DM / DNB Cardiology Entrance New Test Series 3
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Source: Cardiophile MD - July 9, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
Ignorance based STEMI care : What is the optimal gap between “Pharmaco” and “Invasive” strategy ?
Less than a century ago an easy chair was enough to manage this most important medical emergency of mankind. Of course, at that time mortality of STEMI was estimated to be around 30%.We have since pushed the in-hospital death rate down to less than 10 % and its around 5-8% currently.(*The lifeless chairs were able to save 70 lives is a different story!)
Heparin , thrombolytic agents, critical coronary care has helped us to achieve this , of course It must be admitted primary PCI also played a small role (at best 1 % ) in our fight against this number one killer.
Now, why not combine both lysis and PCI ?
The concept o...
Source: Dr.S.Venkatesan MD - July 2, 2016 Category: Cardiology Authors: dr s venkatesan Tags: acute coronary syndrome Cardiology -Therapeutic dilemma cardiology -Therapeutics Cardiology -unresolved questions Primary PCI Uncategorized failed thrombolysis pharmaco Invasive strategy Source Type: blogs
Ignorance based STEMI care : What is the optimal gap between “ Pharmaco ” and “ Invasive ” strategy ?
Less than a century ago an easy chair was enough to manage this most important medical emergency of mankind. Of course, at that time mortality of STEMI was estimated to be around 30%.We have since pushed the in-hospital death rate down to less than 10 % and its around 5-8% currently.(*The lifeless chairs were able to save 70 lives is a different story!)
Heparin , thrombolytic agents, critical coronary care has helped us to achieve this , of course It must be admitted primary PCI also played a small role (at best 1 % ) in our fight against this number one killer.
Now, why not combine both lysis and PCI ?
The concept o...
Source: Dr.S.Venkatesan MD - July 2, 2016 Category: Cardiology Authors: dr s venkatesan Tags: acute coronary syndrome Cardiology -Therapeutic dilemma cardiology -Therapeutics Cardiology -unresolved questions Primary PCI Uncategorized failed thrombolysis pharmaco Invasive strategy Source Type: blogs
Assessing the Validity of MACRA’s Risk Adjustment Methods
By KIP SULLIVAN
The feedback doctors will receive from CMS under CMS’s proposed MACRA rule will arrive in two forms: Money (more or less of it) and data. Neither form of feedback will be accurate. For that reason, the behavior desired by Congress and CMS – “smarter care” (as CMS puts it) producing lower costs and higher quality – will not materialize.
As I noted in the first installment of this three-part series, the two most important sources of noise in CMS’s feedback will be CMS’s inability to determine which patients “belong” to which doctor (the attribution problem) and its inability to adjust cost ...
Source: The Health Care Blog - June 14, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Assessing the Validity of MACRA’s Risk Adjustment Schemes
By KIP SULLIVAN
The feedback doctors will receive from CMS under CMS’s proposed MACRA rule will arrive in two forms: Money (more or less of it) and data. Neither form of feedback will be accurate. For that reason, the behavior desired by Congress and CMS – “smarter care” (as CMS puts it) producing lower costs and higher quality – will not materialize.
As I noted in the first installment of this three-part series, the two most important sources of noise in CMS’s feedback will be CMS’s inability to determine which patients “belong” to which doctor (the attribution problem) and its inability to adjust cost ...
Source: The Health Care Blog - June 14, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes
Conclusions: In the select group of hypokalemic patients studied, potassium infusions of 20 to 40 mmol delivered over 1 hr were safe to administer and effectively increased serum potassium levels in a dosedependent and predictable fashion. Furthermore, these results were independent of the patient's underlying renal function or associated diuretic administration. (Crit Care Med 1991; 19:694)Concentrated Potassium Chloride Infusions in Critically Ill Patients with HypokalemiaThe Journal of Clinical Pharmacology. Volume 34, Issue 11, pages 1077–1082, November 1994Although concentrated infusions of pota...
Source: Dr. Smith's ECG Blog - April 7, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs
After a Decade, CABG Pulls Ahead of Meds for HF
–Life-saving benefit of CABG now clear in long-term trial follow-up Finally, after 10 years of follow-up, the life-saving benefits of coronary artery bypass graft (CABG) surgery in heart failure patients with coronary artery disease are clear. More than 15 years ago, the NIH funded the original STICH trial to answer a question that was already...Click here to continue reading... (Source: CardioBrief)
Source: CardioBrief - April 4, 2016 Category: Cardiology Authors: Larry Husten Tags: Heart Failure Interventional Cardiology & Surgery People, Places & Events CABG coronary artery disease STICH STICHES Source Type: blogs
Critical management issues in CAD : OMG ! . . where is OMT ?
