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This randomized #clinicaltrial demonstrated that adding low-dose intra-arterial alteplase after endovascular thrombectomy in acute ischemic #Stroke improved microvascular perfusion and functional outcomes compared with thrombectomy alone. Despite these findings, increased #mortality in the #alteplase group highlights the need for careful risk-benefit assessment when considering adjunctive pharmacologic strategies. 📖 Read... show more

JAMA

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16,592 görüntüleme • 2 ay önce •via X (Twitter)

#clinicaltrial #Stroke

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Doctor24 profil fotoğrafı

Doctor242 ay önce

Restoring blood flow in a blocked artery is only part of the challenge—reperfusing the brain’s tiny blood vessels may further improve recovery. The higher mortality signal in the alteplase group shows why promising results must always be weighed against safety before changing clinical practice.

Anjan Gupta profil fotoğrafı

Anjan Gupta2 ay önce

The old concept of using Angiojet to do pulse spray thrombolytics before thrombectomy always worked

Internist online, Bremen, Hamburg profil fotoğrafı

Internist online, Bremen, Hamburg2 ay önce

What a strange video presentation...is that an actress?

Melissa Bime profil fotoğrafı

Melissa Bime2 ay önce

Addressing incomplete microvascular reperfusion after large-vessel thrombectomy is an important next frontier in stroke care. These results are promising for functional recovery but require confirmation and clearer risk stratification before changing practice.

Benzer Videolar

NEJM Editorial Fellow Minali Nigam, MD, shares the key results of the ORIENTAL-MeVO trial, which investigated whether endovascular thrombectomy for acute ischemic stroke improves functional outcomes in patients with medium-vessel occlusion and moderate-to-severe deficits. Read the full trial results:

NEJM Editorial Fellow Minali Nigam, MD, shares the key results of the ORIENTAL-MeVO trial, which investigated whether endovascular thrombectomy for acute ischemic stroke improves functional outcomes in patients with medium-vessel occlusion and moderate-to-severe deficits. Read the full trial results:

NEJM

16,994 görüntüleme • 1 ay önce

In low-risk patients with MI and early complete revascularization, stopping aspirin after 1 month and continuing P2Y12 monotherapy was noninferior to dual antiplatelet therapy for ischemic outcomes and led to reduced bleeding at 1 year. Read the full TARGET-FIRST trial results in the Original Article “Early Discontinuation of Aspirin after PCI in Low-Risk Acute Myocardial Infarction”:

In low-risk patients with MI and early complete revascularization, stopping aspirin after 1 month and continuing P2Y12 monotherapy was noninferior to dual antiplatelet therapy for ischemic outcomes and led to reduced bleeding at 1 year. Read the full TARGET-FIRST trial results in the Original Article “Early Discontinuation of Aspirin after PCI in Low-Risk Acute Myocardial Infarction”:

NEJM

32,436 görüntüleme • 10 ay önce

A population-based study in Ontario, Canada, examined outcomes for more than 28,000 individuals treated for a nonfatal #opioidoverdose and discharged from the #emergency department. Within 1 year, more than 1 in 5 had a repeat overdose, nearly 9% died, with nearly two-thirds of deaths resulting from another opioid overdose. The 1-year #mortality rate was higher among those with a prior overdose in the preceding 5 years. These findings indicate that the post-discharge period is a time of acute, sustained risk and highlight the importance of low-barrier interventions such as opioid agonist therapy, take-home #naloxone, and rapid follow-up for #survivors. 📖 Read the full article to learn more:

A population-based study in Ontario, Canada, examined outcomes for more than 28,000 individuals treated for a nonfatal #opioidoverdose and discharged from the #emergency department. Within 1 year, more than 1 in 5 had a repeat overdose, nearly 9% died, with nearly two-thirds of deaths resulting from another opioid overdose. The 1-year #mortality rate was higher among those with a prior overdose in the preceding 5 years. These findings indicate that the post-discharge period is a time of acute, sustained risk and highlight the importance of low-barrier interventions such as opioid agonist therapy, take-home #naloxone, and rapid follow-up for #survivors. 📖 Read the full article to learn more:

JAMA

16,194 görüntüleme • 1 ay önce

Catheter-Directed PE Treatment: Does it Deliver? NEJM Clinician Editor-in-Chief Raja-Elie Abdulnour, MD (Raja-Elie Abdulnour), explains a trial recently published in NEJM that compared catheter-directed thrombolysis to anticoagulation alone for acute, intermediate-risk pulmonary embolism. Read the key results and comment from Michael E. Billington, MD: Visit to see What Matters Most This Week, including: 🫀 New ACC/AHA Guideline on Lipid Management and ASCVD Prevention 💊 Chronic Beta-Blocker Use in Low-Risk Patients after MI: Time to Re-Evaluate 🧠 Reducing the Risk of Recurrent Stroke in Patients with Left Ventricular Dysfunction 🎯 What's the Ideal LDL Target for Patients with Cardiovascular Disease?

Catheter-Directed PE Treatment: Does it Deliver? NEJM Clinician Editor-in-Chief Raja-Elie Abdulnour, MD (Raja-Elie Abdulnour), explains a trial recently published in NEJM that compared catheter-directed thrombolysis to anticoagulation alone for acute, intermediate-risk pulmonary embolism. Read the key results and comment from Michael E. Billington, MD: Visit to see What Matters Most This Week, including: 🫀 New ACC/AHA Guideline on Lipid Management and ASCVD Prevention 💊 Chronic Beta-Blocker Use in Low-Risk Patients after MI: Time to Re-Evaluate 🧠 Reducing the Risk of Recurrent Stroke in Patients with Left Ventricular Dysfunction 🎯 What's the Ideal LDL Target for Patients with Cardiovascular Disease?

NEJM

12,682 görüntüleme • 5 ay önce

Massive Study Reveals More Bad News for the COVID Vaccinated The "conspiracy theorists" were right once again. There are HUGE health risks from the jab, no matter how much the media tries to downplay it. Take a look for yourself: Moderna (Dose 1/2): • Swelling of the brain and spinal cord: Almost 4 times (400%) increased risk (first dose) • Myocarditis: 3.48 times increased risk (first dose) • Pericarditis: 1.74 times increased risk (first dose) • Myocarditis (Second shot): 6.1 times increased risk AstraZeneca: • Blood clots: 3.23 times (320%) increased risk • Guillain–Barré syndrome (could lead to paralysis): 2.49 times increased risk • Pericarditis (Third dose): 6.91 times increased risk Pfizer: • Myocarditis (First dose): 2.78 times increased risk • Myocarditis (Second dose): 2.86 times increased risk • Myocarditis (Third dose): 2.09 times increased risk Moderna (Further doses beyond the first): • Myocarditis from the second shot: 6.1 times increased risk • Pericarditis (Fourth dose): 2.64 times increased risk • Myocarditis from the third dose: 2.01 times increased risk This study conducted by the Global Vaccine Data Network (GVDN) looked at a cohort of 99 million vaccinated individuals. The increased risks were compared to what was expected based on pre-COVID-19 vaccination healthcare data, or in simpler terms, if you did not receive the jab at all. Most of the above risk factors are calculated based on a single dose. When you consider many people took three shots or more, the results of the study become even more alarming. Listen to what Del Bigtree, host of The Highwire, had to say: “And they’re not even talking about cancer … but how about this? You’re like, well, only six times the amount of myocarditis. But if you add that six times to the two or three times for myocarditis. And what about the blood clots and stroke? What happens? “They’re not just six by themselves. They all stack up. What are we, like, 20 times the amount of risk for getting totally jacked up by this vaccine? And they’re only just starting the list. “And trust me, the scientists did everything they could to make this as conservative as they possibly could because no one wants to be responsible for, God forbid, say, we need to recall a vaccine.”

