Inter-hospital transfer for primary angioplasty: delays are often due to diagnostic uncertainty rather than systems failure and universal time metrics may not be appropriate

April 22, 2014Academic Publicationsangioplasty, Inter-hospitaldam_admin

Abstract

Aims: We aimed to investigate why many patients with ST-segment elevation myocardial infarction (STEMI) initially present to non-primary percutaneous coronary intervention (PPCI) equipped hospitals in a region that offers a 24-hour direct access Heart Attack Centre.

Taking action on sugar – applying lessons from the salt reduction programme

January 9, 2014Academic Publicationsdam_admin

The food industry is currently adding growing amounts of sugar to our food. Consumers are largely unaware of this, as the sugar is mostly hidden.

Author’s reply to Lichtenstein, Tedstone and Pyne, Mann and colleagues, Lim, and Clifton

November 19, 2013Academic PublicationsAuthor’s reply to Lichtensteindam_admin

Saturated fat is known to increase low density lipoprotein (LDL)-cholesterol.

Saturated Fat in Cardiovascular Disease and Obesity: Friend or Foe?

October 8, 2013Academic Publicationsdam_admin

Abstract:

As health professionals and policy makers debate what are the most effective means to combat the global obesity epidemic, one important question one must ask is whether we have been following the wrong dietary advice over the past three decades. This chapter presents a summary of evidence arguing the relationship between saturated fat consumption, cardiovascular disease, and obesity.

Too much angioplasty

September 24, 2013Academic Publicationsdam_admin

Stenting offers no prognostic benefit over drugs in stable coronary disease.

Improving the UK’s performance on survival after cardiac arrest

July 31, 2013Academic Publicationsdam_admin

We thank Malhotra and Rakhit [1] for their observations of the challenges and potential beneficial outcomes in the management of out-of-hospital cardiac arrest. Clearly, prevention is the best course of action and therefore the promotion of greater awareness of the prodromal symptoms and signs that may precede a cardiac arrest and when to call for help is paramount. If and when a cardiac arrest does occur, survival rates will be greater if this occurs when the ambulance is already on scene after an early call for help. These actions need to be combined with improved levels of bystander cardiopulmonary resuscitation (CPR) and reduced times to defibrillation for all victims of cardiac arrest.

High incidence of acute coronary occlusion in patients without protocol positive ST segment elevation referred to an open access primary angioplasty programme

July 30, 2013Academic Publicationsdam_admin

Background:

Primary percutaneous coronary intervention (PPCI) programmes vary in admission criteria from open referral to acceptance of electrocardiogram (ECG) protocol positive patients only. Rigid criteria may result in some patients with acutely occluded coronary arteries not receiving timely reperfusion therapy.

It’s time to ban junk food on hospital premises

June 26, 2013Academic Publicationsdam_admin

To combat obesity, we doctors must start in our own back yard.

The dietary advice on added sugar needs emergency surgery

May 21, 2013Academic Publicationsdam_admin

I welcome the response from Barbara Young, chief executive of Diabetes UK to my article entitled “the dietary advice for added sugar is need of emergency surgery.”

Winding back the harms of too much medicine

March 19, 2013Academic Publicationsdam_admin

BMJ’s too Much Medicine Campaign should be welcomed. An increasing evidence base exists documenting the harms and costs of over diagnosis and over treatment.(1)