ICU Management & Practice, ICU Volume 8 - Issue 4 - Winter 2008/2009
The use of ultrasound waves for deep vein thrombosis (DVT) may help dissolve blood clots in less time than using clot-busting drugs alone, according to researchers at Emory University. "These clots are a main cause of both heart attacks and stroke and the more quickly you can eliminate them the better," says Karthikeshwar Kasirajan, MD, assistant professor of surgery in the Emory University School of Medicine.
A DVT is a blood clot that forms in a vein deep in the body, most often in the lower leg or thigh. A loose clot, called an embolus, can break off and travel through the bloodstream to the lungs and block blood flow. The life-threatening condition is called pulmonary embolism. The surgeon general's campaign estimates that every year, between 350,000 and 600,000 Americans get one of these clots - and at least 100,000 of them die.
"We now know that using ultrasound, along with the traditional method of using drugs to break up or dissolve blood clots, will help restore flow, prevent valve damage and also prevent the possibility of pulmonary embolism," says Kasirajan.
Researchers treated 37 patients with the clot-dissolving drug called tPA (tissue plas - minogen activator), while using ultrasound to loosen the proteins in their blood clots and send the drug into the clots faster. Of the 37, 16 had DVT and 21 had acute insitu arterial thrombosis. All the patients with arterial thrombosis had their clots completely dissolved, and all but six of the DVT patients had theirs completely dissolved. Four DVT patients had their clots partially dissolved and two saw no change. Only one of the 37 had a complication (neck hema toma). Most of the 37 (83 percent) were subsequently treated with angioplasty and stent placement.
Visionaries and Dreamers
The Story of the Founding Fathers of Israeli Anaesthesiology
Almost sixty years after the creation of the Israel Society of Anaesthes iologists (1952), a book containing the stories of the founding fathers of the profession in this country has been written and edited by Gabriel M. Gurman, MD.
Visionaries and Dreamers describes the endless efforts of anaesthesia’s founding fathers in Israel to bring this profession to a level accepted all over the world.
Within its’ pages, the reader will find stories, memories, and facts, as well as personal opinions, details of successes and failures of the pioneers of Israeli Anaesthesiology in the second part of the last century.
As Israeli Anaesthesiology is currently experiencing a serious manpower crisis, this book hopes to offer young Israeli physicians a real insight into the profession and guide them towards Anaesthesiology as a future professional carrier.
Gurman is professor emeritus at Ben-Gurion University of the Negev, a past president of the Israel Society of Anaesthesiologists and a former chairman of the Division of Anaesthesiology at Soroka Medical Center and Faculty of Health Sciences, Beer-Sheva, Israel. Sponsored by a series of scientific, professional and industrial organisations, this book was written in collaboration with Lior Granot, a young poetess and an alumna of Ben-Gurion University of the Negev, who edited the book and took part in a long series of interviews with the pioneers of Israeli Anaesthesiology and their families. It is printed in a bilingual edition – Hebrew and English.
