PICSO: Population, Intervention, Control, Setting, Outcome
Things likethis NICE manual talk aboutsetting, when formulating a search question, and there is the SPICE scheme, where S is the setting. But I am not sure I have seen a version of the PICO grid which includes setting.If there is one, it would be good to know about it and you can tell me in the comments.  But if not, I may have just invented it. But I can ' t claim the credit. My eye was caught bya Guardian article today about whether face masks work to prevent the spread of COVID-19, and my eye was particularly caught because the author is Professor Trisha Greenhalgh of Oxford Uni...
Source: Browsing - June 6, 2020 Category: Databases & Libraries Tags: EBP literature searching Source Type: blogs
Microfluidic Device Mimics Blood Vessels to Test Clotting
Researchers at Texas A&M University have developed a microfluidic device that mimics the complex architecture of vasculature to better study blood clot treatments. The device includes channels with spirals, bends, and curves that are similar to those found in blood vessels, and which can influence blood clotting. Besides being biomimetic, the device is also faster and less expensive than existing blood clot testing technologies, and does not require a skilled technician to operate it.
Blood clots are involved in numerous diseases, from strokes to heart attacks and specific clotting disorders such as hemophilia. Rese...
Source: Medgadget - June 4, 2020 Category: Medical Devices Authors: Conn Hastings Tags: Diagnostics Medicine Source Type: blogs
1 hour of CPR, then ECMO circulation, then successful defibrillation....
An elderly woman had sudden ventricular fibrillation.She was unable to be defibrillated but was cannulated and placed on ECMO in our Emergency Department (ECLS - extracorporeal life support). ECMO Flow was achieved after approximately 1 hour of high quality CPR.After good ECMO flow was established, she was successfully defibrillated.Here is her monitor rhythm:Notice the " Shark Fin " morphology in lead I monitor rhythm.Also notice that the arterial line mean arterial pressure is 63 mmHg, but there is no waveform (and SpO2 says " no pulse " ), as the flow is continuous on ECMO and the LV function at this point was ext...
Source: Dr. Smith's ECG Blog - May 18, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
COVID19 and Finding Effective Medical Therapies
This post introduces a column I wrote over at TheHeart.org | Medscape Cardiology
—
The good news is that most people infected with coronavirus don’t need a hospital or doctor. But some do. Some get very ill.
The maddening thing is that doctors don’t have an effective treatment for the virus. There are no cures. The Worldmeter today shows nearly 5 million infections and more than 300,000 deaths. And no effective therapy.
Excluding a possibly modest effect of Remdesivir, our care is supportive, which is medical jargon for giving simple things like oxygen, acetaminophen, IV fluids and letting ...
Source: Dr John M - May 16, 2020 Category: Cardiology Authors: Dr John Source Type: blogs
Difficult calls in cardiology : Be ready for DC cardioversion during pregnancy !
This report from Taiwan reassures there is no adverse effect by measuring umbilical artery flow (Yu-Chi Wang European Journal of Obstetrics & Gynecology and Reproductive Biology 126 (2006) 268–274)While we consider DC shock during pregnancy is safe for the fetus, still, shock pads close to the abdomen, amniotic fluid being a good conductor of electricity at least one mother showed a sustained contraction of the uterus and fetal distress. This was possibly attributable to DC shock Eleanor J. Barnes BJOG 2003 https://doi.org/10.1046/j.1471-0528.2002.02113.
Final message Most cardiac arrhythmias in pregnancy ...
Source: Dr.S.Venkatesan MD - May 11, 2020 Category: Cardiology Authors: dr s venkatesan Tags: cardiology women Pregnancy and heart Uncategorized amiodarone verapamil in pregnancy avnrt avrt during pregnancy cardioversion during pregnancy dc shock during pregnancy fetal distress during dc shock peripartum cardiomyopathy vt vpd managem Source Type: blogs
The perfect storm
by Gertrud U. Rey A small subset of people are more vulnerable to severe complications and death resulting from SARS-CoV-2 infection. What causes this vulnerability? An increasing body of evidence suggests that patients suffering from severe COVID-19 often have one or more pre-existing conditions (co-morbidities). In an effort to describe the co-morbidities of COVID-19 patients […] (Source: virology blog)
Source: virology blog - May 7, 2020 Category: Virology Authors: Vincent Racaniello Tags: Basic virology Gertrud Rey Information COVID-19 cytokine storm D-dimer GWAS IL-6 SARS-CoV-2 severe disease SNP thrombosis viral virus viruses Source Type: blogs
Why we ignore LA appendage when measuring LA volume?
This study suggests we have to be careful about the hidden potential of LAA to expand and if ignored the device is likely to get dislodged with volume overloading. These observations make it clear we can’t isolate LAA volume when calculating LA volume.
Final message
There is a strong case for measuring LAA size & volume separately and preferably be added in the net LA volume Index. We can’t simply Ignore this vital and inherent part of LA , just because its called as an appendage. Of course, even a novice will rank LAA first, as the pathological hot spot within the entire LA.
Reference
Aun...
