Dabigatran versus Warfarin in Patients with Mechanical Heart Valves
Sep 16 2013- Details
The use of dabigatran in patients with mechanical heart valves was associated with increased rates of thromboembolic and bleeding complications, as compared with warfarin, thus showing no benefit and an excess risk.
WASP Meeting 2013
Sep 14 2013- Details
Minutes of the meeting of
Welsh Association of Stroke Physicians 7/3/13
Bangor.
Welcome at 17.55
Attendees: Dick Dewar, K N Ganeshram, Yaqoob Bhat, V Adhiyaman,
Bim Bhowmick, Ailsa Dunn, Tony Starczewski, Gordon Black, Praphull
Shukla, Rajeev Mammachan, Jonathan Hewitt, Salah Elghenzai.
Apologies: Anthony White, Shakeel Ahmed, Hamsaraj Shetty, Tom
Hughes, Mujtaba Hasan.
1) 18.00 Meeting started with presentation by Dr K N Ganeshram
on ‘ Telestroke North Wales’ showing the number of stroke
thrombolysis trebled since inception of 24/7 thrombolysis. Further
discussion ensued about home connections for stroke physicians on
rota. Dr Freeman explained that it is gradually rolled out across
Wales.
2) Minutes of previous meeting was agreed as true reflection of the
proceedings.
3) Stroke sentinel audit was in the agenda but was discussed
quickly as all health boards are supported by DSU, lead by Dr A
Freeman. The improvement that has occurred was appreciated. But
all agreed that the pressure need to be sustained to continue the
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improvement.
4) Weekly telestroke MDT meeting happens on Wednesday
afternoon. This meeting has improved communication between
physicians in South Wales as this also discuss management issues.
But North Wales clinicians are not able to join the meeting on
Wednesdays. Dr Ganeshram informed that North Wales has one
MDT per month on the last Thursday afternoon to discuss all out of
Hours thrombolysis. Also once a month Dr Ian Turnbull, retired
Neuroradiologist (ASTRACAT course) lead a meeting in Glan
Clwyd on first Tuesday afternoon. All suggested that Dr
Ganeshram to write to Tom Hughes suggesting that one of the
South Wales meeting be organised on a Tuesday for North Wales
clinicians to join. ACTION: Dr KNG to write to Tom.
5) Further discussions happened in regards to criteria’s for
hemicraniectomy in stroke. Neurosurgery department in Walton,
Liverpool has an online referral system. It was decided that this has
to be discussed in detail on a later date.
6) TIA and Rehabilitation bundles: It was decided that the existing
resources is making it extremely challenging for teams to fill in
these data.
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7) SSNAP: members had a lengthy discussion about intelligent
targets and the new SSNAP from RCP. Dr Freeman mentioned that
Health boards across Wales are to join the first 72 hours SSNAP
audit by July 2013. It was also mentioned that RCP is doing a
training meeting for teams on 15/3/13 at 1pm. Possibly from
November 2013, Wales will join the SSNAP in its full form.
Intelligent targets may be phased out over this time period.
Next meeting 20/6/2013 .