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healthbes · 4 years

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8 Examples of Awesome Content From Real Healthcare Blogs

One of the best ways to drive traffic to your healthcare website is to publish a blog. A blog will help you engage your patients or buyers and showcase expertise in your field. In the process, you can instill trust and build strong relationships. Ultimately, this could result in more business for your healthcare organization. How? B2B marketers that use blogs receive 67 percent more leads than those that do not.

But before you begin creating posts, you need to know your customers. Who are they? What is their profession? How do they make decisions? Once you understand your audience, you will then be able to write content that fits their needs and online searches.

While starting a blog may seem easy, coming up with relevant and quality content consistently is a challenge for many bloggers. Here are some strategic content ideas to consider for your healthcare blog.

1. Healthcare Basics

Many people lack knowledge about the basic concepts of healthcare. For instance, you could write about topics such as “Health Insurance Basics” and “National Healthcare Policy Explained.” Though this information might be too simple for many, others would find it extremely helpful. Such topics will drive more traffic to your blog and website. You could also offer some information about specific medical conditions. For example, Dr. John Mandrola has written a great article about atrial flutter.

2. "How-To" Guides

One of the most effective types of content is how-to guides or tutorials. This is basically a post that highlights an issue and provides a step-by-step solution for dealing with it. Such posts are very effective because they are easy to read and address problems people deal with every day. As a result, how-to guides are likely to drive more organic traffic to your blog. However, you need to ensure that the information presented in the post is factual and current. Offering flawed information could have grievous effects on your credibility. DrEd.com has a great article about malaria prevention for travelers.

3. Lists

Most people love lists because they are brief and to the point. One of the most popular types of lists are those that rank things in a certain order. For example, you could have a list of the “10 Ways Cancer May be Treated” or “15 Home Remedies for the Flu.” Getreferralmd.com has compiled a great list outlining how social media has impacted healthcare.

You can read more.

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semaglutid-blog · 2 years

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Der Kardiologe ist spezialisiert auf klinische Elektrophysiologie und arbeitet bei der Baptist Health Medical Group Cardiology in Louisville, Kentucky.

#Studien 2021 #Studien #Adopositas #Top 10

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shovelrise85 · 2 years

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Unblocked School Games

For the few days ending October 30, 2020, John Mandrola, MD responses from the following development and features tales. Just before I recorded the podcast, the report was covered by 30 news businesses, and Tweeted by 106 records. But this paper tells us absolutely nothing useful. The authors criticize the Puntmann (German) paper as having included patients with co-morbid conditions, or ongoing COVID-19 signs. Let’s today talk about a JACC paper that sought to define echo abnormalities involving myocardial damage and prognosis in patients with COVID-19. A total of 55 authors from new york and Milan teamed up to publish a chart review study of 305 clients who had COVID-19 and were sick enough to get echocardiograms. As for the effects when you look at the paper, in the event that you count customers sick adequate to have an echo, and those unwell adequate to have troponins, and sick adequate to have echo abnormalities (that could be old or brand-new), then can it be any surprise that these are markers for increased danger of death?

Live recreations wagering is now ever more popular nowadays and you may know what our company is discussing only if you have got ever tried. Aaron Finch: We will bat initially. First, there are two primary choices: 1 player and 2 player settings. To start with, it really is a select set of sick patients-they needed to be getting an echocardiogram carried out in 1st spot. Simply fit the handle to disengage the stopping method, adjust the height, then launch the handle to interact the stopping method which locks the hoop in place. It is popular that bouts of intense workout could cause troponin launch and edema and infection on cardiac magnetized resonance (CMR) imaging. The procedure of any troponin not due to plaque rupture or type we MI is remedy for the root cause, which is the coronavirus illness and its particular sequalae, and that will be being done in every in-patients-everywhere.

