Effectiveness And Adherence To Hospital Infection Control Preventive Practice In Cardiac Implantable Electronic Devices

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Michel Lotfy Kolta ◽  
Maha Mohamed Mohamed Khalifa ◽  
Mazen Tawfik Ibrahmi ◽  
Said AbdElHaffez khaled
Keyword(s):  
Diabetes Mellitus ◽  
Infection Control ◽  
Electronic Devices ◽  
P Value ◽  
Related Factors ◽  
Cardiac Device ◽  
Control Protocol ◽  
The Past ◽  
Cardiac Implantable Electronic Devices ◽  
Device Implantation

Abstract Background Cardiac implantable electronic device (CIED) have been increasingly used in the past years, There is arise in CIED related complications in the past years with the increase in the number of devices implanted, CIED associated infection is challenging in its management, including system removal (generator and leads ), antimicrobial therapy, replantation at another site. Objectives The aim of the study is to evaluate the adherence to the steps of infection control protocol in cardiac device implantation related infection . Patients and Methods One hundred patients referred for cardiac device implantation was enrolled in the study and prospectively evaluated regarding applying of infection control measures and followed up for six months to study effect of adherence to these measures in prevention of postoperative device related infection. Results analysis of all factors of infection control protocol revealed significant correlation between postoperative device related infection and the following factors, Age ( p value = 0.010) , DM ( p value = 0.024) and number of Operators≥4.0 ( p = 0.001) as well as duration of sterilization ( p = 0.001), wearing double gloves (p = <0.001). Conclusion Our results proved certain factors as significant risk factors for device related infection, they are either patient related factors including and diabetes mellitus or device related factors reflecting higher incidence with CRT devices (p = 0.025), others related to applying anti septic measures namely double glove technique and duration of skin disinfect prior to the procedure. Abbreviation list; CIED (cardiac implantable electronic devices), DRI (device related infection), CKD (chronic kidney disease), DM (diabetes mellitus), HTN (hypertension), CRT (cardiac resynchronization therapy), DDD (dual chamber device), VVI (ventricular demand pacing), ICD (implantable cardioverter defibrillator).

The effect of glove contamination on the bond strength of resin to enamel

2004 ◽  
Vol 28 (4) ◽  
pp. 339-341 ◽  
Author(s):  
Brian Sanders ◽  
Adam Pollock ◽  
James Weddell ◽  
Keith Moore
Keyword(s):  
Infection Control ◽  
Bond Strength ◽  
Shear Bond Strength ◽  
Dental Material ◽  
Bonding Agent ◽  
Control Protocol ◽  
The Past ◽  
Latex Gloves ◽  
Potential Interactions ◽  
Powdered Latex Gloves

Over the past twenty years infection control protocol has evolved and use of gloves is now mandatory. Practitioners have become aware of potential interactions between the latex gloves and many of the dental material used as well as the potential for contamination from the gloves. The purpose of this study was to evaluate the shear bond strength of bonded restorations to enamel of uncontaminated and contaminated resin adhesive with powder free and powdered latex gloves. The results of the study demonstrated that the resin bonding agent that was in contact with either powdered or non- powdered latex gloves did not have a significant effect on the shear bond strength of the bonded restoration.

scholarly journals Infection control in implantation of cardiac implantable electronic devices: current evidence, controversial points, and unresolved issues

EP Europace ◽  
2015 ◽  
Vol 18 (4) ◽  
pp. 473-478 ◽  
Author(s):  
Panagiotis Korantzopoulos ◽  
Skevos Sideris ◽  
Polychronis Dilaveris ◽  
Konstantinos Gatzoulis ◽  
John A. Goudevenos
Keyword(s):  
Infection Control ◽  
Electronic Devices ◽  
Current Evidence ◽  
Cardiac Implantable Electronic Devices

