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Biotech / Medical : World Heart Corp - WHRT and TSE/WHT

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To: Dan Hamilton who wrote (83)6/22/1998 8:01:00 PM
From: Dan Hamilton   of 500
 
Here's an article on web sites that may be of interest to those researching cardiology topics...

Cardiology Web Sites That Can't Be Beat

Author: Stephen E. Smith, PA-C, Medscape, Inc., NY.

[Information Today 15(2):11-12, February 1998.]

Introduction

Cardiology resources for the physician abound on the Internet. Medical Matrix
(www.medmatrix.org/index.asp) lists nearly 200 sites and directories. Emory
University's MedWeb (www.gen.emory.edu/medweb/medweb.cardiology.html)
directory, the other giant medical hotlist, is about 20 browser pages long. The
problem of course, is how to find the sites that are worth visiting. This article will
describe the sites that I've found most valuable when teaching cardiologists about
the Web.

The American Heart Association (www.americanheart.org)

The American Heart Association offers two primary sources of information for
physicians: the Association's Scientific Statements and their patient information
documents. The scientific statements are extensive summaries of current
knowledge and practice guidelines covering topics from Alcohol and Heart
Disease to Exercise Standards to Cardiovascular Disease in Women. The patient
information documents discuss the nature, prevention, and treatment of heart
disease, and include such items as a coronary disease risk calculator, and recipes
for "heart smart" eating. Because there are over 100 documents in each of these
collections, the fastest way to get the information you are looking for is to use the
site's search engine. You'll see a ranked results list with meaningful descriptions of
the documents listed.

Cardiovascular Drug Reviews: Medical Sciences Bulletin
(pharminfo.com/pubs/msb/msbcard.html) A much smaller site worth visiting when
you are searching for information about pharmacotherapy for heart diseases -- or
drugs that potentiate those diseases, is Cardiovascular Drug Reviews. Here you'll
find dozens of well-referenced, condensed, current literature reviews and
expanded news capsules on drugs and cardiovascular diseases. Some of the
articles contain no citation information or posting date, but most are flagged in
some way so you can determine the age of the information.

E-chocardiography Journal: An Electronic Journal of
Cardiac Ultrasound (www2.umdnj.edu/%7Eshindler/echo.html)

Don't let the name fool you. This is more than an echocardiography journal. This
site, assembled by Daniel Shindler, MD, of the University of Medicine and
Dentistry of New Jersey-Robert Wood Johnson Medical School, hosts an
extensive and up-to-date electronic hyper-textbook of cardiology.

Shindler has culled top-quality articles, abstracts, images, cases, and other
resources from multiple Web sites, and organized them into a hyperlink textbook
that provides background, diagnosis, and management information on
cardiovascular disease.

This "Shindler's List" of heart diseases is extensive, covering more than 200
entities. Under each disease is a manageable set of links.

For example, under "endocarditis" you'll find:

A nicely outlined and illustrated general introduction from Loyola
University's Stritch School of Medicine;
A brief description with references to endocarditis causes and presentation,
from Vanderbilt University;
A case presentation/quiz from Cornell;
A transesophageal echo of mitral valve vegetation posted by Shindler;
Prevention recommendations from the American Heart Association;
Letters to the editor in JAMA commenting on those AHA
recommendations;
Images and text describing some sequelae of endocarditis, and so on.

Fetal Electrocardiography Homepage
(www.med.upenn.edu/fetus/echo.htm)

This Home page of The University of Pennsylvania School of Medicine and
Children's Hospital of Philadelphia features clinical information for physicians,
medical students and healthcare professionals.

The focus is analysis of fetal echocardiograms, so if you want to hone your
understanding of pediatric echocardiography, this is the online place to go. The site
starts with dozens of "normal" views to lay the foundations, and then moves on to
the "typical" abnormal views of entities such as ventriculoseptal defect, Ebstein's
anomaly, and fetal hydrops. From there you can move on to the case library. The
design isn't pretty, and the images could use captions, but there is plenty of value
here.

HeartWeb (www.heartweb.org/)

For about the past year, this online journal has "published" issues containing one to
five articles each month. The focus is almost exclusively on pacemakers. The
articles are short, readable, and well illustrated. There is a strong offering of cases
based on evaluation of chest radiographs following pacemaker placement.