Massive Study Reveals More Bad News for the COVID Vaccinated The "conspiracy theorists" were right once again. There are HUGE health risks from the jab, no matter how much the media tries to downplay it. Take a look for yourself: Moderna (Dose 1/2): • Swelling of the brain and spinal cord: Almost 4 times (400%) increased risk (first dose) • Myocarditis: 3.48 times increased risk (first dose) • Pericarditis: 1.74 times increased risk (first dose) • Myocarditis (Second shot): 6.1 times increased risk AstraZeneca: • Blood clots: 3.23 times (320%) increased risk • Guillain–Barré syndrome (could lead to paralysis): 2.49 times increased risk • Pericarditis (Third dose): 6.91 times increased risk Pfizer: • Myocarditis (First dose): 2.78 times increased risk • Myocarditis (Second dose): 2.86 times increased risk • Myocarditis (Third dose): 2.09 times increased risk Moderna (Further doses beyond the first): • Myocarditis from the second shot: 6.1 times increased risk • Pericarditis (Fourth dose): 2.64 times increased risk • Myocarditis from the third dose: 2.01 times increased risk This study conducted by the Global Vaccine Data Network (GVDN) looked at a cohort of 99 million vaccinated individuals. The increased risks were compared to what was expected based on pre-COVID-19 vaccination healthcare data, or in simpler terms, if you did not receive the jab at all. Most of the above risk factors are calculated based on a single dose. When you consider many people took three shots or more, the results of the study become even more alarming. Listen to what Del Bigtree, host of The Highwire, had to say: “And they’re not even talking about cancer … but how about this? You’re like, well, only six times the amount of myocarditis. But if you add that six times to the two or three times for myocarditis. And what about the blood clots and stroke? What happens? “They’re not just six by themselves. They all stack up. What are we, like, 20 times the amount of risk for getting totally jacked up by this vaccine? And they’re only just starting the list. “And trust me, the scientists did everything they could to make this as conservative as they possibly could because no one wants to be responsible for, God forbid, say, we need to recall a vaccine.”

The Vigilant Fox 🦊

810,098 görüntüleme • 2 yıl önce

Largest Vaccine Study Ever Reveals What the "Conspiracy Theorists" Said All Along Scientists found MASSIVE increased risks of developing several serious health conditions post-jab. But headlines suggest they're "small" and "rare." Take a look for yourself. Moderna (1st Dose): • Swelling of the brain and spinal cord: Almost 4 times (400%) increased risk • Myocarditis: 3.48 times increased risk • Pericarditis: 1.74 times increased risk • Myocarditis (Second shot): 6.1 times increased risk AstraZeneca: • Blood clots: 3.23 times (320%) increased risk • Guillain–Barré syndrome (could lead to paralysis): 2.49 times increased risk • Pericarditis (Third dose): 6.91 times increased risk Pfizer: • Myocarditis (First dose): 2.78 times increased risk • Myocarditis (Second dose): 2.86 times increased risk • Myocarditis (Third dose): 2.09 times increased risk Moderna (Further doses beyond the first): • Myocarditis from the second shot: 6.1 times increased risk • Pericarditis (Fourth dose): 2.64 times increased risk • Myocarditis from the third dose: 2.01 times increased risk This study conducted by the Global Vaccine Data Network (GVDN) looked at a cohort of 99 million vaccinated individuals. The increased risks were compared to what was expected based on pre-COVID-19 vaccination healthcare data, or in simpler terms, if you did not receive the jab at all. Most of the above risk factors are calculated based on a single dose. When you consider many people took three shots or more, the results of the study become even more alarming. Listen to what Del Bigtree had to say: "You're like, well, only six times the amount of myocarditis. But if you add that six times to the two or three times for myocarditis. And what about the blood clots and stroke? What happens? "They're not just six by themselves. They all stack up. What are we, like, 20 times the amount of risk for getting totally jacked up by this vaccine? And they're only just starting the list. "And trust me, the scientists did everything they could to make this as conservative as they possibly could because no one wants to be responsible for, God forbid, say, we need to recall a vaccine."

Largest Vaccine Study Ever Reveals What the "Conspiracy Theorists" Said All Along Scientists found MASSIVE increased risks of developing several serious health conditions post-jab. But headlines suggest they're "small" and "rare." Take a look for yourself. Moderna (1st Dose): • Swelling of the brain and spinal cord: Almost 4 times (400%) increased risk • Myocarditis: 3.48 times increased risk • Pericarditis: 1.74 times increased risk • Myocarditis (Second shot): 6.1 times increased risk AstraZeneca: • Blood clots: 3.23 times (320%) increased risk • Guillain–Barré syndrome (could lead to paralysis): 2.49 times increased risk • Pericarditis (Third dose): 6.91 times increased risk Pfizer: • Myocarditis (First dose): 2.78 times increased risk • Myocarditis (Second dose): 2.86 times increased risk • Myocarditis (Third dose): 2.09 times increased risk Moderna (Further doses beyond the first): • Myocarditis from the second shot: 6.1 times increased risk • Pericarditis (Fourth dose): 2.64 times increased risk • Myocarditis from the third dose: 2.01 times increased risk This study conducted by the Global Vaccine Data Network (GVDN) looked at a cohort of 99 million vaccinated individuals. The increased risks were compared to what was expected based on pre-COVID-19 vaccination healthcare data, or in simpler terms, if you did not receive the jab at all. Most of the above risk factors are calculated based on a single dose. When you consider many people took three shots or more, the results of the study become even more alarming. Listen to what Del Bigtree had to say: "You're like, well, only six times the amount of myocarditis. But if you add that six times to the two or three times for myocarditis. And what about the blood clots and stroke? What happens? "They're not just six by themselves. They all stack up. What are we, like, 20 times the amount of risk for getting totally jacked up by this vaccine? And they're only just starting the list. "And trust me, the scientists did everything they could to make this as conservative as they possibly could because no one wants to be responsible for, God forbid, say, we need to recall a vaccine."

The Vigilant Fox 🦊

523,976 görüntüleme • 2 yıl önce

Have We Changed our Approach to Hamstring Injuries? 🎯 Five key points for clinical practice: 1⃣ - Strength and Flexibility are weak risk factors for hamstring injuries and continue to form a small but important part of the causal pathway. Although the evidence for stretching is lacking, multi-faceted prevention programmes might consider including these components to be successful in the prevention of hamstring injuries. 2⃣ - Intrinsic neuromuscular function may be altered post-injury. Clinicians should focus on returning the player to full function during the rehabilitation of hamstring injuries, which may include specific targeted intervention even after return to play. 3⃣ - Our common strength and flexibility tests have poor predictive value, and do not possess the characteristics needed to successfully identify individual players at greater risk of hamstring injury. This is evident in the large amount of variability between seasons, and poor sensitivity and specificity demonstrated for these measurements. The wide overlap in distribution of pre-season strength between injured and uninjured players demonstrates the difficulty in identifying a subgroup of at-risk players that might benefit from targeted intervention. It is therefore recommended that prevention programs be implemented for all players. 4⃣ - Workload monitoring provide another potential way in which we may reduce the risk of injury. The aggregation of chronic workload, as well as careful planning of acute workload increases, may reduce the risk of hamstring injury. However, high-level evidence to support this is lacking. 5⃣ - Understanding the context in which injuries occur and appreciating the complex nature of these injuries are important considerations to better manage players with hamstring injuries 🔗Read the full article 👉 ✍️ Roald Bahr & Nicol van Dyk

