Radial or Femoral essay

Radial or Femoral essay Introduction Transradial and transfemoral approaches are two different types of techniques that are used to perform diagnostic percutaneous coronary intervention (PCI) and coronary angiography (CA). Transradial approach is currently being used as the most effective alternative approach for cardiac catheterization to transfemoral approach. This is because of the several benefits it has for the patients over transfemoral approach. This paper provides the advantages and the benefits of transradial approach over transfemoral approach in creating care value for PCI and CA patients. Chuntao W Ed. (2011). The Transradial Approach is Associated with Lower Risk of Adverse Outcome Following Percutaneous Coronary Intervention. A Single-Center Experience , 1-9. In this article, the authors are aimed at testing the hypothesis that the transradial approach is more linked to the lower risks of bad results in accordance to percutaneous coronary intervention (PCI) more than transfemoral approach (Chuntao W Ed, 2011). It also analyses whether the approval of transradial approach can lead to improved quality management of PCI in a single center practice (Chuntao W Ed, 2011). ). The researchers identified and reviewed 625 transfemoral and 462 transradial cases that were treated at their center from January 2007 to March 2009. During the treatment of risks associated with hospital mortality, vascular complications and bleeding, the researchers tried to examine the major differences that exist between transfemoral and transradial approaches (Chuntao W Ed, 2011). ). From the research analysis, the researchers established that exposure to bleeding was very much lower in the transradial patients than transfemoral group with the following percentag es, 2.60 percent and 6.08 percent respectively (Chuntao W Ed, 2011). Transradial patients also have lower risks of vascular complications (0 percent) than transfemoral patients (1.44 percent). The mortality rate observed in the hospital indicated that, it was lower for transradial approach (0.87 percent) than transfemoral approach (2.24 percent). Some-day discharges were less common in transfemoral patients than transradial patients (2.2% versus 14.2%) Chuntao W Ed, 2011). From the research results, the researchers established that risk of vascular complications and bleeding were lower for transradial approach and therefore its adoption may lead to improved quality care for PCI. In support of their findings, other scientific studies have also established that patients who receive PCI via radial arteries were less at risk of developing vascular complications and bleeding when compared to patients who receive it through femoral arteries (Chuntao W Ed, 2011). In addition, transrad ial approach was also established to be associated with lower risk of mortality than transfemoral approach. Researchers therefore agree that, radial approach should be adopted for improving quality of care to PCI patients in a specified center of practice Chuntao W Ed, 2011). Sandy M. (2010). Procedure Provides Comfort and Convenience, Reduces Complications of Cardiac Intervention. Radial Artery Catheterization makes a Comeback , 1. This article is about a coronary disease patient, Floyd, who suspected himself of being attacked by heart attack after performing a strenuous activity. He immediately called his doctor on Friday afternoon who instructed him to head straight to the emergency room (Sandy, 2010). Following his two past cardiac catheterization procedures, he was very afraid to undergo it again due to pain he experienced. But after being examined, the doctor established that he suffered no heart attack, but catheterization was still required to diagnose the cause of the chest pain and to treat it if possible. Something that interested Floyd most is that a new technique that would minimize discomfort was going to be used during catheterization process (Sandy, 2010). The method that was used in catheterization process is radial approach. This approach is becoming a very popular treatment technique that is used to treat blocked arteries. This is because of the improved tools, medicine and devices used. Acco rding to the article, patients requiring catheterization need to be diagnosed through radial approach (Sandy, 2010). This is because, through radial artery, the doctors can handle bleeding more appropriately and patients can thereafter, walk and eat. But with the femoral artery, patients leave the theater rooms with a sheath in the femoral artery (Sandy, 2010). After this process patients can not resume their duties because they have to stay in the hospital beds for up to ten hours while bleeding is being controlled depending on the degree of anticoagulants received. With the radial approach, the doctor assured Floyd he was to get back home on the following day and resume work only after three days of rest. Radial approach is more effective and comfortable for treating blocked arteries as compared to femoral approach since it is less complicated, comfortable and bleeding can easily be controlled after the process (Sandy, 2010). With the advent of radial approach, Floyd doctor believ es that patients with cardiac intervention will leave the hospital beds the same day after being treated. Schussler J. M. (2011). Effectiveness and Safety of Transradial Artery Access for Cardiac Catheterization. 1. This article suggests that transradial approach is slowly become more popular in coronary angioplasty and angiography than transfemoral approach (Schussler, 2011). This approach has several benefits to the patients such as reduced discomfort, reduced bleeding and low costs. Diagnosis of coronary angioplasty and angiography are usually characterized by several risks including excessive bleeding, stroke and death. Despite of the increased use of ad hoc angioplasty and blood thinners, exposure to these risks has remained stable. This is because the procedures involved in transfemoral technique are complex since they involve femoral access (Schussler, 2011). In order to take care of this situation, transradial technique was described in late 1980s and it is currently being considered as the best alternative to replace traditional femoral technique. In transradial approach, the risks of damaging the limbs are minimal since there is enough supply of blood from ulnar artery to palmar arch (Schussler, 2011). In transfemoral technique, coronary angioplasty and angiography are performed after drugs that reduce arterial thrombosis and spasm are administered. One of the advantages of transradial technique is that in this process, certain types of specially shaped catheters are used, and they enable the doctors to access both right and left coronary angiograms including venticulogram without switching different catheters (Schussler, 2011). One of the major benefits of transradial approach over transfemoral approach is the reduction in the number of complications that results after the diagnosis. Another benefit of transradial technique is the patient satisfaction. The patients are able to get back home on the same day of treatment and resume working three days after unlike transfemoral technique that required the patients to stay in the hospital beds for more than ten days depending in the complications they receive after the process (Schussler, 2011). Conclusion Both transradial and transfemoral approaches are for diagnostic percutaneous coronary intervention and for coronary angiography. Transfemoral approach, however, is results into several problems after it is performed. The acknowledgement of transradial approach provided an effective basis over which these problems can be solved. Radial approach has thus been established as the best alternative approach diagnostic PCI and CA. It has several benefits to the patients which include low cost of treatment, reduced bleeding , less time spent ihn the hospital beds and they are able to resume their jobs only three days after treatment, and this is supported by all the three articles summarized above.

