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Journal and News Scan

Source: American College of Cardiology
Author(s): Marc P. Bonaca

Short but promising follow-up: the intervention appears again to trade off short-term peripheral vascular complications for hitherto semi-qualified MAJOR bleed in patients undergoing revascularization for peripheral vascular disease, for an assumed considerable financial cost.

Source: The New England Journal of Medicine
Author(s): Avan K. Bhatraju, Bijan J. Ghassemieh, Michelle Nichols, Richard Kim, Keith R. Jerome, Arun K. Nalla, Alexander L. Greninger, Sudhakar Pipavath, Mark M. Wurfel, Laura Evans, Patricia A. Kritek, T. Eoin West, Andrew Luks, Anthony Gerbino, Chris R. Dale, Jason D. Goldman, Shane O’Mahony, Carmen Mikacenic

Useful series from the Pacific North West, main questions:

-Why four patients who had a do-not-resuscitate order on admission were included in the dead and, ultimately, why been admitted in an ITU/ICU setting?

-How come no sputum samples from nine fatalities were ever sent for bacterial culture in an ITU/ICU setting?

It has been highlighted by experts such as Ioannides of Stanford that, since we cannot/will not screen for this elusive SARS-associated virus, we cannot computate mortality nor ultimately ascribe CAUSATION. 

Source: Circulation Research
Author(s): Floriana M Farina, Ignacio Fernando Hall, Simone Serio, Stefania Maria Zani, Montserrat Climent, Nicolò Salvarani, Pierluigi Carullo, Efrem Civilini, Gianluigi Condorelli, Leonardo Elia , Manuela Quintavalle

Interesting to follow up the translational potential of this rodent-model of carotid intimal re-hyperplasia/stenosis.

Source: JAMA Cardiology
Author(s): Shaobo Shi, Mu Qin, Bo Shen, Yuli Cai, Tao Liu, Fan Yang, Wei Gong, Xu Liu, Jinjun Liang, Qinyan Zhao, He Huang, Bo Yang, Congxin Huang

In a cohort of 416 patients hospitalized with COVID-19, nearly 20% had elevated troponins indicating myocardial injury.  These patients also had a host of other serum and radiographic abnormalities, were older, had more comorbidities, and more often required ventilatory support.  Their mortality rate was 51% compared to 4.5% for other hospitalized patients.  Elevated troponins were an independent predictor of mortality (HR 4.26).

Source: New England Journal of Medicine
Author(s): Ezekiel J. Emanuel, Govind Persad, Ross Upshur, Beatriz Thome, Michael Parker, Aaron Glickman, Cathy Zhang, Connor Boyle, Maxwell Smith, James P. Phillips

A frank, eye opening discussion with specific recommendations about allocating scarce resources in a time of pandemic.

Source: New England Journal of Medicine
Author(s): Robert D. Truog, Christine Mitchell, George Q. Daley

A thoughtful commentary about the need for a triage committee to determine the optimal allocation of ventilators in a time of competing needs, and how these determinations are best communicated to caregivers and families.

Source: Journal of Critical Care
Author(s): Andrea Cortegiania, Giulia Ingoglia, Mariachiara Ippolitoa, Antonino Giarratanoa, Sharon Einavb

This is an interesting systematic review looking at the evidence so far for chrloroquine for COVID. it is a fast moving field but this cheap option to treat coronavirus may soon become accepted for treatment once the studies have been fully evaluated. 

Source: Canadian Journal of Anesthesia
Author(s): Lian Kah Ti, Lin Stella Ang, Theng Wai Foong, Bryan Su Wei Ng

Succinct recommendations for the management of COVID-19 cases in the operating room.  Includes infographic outlining comprehensive operating room workflow, detailing the roles and responsibilities of each OR team member.

Source: The Lancet
Author(s): Michael A Matthay, J Matthew Aldrich, Jeffrey E Gotts

A succinct comment with a wealth of up-to-date references vis-a-vis the SARS-CoV-2 pandemic.

Author(s): John P.A. Ioannidis

Interesting input from a Stanford expert on the hottest topic on the planet at the moment.