Have We Changed our Approach to Hamstring Injuries? 🎯 Five key points for clinical practice: 1⃣ - Strength and Flexibility are weak risk factors for hamstring injuries and continue to form a small but important part of the causal pathway. Although the evidence for stretching is lacking, multi-faceted prevention programmes might consider including these components to be successful in the prevention of hamstring injuries. 2⃣ - Intrinsic neuromuscular function may be altered post-injury. Clinicians should focus on returning the player to full function during the rehabilitation of hamstring injuries, which may include specific targeted intervention even after return to play. 3⃣ - Our common strength and flexibility tests have poor predictive value, and do not possess the characteristics needed to successfully identify individual players at greater risk of hamstring injury. This is evident in the large amount of variability between seasons, and poor sensitivity and specificity demonstrated for these measurements. The wide overlap in distribution of pre-season strength between injured and uninjured players demonstrates the difficulty in identifying a subgroup of at-risk players that might benefit from targeted intervention. It is therefore recommended that prevention programs be implemented for all players. 4⃣ - Workload monitoring provide another potential way in which we may reduce the risk of injury. The aggregation of chronic workload, as well as careful planning of acute workload increases, may reduce the risk of hamstring injury. However, high-level evidence to support this is lacking. 5⃣ - Understanding the context in which injuries occur and appreciating the complex nature of these injuries are important considerations to better manage players with hamstring injuries 🔗Read the full article 👉 ✍️ Roald Bahr & Nicol van Dyk

Aspetar سبيتار

11,733 görüntüleme • 2 yıl önce

This woman has a hole in her heart that has been causing reoccurring stroke events She has full health insurance but they denied the coverage to close the hole in her heart, saying it was unnecessary After having multiple more strokes, she had to privately raise money from donations to afford the surgery, even though she has full health insurance We need healthcare reform and we need it right now. It keeps getting worse and worse “My insurance declined any coverage for a procedure to close a hole in my heart that has been causing me to have minor strokes. Their reason for doing this is my age and the amount of bubbles on my echo, and they said I am a low risk for reoccurring stroke events. I have been having stroke events since May 4th. Last night I did have another stroke event after being inpatient and admitted into a hospital for having a stroke event” “Six days later, I had another stroke event, even though my insurance deemed me as low risk. Thankfully, with crowdfunding and private and public donations, I was able to raise about half of the $75,000 goal needed for the procedures and the hospital has allowed me to schedule the procedure” This procedure is only about an hour long outpatient procedure but the cost is $75,000…. WE NEED healthcare reform

This woman has a hole in her heart that has been causing reoccurring stroke events She has full health insurance but they denied the coverage to close the hole in her heart, saying it was unnecessary After having multiple more strokes, she had to privately raise money from donations to afford the surgery, even though she has full health insurance We need healthcare reform and we need it right now. It keeps getting worse and worse “My insurance declined any coverage for a procedure to close a hole in my heart that has been causing me to have minor strokes. Their reason for doing this is my age and the amount of bubbles on my echo, and they said I am a low risk for reoccurring stroke events. I have been having stroke events since May 4th. Last night I did have another stroke event after being inpatient and admitted into a hospital for having a stroke event” “Six days later, I had another stroke event, even though my insurance deemed me as low risk. Thankfully, with crowdfunding and private and public donations, I was able to raise about half of the $75,000 goal needed for the procedures and the hospital has allowed me to schedule the procedure” This procedure is only about an hour long outpatient procedure but the cost is $75,000…. WE NEED healthcare reform

Wall Street Apes

94,796 görüntüleme • 1 ay önce

Last night Dr David Unwin was on mainstream news talking about the benefits of reducing carbs for those living with diabetes. The results he gets are amazing. I know it can be replicated by others because I copy what he does in my own clinical practice using David Oliver, Freshwell resources (which are free btw). As a result, in 2024 forty of my patients achieved remission too. The news report featured an endocrinologist Shivani Misra who, at the 4mins 27s timestamp in the video, said: "If someone does a low carb with higher fat what does that mean for their cholesterol and their cardiovascular disease risk? We don't know the answer to this" I'm here to tell you this is a false statement. The research has been done. Let me show you: In 2020 a meta analysis looking at the effects of low carb on CVD risk found: "For total cholesterol there was no significant change in the data corresponding to low-carbohydrate diets lasting 12–23 months and over 24 months" With regards LDL the meta analysis says: "For plasma LDL, as the forest map shows, that there was no significant difference between the low-carbohydrate diet group and the control group at 6–11 months, 12–23 months, and 24 months" All other factors improved (blood pressure, triglycerides, etc) The meta analysis concluded: "In conclusion, the overall effect of a low-carbohydrate diet on cardiovascular risk factors tended to be favorable at less than 6 months and 6–11 months, but after 2 years of a low-carbohydrate diet, there was no significant effect on cardiovascular risk factors" So short term: CVD risk factors are improved, long term, things don't get worse". This mirrors what I see in clinical practice and with myself having been low carb full time since the start of 2020 - all my CVD risk markers are in the normal range. Study source: The reporter also talks about low carb as a "restrictive diet". What's more restrictive: Giving up bagels, bread, sweets and other junk IN FAVOUR OF protein, vegetables etc Or Giving up solid food entirely for a 850kcal liquid diet for months? Despite the latter being far more restrictive it has been rolled out nationally by the NHS. Nothing wrong with this as it works but so does low carb. Why not give patients a choice? The reporter also says Dr Unwins results are just because of the support he provides. Whilst support matters (a lot), this is blatant misinformation. Plenty of studies show that reducing carbs is disproportionately better for those with diabetes than low fat. Here are some: In 2023 Novo Nordisk published a randomized controlled trial comparing low carb to low fat for diabetes. They found: 🩸 Low carb led to the greatest reduction in hba1c 💉 Only the low carb group reduced medications 📉 Low carb had the greatest reduction in triglycerides + higher HDL (LDL was similar) ⚖️ Low carb group lost more weight + more fat spontaneously despite eating more calories 🩸 Systolic blood pressure was lower for low carb The low carb group non significantly raises their LDL but 0.23mmol. The researchers said: "we consider the beneficial effects of low carb to outweigh the minor increase in LDL (0.23mmol) induced by the diet. This is supported by other studies" So low carb is better and CVD risk markers overall improved. Naturally, the study was hidden behind a Paywall. Link: I can hear the skeptics now: "But Mike, this is one study, it's not enough" Ok here's a meta analysis showing that hba1c is directly proportional to the carbs eaten: This meta analysis concluded:

