 Updated 28/01/2019 While this website concentrates on finding relevant publications from the world of Critical Care, there are always papers from other fields that attract our attention. Recently, a remarkable detail from a publication of an even more noteworthy journal has been brought to our notice. I admit I rarely read articles on 'Nature', but this article is worth a very close look after all. Chiou L. et al. have published an article about a noninvasive genomic sequencing of populations from faeces in this years January issue of Scientific Reports of 'Nature'. In this article, they deal with the problem that it is difficult to obtain high-quality samples for genomic studies from wild animals. They, therefore, describe a cost-effective method for enriching host DNA from noninvasive faecal samples. And in fact, it is worthwhile to have a closer look at the faeces sample in this article as Nature has placed a portrait of Mr Trump in a rather delicate position. Finding the hidden Trump-Portrait, here's how:   This publication impressively demonstrates the interdependence of science and politics. Remember, sometimes the unexpected lies in the detail. Did the editors of Nature actually realise this? Update 28/01/2019: Well, obviously they now have! OPEN ACCESS: Chiou KL et al. Scientific Reports 2018 January 31: Methylation-based enrichement facilitates low-cost, noninvasive genomic scale sequencing of populations from feces
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 Anticoagulated patients are common, and the amount of available oral anticoagulants is becoming more diverse and confusing. Anticoagulation is the cornerstone in the treatment of thrombosis and thromboembolic complications in a variety of diseases. Lixiana, Pradaxa, Eliquis and Xarelto are some of these pretty-sounding drugs that many doctors know but find it difficult to keep up. So if you work in an emergency room, anaesthesia or intensive care, there's a good chance you will be facing an anticoagulant patient with potentially critical bleeding that could require urgent treatment... And this leaves you with the following questions: - What is a critical bleed (apart from obvious massive bleeding)? Does this bleeding need imminent reversal? - Do I need any laboratory testing before? - What treatment should I actually give the patient? If you do not have a guideline in your institution, it may be time to create one, and the following publication is indeed very useful for this purpose! The 2017 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants very nicely summarises current evidence and expert opinion on these issues. But the very best are their excellent figures, providing all the answers you need: simple and very understandable! What is a Critical Bleeding?
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