The U.S. Environmental Movement

The U.S. Environmental Movement When did the U.S. environmental movement begin? Its hard to say for sure. Nobody held an organizing meeting and drew up a charter, so there is no absolute definitive answer to the question of when the environmental movement really began in the United States. Here are some important dates, in reverse chronological order: Earth Day April 22, 1970, the date of the first Earth Day celebration in the United States, is often cited as the start of the modern environmental movement. On that day, 20 million Americans filled parks and took to the streets in a nationwide teach-in and protest about critical environmental issues facing the United States and the world. It is probably around that time that environmental issues also truly became political issues. Silent Spring Many other people associate the beginning of the environmental movement with the 1962 publication of Rachel Carsons groundbreaking book, Silent Spring, which spelled out the dangers of the pesticide DDT. The book awakened many people in the United States and elsewhere to the potential environmental and health hazards of using powerful chemicals in agriculture and led to a ban on DDT. Up until that point, we understood that our activities could be harmful to the environment, but Rachel Carsons work suddenly made it clear to many of us that we were also harming our bodies in the process. Earlier, Olaus and Margeret Murie were early pioneers of conservation, using the burgeoning science of ecology to encourage the protection of public lands where functioning ecosystems could be preserved. Aldo Leopold, a forester who later laid the foundations of wildlife management, continued focusing ecological science on the quest for a more harmonious relationship with nature.   A First Environmental Crisis An important environmental concept, the idea that active engagement by people is necessary to protect the environment, probably first reached the general public at the very beginning of the 20th century. During the period 1900-1910, wildlife populations in North America were at an all-time low. Populations of beaver, white-tailed deer, Canada geese, wild turkey, and many duck species were almost extinct from market hunting and loss of habitat. These declines were obvious to the public, which largely lived in rural areas at the time. As a result, new conservation laws were enacted (for example, the Lacey Act), and the very first National Wildlife Refuge was created.  Ã‚   Still, others might point to May 28, 1892, as the day when the U.S. environmental movement began. That is the date of the first meeting of the Sierra Club, which was founded by noted preservationist John Muir and is generally acknowledged as the first environmental group in the United States. Muir and other early members of the Sierra Club were largely responsible for preserving the Yosemite Valley in California and persuading the federal government to establish Yosemite National Park. No matter what first sparked the U.S. environmental movement or when it actually began, its safe to say that environmentalism has become a powerful force in American culture and politics. Ongoing efforts to understand more clearly how we can use natural resources without depleting them, and enjoy natural beauty without destroying it, is inspiring many of us to take a more sustainable approach to the way we live and to tread a little more lightly on the planet. Edited by Frederic Beaudry.