Many of the wonderful breakthrough articles are totally free . Enjoy and enrich .
Posted in cardiology journals, cardiology-ethics, Cardiology-Land mark studies, tagged academic cowardice, data manipulation', data torturin, fraud in medical research, intentional mis communication, medcial ethics, medical cowardice, medical obsfuscation, medical research on December 31, 2012 | Leave a Comment »
This world can not be a perfect place and it is foolish to expect the same ! What is published in medical literature is at best , an abstract thinking of an unfinished agenda . Still public think science is . . . what doctors say ! They feel doctors can not simply watch a person dying. They want us act like God. This is how medical men became Demi-Gods by default.
Here was a big opportunity . Who exploited it ? Obviously the greedy corporates who embarked on a dirty journey to en- cash this trust and fill their coffers .This is the foundation on which the basics of medical market economy rides !
It is an un-pardonable on-going deceit among modern human civilization . It has spoiled the trust between the patient and doctor and probably irreversibly contaminated in recent decades !
There are very few positives though, with occasional noble medical souls (Like BMJ,Lancet ) trying to keep the sinking ship afloat !
This sounding board article (Now we rarely get to see ) from NEJM way back in 1975 exposes a shocking revelation politely . Now, 40 years after , the importance of such article has grown many fold . We are witnessing every day , medical scientist break stories ( Yes . . . it is story ) in general media with absolute academic cowardice !
We expect more such face bashing articles from NEJM . It would definitely make immense good for our profession which needs it desperately !
I’m linking the original NEJM article ; Hope it does not violate copy right !
Posted in cardiology journals, Cardiology-Land mark studies, Uncategorized, tagged circulation 2008 nright ventricle review article, right ventricle anatomy physiology review article, semianr on right ventricle, symposium on right ventricle on November 30, 2012 | Leave a Comment »
Posted in bio ethics, cardiology journals, Cardiology quotes, cardiology-ethics, tagged ebn, emprical medicine, ethics in medicine, evidence based medicine, favorite medical quotes, hippocrates, randomised control trial on June 14, 2012 | Leave a Comment »
Posted in cardiac surgery, Cardiology -Interventional -PCI, cardiology -Therapeutics, cardiology journals, cardiology-ethics, tagged aortic stenosis, nejm partnet a study, partner study, risk of stroke, tavi, transcatheter aortic valve implantation on June 19, 2011 | 1 Comment »
There was a time , even cardiac catheterisation was contraindicated if the aortic valve is significantly calcified. LV angiogram was judiciously avoided in all such patients . Why ? A significant increase in disabling strokes were witnessed .Those were the time a sense of fear (common sense ?) prevailed . Every one was following this dictum with sanctity .
Now in 2010 .TAVI has arrived with great fanfare . We not only cross the calcific valve , we literally play a violent contact sport in the aortic root for over two hours with all sorts of pushes and passes on a fragile valve.And we are happy to claim that stroke rate is comparable to aortic valve surgery and TAVI is not-inferior to AVR in high risk surgeries .
How is this possible ? As the times changed ? Is it true , our stroke fears are just imaginations or have we lost our faculty of reasoning and sense ? (Will it be logical to fund a research if someone claims a surgical technique to replace aortic valve in a beating heart without aortic cross clamping !)
Data shows even if distal protection devices are used the stroke rates can reach to objectionable levels .It remained a mystery , at least to me how no body was questioning this ? I was happy to find this editorial in NEJM which just stopped short of banishing this modality in its current form.
What price it asks ? and leaves the readers to guess the answer ? NEJM wants to be too decent and polite , but in science politeness is generally not required , as long as your observations are correct !
For all those enthusiastic interventional cardiologists here is a positive message .
Nothing comes easy in science.Great inventions do have problems initially . Without major hurdles there can be no progress ! It is because of you modern cardiology is making giant strides . Remember the early days of angioplasty , early days of pacemaker . But please realise the most important issue is , whatever we innovate or discover it should be shown superior to the best existing modality in all aspects(Technique, procedural complications, long term outcome ,costs, side effects etc ) .It is awful to note new drugs or devices are rarely compared with the best treatment that is currently available .
