Tag Archives: Germany

Emergency Care: Flying Intervention Team Use In Acute Ischemic Stroke

In a nonrandomized controlled intervention study published in JAMA, researchers in Germany assessed whether deployment of a flying interventional team, consisting of a neurointerventional radiologist and an angiography assistant, was associated with a shorter time to endovascular thrombectomy for patients in rural or intermediate population areas in Southeast Bavaria.

This video explains the study design. Click https://ja.ma/FIT for full details.

COMMENTARY:

Stroke prevention by a healthy lifestyle, including a good diet, regular exercise, and sleep is of course preferable to treatment.

However, stroke still claims more than 100,000 lives per year in the United States, and is a major factor in disability.

Recognition of a stroke is the first crucial step, and has been discussed in DWWR previously; FAST is the Menmonic and guiding principle. Ask the patient to smile, and it may be assymmetric, with one side drooping. Ask the patient to raise both arms, and one may drift down. Ask the patient to repeat a simple sentence, and he may be unable to do so. And above all be speedy, since time is of the essence, and treatment must take place within a very few hours.

Modern medical centers in large cities frequently have a team dedicated to treating stroke. The patient goes for a CT or MRI while  the Catheter team assembles. An intravenous clot dissolver, tPA, is often used, or possibly a catheter is inserted into an artery and guided to the  proper location. Sometimes the clot is mechanically removed as in the accompanying video.

The helicopter stroke response team featured in the posting is one aspect of the speed that is so essential; any delay will result in death, sometimes permanently, of brain cells.

Acute Heart attack treatment is basically similar to stroke, and was the pioneering venture into the interventional radiology described above. Also, the heart may be the source of the clots that lodge in the brain, especially from atrial fibrillation.

Please enjoy the following video which shows how mechanical clot removal is achieved.

—Dr. C.

ANALYSIS: MULTIRESISTANT BACTERIA THAT OUTSMART ANTIBIOTICS (VIDEO)

Antimicrobial resistance is one of the greatest medical challenges of our time. Among the causes are industrial livestock farming, poor hygiene in hospitals, and the misuse of antibiotics. This documentary looks at approaches to fighting multiresistant strains of bacteria.

Each year 33,000 people in Europe die after becoming infected with bacteria that are resistant to antibiotics. Hygiene specialist Dr. Ron Hendrix has been working for years to prevent outbreaks of infectious disease in hospitals. Dr. Hendrix says that he and other experts in the Netherlands recognized early on that they’d have to fight the spread of bacteria just as actively as they would the actual infection.

Hendrix has convinced a number of German hospitals to re-open their diagnostic laboratories, as well. In the early 2000s, many of these labs had been shut down as a cost-cutting measure. And farmers in Denmark voluntarily chose to sharply reduce their use of antibiotics, after evidence showed that intensive livestock farming caused multiresistant bacteria to multiply.

Infectious disease specialist Dr. Patrick Soentjens was able to convince Belgium’s health ministry to allow the use of “phages” to treat stubborn antimicrobial resistant pathogens. Phages are special viruses that kill bacteria. Dr. Soentjens is certain that this well-known, but largely forgotten option could save many lives. Belgium has become the first western European country where phages have been officially recognized as a legitimate medical treatment.