Sunday, 26 August 2018

The safest level of drinking is none

Alcohol use is a leading risk factor for disease burden worldwide, accounting for nearly 10% of global deaths among populations aged 15–49 years, and poses dire ramifications for future population health in the absence of policy action today. The widely held view of the health benefits of alcohol needs revising, particularly as improved methods and analyses continue to show how much alcohol use contributes to global death and disability. Our results show that the safest level of drinking is none. This level is in conflict with most health guidelines, which espouse health benefits associated with consuming up to two drinks per day. Alcohol use contributes to health loss from many causes and exacts its toll across the lifespan, particularly among men. Policies that focus on reducing population-level consumption will be most effective in reducing the health loss from alcohol use.



Percutaneous closure of patent ductus arteriosus via internal jugular vein

DAPT score

Yeh RW, Secemsky EA, Kereiakes DJ, Normand SL, Gershlick AH, Cohen DJ, et al.; DAPT Study Investigators. Development and validation of a prediction rule for benefit and harm of dual antiplatelet therapy beyond 1 year after percutaneous coronary intervention. JAMA 2016;1:1735-49


PRECISE-DAPT score: This score gives baseline bleeding risk and shall be calculated at the time of stenting. It is calculated from five variables (age, creatinine clearance, hemoglobin, white blood cell count, and prior spontaneous bleeding), and the score ranges from 0 to 100. Patients with a score ≥25 are deemed to be at high-bleeding risk and shall be considered for short-term DAPT.

Costa F, van Klaveren D, James S, Heg D, Räber L, Feres F, et al. Derivation and validation of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score: A pooled analysis of individual-patient datasets from clinical trials. Lancet 2017;1:1025-34. 

Saturday, 18 August 2018

Teach the tangent method


The inset shows the ‘teach the tangent’ method where a tangent line is drawn on the downslope of the T-wave to the intersection of the isoelectric line. This is the end of the QT interval. The
average heart rate is 59 beats/min, giving a QTc of 506 ms using Bazett’s formula. This is a markedly prolonged QT interval.