LMITransactions&Report2014-15

More documents

Recommendations

Info

LMI Transactions and Report 2014 - 2015 ethical principles regarding human experimentation developed for the medical community by the World Medical Association. The presentation will seek to inform the audience about what led to the Nuremberg Trials - and invite them to reflect on whether it is unethical to use information gained from Nazi experiments, or if to ignore it would mean millions of people ‘died for nothing’. Sophie Gealy-Evans - Runner-Up ‘Anaesthesia in the First World War’ Anaesthetics is now considered an essential part of medicine, but in 1914 it was a game of trial and error. The First World War was a brutal massacre of life, for which both soldiers and medical professionals were severely unprepared. There was a sudden advancement in anaesthetic techniques in this period (1914-1918), during which a massive need for pain relief and emergency treatment resulted in the established role of the anaesthetist. Out of the desperation came innovative new ways to deal with casualties and poor facilities. I believe there were three key elements that were outcomes of the harsh conditions of war - the role of the anaesthetist, the development of anaesthetic agents and their administration and the better understanding of the physiology behind them. In this presentation, I would like first to give some background on what was already known about anaesthetics at the time, and then consider how each of these three aspects developed, and why the War was so integral in their progression. On the year of its centenary, it is especially important that we recall how this war shaped and moulded these three elements, and I will consider how the setting of World War I was both a catalyst, and limiting factor, to the advancements of anaesthetics, which shaped the course of new advancements. It should be remembered whilst looking at new developments in the war zone that these must be fully explored and adapted to civilian life, away from the limitations of combat, so that positives can be taken from the horrific situations from where they came. I believe it is a topical subject, and an educational way to pay respect to those who died during the First World War. 22
LMI Transactions and Report 2014 - 2015 Minutes of the Third Ordinary Meeting Held on Thursday 20th November 2014 ‘Catheter Ablation for Cardiac Arrhythmias: What’s New?’ Dr Dhiraj Gupta, Consultant Cardiologist and Electrophysiologist, Liverpool Heart and Chest Hospital ‘Device Therapy for Heart Failure’ Dr Richard Snowdon, Consultant Cardiologist and Electrophysiologist, Liverpool Heart and Chest Hospital The President introduced Dr Dhiraj Gupta and Dr Richard Snowdon from the Liverpool Heart and Chest Hospital. In his introduction he reflected on his own memories of cardiology and how things have changed in the intervening years. Dr Gupta introduced his subject of arrhythmia ablation, explaining that the Liverpool Heart and Chest Hospital served a population of 2.8 million and carried out around 1200 procedures per year. The ablation of cardiac arrhythmias relies on mapping the focus generating the arrhythmia and then delivering either heat or cold to that area. Intravascular catheters are able to locate the focus of the generation of the arrhythmia to deliver an electrical burn and to measure the temperature, or as an alternative, to deliver cold. The technique may be used to treat supraventricular tachycardias, atrial flutter, Wolff-Parkinson-White syndrome and re-entry tachycardias, atrial fibrillation being increasingly common. Paroxysmal atrial fibrillation is the most common arrhythmia treated, and untreated can result in serious disability with shortness of breath and stroke, symptomatic spells and may reduce life expectancy significantly. In around 2000 it had been determined by intracardiac electrical mapping that the commonest position was around the origins of the pulmonary veins and creating a circular scar around this area had an 80% success rate in suppression of such arrhythmias. A cryo generating balloon was also very effective and could reduce the symptomatic rate by 80-90%. In the last decade of the 20th century, a surgical approach had been adopted using basket electrodes in the atrium to map arrhythmia origins followed by surgical burning. This technique sometimes involved 2 or 3 procedures but had an 80% success rate. The ability to carry out this procedure by intracardiac catheter had now superseded the surgical approach. The procedures were not without some complications, but these were increasingly uncommon with increasing experience. Bleeding from the catheter entry site, usually in the groin, tamponade from perforation and the accumulation of intrapericardial fluid were not unknown but were increasingly uncommon, particularly with the advent of ultrasound guidance to determine accurately the catheter position. Subsequently pulmonary vein stenosis at the site of the scar was not unknown but rare. The starting point for consideration of catheter ablation of arrhythmias was the failure of drug antiarrhythmic treatment. There is now approximately ten years’ experience of catheter ablation with good long term results gradually accumulating. Dr Richard Snowdon discussed recent advances in implanted devices, in particular, pacemakers for the treatment of heart block and bradicardias, for the termination of tachyarrhythmias and resynchronisation of atrial and ventricular 23
Page 1 and 2: Liverpool Medical Institut ion Tran
Page 3 and 4: Liverpool Medical Institution Regis
Page 5 and 6: LMI Transactions and Report 2014 -
Page 9 and 10: 7 LMI Transactions and Report 2014
Page 23: LMI Transactions and Report 2014 -
Page 69 and 70: Presidents of the Liverpool Medical
Page 72: LMI Conference Centre An exceptiona

LMITransactions&amp;Report2014-15

Create successful ePaper yourself

Delete template?

Save as template?

LMITransactions&Report2014-15