A tale of two cities: STEMI interventions in developed and developing countries and the potential of telemedicine to reduce disparities in care.

Objectives: To utilize telemedicine as a foundation platform for creating population-based STEMI networks.

Background: Disparate acute myocardial infarction (AMI) management occurs in developed and developing countries on account of differences in infrastructure resources. As a result, developed countries utilize primary percutaneous coronary intervention (PCI) and second- and third-generation thrombolytic therapy, in contrast to developing countries, which primarily rely on earlier-generation thrombolytic therapy and basic medical management.

Telemedicine: The Future of Global STEMI Care.

Telemedicine is an innovative tool in the setting of ST-elevation myocardial infarction (STEMI), because it addresses the greatest challenge-delivering optimal reperfusion therapies in a timely manner. Telemedicine targets delays related to geography, distance, and stated prehospital systems of care. Integration of telemedicine into prehospital STEMI management has been shown to yield cost-effective improvements in patient care.

Door-to-Balloon ST-Elevation Myocardial Infarction Interventions: Illustrated Cases.

ST-elevation myocardial infarction (STEMI) intervention comprises 2 components, the STEMI procedure and the STEMI process, which have unique aspects that can be modified and improved, ultimately affecting patient outcome. The 15 illustrated cases in this article highlight suggested improvements mainly in the STEMI procedure, with some references as to how the authors practically improved the STEMI process for the described procedure. The illustrated procedures have been meticulously selected from more than 1000 short door-to-balloon STEMI interventions recorded in the Single Individual Community Experience Registry (SINCERE) database, and are aimed at educating the reader about unique STEMI skills.

Compulsive Thrombus Management in STEMI Interventions.

Thrombus is a fundamental concept in the pathophysiology of ST-elevated myocardial infarction (STEMI). Distal embolization and no reflow are associated with less angiographic success, reduced myocardial blush, less ST resolution after primary percutaneous coronary intervention, larger enzymatic infarct size, lower left ventricular ejection fraction at discharge, and higher long-term mortality. We believe that with the use of thrombectomy devices, these shortcomings can be minimized.

Optimal Anticoagulant Therapy in ST Elevation Myocardial Infarction Interventions.

Bivalirudin is a direct thrombin inhibitor. It is a new recommendation for the treatment of patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention. Bivalirudin combined with aspirin and P2Y inhibitors has proved to be an effective and safe choice for the management of thrombus in coronary artery disease.

Automated analysis of sleep-wake state in rats.

A fully automated computer-based sleep scoring system is described and validated for use in rats. The system was designed to emulate visual sleep scoring by using the same basic features of the electroencephalogram (EEG) and electromyogram (EMG), and a similar set of decision-making rules. State indices are calculated for each 5s epoch by combination of amplitudes (microVrms) of 6 filtered EEG frequency bands (EEGlo, d.

Amplification by long RT-PCR of near full-length norovirus genomes.

A long RT-PCR method was developed to amplify the norovirus genome. Starting from RNA extracted directly from clinical samples and using broadly reactive primers, it can generate near full-length amplicons that allow for easy determination of the near complete genomic sequence. Two norovirus isolates from Toronto, Canada, in 2002 and 2005 were sequenced.