Per the fourth universal meaning, the existence of a heightened troponin means there clearly was myocardial injury. Tenex ended up being approved for usage because of the Food And Drug Administration in 2012. There are many published studies on its security and effectiveness with increased research ongoing. Diamonds are special and also suited to a wedding gift, so you should purchase a marriage diamond band for the future partner, if you'd like to wow. Next, you need to make a minimum subscription to take part and once you start winning cash you should use the credits to play the near future games. The more organized and organized you are able to your draft, the more fun each group needs in addition to quicker the entire procedure should go. Hall of Famers: Each staff will get one point per Hall-of-famer which invested at the very least 5 years with all the business. Sorry to say, many young ones who've a pool of one's own get to a point where they might perhaps not see the advantageous asset of the share on its own. The authors point out that markers which you can use as myocardial damage, such troponin, can overlap with athletic minds. The problem is, with a quick stature and a finite skill set, young ones can not live out those aspirations on a 10-foot basketball rim.

yet not here. It’s just a chart post on five clients per writer that shows the sicker one is, the higher the possibility of dying. Prof Landray from Oxford highlights that if you posit clients when you look at the low-flow oxygen arm do better, than you must posit that remdesivir harms those who find themselves sicker. Because of the risk to healthcare employees, at least in our hospital, we now have protocols that basically say COVID positive patients only get tests that are thought is essential. 메이저 놀이터 s broken up by oxygen subgroups, that will be a surrogate for how sick clients are. They're in a mood to cover large numbers towards the best people so that you can fabricate an unbeatable team which means this will surely not function as final summer time for which they will chuck money around. Fans may also highlight your favorite group or player just by hitting the celebrity symbol offered regarding the web page.

Behar-Cohen and staff learned 16 eyes from 16 patients (mean age 53 years; 88% men) with persistent non-resolving CSC have been addressed with either eplerenone or spironolactone (each at 25 or 50 mg/day) for at least a few months (suggest 21 months). Hyperkalemia ended up being 2.3% vs 0.9% with placebo, but supposedly this drug features less hyperkalemia-producing tendencies as compared to other two MRA medications, spironolactone and eplerenone. The drug has biologic plausibility; this has understood antiviral activity. Speed, efficiency, and a good result tend to be points of justification for both sides for the expert remodeler debate, so let’s dig just a little much deeper to get some truly unique benefits that include hiring experienced contractors. Offense/Defense Rankings: Both Alabama and Ohio State have actually performed rather likewise on both edges of this baseball during the 2020 college soccer period. A significant challenge in such score schemes, particularly in the faculty environment, may be the lack of connectivity into the routine graph.

#메이저 놀이터

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calorieworkouts · 6 years

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News: Exercise Doesn`t Always Lead to Weight Loss

Greatist Information analyzes as well as describes the patterns and research studies making headlines in fitness, health, and also joy. Take a look at all the news here.

That 2nd cupcake is A-OK if we struck the fitness center later ... right? Well, not so quick. New research study recommends exercise may not be the key to weight loss Hunter-Gatherer Energetics as well as Human Excessive weight. Pontzer, H., Raichlen, D.A., Timber, B.M., et al. Department of Anthropology, Seeker College, New york city, New york city. PLoS One 2012,7( 7): e40503.. According to the scientists, with the exception of elite professional athletes (like Olympians), people burn virtually the same quantity of energy daily whatever sort of exercise they do. If we cannot affect the result, then input is much more essential. The research writers state it's a lot more important to concentrate on just how much energy - aka exactly how numerous calories, also known as how several cupcakes - we took into our bodies.

The Study

Herman Pontzer and a team of Hunter College anthropologists compared daily power expenditures in the Hadza (a modern-day hunter-gatherer people in Africa) as well as Western populations, who had much more less active lifestyles Hunter-Gatherer Energetics as well as Human Weight problems. Pontzer, H., Raichlen, D.A., Wood, B.M., et al. Division of Anthropology, Seeker College, New york city, New york city. PLoS One 2012,7( 7): e40503.. As researchers anticipated, the Hadza were much more energetic compared to their laptop-loving Western equivalents. Yet below's the twist: When researchers measured just how much energy each team spent on a day-to-day basis, it ended up the Hadza people burnt roughly the same quantity as their Western counterparts.

Sound strange? Apparently humans burn roughly the exact same amount of power each day no matter what kind of bodily workout we do. Rather, the researchers believe the Hadza individuals's bodies were able to invest added power on exercising by conserving energy somewhere else, like on biological processes that happen inside cells. Based on these outcomes, scientists say people who intend to reduce weight ought to focus much more on how lots of calories they eat and also much less on the amount of they burn. And also, regardless of just what many health organizations claim, modern sedentary way of livings could not be the sole cause of the excessive weight epidemic.

Can We Trust It?

