Recommended Reading

1) Perkins GD, et al. Brain injury after cardiac arrest. Cardiac Arrest 2021;398(10307):P1269-78. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00953-3/fulltext

As more people are surviving cardiac arrest, focus needs to shift towards improving neurological outcomes and quality of life in survivors. Brain injury after resuscitation, a common sequela following cardiac arrest, ranges in severity from mild impairment to devastating brain injury and brainstem death. Effective strategies to minimise brain injury after resuscitation include early intervention with cardiopulmonary resuscitation and defibrillation, restoration of normal physiology, and targeted temperature management. It is important to identify people who might have a poor outcome, to enable informed choices about continuation or withdrawal of life-sustaining treatments. Multimodal prediction guidelines seek to avoid premature withdrawal in those who might survive with a good neurological outcome, or prolonging treatment that might result in survival with severe disability. Approximately one in three admitted to intensive care will survive, many of whom will need intensive, tailored rehabilitation after discharge to have the best outcomes.

2). Coronavirus vaccine protection was much weaker against omicron, data shows. https://www.washingtonpost.com/health/interactive/2022/vaccine-protection-was-much-weaker-against-omicron-cdc-data-shows/

3) LAVA ECMO Might Benefit Patients With Cardiogenic Shock. https://medicaldialogues.in/cardiology-ctvs/news/lava-ecmo-might-benefit-patients-with-cardiogenic-shock-88301

4) Aengevaeren VL. Exercise-induced Cardiac Troponin Elevations. From Underlying Mechanisms to Clinical Relevance. Circulation. 2021;144(24):1955-72. https://www.medscape.com/viewarticle/967160_1

Serological assessment of cardiac troponins (cTn) is the gold standard to assess myocardial injury in clinical practice. A greater magnitude of acutely or chronically elevated cTn concentrations is associated with lower event-free survival in patients and the general population. Exercise training is known to improve cardiovascular function and promote longevity, but exercise can produce an acute rise in cTn concentrations, which may exceed the upper reference limit in a substantial number of individuals. Whether exercise-induced cTn elevations are attributable to a physiological or pathological response and if they are clinically relevant has been debated for decades. Thus far, exercise-induced cTn elevations have been viewed as the only benign form of cTn elevations. However, recent studies report intriguing findings that shed new light on the underlying mechanisms and clinical relevance of exercise-induced cTn elevations. We will review the biochemical characteristics of cTn assays, key factors determining the magnitude of postexercise cTn concentrations, the release kinetics, underlying mechanisms causing and contributing to exercise-induced cTn release, and the clinical relevance of exercise-induced cTn elevations. We will also explain the association with cardiac function, correlates with (subclinical) cardiovascular diseases and exercise-induced cTn elevations predictive value for future cardiovascular events. Last, we will provide recommendations for interpretation of these findings and provide direction for future research in this field.

5). McCall B. Inside Insulin (Part 1): The Feuds and Vitriol Behind the Discovery of This Life-Saving Therapy. 2022. https://www.medscape.com/viewarticle/967711

Editor’s Note: This is the first in a two-part series commemorating the 100 year anniversary of the first use of insulin in humans.

6). McCall B. Inside Insulin (Part 2): Approaching a Cure for Type 1 Diabetes? 2022. https://www.medscape.com/viewarticle/969298

Editor’s Note: The second part focuses on how insulin and the treatment of type 1 diabetes have changed over the past 100 years and what to expect in the next 100.

7). Sallnow L. Report of the Lancet Commission on the Value of Death: bringing death back into life. The Lancet Commissions. 2022;399(10327):P837-84. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02314-X/fulltext

The story of dying in the 21st century is a story of paradox. While many people are overtreated in hospitals with families and communities relegated to the margins, still more remain undertreated, dying of preventable conditions and without access to basic pain relief. The unbalanced and contradictory picture of death and dying is the basis for this Commission.

How people die has changed radically over recent generations. Death comes later in life for many and dying is often prolonged. Death and dying have moved from a family and community setting to primarily the domain of health systems. Futile or potentially inappropriate treatment can continue into the last hours of life. The roles of families and communities have receded as death and dying have become unfamiliar and skills, traditions, and knowledge are lost. Death and dying have become unbalanced in high-income countries, and increasingly in low-and-middle-income countries; there is an excessive focus on clinical interventions at the end of life, to the detriment of broader inputs and contributions.

8). Gene-editing treatment for Sickle cell Anemia.https://www.bbc.com/news/health-60348497

9) Grant L, Khan F. The precariousness of balancing life and death. The Lancet 2022;399(10327):P775-777. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00162-3/fulltext#seccestitle10

Despite the centrality of death to our lives, people from many societies avoid meaningful conversations about death, and its value as a fundamental human experience has been largely lost. Diminishing the inevitability and humanity of death has obscured our understanding of health and life.

10) The Illustrious Patient – Diseases of Famous People. https://www.medscape.com/slideshow/illustrious-patient-6014879?uac=346576HG&faf=1&sso=true&impID=4061062&src=mkm_ret_220307_mscpmrk_trdalrt_int

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