Reprocessing of electrophysiology material in EHRA countries: an EHRA Young EP survey

EP Europace ◽  
2020 ◽  
Author(s):  
David Duncker ◽  
Martin Svetlosak ◽  
Federico Guerra ◽  
Klaudia Vivien Nagy ◽  
Philippe Vanduynhoven ◽  
...  

Abstract Data on reprocessing of electrophysiology (EP) materials are sparse. Reprocessing of catheters and other materials in daily routine varies through countries and may depend on specific material characteristics, supplier, or federal law. The aim of this study was to collect data on reprocessing usage through EHRA countries. An online survey consisting of 27 questions was distributed to EHRA Young EP members and members of national EP working groups. Two hundred and two participants from 34 EHRA countries completed the survey. One hundred and seven respondents (53.0%) reported having used and using reprocessed EP material, 30 (14.9%) respondents have used reprocessed EP material in the past but not at the time of the survey, 65 (32.2%) had never used reprocessed EP material. The most reprocessed EP materials include cables (70%), diagnostic EP catheters with deflectable (64%) or fixed curve (63%), non-irrigated ablation catheters (51%), and other conventional diagnostic catheters (41%). The most durable material was diagnostic EP catheters with a fixed curve (61%), the most sensitive material was ablation catheters with contact force sensors (21%). Important benefits were seen in reducing costs for the providing hospital (65%) and the healthcare provider (42%) and making EP procedures available for a greater number of patients (42%). Main concerns were on quality aspects (58%), contamination (52%), and loss of precision (47%). Reprocessing of EP materials is heterogeneously managed among EHRA countries. The present survey shows that European electrophysiologists consider the use of reprocessed EP material as generally safe and cost-effective.

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
D Duncker ◽  
M Svetlosak ◽  
F Guerra ◽  
K V Nagy ◽  
P Vanduynhoven ◽  
...  

Abstract Introduction Reprocessing of electrophysiology (EP) catheters in daily routine varies through countries and may depend on national laws, catheter (cath.) models or supplier. Data on reprocessing of EP materials is sparse and remains a matter of controversy. The aim of this study is to collect data on reprocessing usage through EHRA countries. Methods and results A structured online questionnaire comprising 27 questions was distributed among electrophysiologists in EHRA countries. Two-hundred-and-two participants from 34 countries completed the survey (161 males, 36.8 ± 5.8 years old). Overall, 111 (55%) of respondents currently use reprocessed materials and 30 (15%) have used them in the past. Cables, diagnostic cath. with deflectable curve and diagnostic cath. with fixed curve were the most frequently reprocessed materials (87%, 80% and 78% respondents, respectively). Maximum number of times (median) a cath. was usually reprocessed was 6 for diagnostic cath. and 5 for ablation cath. Among potential benefits of reprocessing, cost reduction for the providing hospital (65%), cost reduction for the health provider (42%) and making EP procedure available for more patients (42%) were most frequently reported. Respondents reported a need to change the reprocessed material due to its insufficient functionality in around 15% of cases. They were also concerned about the quality of the reprocessed material (58%), contamination issues (52%) and loss of precision (47%). Nineteen (17%) users of reprocessed EP material reported at least one complication potentially related to the reprocessing during their whole reprocessing experience. Sixty-six (73%) respondents who did not use reprocessed EP material would consider using it in the future. Conclusions Reprocessing of EP material is heterogeneously managed among the EHRA countries, as wide differences are present in terms of national and local regulations, clinical practice and technical aspects. Nonetheless, the current data show that European electrophysiologists consider the use of reprocessed EP material as generally safe and cost-effective.


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 591-601
Author(s):  
Akansha Kishen ◽  
Anjali A K ◽  
Brundha M P ◽  
Muralidharan N P

Covid 19 is considered to be a pandemic virus infection. SARS-Cov-2 causes it. It is a viral infection that is transmitted through aerosol and droplet contamination, cross-infection, etc. Dentists are at a higher risk due to this corona. It has affected daily routines of dentist's life as they are unavailable to run the clinic and attend to patients. Different search engines like PubMed, and Google Scholar was used. The questionnaire consisting of twenty questions was prepared by using online survey google forms and circulated among the participants. SPSS software was used to evaluate the results and data collection. Statistical analysis was done by chi-square test. Later, results were being tabulated. This survey that is taken among dental students, dentists, and random public, it is seen that the majority of them are well aware of this recent pandemic attack. (COVID-19). It is concluded that dentists are affected to a significant extent due to coronavirus as their daily routine is affected severely. This study aims to identify the effect on dentist life on a routine basis due to the pandemic COVID - 19.