It's tough to compare the Hadza tribe to modern-day Westerners because their exercising and also diet are so different from the kind we do at the neighborhood health club. That distinction might not matter. Pontzer says he has need to believe human beings have been spending roughly the exact same quantity of calories each day today for 100,000 years.

These searchings for typically aren't absolutely separated, with various other study recommending exercise treatments normally don't help people shed weight Why do individuals not shed more weight from an exercise intervention at a specified dose? An energy equilibrium evaluation. Thomas, D.M., Bouchard, C., Church, T., et al. For Measurable Excessive weight Research study, Montclair State University, Montclair, NJ. Obesity Review 2012,10.1111: j.1467-789X. .

But it's prematurely to start mass-cancelling our gym subscriptions. ' Obesity is just one element of health and wellness,' Pontzer spokened, including that workout could also improve psychological health and wellness and also body immune system function. And the concept of an established metabolic price does not always put on high-functioning professional athletes like Michael Phelps, who can melt as several as 8,000 calories a day.

Greatist Expert and also cardiologist John Mandrola spokens neither exercise neither diet holds the option to obesity: 'Absolutely health, or wellness, comes only when humans utilize their body and also after that feed it wisely every day.'

Has work out been a weight-loss allow down or do you speak highly of the gym? Share your ideas in the comments below.

#aerobic #exercise #fitness #fitness center #gym #health #health and wellness #health club #the fitness center #weight #wellness #work out #workout

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perfectbooklibrary · 3 years

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FREE EBOOK The Haywire Heart How too much exercise can kill you and what you can do to protect your heart [DOWNLOAD]

FREE EBOOK The Haywire Heart: How too much exercise can kill you, and what you can do to protect your heart [DOWNLOAD]

The Haywire Heart: How too much exercise can kill you, and what you can do to protect your heart

[PDF] Download The Haywire Heart: How too much exercise can kill you, and what you can do to protect your heart Ebook | READ ONLINE

Author : Chris Case Publisher : ISBN : 1937715884 Publication Date : -- Language : Pages :

To Download or Read this book, click link below:

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Synopsis : FREE EBOOK The Haywire Heart: How too much exercise can kill you, and what you can do to protect your heart [DOWNLOAD]

Too much exercise can kill you. The Haywire Heart is the first book to examine heart conditions in athletes. Intended for anyone who competes in endurance sports like cycling, triathlon, running races of all distances, and cross-country skiing, The Haywire Heart presents the evidence that going too hard or too long can damage your heart forever. You ll find what to watch out for, what to do about it, and how to protect your heart so you can enjoy the sports you love for years to come.The Haywire Heart shares the developing research into a group of conditions known as athlete s heart, starting with a wide-ranging look at the warning signs, symptoms, and how to recognize your potential risk. Leading cardiac electrophysiologist and masters athlete Dr. John Mandrola explores the prevention and treatment of heart conditions in athletes like arrhythmia, atrial fibrillation and flutter, tachycardia, hypertrophy, and coronary artery disease. He reviews new research about exercise intensity and duration, recovery, inflammation and calcification, and the ways athletes inflict lasting harm.These heart problems are appearing with alarming frequency among masters athletes who are pushing their bodies harder than ever in the hope that exercise will keep them healthy and strong into their senior years. The book is complete with gripping case studies of elite and age-group athletes from journalist Chris Case like the scary condition that nearly killed cyclist and coauthor Lennard Zinn and includes a frank discussion of exercise addiction and the mental habits that prevent athletes from seeking medical help when they need it.Dr. Mandrola explains why many doctors misdiagnose heart conditions in athletes and offers an invaluable guide on how to talk with your doctor about your condition and its proven treatments. He covers known heart irritants, training and rest modifications, effective medicines, and safe supplements that can reduce the likelihood of heart damage from exercise.Heart conditions affect hardcore athletes as well as those who take up sports seeking better health and weight loss. The Haywire Heart is a groundbreaking and critically important guide to heart care for athletes. By protecting your heart now and watching for the warning signs, you can avoid crippling heart conditions and continue to exercise and compete for years to come.'

#fullbook fileebook

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consultatiiladomiciliu-ro · 3 years

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Dr Mandrola: De ce mă îngrijorează Long COVID

Citeste articolul pe https://consultatiiladomiciliu.ro/dr-mandrola-de-ce-ma-ingrijoreaza-long-covid/

Dr Mandrola: De ce mă îngrijorează Long COVID

De ce mă îngrijorează Long COVID

John M. Mandrola, MD:

Long COVID mă îngrijorează. Imensitatea simptomelor sale, incertitudinea cauzelor sale și atenția imensă pe care o primește oferă o configurație pentru iatrogeneză, o “boală” cauzată de asistența medicală.