Impaired Awareness of Hypoglycaemia in Insulin-treated Type 2 Diabetes Mellitus

2019 ◽  
Vol 15 (5) ◽  
pp. 407-413 ◽  
Author(s):  
Mohammad J. Alkhatatbeh ◽  
Nedaa A. Abdalqader ◽  
Mohammad A.Y. Alqudah
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy ◽  
Severe Hypoglycaemia ◽  
Severe Hypoglycemia ◽  
P Value ◽  
The Past ◽  
Impaired Awareness

Background: Patients with Type 2 Diabetes Mellitus (T2DM) may develop hypoglycemia as an adverse effect of insulin therapy. Hypoglycemia has dangerous consequences that result from neuroglycopenia and hypersecretion of counter-regulatory hormones. Patients who recognize early symptoms of hypoglycemia can initiate self-treatment and rectify the situation. Impaired Awareness of Hypoglycemia (IAH) predisposes patients to severe hypoglycemia and unconsciousness. Objective: To assess the prevalence of IAH, the intensity of hypoglycaemic symptoms, the frequency of severe hypoglycemia and factors associated with IAH in patients with insulin-treated T2DM. Methods: This is a cross-sectional study that used Clarke's and Gold's surveys to assess IAH and Edinburgh survey to assess the intensity of hypoglycemic symptoms in patients with insulin-treated T2DM (n= 388). The frequency of hypoglycemia and other data were collected by self-reporting or from medical records. Results: The prevalence (95% confidence interval) of IAH was 17.01% (13.27%-20.75%) as determined by Clarke’s method and 5.93% (3.58-8.28) by Gold’s method (Odds= 3.25, p-value<0.00001). Drowsiness, hunger, sweating, tiredness, trembling and weakness, were the most intense hypoglycaemic symptoms, and 6.19% of participants reported at least one episode of severe hypoglycaemia within the past year. Regardless of classification method used, IAH is not dependent on age, gender, duration of T2DM or duration of insulin therapy (p-values>0.05). Instead, IAH is positively associated with frequency of hypoglycaemia during the previous six months (p-value<0.05) and development of severe hypoglycaemia within the past year (p-value <0.05). Conclusion: This study highlights large variability in IAH depending on the method used for assessment. Increased hypoglycaemia frequency may increase the prevalence of IAH and thus the development of severe hypoglycemia

scholarly journals Application of an Infection Control Protocol (ICP) Reduced Cardiac Device Infection (CDI) in Low-Volume Centers

2018 ◽  
Vol 24 ◽  
pp. 1366-1372 ◽  
Author(s):  
Gongchang Guan ◽  
Zhongwei Liu ◽  
Yong Zhang ◽  
Fangyun Wang ◽  
Haiming Ji ◽  
...  
Keyword(s):  
Infection Control ◽  
Cardiac Device ◽  
Control Protocol ◽  
Device Infection ◽  
Low Volume ◽  
Cardiac Device Infection

scholarly journals Deciphering the complex interplay between pancreatic cancer, diabetes mellitus subtypes and obesity/BMI through causal inference and mediation analyses

Gut ◽  
2020 ◽  
pp. gutjnl-2019-319990 ◽  
Author(s):  
Esther Molina-Montes ◽  
Claudia Coscia ◽  
Paulina Gómez-Rubio ◽  
Alba Fernández ◽  
Rianne Boenink ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Pancreatic Cancer ◽  
Causal Effect ◽  
Glycated Haemoglobin ◽  
Mendelian Randomisation ◽  
P Value ◽  
Causal Association ◽  
Related Factors ◽  
Logistic Regression Models ◽  
Mediation Analyses