Last night Dr David Unwin was on mainstream news talking about the benefits of reducing carbs for those living with diabetes. The results he gets are amazing. I know it can be replicated by others because I copy what he does in my own clinical practice using David Oliver, Freshwell resources (which are free btw). As a result, in 2024 forty of my patients achieved remission too. The news report featured an endocrinologist Shivani Misra who, at the 4mins 27s timestamp in the video, said: "If someone does a low carb with higher fat what does that mean for their cholesterol and their cardiovascular disease risk? We don't know the answer to this" I'm here to tell you this is a false statement. The research has been done. Let me show you: In 2020 a meta analysis looking at the effects of low carb on CVD risk found: "For total cholesterol there was no significant change in the data corresponding to low-carbohydrate diets lasting 12–23 months and over 24 months" With regards LDL the meta analysis says: "For plasma LDL, as the forest map shows, that there was no significant difference between the low-carbohydrate diet group and the control group at 6–11 months, 12–23 months, and 24 months" All other factors improved (blood pressure, triglycerides, etc) The meta analysis concluded: "In conclusion, the overall effect of a low-carbohydrate diet on cardiovascular risk factors tended to be favorable at less than 6 months and 6–11 months, but after 2 years of a low-carbohydrate diet, there was no significant effect on cardiovascular risk factors" So short term: CVD risk factors are improved, long term, things don't get worse". This mirrors what I see in clinical practice and with myself having been low carb full time since the start of 2020 - all my CVD risk markers are in the normal range. Study source: The reporter also talks about low carb as a "restrictive diet". What's more restrictive: Giving up bagels, bread, sweets and other junk IN FAVOUR OF protein, vegetables etc Or Giving up solid food entirely for a 850kcal liquid diet for months? Despite the latter being far more restrictive it has been rolled out nationally by the NHS. Nothing wrong with this as it works but so does low carb. Why not give patients a choice? The reporter also says Dr Unwins results are just because of the support he provides. Whilst support matters (a lot), this is blatant misinformation. Plenty of studies show that reducing carbs is disproportionately better for those with diabetes than low fat. Here are some: In 2023 Novo Nordisk published a randomized controlled trial comparing low carb to low fat for diabetes. They found: 🩸 Low carb led to the greatest reduction in hba1c 💉 Only the low carb group reduced medications 📉 Low carb had the greatest reduction in triglycerides + higher HDL (LDL was similar) ⚖️ Low carb group lost more weight + more fat spontaneously despite eating more calories 🩸 Systolic blood pressure was lower for low carb The low carb group non significantly raises their LDL but 0.23mmol. The researchers said: "we consider the beneficial effects of low carb to outweigh the minor increase in LDL (0.23mmol) induced by the diet. This is supported by other studies" So low carb is better and CVD risk markers overall improved. Naturally, the study was hidden behind a Paywall. Link: I can hear the skeptics now: "But Mike, this is one study, it's not enough" Ok here's a meta analysis showing that hba1c is directly proportional to the carbs eaten: This meta analysis concluded:

Mike - Low Carb Dietitian

17,028 görüntüleme • 1 yıl önce

After I moved more breast reconstruction surgeries to an outpatient surgery center, the hospital proposed sending my remaining DIEP flap patients to the ICU, despite the fact that these patients had never previously required ICU care. The ICU is one of the most expensive places in a hospital. So I called hospital leadership to explain why I believed this wasn’t in the best interest of patients. I’m sharing that conversation with you. Over the past 13 years, our team has performed thousands of breast reconstruction procedures with a 99.7 % success rate. These patients do not need ICU care. They need specialized nurses who understand breast reconstruction, early mobility, and a pathway that gets them safely home. The documented rationale for the change had nothing to do with patients actually needed more acute care. It had everything to do with declining case volume. We can learn a lot about priorities by observing how people and systems respond to stress. I improved outcomes and lowered the cost of breast reconstruction by moving it to an outpatient center. The system responded by increasing the cost per patient. We should all take note.

After I moved more breast reconstruction surgeries to an outpatient surgery center, the hospital proposed sending my remaining DIEP flap patients to the ICU, despite the fact that these patients had never previously required ICU care. The ICU is one of the most expensive places in a hospital. So I called hospital leadership to explain why I believed this wasn’t in the best interest of patients. I’m sharing that conversation with you. Over the past 13 years, our team has performed thousands of breast reconstruction procedures with a 99.7 % success rate. These patients do not need ICU care. They need specialized nurses who understand breast reconstruction, early mobility, and a pathway that gets them safely home. The documented rationale for the change had nothing to do with patients actually needed more acute care. It had everything to do with declining case volume. We can learn a lot about priorities by observing how people and systems respond to stress. I improved outcomes and lowered the cost of breast reconstruction by moving it to an outpatient center. The system responded by increasing the cost per patient. We should all take note.

Elisabeth Potter MD

55,826 görüntüleme • 2 ay önce

Alberta government COVID-19 review calls for immediate halt to COVID-19 mRNA vaccines, citing safety concerns The Alberta government’s newly, albeit quietly, released COVID-19 response review has made waves with its bold recommendations, especially its call for an immediate halt to the use of the novel, modified RNA COVID-19 vaccines particularly for healthy children and teenagers. This critical report, commissioned by Premier Danielle Smith, uncovers alarming gaps in the data used to authorize these vaccines and raises serious concerns about their safety and efficacy. The review was initiated in 2022 under the leadership of Dr. Gary Davidson, a clinical lead in emergency medicine in central Alberta. Dr. Davidson was tasked with evaluating the pandemic’s response, focusing on various aspects such as non-pharmaceutical interventions (masking and lockdowns), the accuracy of predictive modelling, and the role regulatory bodies played in the response. Experts like Dr. Jay Bhattacharya, Dr. Byram Bridle, and Dr. David Speicher contributed to the investigation, each bringing their expertise to bear on a comprehensive assessment of pandemic policies. Among the most striking findings of the report is the task force’s criticism of Health Canada’s decision-making process for the rushed to market novel modified RNA injections. The group points out that there were “significant gaps” in the data supporting the approval of the COVID-19 vaccines. In fact, Health Canada has failed to disclose whether a proper risk assessment was ever conducted to justify the widespread use of these vaccines in individuals under 18, particularly considering the lack of long-term clinical data. One of the most disturbing aspects highlighted in the review is the data from Pfizer’s post-authorization trial. The report reveals that 1,223 deaths and 42,086 injuries were reported within just four days of vaccination. Notably, nearly half of these adverse events occurred in individuals aged 18-50—those at negligible risk of severe COVID-19 outcomes. This troubling information calls into question the overall safety profile of the vaccines, especially in young and healthy populations. The report also discusses the known risks associated with the lipid nanoparticles (LNPs) used to deliver the modified RNA and spike protein into cells. These synthetic fat molecules have a well-documented toxicity profile, and there are concerns about the long-term health impacts of repeated doses. Furthermore, the review raises alarms over the increased risk of myocarditis and pericarditis, two heart conditions that can have lifelong and potentially fatal consequences, particularly for young individuals. Another critical aspect addressed in the Alberta report is the rushed approval process for these vaccines under Emergency Use Authorization. The review underscores that while such a pathway is easier to navigate in times of crisis, it becomes incredibly challenging to reverse decisions once questions about safety arise. The task force also points out the difficulty of obtaining accurate data on vaccine safety and efficacy within Alberta’s publicly funded healthcare system, making it almost impossible to conduct independent analysis or verification of safety claims made. The Alberta report draws attention to the discrepancies in the clinical trials, which were plagued by inadequate follow-up, missing data, and conflicts of interest. The interim findings of Pfizer’s clinical trial revealed that 21 deaths occurred in the vaccinated group compared to 17 in the placebo group, with an alarming 3.7-fold increase in cardiac events. Moreover, the report highlights issues with underreporting adverse events, noting that only 1-10% of adverse events were properly documented. Even more concerning is the data on pregnant women, which reveals a devastating 87.5% fetal/neonatal mortality rate in the limited trials conducted. These findings, alongside the acknowledged risks of the lipid nanoparticle delivery system, underscore the need for a re-evaluation of the vaccines' safety profile. Despite the mounting evidence, the public health narrative has largely ignored these critical concerns, dismissing them as misinformation. However, the Alberta review demands transparency, accountability, and a rigorous risk-benefit analysis moving forward. As the province calls for a halt to the use of these vaccines in healthy young individuals, the question remains: will these calls be heeded, or will the push for blanket vaccination recommendations continue unchecked? The review emphasizes the need for a more cautious, evidence-based approach in future pandemic responses, prioritizing transparency and informed consent over knee-jerk policies. The Alberta government’s newly, albeit quietly, released COVID-19 response review has made waves with its bold recommendations, especially its call for an immediate halt to the use of the novel, modified RNA COVID-19 vaccines, particularly for healthy children and teenagers. This critical report, commissioned by Premier Danielle Smith, uncovers alarming gaps in the data used to authorize these vaccines and raises serious concerns about their safety and efficacy.