Un pacient de vârstă mijlocie raportează oboseală neobișnuită la câteva luni după infecția cu SARS-CoV-2. Un clinician comandă electrocardiografia (ECG) pentru a investiga boala cardiacă post-COVID. ECG arată modificări nespecifice, ceea ce conduce la un test de stres cardiac RMN foarte scump. Angiografia coronariană efectuată pentru a evalua scanarea anormală nu prezintă nicio boală a arterelor coronare, dar o disecție coronariană indusă de cateter necesită un stent, alți bani, altă distracție. Și alte, și alte domino-uri de acest gen.

Acest caz este fictiv, dar este similar cu cel publicat recent în JAMA Internal Medicine.

Patru factori determină majoritatea cazurilor de iatrogeneză: intenții bune, incertitudine, stimulentul de a acționa mai degrabă decât de a observa și, cel mai important, frica.

ÎnvățĂM să Ne temEM

Atenția intensă acordată COVID pe termen lung creează un fenomen de învățare socială prin care oamenii învață să se aștepte (și să se teamă) de simptome mult timp după infectarea cu SARS-CoV-2.

În era digitală, cu greu este nevoie de o citare pentru a documenta învățarea socială.

Dar aici este una: în această revizuire a studiilor medicamentelor pentru depresia majoră de peste două decenii, autorii au constatat o creștere semnificativă a răspunsului la placebo în timp. Placebo-urile sunt inerte și nu ar trebui să devină mai eficiente în timp. O explicație este că, pe măsură ce tratamentul pentru depresie a devenit obișnuit, oamenii au învățat să se aștepte la rezultate pozitive de la terapie.

O căutare pe Google pentru „COVID pe termen lung” a dat 83 de milioane de rezultate. Numeroase medii influente au prezentat anecdote convingătoare ale persoanelor care se confruntă cu o gamă largă de simptome misterioase la câteva luni după infecția inițială.

COVID lung are de asemenea atenția academicienilor. Luați în considerare faptul că o revizuire a sindromului COVID-19 post-acut în Nature Medicine, prezentată în octombrie 2020, la doar 7 luni de la pandemie, a inclus 226 de citații. Și având în vedere că Institutele Naționale de Sănătate vor cheltui 1,15 miliarde de dolari pentru a studia ceea ce se numește acum sechele postacute ale infecției cu SARS-CoV-2 (PASC), așteptați și mai multă atenție din partea oamenilor de știință subvenționate.

IntențiiLE bune

Clinicienii citesc de asemenea știrile. Care uneori sunt FALSE (vezi cum si de ce se răspândesc). Și noi suntem conștienți de numeroasele grupuri de susținere a pacienților care promovează recunoașterea și pericolul reputațional de a fi percepuți ca fiind insuficient preocupați de suferința fizică de COVID îndelungat.

De exemplu, știm de la influentul scriitor atlantic Ed Yong că orice sugestie că stresul sau anxietatea joacă un rol în simptomele COVID lungi este ca și cum ai pune gaz pe foc în medicină.

Există două moduri de bază prin care un clinician poate demonstra diligență în îngrijire. Una este să stai, să asculti activ și să exprimi empatie. Este greu. O modalitate mai ușoară de a face este să comanzi teste de laborator.

Normele sociale susțin că simptomele fizice merită testate: „Doctorul meu trebuie să aibă grijă întrucât a comandat o serie de teste, inclusiv un RMN”. Dar testele pot duce la ăncă și mai multe teste, iar cascada poate duce la daune psihologice, fizice sau financiare.

COVID lung și incertitudineA

Este o provocare să descrii specific COVID-ul lung

Începeți cu simptomele. Unele dintre cele mai frecvente – oboseală, slăbiciune, insomnie , dispnee și ceață cerebrală – sunt dificil de cuantificat. Oboseală în comparație cu ce? În ceea ce privește cunoașterea, ultimele 12 luni nu au fost un moment ușor pentru a rămâne în sarcină. Și aproape că pot conta pe două mâini numărul de oameni pe care i-am văzut în clinică care raportează că dorm bine.