2000 ◽  
Vol 35 (2) ◽  
pp. 169-175 ◽  
Author(s):  
Robert A. Quercia ◽  
Ronald Abrahams ◽  
C. Michael White ◽  
John D'Avella ◽  
Mary Campbell

A pharmacy-managed anemia program included distribution and clinical components, with the goal of making epoetin alpha therapy for hemodialysis patients more cost-effective. The Pharmacy Department prepared epoetin alpha doses for patients in unit-dose syringes, utilizing and documenting vial overfill. Pharmacists dosed epoetin alpha and iron (oral and intravenous) per protocol for new and established patients. Baseline data were obtained in 1994, one year prior to implementation of the program, and were re-evaluated in 1995 and 1998. Cost avoidance from utilization of epoetin alpha vial overfill in 1995 and 1998 was $83,560 and $91,148 respectively. In 1995 and 1998, cost avoidance from pharmacy management of anemia was $191,159 and $203,985 respectively. The total cost avoidance from 1995 through 1998 was estimated at $1,018,638. The number of patients with hematocrits under 31% decreased from 32% in 1994 to 21% and 14% in 1995 and 1998 respectively. We conclude that a pharmacy-managed anemia program for hemodialysis patients results in significant cost savings and better achievement of target hematocrits.


Author(s):  
Adrianos Golemis ◽  
Panteleimon Voitsidis ◽  
Eleni Parlapani ◽  
Vasiliki A Nikopoulou ◽  
Virginia Tsipropoulou ◽  
...  

Summary COVID-19 and the related quarantine disrupted young adults’ academic and professional life, daily routine and socio-emotional well-being. This cross-sectional study focused on the emotional and behavioural responses of a young adult population during the COVID-19-related quarantine in April 2020, in Greece. The study was conducted through an online survey. A total of 1559 young adults, aged 18−30 years, completed Steele’s Social Responsibility Motivation Scale and the De Jong Gierveld Loneliness Scale, and answered questions about compliance with instructions, quarantine-related behaviours and coping strategies. According to the results, participants displayed a relatively high sense of social responsibility (M = 16.09, SD = 2.13) and a trend towards moderate feeling of loneliness (M = 2.65, SD = 1.62); young women reported significantly higher levels of loneliness than men. The majority complied with instructions often (46.4%) or always (44.8%). Significantly more women created a new social media account and used the social media longer than 5 h/day, compared with men. Resorting to religion, practicing sports and sharing thoughts and feelings about COVID-19 with others predicted higher levels of social responsibility; humour, practicing sports and sharing thoughts and feelings about COVID-19 with others predicted lower levels of loneliness. Conclusively, COVID-19 is expected to have a significant psychological impact on young adults. Currently, Greece is going through the second quarantine period. This study raises awareness about loneliness in young adults during the COVID-19-related quarantine and highlights the importance of developing online programmes, attractive to younger people, to nurture adaptive coping strategies against loneliness.


Author(s):  
Sabrina R Raizada ◽  
Natasha Cleaton ◽  
James Bateman ◽  
Diarmuid M Mulherin ◽  
Nick Barkham