Rebel News

125,819 görüntüleme • 1 yıl önce

PHOTON COUNTING CT is NOT a better CT It is a NEW imaging modality Photon Counting CT (PCCT) represents a transformative leap in medical imaging, not only as a molecular imaging modality but also as a technology offering ultra-high resolution and functional imaging capabilities. It is fundamentally more than just an enhanced version of traditional CT—PCCT introduces new ways of seeing and understanding the human body, providing critical insights at the molecular, structural, and functional levels. This positions PCCT as a unique imaging modality that requires a fresh approach to technical implementation, operational workflows, and financial planning. Despite the larger upfront investment, PCCT’s ability to drastically reduce downstream healthcare costs makes it a highly valuable investment in the long run. 1. Technical Innovations • Molecular Imaging and Energy Discrimination: Unlike traditional CT, which simply measures the total absorbed energy, PCCT counts individual X-ray photons and differentiates their energy levels. This allows for precise molecular imaging, revealing the composition of tissues and materials at a biochemical level. By distinguishing between different tissue types and contrast agents, PCCT opens up new diagnostic possibilities, such as identifying molecular biomarkers in tumors or distinguishing between stable and unstable plaque in coronary arteries. This capability shifts the focus of imaging from purely anatomical to both anatomical and molecular, offering more comprehensive diagnostic information. • Ultra-High Spatial Resolution: PCCT features significantly smaller detector elements compared to conventional CT scanners, allowing for ultra-high resolution imaging. This means clinicians can visualize fine structures such as microcalcifications in arteries, small lesions in soft tissues, or the intricate architecture of bones. This level of detail was previously unattainable with traditional CT. When combined with molecular imaging, this ultra-high resolution allows for the precise localization and characterization of disease at very early stages, which is essential for early diagnosis and intervention. • Functional Imaging Capabilities: PCCT also excels as a functional imaging modality. By capturing energy-resolved information, PCCT can provide insights into tissue functionality and dynamic physiological processes. For instance, it can detect changes in blood flow, tissue perfusion, and oxygenation without the need for additional contrast agents or scans. This functionality allows for real-time assessment of physiological processes, making it particularly valuable in cardiology, oncology, and neurology for evaluating organ function and monitoring disease progression. • Reduced Noise and Artifact Reduction: Photon-counting technology dramatically reduces electronic noise and imaging artifacts, such as beam hardening, resulting in clearer and more accurate images. The ability to deliver ultra-high resolution images with minimal artifacts improves diagnostic accuracy, reducing the need for repeat scans and ensuring that even subtle abnormalities are detected. 2. Operational Considerations • New Workflow for Molecular, High-Resolution, and Functional Imaging: The integration of molecular, ultra-high resolution, and functional imaging into routine clinical workflows introduces complexity that requires adaptation. Radiologists and technicians need specialized training to interpret and analyze multi-energy datasets that include molecular and functional information. PCCT produces a vast amount of detailed data, requiring clinicians to adopt new imaging protocols and refine their diagnostic approaches to fully leverage its capabilities. • Post-Processing and Data Management: PCCT generates richer, more complex datasets, which necessitates advanced post-processing tools and data management systems. Existing PACS and imaging software may not be equipped to handle such large volumes of data or to process functional and molecular information effectively. This means healthcare institutions must invest in robust IT infrastructure, including upgraded software and storage solutions, as well as provide additional training for staff on new imaging analysis techniques. • Revised Clinical Protocols: The molecular, functional, and ultra-high resolution imaging capabilities of PCCT will likely prompt changes in clinical protocols. For instance, the need for contrast agents may be reduced, simplifying patient preparation and decreasing the risk of adverse reactions. Additionally, the ability to monitor physiological functions in real-time through functional imaging could lead to more dynamic diagnostic procedures, such as assessing the effectiveness of interventions or treatments in real-time. 3. Financial Impact • Higher Initial Investment: PCCT systems are more expensive than traditional CT scanners due to their advanced technology, which includes photon-counting detectors and the computational power required for high-resolution, molecular, and functional imaging. While this upfront cost is significant, it is crucial to view it in the broader context of the downstream benefits and cost reductions that PCCT offers. • Downstream Cost Reductions: Although the initial capital investment is higher, PCCT’s ability to combine molecular, functional, and ultra-high resolution imaging leads to substantial reductions in downstream healthcare costs. Its superior diagnostic accuracy minimizes the need for follow-up tests, repeat scans, or invasive diagnostic procedures, such as diagnostic coronary angiographies. For example, in cardiology, PCCT can precisely differentiate between types of coronary plaque, reducing the need for invasive procedures to assess risk. • Lower Overall Healthcare Expenditures: By enabling earlier, more accurate diagnoses, PCCT can reduce the overall cost of patient care. Early detection of disease, particularly through its molecular and functional imaging capabilities, allows for more targeted treatments, potentially preventing the need for more aggressive and expensive interventions down the line. For instance, early-stage tumor detection via molecular imaging could lead to less invasive treatments, reducing hospital stays and improving patient outcomes, ultimately driving down healthcare costs. • Increased ROI Through Enhanced Patient Outcomes: Over time, the combination of molecular, functional, and ultra-high resolution imaging enhances diagnostic precision, which translates into better patient outcomes. Improved diagnostic accuracy reduces the incidence of unnecessary procedures, minimizes treatment delays, and results in more personalized and effective care. This leads to increased patient satisfaction, better healthcare outcomes, and greater patient throughput—all factors that improve the institution’s return on investment (ROI). • Competitive Advantage and New Revenue Streams: By adopting PCCT, healthcare institutions position themselves at the forefront of advanced imaging technologies. The ability to offer molecular, functional, and ultra-high resolution imaging creates a competitive advantage, attracting more complex and high-value cases. This can boost the institution’s reputation for excellence in diagnostics, leading to increased referrals, new patient populations, and expanded revenue opportunities. Summary Photon Counting CT (PCCT) is not just an evolution of existing CT technology—it is a molecular, ultra-high resolution, and functional imaging modality that fundamentally transforms the diagnostic landscape. Its ability to capture detailed molecular data, visualize minute anatomical structures with ultra-high resolution, and provide real-time functional imaging opens new possibilities for earlier and more precise diagnoses. While the financial investment in PCCT is larger, the reduction in downstream healthcare costs through improved diagnostic accuracy, fewer unnecessary interventions, and earlier disease detection far outweighs the initial expense. For institutions committed to advancing patient care and improving long-term financial outcomes, PCCT is an essential investment in the future of medical imaging. The video attached shows a patient accessing the Hospital for ACS. PCCT can provide ALL the imaging information of the concurrent imaging modalities (CXR, CAG, Echo, CMR) that you see around it... that's a lot! #PhotonCountingCT #MolecularImaging #UltraHighResolution #FunctionalImaging #FutureOfImaging #AdvancedMedicalImaging #EarlyDiseaseDetection #InnovativeCT #CuttingEdgeHealthcare #PrecisionDiagnostics #HealthcareInnovation #MedicalTechnology #CostEffectiveImaging #NextGenCT #PatientCareRevolution