ObjectivesTo characterise the association between type 2 diabetes mellitus (T2DM) subtypes (new-onset T2DM (NODM) or long-standing T2DM (LSDM)) and pancreatic cancer (PC) risk, to explore the direction of causation through Mendelian randomisation (MR) analysis and to assess the mediation role of body mass index (BMI).DesignInformation about T2DM and related factors was collected from 2018 PC cases and 1540 controls from the PanGenEU (European Study into Digestive Illnesses and Genetics) study. A subset of PC cases and controls had glycated haemoglobin, C-peptide and genotype data. Multivariate logistic regression models were applied to derive ORs and 95% CIs. T2DM and PC-related single nucleotide polymorphism (SNP) were used as instrumental variables (IVs) in bidirectional MR analysis to test for two-way causal associations between PC, NODM and LSDM. Indirect and direct effects of the BMI-T2DM-PC association were further explored using mediation analysis.ResultsT2DM was associated with an increased PC risk when compared with non-T2DM (OR=2.50; 95% CI: 2.05 to 3.05), the risk being greater for NODM (OR=6.39; 95% CI: 4.18 to 9.78) and insulin users (OR=3.69; 95% CI: 2.80 to 4.86). The causal association between T2DM (57-SNP IV) and PC was not statistically significant (ORLSDM=1.08, 95% CI: 0.86 to 1.29, ORNODM=1.06, 95% CI: 0.95 to 1.17). In contrast, there was a causal association between PC (40-SNP IV) and NODM (OR=2.85; 95% CI: 2.04 to 3.98), although genetic pleiotropy was present (MR-Egger: p value=0.03). Potential mediating effects of BMI (125-SNPs as IV), particularly in terms of weight loss, were evidenced on the NODM-PC association (indirect effect for BMI in previous years=0.55).ConclusionFindings of this study do not support a causal effect of LSDM on PC, but suggest that PC causes NODM. The interplay between obesity, PC and T2DM is complex.

scholarly journals Risk Factors Predicting Complications of Transvenous Lead Extraction

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Wojciech Jacheć ◽  
Anna Polewczyk ◽  
Maciej Polewczyk ◽  
Andrzej Tomasik ◽  
Marianna Janion ◽  
...  
Keyword(s):  
Risk Factors ◽  
Electronic Devices ◽  
Technical Problem ◽  
Female Gender ◽  
Lead Extraction ◽  
Efficacy And Safety ◽  
Clinical Factors ◽  
Short Term ◽  
Related Factors ◽  
Cardiac Implantable Electronic Devices

Objective. Transvenous lead extraction (TLE) is the gold standard in the management of patients with cardiac implantable electronic devices (CIED)-related complications. Knowledge of TLE risk factors is very important.Methods. Clinical data from 1915 patients undergoing TLE at the Reference Center between 2006 and 2015 were analyzed. The effects of clinical and procedure-related factors on the development of major (MJC) and minor (MIC) complications and survival after TLE were evaluated.Results. MJC were caused mainly by lead implant duration, presence of abandoned leads, multiple procedures preceding TLE, and any technical problem during TLE. Of clinical factors female gender and anemia increased the risk of MJC. MIC were reported in patients with the first implantation of CIED under the age of 30 and after sternotomy analysis of 30-day survival after procedure demonstrated a significant effect of clinical factors and lead dwell times, previous unsuccessful TLE, and MIC.Conclusions. Efficacy and safety of TLE depend mainly on procedure-related factors. This knowledge is essential for preventing MJC and MIC. Mortality at 30 days following TLE is mainly associated with the clinical factors; however, there was also a significant effect of lead dwell time and periprocedural complications on the short-term prognosis of patients undergoing TLE.

Preventive infection control in cardiac device implantation

2020 ◽  
Author(s):  
Maha Mohamed Mohamed Khalifa ◽  
Michel Lotfy Kolta ◽  
Mazen Tawfik ◽  
Said Khaled ◽  
Emad Effat Fakhry
Keyword(s):  
Infection Control ◽  
Cardiac Device ◽  
Device Implantation

COSTS OF INFECTIONS RELATED TO TREATMENT WITH CARDIAC IMPLANTABLE ELECTRONIC DEVICES

2019 ◽  
Vol 3 (52) ◽  
pp. 24-28
Author(s):  
Przemysław Mitkowski
Keyword(s):  
Renal Failure ◽  
High Risk ◽  
Electronic Devices ◽  
Cardiac Resynchronization ◽  
Cardiac Device ◽  
Oral Anticoagulant Treatment ◽  
Term Outcome ◽  
Healthcare Budget ◽  
Long Term Outcome ◽  
Cardiac Implantable Electronic Devices