Abstract Objectives During the COVID-19 pandemic, face-to-face rheumatology follow-up appointments were mostly replaced with telephone or virtual consultations in order to protect vulnerable patients. We aimed to investigate the perspectives of rheumatology patients on the use of telephone consultations compared with the traditional face-to-face consultation. Methods We carried out a retrospective survey of all rheumatology follow-up patients at the Royal Wolverhampton Trust who had received a telephone consultation from a rheumatology consultant during a 4-week period via an online survey tool. Results Surveys were distributed to 1213 patients, of whom 336 (27.7%) responded, and 306 (91.1%) patients completed all components of the survey. Overall, an equal number of patients would prefer telephone clinics or face-to-face consultations for their next routine appointment. When divided by age group, the majority who preferred the telephone clinics were <50 years old [χ2 (d.f. = 3) = 10.075, P = 0.018]. Prevalence of a smartphone was higher among younger patients (<50 years old: 46 of 47, 97.9%) than among older patients (≥50 years old: 209 of 259, 80.7%) [χ2 (d.f. = 3) = 20.919, P < 0.001]. More patients reported that they would prefer a telephone call for urgent advice (168, 54.9%). Conclusion Most patients interviewed were happy with their routine face-to-face appointment being switched to a telephone consultation. Of those interviewed, patients >50 years old were less likely than their younger counterparts to want telephone consultations in place of face-to-face appointments. Most patients in our study would prefer a telephone consultation for urgent advice. We must ensure that older patients and those in vulnerable groups who value in-person contact are not excluded. Telephone clinics in some form are here to stay in rheumatology for the foreseeable future.


Author(s):  
Belinda Borrelli ◽  
Romano Endrighi ◽  
Lisa M Quintiliani ◽  
Rosemary B Hughes ◽  
Sherry Pagoto

Abstract People with mobility impairments (MIs; use assistive devices to ambulate) have twice the smoking prevalence versus the general population. A Facebook intervention could improve reach to smokers with MIs, but use and patterns of use are unknown. The study examined: (a) Facebook use and relationship with Facebook-based social support and (b) whether Facebook use differs by motivation to quit smoking. Participants (N = 510; 56.3% female, mean age = 42.4 years) were recruited via a recruitment company to complete a one-time online survey assessing motivation to quit within 30 days, Facebook use (Facebook Activities Scale), reasons for use (Facebook Motives Scale), attitudes (Facebook Intensity Scale), and social support (Facebook Measure of Social Support). The vast majority said that Facebook is part of their daily routine (92.9%), 83% checked Facebook >once a day, and 69% spent >30 min/day on Facebook. Facebook was used to connect with similar others (68.4%), participate in groups (72.9%), decrease loneliness (69.2%), and obtain health information (62.5%); 88% said that they would join a Facebook program to help them quit smoking. A greater number of Facebook friends (rs = .18–.22, p < .001) and greater Facebook use (rs = .20 to rs = .59; p < .001) were correlated with greater perceived social and emotional support. Those motivated to quit posted more frequently (odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.10, 2.22) and were more likely to indicate that they would join a Facebook group for smoking cessation (OR = 4.15, 95% CI = 2.05, 8.38) than those not motivated. Facebook could circumvent disability and environmental barriers to accessing cessation among this health disparity population.


2021 ◽  
Vol 11 (8) ◽  
pp. 3365
Author(s):  
Benjie Law ◽  
Hui Yuh Soh ◽  
Syed Nabil ◽  
Rama Krsna Rajandram ◽  
Abd Jabar Nazimi ◽  
...  

Osteoradionecrosis (ORN) of the jaws and medication-related osteonecrosis of the jaws (MRONJ) are uncommon but serious diseases affecting the oral and maxillofacial region with clinically similar appearance but distinct pathophysiology. Management of ORN and MRONJ is inherently challenging and the treatment outcomes are unpredictable. The use of autologous platelet concentrates (APCs) to promote hard and soft tissue healing is well described in the literature, and the efficacy of leucocyte and platelet-rich fibrin (L-PRF) has been well documented in a number of clinical studies. The aim of this study was to present our treatment strategy and the outcomes of incorporating L-PRF as a surgical adjunct in management of ORN and MRONJ in our centre. Methods: eight cases of ORN and MRONJ were treated with a combination of sequestrectomy and L-PRF as a surgical adjunct. Results: the overall success was 87.5%. Using L-PRF as an adjunct, we were able to predictably manage ORN and MRONJ without causing significant morbidity. Conclusion: our experience shows that L-PRF may be used as a valuable and cost-effective adjunct to surgical management of ORN and MRONJ. However, due to a limited number of patients, and a short period of review, the true effectiveness of the method is yet to be demonstrated in a longer follow-up study including a greater number of patients, besides the inclusion of a control group.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jean-Luc Fellahi ◽  
Emmanuel Futier ◽  
Camille Vaisse ◽  
Olivier Collange ◽  
Olivier Huet ◽  
...  

