Evidence has consistently demonstrated the lack of clinical utility provided by natriuretic peptides. Further studies documenting their incompetencies are no longer necessary, but it is rather enjoyable to highlight their dependable failures. The most recent illustration of natriuretic peptides clinical ineptitude was published this week in CIRCULATION by Stienen et al (1). … [Read more...]
EMNerd
The Nihilistic Ramblings of Rory Spiegel, MD
EM Nerd-The Case of the Tardy Delegate Continues
In 2000 Fazzini et al published a paper comparing the use of ionization vs photoelectric smoke alarms in rural Alaskan homes (1). The authors noted that at the time of the article’s publication. the fire fatality rate for native Alaskans was 9.6 times the national rate and 3.5 times higher than the general rate in Alaska. Since working fire alarms have been shown to reduce the … [Read more...]
EM Nerd-The Case of Corporeal Clock
How exactly do trialists proceed when deciding upon the appropriate acronyms for their soon-to-be blockbuster trial? Is the proper etiquette to follow a traditional prospective process, utilizing the first letter of each word in a trial’s longer title? Or is the selection of an acronym based on its ability to inspire and only then, retrospectively conceive of a full title? In … [Read more...]
EM Nerd-The Case of the Inert Remedy
In 1959 Cobb et al published a trial of 17 patients investigating the efficacy of internal mammary artery ligation for the treatment of symptomatic angina. The authors randomized 17 patients “seriously limited by angina” to either bilateral internal mammary artery ligation or a blinded sham procedure (1). At 6-months follow up the authors reported the patients in both groups … [Read more...]
The Case of an Ugly Truth
The great tragedy of Science — the slaying of a beautiful hypothesis by an ugly fact. -Thomas Henry HuxleyThe use of lung protective ventilation has become ubiquitous in the culture of critical care medicine. And while its logistical implementation has not … [Read more...]