Search Results for: tpa

Impedance Threshold Devices Are Useless

So, supposedly, impedance threshold devices installed inline for ventilation during CPR potentially improve hemodynamics via negative intrathoracic pressure.  This is a prospective, randomized, multi-center, placebo-controlled sham study that really meets a very high standard for internal validity.  Over 4000 patients in the ITD group, the sham ITD group, and the not-enrolled comparison cohort. Short summary: – … Continue reading “Impedance Threshold Devices Are Useless”

CT Coronary Angiography Proves People WIth CAD Die Sooner

This is a neat study that followed up 23,854 patients from a multicenter CTCA registry – the CONFIRM registry – over three years to evaluate their long term prognostic risk.  And – amazingly enough – the patients who had no coronary artery disease identified on their CTCA had an annualized rate of 0.28% of death … Continue reading “CT Coronary Angiography Proves People WIth CAD Die Sooner”

Significant Populations Have No Timely Access to Stroke, Pediatric Trauma Care

These are a couple studies from a family of publications that use population data, GIS mapping tools, and travel times by air and ground to estimate what percentage of the population has access to a certain healthcare resource.  In these two papers, the resources in question are Primary Stroke Centers and Pediatric Trauma Centers.  They … Continue reading “Significant Populations Have No Timely Access to Stroke, Pediatric Trauma Care”

Overdiagnosis of Pulmonary Embolism

Another over-testing over-diagnosis article effectively illustrating issues endemic to our current medical culture. They do a retrospective national database review regarding the impact of the introduction of CTPA protocol for rule-out PE, and note that we’ve diagnosed three times as many PEs in 2006 as we did in 1998.  And, by detecting more PEs, we … Continue reading “Overdiagnosis of Pulmonary Embolism”

72-Hour Returns – Fun, But Not Useful

Our EMR lets us generate reports of our 72-hour returns – and it’s a fun toy, but, reading through it is rarely illuminating.  On a rare occasion you see a “true miss”, where one of your colleagues finds something through another line of thinking.  But, mostly, it’s wound checks, admissions for failed outpatient antibiotic therapy … Continue reading “72-Hour Returns – Fun, But Not Useful”

Intracranial Extension of Sinusitis in Children

Interesting descriptive study of a decade’s worth of children transferred/admitted to Texas Children’s in Houston with intra-orbital or intra-cranial extension of their sinusitis.  It’s really just a summary of the clinical and hospital courses of 118 patients identified through retrospective chart review. Interesting tidbits:– Of these patients, 40% had been prescribed outpatient courses of antibiotics … Continue reading “Intracranial Extension of Sinusitis in Children”