AbstractDespite a large body of evidence, the implementation of guidelines on hemodynamic optimization and goal-directed therapy remains limited in daily routine practice. To facilitate/accelerate this implementation, a panel of experts in the field proposes an approach based on six relevant questions/answers that are frequently mentioned by clinicians, using a critical appraisal of the literature and a modified Delphi process. The mean arterial pressure is a major determinant of organ perfusion, so that the authors unanimously recommend not to tolerate absolute values below 65 mmHg during surgery to reduce the risk of postoperative organ dysfunction. Despite well-identified limitations, the authors unanimously propose the use of dynamic indices to rationalize fluid therapy in a large number of patients undergoing non-cardiac surgery, pending the implementation of a “validity criteria checklist” before applying volume expansion. The authors recommend with a good agreement mini- or non-invasive stroke volume/cardiac output monitoring in moderate to high-risk surgical patients to optimize fluid therapy on an individual basis and avoid volume overload. The authors propose to use fluids and vasoconstrictors in combination to achieve optimal blood flow and maintain perfusion pressure above the thresholds considered at risk. Although purchase of disposable sensors and stand-alone monitors will result in additional costs, the authors unanimously acknowledge that there are data strongly suggesting this may be counterbalanced by a sustained reduction in postoperative morbidity and hospital lengths of stay. Beside existing guidelines, knowledge and explicit clinical reasoning tools followed by decision algorithms are mandatory to implement individualized hemodynamic optimization strategies and reduce postoperative morbidity and duration of hospital stay in high-risk surgical patients.


2017 ◽  
Vol 23 (5) ◽  
pp. 644-646 ◽  
Author(s):  
Maria Pia Sormani

The calculation of the sample size needed for a clinical study is the challenge most frequently put to statisticians, and it is one of the most relevant issues in the study design. The correct size of the study sample optimizes the number of patients needed to get the result, that is, to detect the minimum treatment effect that is clinically relevant. Minimizing the sample size of a study has the advantage of reducing costs, enhancing feasibility, and also has ethical implications. In this brief report, I will explore the main concepts on which the sample size calculation is based.


Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Janice Sandt ◽  
Sarah E Brown ◽  
Colleen Lechtenberg ◽  
Cherie Boxberger

Background and Purpose: Kansas is a rural state lacking geographically distributed Primary Stroke Centers. Of the 128 hospitals in the state, 88 are designated as Critical Access (< 25 beds). The IV r-tPA treatment rate in the state of Kansas is less than 2%. The pre-transport death rate for patients experiencing stroke is 55.4% .The Kansas Initiative for Stroke Survival (KISS) is a non-government task force with the goal of improving stroke survival among Kansans. The task force encourages hospitals to meet the criteria as Emergent Stroke Ready and based on this status engage with their individual communities, emphasizing the need to seek immediate assistance by EMS and arrive at the closest Emergent Stroke Ready hospital. Methods: The Kansas State Stroke Task force determined requirements for a facility to be considered Emergent Stroke Ready. This information was distributed to all acute care hospitals, asking them to attest to their current Emergent Stroke Ready status. Responding facilities were provided access to a 24 x 7 Stroke Support Line - providing access to stroke specialists for the purpose of guiding evaluation and treatment decisions for r-tPA administration or need to transfer to a higher level of care. Also provided is a community education kit. Data is reported through a monthly online survey or GWTG database. Results: In the first phase of the KISS project - forty-two hospitals attested as Emergent Stroke Ready Hospital or were certified Primary Stroke Centers representing an increase from 7% to 33% of hospitals in the state. The post-KISS implementation IV r-tPA treatment rate for the reporting Emergent Stroke Ready Hospitals was 48% compared with a pre-KISS treatment rate of 6%. The post-KISS implementation transfer rate was 26.7% compared with a pre-KISS transfer rate of 18%. Conclusions: The KISS program resulted in a significant increase in the number of Emergent Stroke Ready facilities, stroke patients reporting to their local hospitals, stroke specialist consultations and use of IV r-tPA. A low-cost, statewide program that provides standardized protocols and direct phone consultation can improve access to stroke specialists and approved stroke treatment while offering a cost effective, feasible alternative to telestroke.


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