Apoi, există o părtinire de selecție în multe dintre rapoartele inițiale. O scrisoare de cercetare (cu aproape 900.000 de vizualizări de pagină și 132 de citate) a înscris pacienții dintr-un serviciu ambulatoriu postacut COVID-19. Un alt sondaj a înscris pacienți din programul de recuperare de precizie COVID-19 al Spitalului Muntele Sinai. Și, într-o știre Bloomberg intitulată „ COVID Everlasting ”, studiul în cauză a înscris pacienți prin tweeting: „Dacă vă considerați un caz de COVID Long, vă rugăm să ne anunțați ce simptome ați avut”. Destul de ridicol, nu?

Rapoarte precum aceste eșantioane de grupuri de persoane mai susceptibile de a avea simptome. În întreaga lume au existat 126 de milioane de cazuri de COVID-19; de ce nu se face un eșantion aleatoriu de persoane la intervale diferite după infecția inițială? În acest fel am putea afla adevărata prevalență a simptomelor COVID lungi.

Poate că cel mai uimitor aspect al COVID lung sunt raportările de simptome fără dovezi ale infecției cu SARS-CoV-2. O preimprimare recentă a raportat 205 de tipuri diferite de simptome în lunile de după infecția inițială. Aproximativ 1700 dintre pacienții chestionați au avut un rezultat negativ la un test de reacție în lanț cu transcriptază inversă polimerază și 600 au dat rezultate pozitive. Dintre cele 205 de simptome, doar pierderea mirosului și a gustului a fost semnificativ mai frecventă la cei care au dat rezultate pozitive decât la cei care au dat rezultate negative. Alte grupuri au reprodus aceste constatări.

Testarea pentru SARS-CoV-2 este imperfectă; testele nu au fost disponibile devreme și unii pacienți simptomatici fără rezultate pozitive ale testului COVID au fost probabil fals negativi. Dar, de asemenea, pare probabil că un număr finit de persoane care raportează simptome COVID lungi nu au fost niciodată infectate cu virusul. Acesta este un puzzle.

StimulenteLE

Când se confruntă cu pacienți care prezintă simptome, clinicienii din multe sisteme de sănătate, în special în Statele Unite, sunt motivați să comande teste. Un cardiolog care comandă ecocardiografie , scanare a perfuziei RMN sau monitorizare cardiacă la un pacient cu simptome COVID lungi nu numai că pare un bun îngrijitor, dar câștigă și productivitate, doar testele sunt decontate…

Deși ar fi prea cinic să legăm dezvoltarea clinicilor de îngrijire post-COVID exclusiv cu motivele financiare, nu este de asemenea greșit să observăm caracterul extrem de competitiv al asistenței medicale bazate pe profit pe multe piețe din SUA. Din perspectiva unui administrator de spital, COVID lung este o oportunitate de a crește cota de piață și de a face bani.

Abordarea medicalA conservIVA

Cel mai bun răspuns la problema COVID lung este empirismul.

Mai întâi să ne amintim că majoritatea intervențiilor medicale nu funcționează sau au dimensiuni modeste ale efectului; gloanțele magice, cum ar fi antibioticele, insulina și medicamentele pentru HIV sunt excepția, nu regula. Astfel, nu numai că ar trebui să fim pesimisti că simptomele COVID îndelungate vor avea o soluție ușoară, dar ar trebui să fim atenți și la pericolul de vătămare iatrogenă.

Sindroamele postvirale sunt reale. Pandemia a provocat o mulțime de infecții; vor exista o mulțime de sindroame postvirale. În electrofiziologie, am văzut de mult pacienți cu tulburări autonome (aritmii), cum ar fi tahicardie sinusală necorespunzătoare (IST), care a început misterios după o infecție COVID. Am colegi care au făcut infarct la 2 săptămâni după ce au scăpat de COVID19. Deci ceva se întâmplă după COVID, deocamdata nu știm, pare aleatoriu.

Istoria aritmiilor este instructivă. Descoperirea sa a coincis cu perioada de glorie a ablației cateterului pentru tahicardia supraventriculară (SVT). Alimentat de succesul ablației SVT, mulți medici au favorizat ablația nodului sinusal pentru IST. Acest lucru sa dovedit a fi slab din cauza lipsei de eficacitate și a complicațiilor grave . O abordare conservatoare din punct de vedere medical ar fi salvat mulți pacienți cu IST postviral de daune iatrogene.

