Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor-in-Chief Cardiology eMedinewS

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Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor-in-Chief Cardiology eMedinewS

Dr. Jacques Busquet is President of the International Society of Endovascular Specialists (ISES). He is currently coordinator of Vascular and Endovascular Service at the Clinique Chirurgicale Val d’Or – Saint Cloud, Paris, France.

Endovascular surgery has advanced so much that today one can do interventions from head to toe in any vessel. The need for surgery is reducing day by day. Interventions are now becoming less and less aggressive with reduced hospital stay. The techniques are more advanced with better prostheses, guidewires, stent catheters etc. For the younger generation of intervention cardiologists and vascular interventional specialists, who are getting trained in interventional procedures, treatment today has become easier than before; however, it is not for prevention but only for curative procedures.

In the west, the stent graft can be put in any vessel; however, it is important to perfectly size the graft to get the best results.

The use of the imaging cardiology is equally important.

At the International Society of Endovascular Specialists with 1500 members from 60 countries, we are working towards providing a uniform standard of care. The aim of the society is to produce endovascular intervention cardiologists so that the same treatment is provided irrespective of country you are getting treatment in.

It is very unfortunate that most stents are made in the US and hence their cost is high. More and more research should be held in every country to make indigenous stents and the least expensive stents. The dream of our organization is that the standard of care should be disease specific and not country specific. One should be able to provide same standard of care irrespective of the centre or country he or she is being operated.

New treatment for acute asthma in children

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According to a randomized controlled, double-blind study by Dorit Ater, MD, from Tel Aviv University in Israel, and colleagues published in May 21 in the journal Pediatrics, the use of hypertonic saline inhalations with albuterol (salbutamol) among preschool children with acute wheezing is associated with lower hospital admission rates and shorter hospital stays but is not linked with improved clinical scores. The use of HS treatment with albuterol given to acutely wheezing children in the emergency department comprises 4 mL of HS 5% given with albuterol twice, every 20 minutes.

This was the first study to examine HS treatment in preschool children (32 ± 17 months of age) with a wheezing episode. Most wheezing episodes causing hospitalization or emergency department visits in preschool children are associated with viral respiratory tract infections.

The most common viruses are rhinoviruses, detected in the lower airways and leading to lower airway inflammation. Hypertonic saline (HS) 5% may reverse some of the pathophysiologic abnormalities attributed to virus-induced acute wheezing episodes in small children because of promucus clearance and prohydration.