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Rebel Category: REBEL EM

Tenecteplase for Thrombolysis of AIS?

Background: Alteplase has been the accepted thrombolytic for acute ischemic stroke (AIS) for 25 years. However, recent data has emerged regarding tenectaplase as an alternative.  Tenecteplase is a modified form of alteplase, with a lower cost and more favorable pharmacokinetic ...

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Neurology

The RECOVERY Trial: Tocilizumab

Background: Publication of the RECOVERY trial results on Dexamethasone were game changing – the drug had a clear reduction in mortality in patients requiring oxygen. Since then, we have had little to celebrate in terms of therapeutics in those with ...

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Infectious Disease

APPAC II: Treatment of Uncomplicated Acute Appendicitis

Background: The recently published CODA trial (Link is HERE) comparing antibiotics vs laparoscopic appendectomy for acute uncomplicated appendicitis demonstrated  an antibiotic 1st strategy was non-inferior to laparoscopic appendectomy. However, there were nearly 3 in 10 patient who had undergone appendectomy ...

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Abdominal and Gastrointestinal

OMI-NOMI: Time for a Paradigm Shift

Background: What if we lived in a world where we didn’t call “STEMI alerts”, but instead paged out “OMI alerts”? In the Reperfusion Era of the late 20th century, many large trials showed the benefits of emergent reperfusion therapy, with even ...

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Cardiovascular

Wake Up In Beast Mode

What do Warren Buffet, Tim Cook, Michelle Obama, Oprah Winfrey, and Jack Dorsey have in common? They are all highly successful people with a penchant for rising early. Two additional people I find incredibly motivating, Jocko Willink and Eric Thomas, ...

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