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Archives for October 2010

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Avatar of Larry Husten, PHD

Is the Time Right for a Preprint Archive for Clinical Trials? (29 Oct 2010)

Larry Husten, PhD

Here’s a great idea: a preprint archive for clinical trials. Taking inspiration from the well-established use of preprint archives in physics, math, and other scholarly areas, Martin Fenner, a cancer researcher, proposes the establishment of a preprint archive for clinical trial research papers. Fenner points out that “the results of clinical trials are rarely first reported in a peer-reviewed journal, but rather are usually first presented at a conference — in the case of important practice-changing clinical trials, often before an audience of thousands of people.” He writes that “the peer-reviewed… Continue Reading

Avatar of Shanti Bansal, MD

Drs. Clueless and Apathetic: The State of Imaging Referrals (28 Oct 2010)

Shanti Bansal, MD

Editors’ Note: This text has been modified from its original form. Key elements of the case represent a composite of people and events. On a bright Saturday morning, I was the fellow on duty in the chest pain center. That meant I was responsible for evaluating and stress-testing patients who had been admitted from the ER with an intermediate probability of coronary artery disease. My first patient that morning was Jack — a burly man with course facial hair and a barrel chest. As I approached Jack’s bedside armed with… Continue Reading

Avatar of Catherine Ryan, CardioExchange Staff

The Empty Room (25 Oct 2010)

Westby G Fisher, MD

CardioExchange welcomes this guest post reprinted with permission from Dr. Westby Fisher, an electrophysiologist practicing at NorthShore University HealthSystem, Evanston, IL and a Clinical Associate Professor of Medicine at University of Chicago’s Pritzker School of Medicine. This piece originally appeared on his blog, Dr. Wes. It stands as a monument to a bygone era; clean, quiet, spacious. Mail cubbies adorn the wall with hundreds of names beneath each one — most with dust, but a few contain a few pieces of multi-colored papers within. A bulletin board sits on a wall with skewed notices… Continue Reading

Avatar of Richard A. Lange, MD, MBA

What Do I Plan to Do with Dabigatran? (22 Oct 2010)

Richard A. Lange, MD, MBA

1. Discuss its pros (no need for INR monitoring, less bleeding than coumadin) and cons (cost, dyspepsia) with my atrial fibrillation patients 2. Avoid its use in patients with renal dysfunction (CrCl  <60), liver disease, pregnancy or stroke within the past 6 months 3. Lament the absence of the INR monitoring requirement, which I currently use to (a) check on patient compliance with medication; (b) assess the adequacy of anticoagulation (especially in patients near the extremes of weight); and (c) detect potential drug interactions (although purportedly rare) 4. Worry that… Continue Reading

Avatar of Larry Husten, PHD

Let’s Call the Whole Thing Off! (21 Oct 2010)

Larry Husten, PhD

Some say “dabby-gat-ran.” I say “duh-big-a-tran.” Boehringer Ingelheim wants you to say “pra-dax-a.” One of the most important advances in cardiovascular therapeutics in years is dampened by the inability of cardiologists and other highly educated professionals to agree on how to pronounce “dabigatran.” What do you say? Update: Here’s an official response from a Boehringer spokesperson: “Da-big-a-tran” (The As are all soft— “tran” prounced as in  Transport.) Comments are closed on this post, but please join the conversation at our Dabigatran Resource Round-Up.

Avatar of Sharon Salinger, CardioExchange Staff

Finally: Dabigatran – A New Oral Anticoagulant Is Approved by the FDA (20 Oct 2010)

Westby G Fisher, MD

CardioExchange welcomes this guest post reprinted with permission from Dr. Westby Fisher, an electrophysiologist practicing at NorthShore University HealthSystem, Evanston, IL, and a Clinical Associate Professor of Medicine at University of Chicago’s Pritzker School of Medicine. This piece originally appeared on his blog, Dr. Wes. A new era of nonvalvular atrial fibrillation management has arrived. Tuesday, the FDA approved the first new anticoagulant in fifty years: dabigatran, marketed by Boehringer Ingelheim Pharmaceuticals under the trade name Pradaxa, for stroke prevention in patients with nonvalvular atrial fibrillation. The move was widely anticipated after the drug’s unanimous… Continue Reading

Avatar of John Mandrola, MD, FACC

Dabigatran Is Approved (20 Oct 2010)

John Mandrola, MD, FACC

John Mandrola is a cardiac electrophysiologist and blogger on matters medical and general. Here is a recent post from his blog Dr John M. There can only be one cardiology story to discuss today. Tuesday, the FDA approved dabigatran (Pradaxa), an oral anticoagulant for the prevention of stroke in atrial fibrillation. Previously, the only drug approved to prevent stroke in patients with AF was warfarin. Despite the well-known, sound scientific data in support of warfarin for the prevention of stroke — arguably one of life’s most tragic chapters — the  adverse effects… Continue Reading

Avatar of CardioExchange Editors, Staff

DES: Top Six Things You Should Know (19 Oct 2010)

CardioExchange Editors, Staff

Finding it hard to keep up with all of the new DES research? Interventional Cardiology Co-Moderator Rick Lange offers this brief tutorial on the “top six things every cardiologist should know about DES.” Would you add anything to Rick’s list? Tell us your thoughts here.

Avatar of Catherine Ryan, CardioExchange Staff

“Um” (18 Oct 2010)

Westby G Fisher, MD

CardioExchange welcomes this guest post reprinted with permission from Dr. Westby Fisher, an electrophysiologist practicing at NorthShore University HealthSystem, Evanston, IL and a Clinical Associate Professor of Medicine at University of Chicago’s Pritzker School of Medicine. This piece originally appeared on his blog, Dr. Wes. I never like to hear “Um…” from nurses or industry representatives during surgical procedures. Most people think that the worst thing you could hear while undergoing a surgical procedure is “Oops…” or “Sh*t”, but I would have to politely disagree. You see, people working in EP labs and operating… Continue Reading

Avatar of Shanti Bansal, MD

No Conflict, No Interest (13 Oct 2010)

Shanti Bansal, MD

On a brisk, cold evening I boarded an overnight plane from my hometown to Cincinnati.  Once I landed, a gentleman dressed in a black suit with a grin over his face was waiting for me at the airport to drive me to my hotel.  The driver led me through green untouched pastures and over a river and through bustling neighborhoods.  I asked to be dropped off at the hotel prior to going to the classroom and the driver reluctantly accepted noting that I might be late for the lectures. Some… Continue Reading