COVID lung este, de asemenea, foarte potrivit pentru o abordare conservatoare din punct de vedere medical. Căile de diagnostic și intervențiile terapeutice ar trebui studiate în studii care includ brațe de control adecvate.

Persoanele cu orice simptom sunt, prin definiție, suferinde. Îngrijirea, empatia și puterea de a lăsa timpul și natura să facă cea mai mare parte a vindecării mi se pare cel mai bun mijloc. Faceți din acesta brațul de control; apoi demonstrați că intervenția este mai bună.

În acest fel suntem mai predispuși să ne îndeplinim promisiunea de a nu face rău mai întâi, primo non nocere (angajamentul fundamental al medicinei).

John Mandrola practică electrofiziologia cardiacă în Louisville, Kentucky, și este scriitor și podcaster pentru Medscape. El susține o abordare conservatoare a practicii medicale. Participă la cercetări clinice și scrie deseori despre starea dovezilor medicale.

#aritmii #COVID lung #emotiile #empirismul #frica #iatrogeneză #PASC #post COVID #sechele postacute ale infecției cu SARS-CoV-2 #SVT #tahicardia supraventriculară #TEP #TEV #trombembolism

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newsfastly · 4 years

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Can exercising too hard and too long cause heart problems?

“I could barely get home,” Mandrola recalls.

How could someone as fit and healthy as Mandrola develop heart trouble before age 50? We’ve all heard that exercise is good for the heart, and that’s undeniably true. But researchers have begun to understand that some athletes who exercise to extremes — competing in endurance events for many hours at a time over multiple years — may be at…

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#Exercising #hard #heart #long #problems

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kidneystories2013 · 4 years

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John Mandrola, MD @drjohnm Can We Discuss Flatten-the-Curve in COVID19? My Eight Assertions https://www.drjohnm.org/2020/05/can-we-discuss-flatten-the-curve-in-covid19-my-eight-assertions/ (at Hammond, Indiana) https://www.instagram.com/p/B_1QLsLDZR4/?igshid=13eh16kekf1d8

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a-fibfriend · 6 years

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New Video: Impact of Lifestyle Factors on Patients with Atrial Fibrillation with John Mandrola, MD

We’ve posted a new video with Dr. John Mandrola, MD, a cardiac electrophysiologist from Louisville, KY (Patti’s hometown).

Dr Mandrola on Impact of Lifestyle Factors on A-Fib

In this interview, Dr Mandrola talks about the impact of lifestyle factors on patients with atrial fibrillation. He explains how in past 5–10 years doctors have started to understand that A-Fib can be caused through sort of…

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#causes #Dr. John Mandrola #lifestyle factors

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dixieland--delight · 7 years

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Is CT Angiography Overkill for Low-Risk Chest <b>Pain</b>?

Dr Mandrola: There are a ton of patients presenting with chest pain. This is ... leading cause of ED visits behind abdominal pain, at 6-8 million per year. from Google Alert - abdominal pain http://ift.tt/2iVd5JW

#IFTTT #Google Alert - abdominal pain

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picardonhealth · 4 years

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Why angina shouldn’t be treated as a time bomb in your chest

A new blockbuster study has found that drugs are as effective as surgery

André Picard, The Globe and Mail

Monday, November 25, 2019

For decades, the standard treatment for angina (chest pain) has been to rush patients into surgery for angioplasty and stenting, or coronary bypass surgery.

But a new blockbuster study shows that these common surgical interventions work no better than medications as a treatment for stable angina.

The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches is one of the most thorough and costly clinical trials ever conducted. (It also has a clever acronym: ISCHEMIA, which is a restriction in blood supply to tissues and the underlying cause of angina.)

The $100-million study included 5,179 patients – with an average age of 64, although only 23 per cent were women - with stable angina or suspected blockages. They underwent cardiac stress tests – which are generally done walking briskly on a treadmill – or magnetic resonance imaging.

Study participants were randomly assigned to either surgical intervention or optimal medical therapy. OMT consists of a combination of drugs such as Aspirin, statins, beta-blockers, ACE inhibitors and counselling on diet and exercise. The patients were then followed closely for 3.3 years on average and disease progression and complications monitored.