PHOTON COUNTING CT is NOT a better CT It is a NEW imaging modality Photon Counting CT (PCCT) represents a transformative leap in medical imaging, not only as a molecular imaging modality but also as a technology offering ultra-high resolution and functional imaging capabilities. It is fundamentally more than just an enhanced version of traditional CT—PCCT introduces new ways of seeing and understanding the human body, providing critical insights at the molecular, structural, and functional levels. This positions PCCT as a unique imaging modality that requires a fresh approach to technical implementation, operational workflows, and financial planning. Despite the larger upfront investment, PCCT’s ability to drastically reduce downstream healthcare costs makes it a highly valuable investment in the long run. 1. Technical Innovations • Molecular Imaging and Energy Discrimination: Unlike traditional CT, which simply measures the total absorbed energy, PCCT counts individual X-ray photons and differentiates their energy levels. This allows for precise molecular imaging, revealing the composition of tissues and materials at a biochemical level. By distinguishing between different tissue types and contrast agents, PCCT opens up new diagnostic possibilities, such as identifying molecular biomarkers in tumors or distinguishing between stable and unstable plaque in coronary arteries. This capability shifts the focus of imaging from purely anatomical to both anatomical and molecular, offering more comprehensive diagnostic information. • Ultra-High Spatial Resolution: PCCT features significantly smaller detector elements compared to conventional CT scanners, allowing for ultra-high resolution imaging. This means clinicians can visualize fine structures such as microcalcifications in arteries, small lesions in soft tissues, or the intricate architecture of bones. This level of detail was previously unattainable with traditional CT. When combined with molecular imaging, this ultra-high resolution allows for the precise localization and characterization of disease at very early stages, which is essential for early diagnosis and intervention. • Functional Imaging Capabilities: PCCT also excels as a functional imaging modality. By capturing energy-resolved information, PCCT can provide insights into tissue functionality and dynamic physiological processes. For instance, it can detect changes in blood flow, tissue perfusion, and oxygenation without the need for additional contrast agents or scans. This functionality allows for real-time assessment of physiological processes, making it particularly valuable in cardiology, oncology, and neurology for evaluating organ function and monitoring disease progression. • Reduced Noise and Artifact Reduction: Photon-counting technology dramatically reduces electronic noise and imaging artifacts, such as beam hardening, resulting in clearer and more accurate images. The ability to deliver ultra-high resolution images with minimal artifacts improves diagnostic accuracy, reducing the need for repeat scans and ensuring that even subtle abnormalities are detected. 2. Operational Considerations • New Workflow for Molecular, High-Resolution, and Functional Imaging: The integration of molecular, ultra-high resolution, and functional imaging into routine clinical workflows introduces complexity that requires adaptation. Radiologists and technicians need specialized training to interpret and analyze multi-energy datasets that include molecular and functional information. PCCT produces a vast amount of detailed data, requiring clinicians to adopt new imaging protocols and refine their diagnostic approaches to fully leverage its capabilities. • Post-Processing and Data Management: PCCT generates richer, more complex datasets, which necessitates advanced post-processing tools and data management systems. Existing PACS and imaging software may not be equipped to handle such large volumes of data or to process functional and molecular information effectively. This means healthcare institutions must invest in robust IT infrastructure, including upgraded software and storage solutions, as well as provide additional training for staff on new imaging analysis techniques. • Revised Clinical Protocols: The molecular, functional, and ultra-high resolution imaging capabilities of PCCT will likely prompt changes in clinical protocols. For instance, the need for contrast agents may be reduced, simplifying patient preparation and decreasing the risk of adverse reactions. Additionally, the ability to monitor physiological functions in real-time through functional imaging could lead to more dynamic diagnostic procedures, such as assessing the effectiveness of interventions or treatments in real-time. 3. Financial Impact • Higher Initial Investment: PCCT systems are more expensive than traditional CT scanners due to their advanced technology, which includes photon-counting detectors and the computational power required for high-resolution, molecular, and functional imaging. While this upfront cost is significant, it is crucial to view it in the broader context of the downstream benefits and cost reductions that PCCT offers. • Downstream Cost Reductions: Although the initial capital investment is higher, PCCT’s ability to combine molecular, functional, and ultra-high resolution imaging leads to substantial reductions in downstream healthcare costs. Its superior diagnostic accuracy minimizes the need for follow-up tests, repeat scans, or invasive diagnostic procedures, such as diagnostic coronary angiographies. For example, in cardiology, PCCT can precisely differentiate between types of coronary plaque, reducing the need for invasive procedures to assess risk. • Lower Overall Healthcare Expenditures: By enabling earlier, more accurate diagnoses, PCCT can reduce the overall cost of patient care. Early detection of disease, particularly through its molecular and functional imaging capabilities, allows for more targeted treatments, potentially preventing the need for more aggressive and expensive interventions down the line. For instance, early-stage tumor detection via molecular imaging could lead to less invasive treatments, reducing hospital stays and improving patient outcomes, ultimately driving down healthcare costs. • Increased ROI Through Enhanced Patient Outcomes: Over time, the combination of molecular, functional, and ultra-high resolution imaging enhances diagnostic precision, which translates into better patient outcomes. Improved diagnostic accuracy reduces the incidence of unnecessary procedures, minimizes treatment delays, and results in more personalized and effective care. This leads to increased patient satisfaction, better healthcare outcomes, and greater patient throughput—all factors that improve the institution’s return on investment (ROI). • Competitive Advantage and New Revenue Streams: By adopting PCCT, healthcare institutions position themselves at the forefront of advanced imaging technologies. The ability to offer molecular, functional, and ultra-high resolution imaging creates a competitive advantage, attracting more complex and high-value cases. This can boost the institution’s reputation for excellence in diagnostics, leading to increased referrals, new patient populations, and expanded revenue opportunities. Summary Photon Counting CT (PCCT) is not just an evolution of existing CT technology—it is a molecular, ultra-high resolution, and functional imaging modality that fundamentally transforms the diagnostic landscape. Its ability to capture detailed molecular data, visualize minute anatomical structures with ultra-high resolution, and provide real-time functional imaging opens new possibilities for earlier and more precise diagnoses. While the financial investment in PCCT is larger, the reduction in downstream healthcare costs through improved diagnostic accuracy, fewer unnecessary interventions, and earlier disease detection far outweighs the initial expense. For institutions committed to advancing patient care and improving long-term financial outcomes, PCCT is an essential investment in the future of medical imaging. The video attached shows a patient accessing the Hospital for ACS. PCCT can provide ALL the imaging information of the concurrent imaging modalities (CXR, CAG, Echo, CMR) that you see around it... that's a lot! #PhotonCountingCT #MolecularImaging #UltraHighResolution #FunctionalImaging #FutureOfImaging #AdvancedMedicalImaging #EarlyDiseaseDetection #InnovativeCT #CuttingEdgeHealthcare #PrecisionDiagnostics #HealthcareInnovation #MedicalTechnology #CostEffectiveImaging #NextGenCT #PatientCareRevolution

Dr. Filippo Cademartiri

11,849 görüntüleme • 1 yıl önce

As a cardiologist, I've treated young people who had heart attacks after using cocaine at parties. These drugs can be dangerous for your heart. Patients often ask me about cannabis (marijuana or weed). 📄 We just published a paper showing that cannabis use is associated with an increased risk of heart attack and may trigger acute events—even in young adults with no traditional cardiovascular risk factors. Why? Cannabis can: 🫀 Make the heart work harder (increasing oxygen demand) 🫁 Reduce oxygen delivery when smoked through carbon monoxide exposure ⚠️ Cause coronary artery spasm 🩸 Affect blood vessel function 🩹 Increase the risk of blood clots 📊 Key findings: • Nearly 5× higher risk of heart attack in the first hour after use • 25% higher heart attack risk with daily use 💬 If you use cannabis, discuss it openly with your doctor so you can make informed decisions about your cardiovascular health. 🔗 Read the full paper: #HeartHealth #Cannabis #Weed #marijuana

