americana. Objetivo Comparar o desempenho dos escores HEART, TIMI e GRACE para a predição de MACE em 30 dias de acompanhamento, em pacientes atendidos com dor no...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
Resumo Fundamento M últiplos sistemas de pontuação têm sido elaborados para calcular o risco de eventos cardiovasculares adversos maiores (MACE) em pacientes com dor no peito. Não há dados que avaliem se o escore HEART tem um desempenho superior a TIMI e GRACE para a predição de MACE, especialmente na era de tr oponina I de alta sensibilidade e em uma população exclusivamente latino-americana. Objetivo Comparar o desempenho dos escores HEART, TIMI e GRACE para a predição de MACE em 30 dias de acompanhamento, em pacientes atendidos com dor no...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
Resumo Os sintomas respirat órios, principalmente o desenvolvimento de quadros de síndrome do desconforto respiratório agudo grave, dominam a discussão e as preocupações iniciais da população e dos profissionais de saúde. Entretanto, o sistema cardiovascular é bastante afetado por essas condições e, muitas vezes, é o responsável por complicações e mortalidade desses pacientes. Com o objetivo de mostrar as implicações cardiovasculares em pacientes infectados pela COVID-19 e a importância do iso...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
Source: Journal of Pain Research - Category: Anesthesiology Tags: Journal of Pain Research Source Type: research
June 1, 2020 -- AstraZeneca’s Brilinta (ticagrelor) has been approved in the US to reduce the risk of a first heart attack or stroke in high-risk patients with coronary artery disease (CAD), the most common type of heart disease. The approval...
Source: Drugs.com - New Drug Approvals - Category: Drugs & Pharmacology Source Type: news
Source: Journal of Pain Research - Category: Anesthesiology Tags: Journal of Pain Research Source Type: research
Having responded well to an antidepressant I was determined to continue treatment for 6 months, to increase the probability of a full and lasting recovery. My productivity at work and confidence in social situations increased and it seemed easier to talk about emotional matters. Side effects became gradually less bothersome, though at times I was somewhat apathetic. Escitalopram may have helped to reduce long-standing back pain and niggly acoustic problems. Some symptoms appeared whilst I reduced the antidepressant dosage steadily: these were mild and resolved swiftly, but a few were quite puzzling. I hope this experience ...
Source: International Clinical Psychopharmacology - Category: Psychiatry Tags: Review Articles Source Type: research
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