One of my fellows gave a discharge summary for a 62 year old patient with stable diabetic CAD who had Triple vessel disease with a final advice reading as CABG / PCI/or OMT .
There was a near fury over his angiogram report in the cath meet. How can be eligible for all the three Intervention at the same time ?.(PCI -Percutaneous coroanry Inervention ,CABG-Coroanry artery by-pass graft, OMT-Optimal medical therapy )
The lesion in question was , Triple vessel disease(Non critical LAD) and significant LCX and again a non critical RCA .Syntax was less than 22 for sure , however the patient had class 2 angina (now redu...
Source: Dr.S.Venkatesan MD - March 31, 2016 Category: Cardiology Authors: dr s venkatesan Tags: cardiology -Therapeutics Cardiology -unresolved questions Infrequently asked questions in cardiology (iFAQs) cabg vs omt oci vs cabg vs omt pci vs omt ptca vs medical vs cabg what is optimal medical management omt Source Type: blogs
Critical management issues in CAD : OMG ! . . where is OMT ?
One of my fellows gave a discharge summary for a 62 year old patient with stable diabetic CAD who had Triple vessel disease with a final advice reading as CABG / PCI/or OMT .
There was a near fury over his angiogram report in the cath meet. How can be be eligible for all the three Intervention at the same time ?.(PCI -Percutaneous coroanry Inervention ,CABG-Coroanry artery by-pass graft, OMT-Optimal medical therapy )
The lesion in question was , Triple vessel disease(Non critical LAD) and significant LCX and again a non critical RCA .Syntax was less than 22 for sure , however the patient had class 2 angina (now r...
Source: Dr.S.Venkatesan MD - March 31, 2016 Category: Cardiology Authors: dr s venkatesan Tags: cardiology -Therapeutics Cardiology -unresolved questions Infrequently asked questions in cardiology (iFAQs) cabg vs omt oci vs cabg vs omt pci vs omt ptca vs medical vs cabg what is optimal medical management omt Source Type: blogs
Value Pricing For Drugs: Whose Value, What Price?
It is hard to read a newspaper these days without coming across a story about the high and ever increasing cost of drugs. The Wall Street Journal named drug prices the top health story of 2015. Stories about drug prices fall into two general categories. The first are stories about generic and other manufacturers who are not focused on innovation (like Turing Pharmaceuticals and Valeant) but who acquire generic drugs and increase the price dramatically without adding value while also making it impossible for competitors to manufacture the drug by controlling the distribution.
While this problem is real, it is not the focus ...
Source: Health Affairs Blog - March 28, 2016 Category: Health Management Authors: Robert Rubin Tags: Costs and Spending Drugs and Medical Technology Featured Medicare ACOs Big Pharma cost effectiveness analysis high-cost drugs PCSK9 inhibitors QUALY value-based payment Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 22
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Source: Cardiophile MD - March 21, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
Volume to Value: it ’ s about the caboose
In his post last week, John Halamka expressed optimism:
I left HIMSS this year with great optimism. Vendors, technologies, and incentives are aligned for positive change. 2016 will be a great year.
Perhaps we were seeing different sides of HIMSS.
Yes. there is a “buzz” around the migration from volume to value. Walking the floor of the exhibit hall, it was hard to avoid companies – old and new – describing their population health / care coordination / analytics tools.
Yet I didn’t see very much that was really new – really focused on value. I saw re-configured versions of old stuff. One company has ...
Source: Docnotes - March 12, 2016 Category: Primary Care Authors: Jacobr Tags: Value Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 15
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Source: Cardiophile MD - February 9, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 13
In this study, cangrelor was discontinued 1-6 hours prior to surgery, while aspirin was continued throughout the perioperative period. Bridging with cangrelor did not increase major bleeds prior to surgery, though minor bleeds, mostly ecchymosis at venipuncture site, was higher. P2Y12 assay documented sufficient platelet inhibition corresponding to levels required for anti thrombotic effect [1]. Cangrelor is awaiting approval and more large scale trials regarding the use of bridging are needed.
Reference
1. Angiolillo DJ et al; BRIDGE Investigators. Bridging antiplatelet therapy with cangrelor in patients undergoing ...
Source: Cardiophile MD - February 7, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 10
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Source: Cardiophile MD - February 1, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