As a cardiologist, I've treated young people who had heart attacks after using cocaine at parties. These drugs can be dangerous for your heart. Patients often ask me about cannabis (marijuana or weed). 📄 We just published a paper showing that cannabis use is associated with an increased risk of heart attack and may trigger acute events—even in young adults with no traditional cardiovascular risk factors. Why? Cannabis can: 🫀 Make the heart work harder (increasing oxygen demand) 🫁 Reduce oxygen delivery when smoked through carbon monoxide exposure ⚠️ Cause coronary artery spasm 🩸 Affect blood vessel function 🩹 Increase the risk of blood clots 📊 Key findings: • Nearly 5× higher risk of heart attack in the first hour after use • 25% higher heart attack risk with daily use 💬 If you use cannabis, discuss it openly with your doctor so you can make informed decisions about your cardiovascular health. 🔗 Read the full paper: #HeartHealth #Cannabis #Weed #marijuana

Chayakrit Krittanawong, MD, FACC, FSCAI

16,364 görüntüleme • 2 ay önce

I often have women messaging me to ask if there is a cut off age for taking HRT, or to ask what age they need to stop HRT. The answer is that there is usually no set length of time you should take HRT for - the menopause is a long-term hormone deficiency so women can usually take HRT forever to replace these missing hormones. However, after the Women’s Health Initiative Study was published in 2002, many women have resisted taking HRT, especially after age 65 years, because of fears of perceived risks. However, a new study has been published today showing that these fears are unfounded. The study also showed that women who took oestrogen only HRT beyond the age of 65 was associated with significant risk reductions in mortality, breast cancer, lung cancer, colorectal cancer, congestive heart failure, venous thromboembolism, atrial fibrillation, acute myocardial infarction, and dementia. There were also benefits to future health in women who took combination oestrogen and progesterone. The most benefit was with transdermal oestradiol and progesterone. If you haven’t yet read the study, I would really recommend you do. The link is here: It’s also worth listening to this podcast I recorded with Dr Anna Chiles who is a GP and works with us at Newson Health as a menopause specialist, as we talk more about continuing HRT for many years during that: This article we have on our @balancemenopause website is also worth a read:

I often have women messaging me to ask if there is a cut off age for taking HRT, or to ask what age they need to stop HRT. The answer is that there is usually no set length of time you should take HRT for - the menopause is a long-term hormone deficiency so women can usually take HRT forever to replace these missing hormones. However, after the Women’s Health Initiative Study was published in 2002, many women have resisted taking HRT, especially after age 65 years, because of fears of perceived risks. However, a new study has been published today showing that these fears are unfounded. The study also showed that women who took oestrogen only HRT beyond the age of 65 was associated with significant risk reductions in mortality, breast cancer, lung cancer, colorectal cancer, congestive heart failure, venous thromboembolism, atrial fibrillation, acute myocardial infarction, and dementia. There were also benefits to future health in women who took combination oestrogen and progesterone. The most benefit was with transdermal oestradiol and progesterone. If you haven’t yet read the study, I would really recommend you do. The link is here: It’s also worth listening to this podcast I recorded with Dr Anna Chiles who is a GP and works with us at Newson Health as a menopause specialist, as we talk more about continuing HRT for many years during that: This article we have on our @balancemenopause website is also worth a read:

Dr Louise Newson

95,564 görüntüleme • 2 yıl önce

Cutter Polio Vaccine (1950s): PULLED after 5 deaths and 51 cases of paralysis. Swine Flu Vaccine (1976): PULLED after 25 deaths linked to Guillain-Barré syndrome. RotaShield Vaccine (1999): PULLED after 15 cases of bowel obstruction in infants. COVID Vaccine: STILL on the market despite “thousands upon thousands of peer-reviewed manuscripts indexed in the National Library of Medicine that demonstrate harms from these injections.” Epidemiologist Nicolas Hulscher, MPH says, “These vaccines have far surpassed the threshold for withdrawal of a product.” 1. “There’s 12 studies now and the Vaccine Adverse Events Reporting System that demonstrate these injections do in fact increase your risk of death, reduce life expectancy, and contribute to excess mortality among populations worldwide.” 2. “We also have DNA contamination. This is confirmed worldwide across multiple manufacturers, multiple batches.” 3. “And then we have this negative efficacy. The vaccines don’t work. They increase your risk of infection. And so clearly, these shots have been demonstrated to be dangerous, ineffective.” “These vaccines have far surpassed the threshold for withdrawal of a product. There’s just no argument. The data is there. There is no reason to deny it. People need to act accordingly with the data,” Hulscher says. Follow Nicolas Hulscher, MPH and McCullough Foundation for more breaking news on the COVID-19 injections and other pressing matters involving public health.

Cutter Polio Vaccine (1950s): PULLED after 5 deaths and 51 cases of paralysis. Swine Flu Vaccine (1976): PULLED after 25 deaths linked to Guillain-Barré syndrome. RotaShield Vaccine (1999): PULLED after 15 cases of bowel obstruction in infants. COVID Vaccine: STILL on the market despite “thousands upon thousands of peer-reviewed manuscripts indexed in the National Library of Medicine that demonstrate harms from these injections.” Epidemiologist Nicolas Hulscher, MPH says, “These vaccines have far surpassed the threshold for withdrawal of a product.” 1. “There’s 12 studies now and the Vaccine Adverse Events Reporting System that demonstrate these injections do in fact increase your risk of death, reduce life expectancy, and contribute to excess mortality among populations worldwide.” 2. “We also have DNA contamination. This is confirmed worldwide across multiple manufacturers, multiple batches.” 3. “And then we have this negative efficacy. The vaccines don’t work. They increase your risk of infection. And so clearly, these shots have been demonstrated to be dangerous, ineffective.” “These vaccines have far surpassed the threshold for withdrawal of a product. There’s just no argument. The data is there. There is no reason to deny it. People need to act accordingly with the data,” Hulscher says. Follow Nicolas Hulscher, MPH and McCullough Foundation for more breaking news on the COVID-19 injections and other pressing matters involving public health.

