“What the eye doesn't see and the mind doesn’t accept, DOES EXIST!”
👇 picture of the hands of Thomas Edison’s assistant. Later died from Cancer due exposure to the same ‘invisible’ X-Ray radiation
Why are we discussing this in 2020, during #Covid_19 ?
1/
Radiation is not visible to the human eye and neither is Coronavirus.
The size of the virus is about 0.1 um, smaller than a red blood cell and even some bacteria
Both can have devastating effects , if we do not protect ourselves
2/
#Covid_19 can be transmitted by droplets >5 µm which can quickly form aerosols ≤5 µm.
Besides the well-known transmission by coughing and sneezing, the virus can be transmitted even during SPEECH….in fact the louder you speak, more are chances of transmission..
3/
Why is this virus much worse than previous respiratory infections like SARS-1?
The virus resides in your throat (not lungs): easily coughed out
Asymptomatic carriage is strong and consistent: You can get the virus even when the other person has NO SYMPTOMS! 😱
4/
Enter 😷- Home-made-masks
Medical masks (protect yourself) are different from Home made masks (protect others)
Home-made-masks are great for 'source control' by blocking large droplets as they are emitted in coughing and talking before they are aerosolised
5/
Wearing masks doesn't protect me, but others around me- So ⁉️
An infection has R0-transmission rate
R0=1 one person infects one other person
R0<1 infection dies out
Modelling suggests: A mask 60% effective and worn by 60% people will reduce R0 to <1.0
Real life experiences shows value of universal masking
Every country where mask-wearing introduced as national policy (+other measures), rates of transmission fell in the subsequent days @nytimes
Story of two European neighbors Austria and Czechia @trishgreenhalgh
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Economic value of universal masking:
"The benefits of each additional cloth mask worn by the public are conservatively in the $3,000-$6,000 range due to their impact in slowing the spread of the virus"
As a physicians and Interventional specialist, we deal with radiation everyday and now #COVID_19. WE all wear lead shields to protect ourselves and #N95 while saving YOUR lives
⚫️ 1.Scientific Session
a. 🟡 Dialysis Related
b. 🟢 Others
🔴 #PAD-CLI Bootcamp
🔵 Practical Controversies in #PAE
(Long thread, use color code to jump to relevant sections)
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🟡 1a Dialysis related
Abstract of the year:
Are PTFE covered stents going to be standard of care to address the venous outflow stenosis in AV fistulae (AVeNEW) and AV grafts (AVeVA)?
Results from Dr Bart Dolmatch
2/
🟡 1a Dialysis related
CONCERTO (COmbiNing Cutting and drug-Eluting balloon for Resistant arteriovenous fistula sTenOsis) Pilot Study showed great promise for use of the combination therapy for AVF
First Author:
Mark Wang, Singapore General Hospital
Management of post‐TIPS refractory Hepatic Encephalopathy (HE)
🟢 Definition
🟡 Prevention
🔵 Medical Rx
🔴 Endovascular approach
1/
🟢 HE maybe:
Covert: Minimal or West haven Gr 1
Overt: West Haven Gr 2-4 which maybe episodic, recurrent (bouts within 6 mo) or persistent ( behavioral changes present with intermittent overt HE)
2/
Why does post-TIPS HE occur?
1.Shunting of blood away from liver- decreases 1st pass clearance of intestinal toxins (ammonia) 2. Upregulation of intestinal glutaminase activity- Increase ammonia production
1yr incidence 10-50%
New/ worsening 13-36%
Severe 1-3%
3/
"Intraprocedural Superior Hypogastric Nerve Block (#SNHB) is safe, effective, significantly reduces pain, need for opioids and allows same-day discharge #UFE"
Thread 👇
1/ YOU CAN DO IT! 🤜 🤛
#SNHB technique: Technical success 87% , which included operators who were not initially experienced with this procedure.