The commonly accepted wisdom was that surgery prevents heart attacks more effectively than drugs.

But the ISCHEMIA data showed that, after one year, 7 per cent of the patients in the surgery group had heart attacks, compared to 5 per cent in the medication group. After four years, 13 per cent of those in the procedure group had heart attacks, compared to 15 per cent in the medicine group.

In other words, it was a wash.

The same was true when researchers looked at other measures such as mortality, heart-related hospitalizations and resuscitation after cardiac arrest.

When the findings were presented recently at the annual conference of the American Heart Association conference, those in the know were blown away.

“Cardiology changes today,” wrote Dr. John Mandrola, a Louisville, Ky., cardiac electrophysiologist and columnist for Medscape.

When guidelines are rewritten to reflect these findings, the take-home messages for patients with stable angina and their doctors will be: 1) try medication first; 2) surgery, if it is recommended, is not urgent.

Or, as Dr. Mandrola wrote: “That blockage is not a time bomb in your chest.”

Today, many – and now we know too many – patients with persistent chest pain or even a suggestion of coronary blockages, get either angioplasty and stenting or bypass surgery.

But the ISCHEMIA data are a reminder that while surgical interventions remove specific blockages, drugs probably clear blood vessels more broadly.

(To be clear, the findings don’t apply to patients who have had heart attacks or have unstable heart disease.)

Whether the way patients with stable angina are treated actually changes remains to be seen.

It takes, on average, 17 years for findings of health research to become standard practice.

Physicians are a conservative lot and pretty adept at turf protection, not to mention that much medical practice is based on tradition more than hard evidence.

There is also a lot at stake. Consider that about 17 million or about 5 per cent of Americans are living with angina.

In the U.S., about 500,000 patients a year have stents implanted. That includes 100,000 people with stable angina and 23,000 with no chest pain. The researchers estimated that treating the latter group with drugs instead of surgery would save US$775-million.

(About 15,000 Canadians annually undergo bypass surgery and another 50,000 have angioplasty and stenting, according to data from the Canadian Institute for Health Information. However, not all the procedures are related to angina. Previous research has shown that per capita, Canadians undergo fewer heart procedures than Americans because there are incentives to over-treat in a for-profit system.)

The ISCHEMIA study, among other things, is a reminder that there is very little rigorous study of the effectiveness of surgical practices. While new prescription drugs are tested in clinical trials, that is not the norm for innovations in surgery.

That we have been doing surgery that’s not particularly useful on heart patients for decades also underscores the power of intervention bias – the belief that doing something is better than doing nothing.

As legendary cardiologist Dr. Bernard Lown famously said, cardiac surgeons too often “think like plumbers rather than like scientists,” and are eager to unblock pipes as soon as possible.

Patients also tend to much prefer surgery over drug regimes. As Carolyn Thomas, who writes the popular Heart Sisters blog, notes, changing those ingrained cultural perceptions is going to be difficult.

Having good evidence is one thing; changing minds, and practices, is quite another.

#agina

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toradata · 5 years

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Artes plásticas románicas

Introducción: Las artes figurativas del románico sirvieron para plasmas un programa iconográfico que pretendía trasmitir una doctrina. Por ello las dos características esenciales son la función didáctica y la dependencia del marco arquitectónico. Otras características son el antinaturalismo (de la tradición bizantina) con la representación de figuras rígidas, planas y deshumanizadas. Los personajes están dotados de gran expresividad en los gestos .

Escultura: Se concentraba, fundamentalmente, en portadas y capiteles.

En el tímpano se solía representar el pantocrator, dentro de una mandrola y rodeado de tetramorfos. EN el intradós de las arquivoltas encontramos a los 24 ancianos del apocalipsis y en las jambas y el parteluz diferentes santos, apóstoles y personajes del antiguo testamento.. Todas las figuras se adaptan al mao arquitectónico, cubriéndolo en su totalidad y aplicando de esta manera el principio de horror vacui. Entre los ejemplo mas destacados encontramos a San lazaro de autun, santa magdalena de Vezelay o Santa Fe de Conques en Francia. En España destaca el Pórtico de la Gloria en la catedral de Santiago de Compostela.

Catedral de Jaca, Crismon trinitario: Anagrama de cristo y las letras alfa y omega que aluden al principio y fin de los tiempo. También podría ser la P de Pater y la S de espíritu santo, completando así la santísima trinidad. Puede presentarse solo o flanqueado por dos leones, alegorías del cristo vencedor del mal y la muerte.

