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jellypawss · 3 months

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also advice needed and I forgot to ask my cardiologist today, I’ve been drinking every night for about 2 weeks but got off my heart med (flecanide) today, should I have my 4 beers as usual to avoid withdrawal and potentially more stress OR would having my normal amount cause more bodily stress?

#thanks nurses and docs and medical students I love u!!!!#beta blockers #medical advice #medical help #flecanide #metoprolol #tw medical

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rheamalhotra-blog · 5 years

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Abstract

Optical Coherence Tomography (OCT) is a novel 3D-imaging modality, however there has been limited research utilizing OCT to study physiological impacts of ion-blocking drugs, namely Class I, III, and IV antiarrhythmics. An OCT drosophila model was developed for live non-invasive analysis of cardiovascular disease and pharmaceutical testing. With extensive drug delivery protocol optimization, Ca2+, K+, and Na+ channel blockers were dissolved into sugar based food at 0.1% and 0.01% of standard human dosage, Amlodipine Besylate, Dofetilide, and Flecainide Acetate, respectively.

216 samples’ heart rate and area were processed through a Segmentation and Python algorithms at Instar Stage III and adult. Ultimately, Amlodipine suppressed chronotropy while proarrhythmic characteristics were surprisingly observed in Dofetilide and Flecanide treated samples, signaling potential cardiotoxicity.

Combining chemical therapeutics with bio-optics yields novel implications for potential of optogenetics in cardiotherapy for major chronic heart diseases with 3-dimensional live graphics and enhances understanding of the antiarrythmic biochemical agents currently used to treat them.

The drosophila optical model is an effective way to analyze the chronotropic properties of antiarrythmics to easily test the biomechanical effects of drugs before experimenting on mammalian species or human populations. This reduces the cost and time of developing drugs by quickly identifying experimental molecules with cardiotoxic effects, enhancing general physiological understanding of the drugs to begin with.

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livingwellpage · 5 years

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Does the VA provide high-quality care?

This question is difficult to answer. In many countries with government provided health care, wait times are long. For the Veterans Affairs (VA) beneficiaries, this does not seem to be much of an issue according to a Penn et al. (2019) study covering wait times between 2014 and 2019:

Although wait times in the VA and PS [private sector] appeared to be similar in 2014, there have been interval improvements in VA wait times since then, while wait times in the PS appear to be static. These findings suggest that access to care within the VA has improved over time.

A study by Blay et al. (2017) found that Veterans Affairs provides high quality care as well.

Veterans Affairs hospitals had better outcomes than non-VA hospitals for 6 of 9 PSIs [patient safety indicators]. There were no significant differences for the other 3 PSIs…VA hospitals had better outcomes for all the mortality and readmissions metrics..However, on the patient experience measures, non-VA hospitals scored better overall than VA hospitals for nursing and physician communication, responsiveness, quietness, pain management, and on whether the patient would recommend the hospital to others…For behavioral health measures, non-VA hospitals did better on 4 of 9 measures, while VA hospitals did better on 1 of 9 measures.

A systematic literature review by O’Hanlon et al. (2017) found that the VA does appear to deliver high-quality care according to many studies.

The VA often (but not always) performs better than or similarly to other systems of care with regard to the safety and effectiveness of care. Additional studies of quality of care in the VA are needed on all aspects of quality, but particularly with regard to timeliness, equity, efficiency, and patient-centeredness.

Stories of low-quality care, however, do exist. Consider just a few days ago a news story appeared in the N.Y. Daily News on the care received by one veteran:

…[the patient said that VA] doctors could not identify the cause of the fainting spells and he crashed onto sidewalks 18 times, injuring his eye, face, hands and knees. He said questions about the possibility of a relationship between his heart condition and fainting were ignored…After three years of struggling with the hospital, the veteran said he went to a private doctor, who gave him an electrocardiogram and determined that his heart condition, which resulted from the attack, could be treated with a drug called Flecanide Acetate. It was prescribed on March 11, 2017, and quickly eliminated the fainting problem, he said.

How do we interpret these findings. Does the VA provide high quality care, with a few outlier low-quality outlier cases? Is the VA better at providing high-quality care or is it just better at recording quality metrics? Or does the VA–more so than the private sector–focus on providing high-quality care on public-reported measures and provide lower-quality care on unreported aspects of quality? The answer to these questions is difficult to know, but more research is needed.

Does the VA provide high-quality care? published first on your-t1-blog-url

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maxihealth · 5 years