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Skype Name:================ toniparkers (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - March 24, 2014 Category: Cardiology Authors: qualitymeds Source Type: forums
Clinical question of the week: is the era of 'interventional' treatment of resistant hypertension over?
This week's question of the week comes from our cardiology clinical champion, Sadia Khan
A recent editorial in the BMJ discussed the outcome of Symplicity HTN-3, the world's first blinded randomised controlled trial of renel denervation in hypertension. The trial failed to meets its targeted reduction in blood pressure and questions are now being asked about the design of the trial.
(Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - March 21, 2014 Category: Cardiology Authors: AnneG Source Type: forums
informed consent and risks
I saw this news piece about a cardiothoracic surgeon on the main website
http://www.bmj.com/content/348/bmj.g2160?sso=
which relates to the risk of infection from an individual surgeon - who was colonised by a staph sp present in the operating environment. The issue that came before the court was whether he should be obliged to divulge this information to future patients. Waht does the community think?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - March 17, 2014 Category: Cardiology Authors: sadian Source Type: forums
Quality Improvement recipes - how can we help you?
Hello,
BMJ Quality are keen to find out how we can support you to do quality improvement projects in cardiology.
We realise that many people are keen to undertake projects but are held back by lack of time, resource or ideas.
To get over this, we can design customised step-by-step QI workbooks for specific projects that will give you all the background info and resources that you need to quickly and simply undertake a good QI project.
However, we need your help to tell us what you would like.
So, could you tell us what you think are the top 3 quality improvement projects in cardiology?
Once we have this, ...
Source: Doc2Doc BMJ Cardiology - March 14, 2014 Category: Cardiology Authors: Marc Wittenberg Source Type: forums
Are exercise stress tests overused in your practice/hospital?
Why are screening exercise EKG stress tests are used so widely on low risk people with no risk factors. Aren't there studies that just sufficient activity is a good predictor of mortality in these low risk patients? Why do we need to do these expensive stress tests on millions of low risk patients?
I've designed a survey to get to the root cause of this and would appreciate it if you could chime in with your thoughts
https://www.surveymonkey.com/s/RC8NWKM
Vivek (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - March 4, 2014 Category: Cardiology Authors: techdoc Source Type: forums
what do you think of doxazosin?
I saw a gentleman yesterday who has Ischaemic heart disease and hypertension and normally takes ramipril 10mg and amlodipine 10mg for hypertension. He was seen in the renal clinic last week as he now has stage 3 CKD and had a bp recorded at 220 / 90 (don't know if this was a one-off measurement or rechecked by the doctor) and was prescribed doxazosin 4mg. His BP yesterday was about 80 systolic and he has been feeling dizzy funnily enough. What do you think of this clinical hisotry?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - February 26, 2014 Category: Cardiology Authors: sadian Source Type: forums
Are the figures really horrific?
Anti-alcohol propaganda seems to be making much of the UK figures. 580 deaths in men and 385 in women in one year - in the 75 and over age group. Just what are we allowed to die from and has the current obsession with maximisising length of life become a bit ridiculous ? Of course some folk may be drinking for reasons which warrant social assessment and there may be a fair amount of ignorance about the ill effects. But is it so very awful if some of those over 75 have a slight "what the hell attitude?". Out of the 500,000 deaths pa in the UK these figures fail to appal me. Perhaps Odysseus could give us an Australian view ...
Source: Doc2Doc BMJ Cardiology - February 21, 2014 Category: Cardiology Authors: sken Source Type: forums
should death always be shocking?
this is the title of a bcs website editorial
http://www.bcs.com/pages/news_full.asp?NewsID=19792213
regarding end of life care and implanatable devices
It seems shocking in itself that patients who have DNAR decisions in place are still left with shock therapy on in the 24 hour before death - is this the fault of cardiologists for not educationg patients / other physicians re device care or is it just that deactivating devices is too difficult to discuss?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - February 19, 2014 Category: Cardiology Authors: sadian Source Type: forums
the statin scattergun?
NICE guidelines suggest increasing the indications for statn prescription.
http://www.bmj.com/content/348/bmj.g1518
however as the article points out the impact of cardiovascular disease is unequal - would the money be better spent on reducing health inequalities and smoking rates?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - February 18, 2014 Category: Cardiology Authors: sadian Source Type: forums
Clinical question of the week: Should smoking in cars with children present be banned?
Parliament are due to vote on Monday on whether smoking in cars with children present should be banned . There is a letter with more than 700 signatures of health care professionals in the BMJ. What does the doc2doc community think? Should adults have the right to choose to smoke in the privacy of their cars (or homes for that matter) or should we protect children from the effects of second-hand smoke? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - February 10, 2014 Category: Cardiology Authors: sadian Source Type: forums
sweet teeth
the bbc news website is covering this story about sugar intake and risk of CV events
http://www.bbc.co.uk/news/health-26020017
Will this study add more ' weight ' to the idea that processed foods and drinks high in sugar should be taxed?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - February 5, 2014 Category: Cardiology Authors: sadian Source Type: forums
How effective "Chelation Therapy" is?
Hi ,
I know a patient who is heart patient.
He has one vein fully blocked & two other half blocked.
He's bit affraid of Surgery.
We came to know about a alternative called "Chelation therapy"
I want to know HOW EFFECTIVE it is ???
&
Does it have bad side effects?
Do you think that we should go for it (Chelation therapy) ?????????
Thanks in advance.
testRDS (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - February 4, 2014 Category: Cardiology Authors: testRDS Source Type: forums
It's National Heart month
Today is the first day of national heart month here. One of our patients has kindly agreed to tell her story to raise awareness of heart disease and the BHF is running a campaign. What else is happening in national heart month?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - February 1, 2014 Category: Cardiology Authors: sadian Source Type: forums
Clinical question of the week: Is there still a role for iv beta blockers in the 'modern era' of reperfusion?
I'm old enough to remember iv beta blockers and thrombolysis. A recent study in Circ 128:1495-1503 suggests that early iv beta blockade may be making a come back - well at least in the context of anterior MI. Do you agree? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - January 28, 2014 Category: Cardiology Authors: sadian Source Type: forums
heart attacks - bad at any time, worse after hours?
The meta analysis of almost 2 million patients with STEMI shows a significant increased mortality of presenting with an infarct out of hours. Although the odds ratio appears small -1.06 , the sheer numbers of patients means that the number of potential lives saved is large. Short of running a 24/7 service that is the same day and night , how can we improve out of hours provision ?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - January 25, 2014 Category: Cardiology Authors: sadian Source Type: forums