El pórtico de la Gloria: A los pies de la catedral, sobre la cripta, se abre la fachada principal también conocida como pórtico de la Gloria. Se compone de tres arcadas apoyadas en pilares con columnas adosadas. El santo sostiene el tímpano, donde aparece cristo resucitado y acompañado de ángeles que sostienen los instrumentos de la pasión. En el nivel inferior las jambas conversan entre si e incluso sonríen. Estos detalles nos sitúan en un estilo mas naturalista acercándose al gótico.

Capiteles: Se esculpían temas historiados, vegetales y animales y diferentes temas geométricos. Estos capiteles aparecen en las columnas de los claustros. Los temas historiados hacen referencia a escenas del antiguo y del nuevo testamento y a la vidas de los santos.

Claustro del monasterio de santo domingo de silos: Los capiteles están decorados con temas geométricos y vegetales, animales reales y fantásticos, escenas historiadas de temas religiosos y profanos. Los realices presentan temas cristalográficos como la duda de santo tomas, el descendimiento...

Esculturas de madera policromada: Esculturas de bulto redondo talladas en madera policromada que representan dos temas; cristo crucificado y la virgen con el niño. Los ejemplos as importantes son la majestad batlló. La virgen sigue el modelo bizantino de Kiriotissa. Se representa de frente sin relación alguna entre madre e hijo

La pintura Románica: Tuvo especial importancia en el desarrollo del arte románico por varias razones:

Realzaba las formas arquitectónicas

Contribuía a la caracterización de los fieles con los temas pintados sobre las amplias superficies que quedaban libres en el interior

Recuperaba la tradición romana junto con las influencias prerromanicas y bizantinas

Características:

técnicas variadas; mural, temple sobre tabla y miniatura

La mayor parte e la pintura es al fresco o al temple por lo que requiere una serie de iperacion como el enfoscado, enlucido o estarcido entre otras

La pintura sobre tabla se encuentra, mas frecuentemente, en los frontales de altar y el retablo

La miniatura cuenta con numerosos ejemplos como los rollos de pergamino de las iglesias del sur de Italia, las biblias españolas como la de san Pedro de Roda o los códices con textos de carácter histórico judío como el libro de los testamentos

como otros soportes encontramos miniaturas realizadas en marfil como el caso de la arqueta de San Millan de la Cogolla o el Crucifijo de don Fernando y doña Sancha

Predominio de colores intensos y puros

Contornos perfilados con gruesas lineas negras

sin perspectiva y con muchos rasgos formales de la escultura (Hieratismo, frontalidad o isocefalia)

Pintura mural: Utilizaban la técnica al fresco pintando los temas mas importantes en el abside. (pantocrator o virgen con el niño)

San clemente: Firmeza en el dibujo y un conocimiento y aplicación de la gama de colores mas abundante. Destruida en buena parte, aun queda algunos restos interesantes como el cordero místico envuelto en un nimbo y la parábola del pobre Lazaro

Santa Maria: El temas es la virgen kiriotissa con el niño en los brazos y la epifanía y debajo, dibujos de animales en círculos que recuerdan tejidos orientales. Se conversan oros temas con iconografia como david y goliat. El conjunto revela una formación artística inferior a la anterior.

Panteón de los reyes de la colegiata de san isidoro de León: Destaca la cripta de san isidoro de Leon llamada panteon real, decorada con pinturas. Las bóvedas se decoran con temas muy diferentes, entre ellos; la anunciación, visitación, epifanía, natividad, la pasión con la ultima cena, el pantocrator o escenas dedicadas a la representación del zodiaco. El estilo es mas elegante, naturalista y plagado de detalles anecdoticos.

Ermita de santa cruz de maderuelo: A los pies aparece la representación del pecado, la creación de adán y la tentación de eva. En la bóveda el pantocrator rodeado de tetramorfos y en los laterales profetas, evangelistas y diversas jerarquías angélicas. El abside se reserva para la virgen con el niño y la adoración de los reyes magos.

Pintura sobre tabla: Decoraba los frontales de altar y pequeños retablos. En ellos se aplicaba la técnica al temple, con escenas de santos y mártires, como en los casos del fronal de Avia y el frontal de lx

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