The Vigilant Fox 🦊

313,333 görüntüleme • 1 yıl önce

Vitalik Buterin on Ethereum as the economic layer for AI “The blockchain to me is the most natural way to allow applications and cooperation between many different people in the long term without needing to agree on who to trust. The other thing is also the economic layer. This is the layer where blockchains can support AIs.” Vitalik believes Ethereum will play a large role in the future of decentralized AI: “If you have more decentralized AI, that means you have different AIs (agents, programs) that are controlled by different people and need to interact with each other. And for that interaction to be possible, you need to have an economic layer. Either cooperation is based on economic incentives and economic rules. Or it’s based on central control. It’s usually one of the two, and if we can set up the economic system, that makes more decentralized interaction between AIs possible.” Source: OKX (Apr 2026) Read our full article on why AI agents will need Ethereum for low-risk DeFi below👇

Vitalik Buterin on Ethereum as the economic layer for AI “The blockchain to me is the most natural way to allow applications and cooperation between many different people in the long term without needing to agree on who to trust. The other thing is also the economic layer. This is the layer where blockchains can support AIs.” Vitalik believes Ethereum will play a large role in the future of decentralized AI: “If you have more decentralized AI, that means you have different AIs (agents, programs) that are controlled by different people and need to interact with each other. And for that interaction to be possible, you need to have an economic layer. Either cooperation is based on economic incentives and economic rules. Or it’s based on central control. It’s usually one of the two, and if we can set up the economic system, that makes more decentralized interaction between AIs possible.” Source: OKX (Apr 2026) Read our full article on why AI agents will need Ethereum for low-risk DeFi below👇

Etherealize

115,453 görüntüleme • 4 ay önce

Face-to-face interactions stimulate your newborn’s brain in ways that pave the way for language learning. This according to fascinating new research from Dr. Patricia Kuhl and colleagues at the I-LABS. We’ve long known that serve and return stimulates the infant brain and supports parent/child bonding. But now, through use of magnetoencephalography (a fancy brain scan), Kuhl and colleagues have determined that these early interactions play a role in stimulating specific attention centers in the brain critical to language learning during a sensitive window from 6-12 months. In the study, children with the highest levels of stimulation in these attention centers at 5 months demonstrated superior language learning at five future points, measured up to two years after the initial scans. Fascinating stuff! If you’d like to learn more, check out the great summary by Kristina Compton of Early Learning Nation linked in the first reply below. And if you really want to nerd out, you can read the full study linked in the second reply. This great video example was shared to IG by babies.wonderful.

Face-to-face interactions stimulate your newborn’s brain in ways that pave the way for language learning. This according to fascinating new research from Dr. Patricia Kuhl and colleagues at the I-LABS. We’ve long known that serve and return stimulates the infant brain and supports parent/child bonding. But now, through use of magnetoencephalography (a fancy brain scan), Kuhl and colleagues have determined that these early interactions play a role in stimulating specific attention centers in the brain critical to language learning during a sensitive window from 6-12 months. In the study, children with the highest levels of stimulation in these attention centers at 5 months demonstrated superior language learning at five future points, measured up to two years after the initial scans. Fascinating stuff! If you’d like to learn more, check out the great summary by Kristina Compton of Early Learning Nation linked in the first reply below. And if you really want to nerd out, you can read the full study linked in the second reply. This great video example was shared to IG by babies.wonderful.

Dan Wuori

95,499 görüntüleme • 2 yıl önce

🚨One of the most overlooked consequences of the childhood vaccine program: it disrupted God's original design for protecting infants. Before widespread vaccination, mothers who naturally contracted diseases like measles or chickenpox developed strong, lifelong immunity and passed robust antibodies through the placenta to their babies. This provided powerful, natural protection during the most vulnerable early months, when these illnesses could pose the greatest risk. But mothers who were vaccinated and didn't have natural infection DO NOT pass that immunity to their babies. It was eradicated. Now that the U.S. is moving toward a leaner, more voluntary schedule, Del highlights this trade-off: Measles and chickenpox were once considered trivial childhood illnesses with extremely low mortality in healthy children, thanks in large part to that natural maternal protection. No vaccines are being taken away. If you want the full schedule, it remains available and covered by insurance. However, the power is finally shifting back to parents. Watch the clip below. Bookmark and Share

🚨One of the most overlooked consequences of the childhood vaccine program: it disrupted God's original design for protecting infants. Before widespread vaccination, mothers who naturally contracted diseases like measles or chickenpox developed strong, lifelong immunity and passed robust antibodies through the placenta to their babies. This provided powerful, natural protection during the most vulnerable early months, when these illnesses could pose the greatest risk. But mothers who were vaccinated and didn't have natural infection DO NOT pass that immunity to their babies. It was eradicated. Now that the U.S. is moving toward a leaner, more voluntary schedule, Del highlights this trade-off: Measles and chickenpox were once considered trivial childhood illnesses with extremely low mortality in healthy children, thanks in large part to that natural maternal protection. No vaccines are being taken away. If you want the full schedule, it remains available and covered by insurance. However, the power is finally shifting back to parents. Watch the clip below. Bookmark and Share

The HighWire

29,750 görüntüleme • 8 ay önce

E-CPR is the use of ECMO in the setting of cardiac arrest, similar to what happened in this episode. In this episode a patient without reliable ROSC is emergently cannulated for veno-arterial-ECMO which provides cardiopulmonary support (veno-venous-ECMO is not useful for this indication for those not familiar with the devices). The data on this topic have found an inconsistent benefit in the short-term for improving survival with good neurological outcome. One SR-MA by Tommaso Scquizzato, MD found probable benefit for improving survival with good neurological outcomes when evaluating available RCTs, most notable with an initial shockable rhythm. However, a more recent SR-MA that included these RCTs along with observational data found no benefit. This suggests that the benefits, if present, are probably not as robust as we’d like, particularly when you consider the cost of an E-CPR program. There are several caveats about this data to be aware of… 1. The centers participating in the RCTs have very well-greased systems. These are not centers that dabble in E-CPR. This includes readily available proceduralists, intensivists that are familiar with VA-ECMO, perfusionists, ECMO nurses, RT’s that understand vent management while on ECMO, etc. One high-quality RCT found a median hospital arrival to successful cannulation time of 20 minutes – this is really fast for all the moving pieces involved (PMID: 36720132). Since these are clinical trials, they are also not subject to “indication creep” that invariably occurs when something becomes a routine practice. 2. There is a growing discussion about the applicability of the available data. Advancements in technology, particularly the microaxial flow pumps (e.g. Impella) have changed how we manage MCS, now commonly referred to as “Ecpella”. The Impella technology continues to advance with faster flow rates, right-sided support devices, and potentially future devices with oxygenators. #emergency #emergencymedicine #criticalcare #icu #erlife #iculife #science #army #armymedicine #armyemdoc #resuscitation #research #data #heart #cpr #medx #medtwitter

E-CPR is the use of ECMO in the setting of cardiac arrest, similar to what happened in this episode. In this episode a patient without reliable ROSC is emergently cannulated for veno-arterial-ECMO which provides cardiopulmonary support (veno-venous-ECMO is not useful for this indication for those not familiar with the devices). The data on this topic have found an inconsistent benefit in the short-term for improving survival with good neurological outcome. One SR-MA by Tommaso Scquizzato, MD found probable benefit for improving survival with good neurological outcomes when evaluating available RCTs, most notable with an initial shockable rhythm. However, a more recent SR-MA that included these RCTs along with observational data found no benefit. This suggests that the benefits, if present, are probably not as robust as we’d like, particularly when you consider the cost of an E-CPR program. There are several caveats about this data to be aware of… 1. The centers participating in the RCTs have very well-greased systems. These are not centers that dabble in E-CPR. This includes readily available proceduralists, intensivists that are familiar with VA-ECMO, perfusionists, ECMO nurses, RT’s that understand vent management while on ECMO, etc. One high-quality RCT found a median hospital arrival to successful cannulation time of 20 minutes – this is really fast for all the moving pieces involved (PMID: 36720132). Since these are clinical trials, they are also not subject to “indication creep” that invariably occurs when something becomes a routine practice. 2. There is a growing discussion about the applicability of the available data. Advancements in technology, particularly the microaxial flow pumps (e.g. Impella) have changed how we manage MCS, now commonly referred to as “Ecpella”. The Impella technology continues to advance with faster flow rates, right-sided support devices, and potentially future devices with oxygenators. #emergency #emergencymedicine #criticalcare #icu #erlife #iculife #science #army #armymedicine #armyemdoc #resuscitation #research #data #heart #cpr #medx #medtwitter

armyemdoc

19,508 görüntüleme • 1 yıl önce