Accidents & Violence, Author Interviews, JAMA / 26.07.2019 Interview with: Justin C. McCarty, DO, MPH General Surgery Resident, PGY-4 Department of Surgery | St. Elizabeth’s Medical Center What is the background for this study? What are the main findings?  Response: The main finding of the paper is that the assumption of the training that teaching how to apply one type of tourniquet translates to knowledge and understanding of how to apply any other tourniquet is questionable. I love the Stop the Bleed campaign and what it stands for but I believe that it is important that as it moves forward that there is continuous questioning of the educational curriculum and how it is delivered. Currently, I question whether the best interim method of teaching and empowering laypeople is to focus more on pressure and packing of wounds; a skill that is always fully translatable, doesn’t require anything other than a willing set of hands, and is incredibly effective, rather than tourniquets. A second question I have is whether existing tourniquets and the associated training are approaching the issue from the right angle since to me the device should be designed to not require training and continuous practice, but rather should be intuitive and simple to use, features lacking from all existing devices.   (more…)
Author Interviews, Clots - Coagulation, Heart Disease, JAMA / 05.03.2019 Interview with: Geoffrey Barnes, MD, MSc Assistant Professor Vascular and Cardiovascular Medicine University of Michigan What is the background for this study? What are the main findings? Response: Both aspirin and warfarin are commonly used medications meant to prevent thrombotic complications, but might increase rates of bleeding complications. We used a multi-center anticoagulation collaborative to explore how often patients being treated with warfarin were also taking aspirin but without a clear indication. We found that more than one-third (37.5%) of warfarin-treated patients without a clear reason for aspirin therapy were receiving aspirin. And these patients on both warfarin and aspirin experienced higher rates of bleeding and emergency department visits for bleeding than the patients taking warfarin alone. There were no differences in the rate of thrombotic events between the patients taking warfarin alone or those taking warfarin plus aspirin.  (more…)
Annals Internal Medicine, Author Interviews, Clots - Coagulation, Heart Disease / 27.02.2019 Interview with: Dr Vanessa Selak, MBChB, MPH, PhD, FAFPHM, FNZCPHM Senior Lecturer, Section of Epidemiology & Biostatistics School of Population Health Faculty of Medical and Health Sciences University of Auckland What is the background for this study? Response: In order to determine the balance of benefits and harms of aspirin in primary prevention there’s a need to know an individual’s risk of CVD and their risk of a major bleed without aspirin. We have lots of equations that can be used to determine, among people considering aspirin for primary prevention, an individual’s risk of CVD, but few bleeding risk equations that can be used to determine their risk of a major bleed. We sought to develop a bleeding risk equation that can be used to determine the risk of a major bleed among people in whom aspirin is being considered for the primary prevention of CVD. (more…)
Author Interviews, Pharmacology / 02.12.2016 Interview with: Dr. Charles Pollack MD Professor of Emergency Medicine Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia. What is the background for this study? What are the main findings? Response: RE-VERSE AD™ is a multinational, open-label cohort Phase III trial studying the safety and efficacy of idarucizumab (PRAXBIND) to reverse the anticoagulant effects of dabigatran (PRADAXA) in patients with life-threatening or uncontrolled bleeding, or those who require emergency procedures. It is the largest patient study investigating a reversal agent for a novel oral anticoagulant (NOAC) in real world emergency settings. At the American Heart Association’s Scientific Sessions 2016, we presented updated results from 494 patients participating in the ongoing study, showing that administration of 5g of idarucizumab immediately reversed the anticoagulant effect of dabigatran. (more…)