A new treatment that simply complements or proves non-inferiority can never be considered an invention. How can we portray radio frequency renal denervation ( a complex lab procedure ) for controlling blood pressure as a great innovation for man kind while we have so many drugs and modalities available at a fraction of the cost with little consequence .
Posted in Cardiology -Interventional -PCI, cardiology -Therapeutics, Cardiology -unresolved questions, cardiology journal club, cardiology journals, Uncategorized, tagged comments about transfer ami, facilitated pci, FAILED THROMOLYSIS, journal watch transer ami, letters to the editor transfer ami, nejm transfer ami, REACT STUDY, rescue pci, routine early pci, stemi, tenecteplase failure, time window for pulmoanry thromolysis, TRANSFER -AMI STUDY on January 14, 2011 | Leave a Comment »
The much published TRANSFER -AMI study has few important queries to ponder about.It was supposed to test the role of routine PCI following thrombolysis. In other words it compared rescue only strategy with routine strategy.The caveat is , even among failed thrombolysis, the rescue strategy has not convincingly proven superior to medical management (if the time is lapsed ) as much of the damage is done .
In essence , Acute MI is more about time management than drug or cath lab management
Will the investigators share their experience ?
Why the title of the paper says it is about “Routine angioplasty” and the conclusion emphasizes it is indeed “high risk subsets ofangioplasty” (While the study itself involves a 92 % least risk Killip class 1 ) . Why this double dose of confusion ? (Is it deliberate ! Which i think is unlikely )
NEJM please take note of this . . .
All that glitters are not natural glitter . . .some are made to glitter !
Posted in Cardiology - Clinical, Cardiology -Interventional -PCI, cardiology -Therapeutics, cardiology journals, cardiology- coronary care, Cardiology-Coronary artery disese, Cardiology-Land mark studies, tagged bari 2 study, cass study, coronary intervention, courage study, high risk unstbale angina, how to do priamry pci, how to manage nstemi, ictus, mass 3 study bari 2d, medical management of cad, nstemi, oasis study, pci, ptca, stemi on December 18, 2010 | Leave a Comment »
Cleveland clinic is a leading centre for cardiac care .Major technological breakthrough occurs from this institute than any other place. Thousands of articles come out every year. Some articles , get global attention and make a huge impact. These are usually related to a new hi- tech modality like CRT devices or percutaneous aortic valve deployment etc ,etc.
Some articles , which are very important may not get the due attention . Journal editorial boards often have a scorecard called impact factor .That is , how a journal is impacting the practice habits of medical professionals . Ideally we need to have to grade individual articles with impact factor .Many articles may not have any significant impact however good the impact factor of the journal.
Here is an article, which excellently depicts the principles of management of ACS. It was published in 2003 JACC, by Steven Nissen from Cleveland, Ohio .It deserves more attention . Every cardiologist , involved in ACS management should read this, especially the interventionist.
Posted in Cardiology -Interventional -PCI, cardiology congenital heart disese, cardiology journals, Cardiology-Land mark studies, tagged asd, ASD device closure, jama on December 6, 2010 | Leave a Comment »
It was those great years 1974 -1976. Even before the concept of PTCA was born, few committed cardiologists of New Orleans were on a mission. Closing the ASD in cath lab. They achieved it successfully with a umbrella device.
But 35 years later as on 2010 ,the concept though proven still struggles to prove itself.
Link to related article .
Posted in cardiology journals, Great websites in cardiology, Uncategorized, tagged cardiology journals, great journals in cardiology, hamad medical corporation, heart views journal, heartviews, lesser known journals in cardiology, qatar cardiology journal on November 27, 2010 | Leave a Comment »
Great people do not boast . While there are thousands of hyped up publications in cardiology ,
This one form Qatar excels , which I stumbled upon recently contains very useful information about wide ranging issues in cardiology .
Let us congratulate the Hamad medical corporation for their unique academic vision .