Coronary Angioplasty of Bifurcational Lesions: Use of Simultaneous Over-the-Wire and Probe™ Systems

Different techniques have been used to perform coronary angioplasty of bifurcational lesions. Advantages and disadvantages of the kissing balloon technique, the single guiding-double wire technique, and the double Probe(tm) technique are reviewed. We describe a new technique for coronary angioplasty of bifurcational lesions through a single guiding catheter that has advantages of both the over-the-wire and the Probe(tm) systems.     

Health policy, epidemiology and power: the interest web

The relation between epidemiological research results and policy-making is reviewed. Apparently, traditional models of policy-making(incrementalism, mixed scanning synoptic planning) do not explainwhy research findings are hardly used in policy-making procedures. It is suggested that this phenomenon is related to three determinantsof policy-making: (i) a bias stemming from sets of causal, finaland normative assumptions and presuppositions; (ii) interestwebs of groups in certain domains; and (iii) the power of organizationsto monitor and communicate. The conclusion is that epidemiologistsshould engage in the policy-making process more consciouslyand conscientiously.     

EFFECTS OF OMEPRAZOLE, RANITIDINE, FAMOTIDINE AND LACEBO ON GASTRIC SECRETION IN PATIENTS NDERGOING ELECTIVE SURGERY

We have compared the effects of omeprazole, ranitidine, famotidineand placebo on gastric secretion in a double-blind study in110 patients undergoing elective surgery. Three hours beforeoperation, the patients received, orally, omeprazole 40 mg,ranitidine 150 mg, famotidine 40 mg or placebo. Gastric volumeand pH were measured immediately after induction of anaesthesia.Omeprazole, ranitidine and famotidine produced a significantincrease in gastric pH and a significant decrease in gastricvolume compared with placebo. When the effects of omeprazoleon gastric volume were compared with those of ranitidine andfamotidine, no significant difference was found, but omeprazolewas significantly less effective in increasing gastric pH. Thenumber of patients having a pH less than 2.5 and a volume greaterthan 0.4 mlkg^–1 were: none in the ranitidine group, one(3%) in the famotidine group, four (15%) in the omeprazole groupand six (23%) in the placebo group. We conclude that omeprazole40 mg given 2–4 h before surgery does not afford adequateprophylaxis for the acid aspiration syndrome.