Source: Dr.S.Venkatesan MD - May 7, 2020 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
Pulmonary thromboendarterectomy
Pulmonary thromboendarterectomy is the standard surgical treatment for chronic thromboembolic pulmonary hypertension (CTEPH) if the surgical risk is reasonable to tolerate a prolonged surgery. The centre and surgeon should also have adequate annual volume of cases to maintain competence. CTEPH may occur in about 4% of patients after an episode of acute pulmonary thromboembolism over a one year period. There are persons with CTEPH who do not have a distinct previous history of acute pulmonary embolism as well.
Pulmonary thromboendarterectomy is a technically challenging procedure and hence the importance of operator’...
Source: Cardiophile MD - April 25, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiac Surgery chronic thromboembolic pulmonary hypertension CTEPH Source Type: blogs
Chronic thromboembolic pulmonary hypertension (CETPH)
Chronic thromboembolic pulmonary hypertension (CTEPH) may occur in about 2-4% of patients presenting with acute pulmonary embolism. It is considered when mean pulmonary artery pressure persists at or above 25 mm Hg after an episode of pulmonary thromboembolism [1]. Though it is a rare complication of pulmonary embolism, mortality and morbidity are significant. Upto 90% three year mortality has been reported in those with mean pulmonary artery pressures above 50 mm Hg. Majority of those with CETPH may not give a history suggestive of previous presentation with acute pulmonary embolism.
In those who developed CETPH after pu...
Source: Cardiophile MD - April 24, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology CETPH CTPH Source Type: blogs
Chronic thromboembolic pulmonary hypertension (CTEPH)
Chronic thromboembolic pulmonary hypertension (CTEPH) may occur in about 2-4% of patients presenting with acute pulmonary embolism. It is considered when mean pulmonary artery pressure persists at or above 25 mm Hg after an episode of pulmonary thromboembolism [1]. Though it is a rare complication of pulmonary embolism, mortality and morbidity are significant. Upto 90% three year mortality has been reported in those with mean pulmonary artery pressures above 50 mm Hg. Majority of those with CTEPH may not give a history suggestive of previous presentation with acute pulmonary embolism.
In those who developed CTEPH after pu...
Source: Cardiophile MD - April 24, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology CTEPH CTPH Source Type: blogs
Direct oral anticoagulant (DOAC) – Cardiology MCQ
Direct oral anticoagulant (DOAC) – Cardiology MCQ
Which of the following is not an indication for direct oral anticoagulant (DOAC) like dabigatran:
a) Prophylaxis against stroke in AF
b) Prophylaxis against systemic embolism in nonvalvular atrial fibrillation AF
c) Treatment and prevention of recurrent venous thromboembolism
d) Mechanical prosthetic mitral valve
Post your answer as a comment below
The post Direct oral anticoagulant (DOAC) – Cardiology MCQ appeared first on All About Cardiovascular System and Disorders. (Source: Cardiophile MD)
Source: Cardiophile MD - April 17, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Rationale for Testing Anticoagulants Against COVID-19
This article originally appeared on the Timmerman Report here.
The post Rationale for Testing Anticoagulants Against COVID-19 appeared first on The Health Care Blog. (Source: The Health Care Blog)
Source: The Health Care Blog - April 16, 2020 Category: Consumer Health News Authors: Christina Liu Tags: COVID-19 Patients Physicians anticoagulants cardiology coronavirus Ethan Weiss thrombosis Source Type: blogs
Left ventricular assist device (LVAD)
Left ventricular assist device is used to support the failing left ventricle when it is refractory to guideline directed medical therapy. It can be either a bridge to cardiac transplantation or a destination therapy. In general, cardiac transplantation offers better long term surival compared to LVAD according data available from devices except the most recent.
As per the The Registry of the International Society for Heart and Lung Transplantation: Thirty-fourth Adult Heart Transplantation Report-2017 [1], there were 126,753 pediatric and adult heart transplants between 1982 and June 2015. Median survival was 10.7 years i...
Source: Cardiophile MD - April 16, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiac Surgery LVAD Source Type: blogs
Left atrial appendage closure devices
Anticoagulation for prevention of stroke is a well established modality of treatment in atrial fibrillation. But a significant number of them have bleeding complications. Hence the option of left atrial appendage closure with multiple types of devices have been developed. Left atrial appendage with its sluggish flow is the most common location for thrombus formation in atrial fibrillation.
Following devices have been used with varying success:
Watchman
Amplatzer Cardiac Plug/Amulet
Lariat suture ligation
Atriclip
PROTECT-AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillatio...
Source: Cardiophile MD - April 15, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Great cardiac vein aspiration for refractory LAD No-reflow : A hypothesis waiting for proof.
Preamble The resting coronary blood flow (CBF) is about 5 % of cardiac output. It amounts to 250 ml /min (0.8 ml /mt/gram of myocardium ) It is estimated, blood flow across LAD is 50% . LCX and RCA share 25% each, depending upon the dominance. No need to say , the net return to coronary sinus should match the CBF at rest or exertion.(Minus a small fraction contributed by thebesain and vene cardia minimi flow, into the right heart chambers)Great cardiac vein (GCV) is the venous cousin of LAD. It must receive and empty 125ml of deoxygenated blood every minute into the coronary sinus, if LAD flow is normal. When LAD mic...
Source: Dr.S.Venkatesan MD - April 10, 2020 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized coronary sinus aspiration great cardiac vein aspiration for no reflow microvascular obstruction retrograde thrombus aspiration for no reflow Source Type: blogs