There is an excellent set of pacemaker databases that can be very useful when you
are trying to determine the performance characteristics of a pacemaker and the
patient doesn't have the information and you don't have access to the chart (it
happens all the time). In the "pulse generator" database you can find information on
about 1100 pacemaker models if you know the manufacturer. Or you can base
your search on the x-ray code of the pacer (seen in the chest radiograph)

Med Files: Cardiovascular Case Presentations
(www.geocities.com/HotSprings/2255/heart.html)

This site is a nice, comprehensive hotlist of case presentations in cardiology. The
top section of the page contains links to cardiology resources in general. Scroll
down and as you find better cardiology hotlists, you get to the second section,
which is the real meat of the site. (The links in the first section to ACLS [advanced
cardiac life support] treatment protocols, diagnosis and management guidelines for
unstable angina are worth following later).

The second section contains links to a couple score of cardiology teaching cases
on topics from angina, to iron overload and Leriche's syndrome, to viral
myocarditis. The cases are as diverse as the institutions they come from. Some
have quiz questions; many have images. Some of the links are dead, but that's
pretty much the rule for any hotlist. The live links here are worth the cost of the
occasional dead one.

Medscape (www.medscape.com)

(conflict of interest statement: the author of this article works at Medscape. But
given his humble nature, he guarantees that the description below is a gross
understatement of what the site offers.)

On Medscape's Cardiology Specialty page the first thing you'll notice is list of
articles running in the center column. These are all full-text, practice-oriented,
illustrated and hyperlinked medical journal articles. New articles are posted every
day.

One of the things I really like about this site is the way the editors link articles and
other resources together to construct useful information trails. Examples of this are
the way that articles on related subjects are linked together, articles are linked to
news stories and discussions about the topic of the article, and drugs mentioned in
article abstracts are linked to automated searches in the online drug database.

There are generally about 10 current articles on the cardiology page. Check the
archive pages if you want to browse further. If you are looking for something in
particular, I highly recommend searching: there are more than 250 cardiology
articles on Medscape, and more than 14,000 articles altogether.

From the Cardiology Specialty page you can branch out and run a Drug Search to
investigate drugs that treat (or even worsen) heart diseases, perform a MEDLINE
search, look for patient information on heart diseases, earn CME credit, and read
cardiology news and reviews.

Some of the "don't miss" items are the ECG of the Week series, the Acute
Myocardial Infarction (AMI) clinical calculator, and the conference news
coverage. The ECG of the Week feature lets cardiologists and primary care
physicians test their diagnostic skills on ECGs submitted by series editors Kyuhyun
Wang, MD and J. Willis Hurst, MD (editor of "The Heart"). The AMI clinical
calculator provides instruction and assistance in the difficult task of diagnosing
acute myocardial infarction in the presence of left bundle branch block. Conference
news coverage features same-day posting of summaries of selected sessions from
medical conferences. Summaries from the American College of Cardiology 47th
Annual Scientific Session are currently available.

Pediatric Cardiology Almanac
(www.neosoft.com/%7Erlpierce/pc.htm)

This site offers several well-constructed "multimedia" reviews of congenital
diseases. I liked these because the text length and content was appropriate for an
introduction/review for the medical professional, and in each case the diagnostic
image is accompanied by a line drawing explaining what is seen.

There is an extensive section on evaluating pediatric ECGs. This begins with a
"slide show" of text descriptions of what you'll find in normal newborn and preterm
ECGs. You then move on to descriptions of how different abnormalities manifest
on the ECG. Some of the text slides are illustrated with example QRS complexes.
Real ECGs aren't used. There are also libraries of echocardiographic (small) and
angiographic (larger) images.

The Virtual Hospital -- Information by Organ System:
Cardiovascular
(www.vh.org/Providers/ProviderOrgSys/OSCardiovascular.html)

The Virtual Hospital's Cardiology section is a well-focused, professional resource.
It includes a multimedia textbook on pulmonary embolus (PE), multimedia lectures,
and assorted associated resources. (Multimedia is a bit of an overstatement here,
but the prolific illustrations are excellent.)

The textbook consists of short chapters on PE presentation and diagnosis. It is well
illustrated with enlarging thumbnails of radiographs. One of the best aspects is the
30 case reports of PE that illustrate its many presentations.

There is a pediatric cardiac disease index, covering all the better known congenital
conditions. Each document is given in a short format including presentation,
etiology (pathophysiology), pathology, imaging findings, and a helpful list of
differential diagnosis considerations.

The lecture on hypertensive emergencies is quite good, as are the treatment
guidelines on initiating beta blockers in heart failure, and therapeutic options for
advanced heart failure.

Conclusion

If we didn't have to stop here I would go on to describe several other sites that I
find valuable. But I'm very late on my deadline and I'm pushing the word count
limit. So I'll recommend the above as excellent starting points for finding cardiology
resources on the Internet and you can expand your exploration from these as
needed.


About the Author
Stephen E. Smith, PA-C, Stephen E. Smith is VP and Editorial Director for Medscape, Inc.
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