Treatment with cardiac implantable electronic devices is not free from complications, including infections, which not only influence long term outcome, but also significantly impact healthcare budget. The costs of management of cardiac device related infections ranged from several to tens or even hundreds of thousands euro. A risk of infection varies from 0,5 to 5,0 and more percent and depends on: type of procedure, complexity of system, number of previous procedures performed, renal failure, immunosuppression, heart failure, malignancies, oral anticoagulant treatment, use of temporary pacing before procedure. Based on PADIT trial results infection risk score was established based on 5 parameters (age, type of procedure, renal failure, immunodeficiency, number of previous procedure). This score allows to define population of patients with low, intermediate and high risk to develop infection. In high risk group, despite standard preparation to the procedure, some additional tools should be considered to reduce infection rate. It relates mainly, but is not limited to, device exchange, revisions, up-grades of cardiac resynchronization systems.

scholarly journals Morbidity profile and use of personal protective equipment amongst traffic police of Mumbai

2019 ◽  
Vol 6 (12) ◽  
pp. 5277
Author(s):  
Rupali V. Sabale ◽  
Saurabh N. Tripathi ◽  
Gajanan D. Velhal
Keyword(s):  
Diabetes Mellitus ◽  
Police Officers ◽  
Personal Protective Equipment ◽  
Oxygen Therapy ◽  
P Value ◽  
Protective Equipment ◽  
Chi Square ◽  
Related Factors ◽  
Traffic Police ◽  
Chi Square Test

Background: Traffic police play a very significant role in controlling traffic system. The job of traffic police personnel is a tough job, which has a direct influence on their life. The aim of the present study was to assess prevalence of morbidities, use of personal protective equipment viz., mask, oxygen therapy and pressure stocking amongst Mumbai traffic police and study association of some job related factors with their present health profile.Methods: Record based study was conducted by analyzing 1959 health record forms filled by the traffic police of Mumbai. Frequency, percentages, Chi-square test and unpaired t test were calculated.Results: The mean age of traffic police was 46.87±7.95 years. The duration of years in traffic branch ranged from 6 months to 18 years. Prevalence of stress, hypertension, diabetes mellitus, eye, skin, and ear morbidities were 26%, 20.9%, 14.2%, 10.2%, 3.6%, 3.3% respectively. In traffic police officers, prevalence of hypertension (28.3% v/s 19.8%), diabetes mellitus (23.6% v/s 12.8%), ear morbidities (5.5% v/s 2.9%) and stress (31.1% v/s 25.3%) were significantly high as compared to traffic policemen (p value <0.05). There was significant association of prevalence of respiratory morbidities, ear morbidities with current work placement (p value <0.05). There was significant relation of duration in police service and stress, eye morbidities, diabetes mellitus, hypertension and respiratory morbidities. Proportion of traffic police using mask, oxygen therapy and pressure stockings were 60.2%, 21.5% and 15.8% respectively.Conclusions: Morbidities amongst traffic police is high. Use of personal protective equipment is very low. Worksite Prevention Program should be planned to reduce health problems amongst traffic police. 

scholarly journals Spanish Heart Rhythm Association member´s perspectives on implantable cardiac device reuse in developing countries.

2021 ◽  
Author(s):  
Iñigo Lorenzo ◽  
Larraitz Gaztañaga Arantzamendi ◽  
Xabier Marichalar Mendia
Keyword(s):  
Developing Countries ◽  
Electronic Devices ◽  
Heart Rhythm ◽  
Developed Countries ◽  
Battery Life ◽  
Cardiac Device ◽  
Cardiac Implantable Electronic Devices ◽  
Implantable Cardiac Device ◽  
Strongly Agree ◽  
Self Administered Questionnaire

a) Introduction and objectives Postmortem explanted cardiac implantable electronic devices (CIEDs) from developed countries could provide patients unable to afford new devices in developing countries a treatment they lack nowadays. This study describes the preferences of cardiac electrostimulation specialists from Spain on the management of explanted CIEDs and opinions and concerns regarding reuse in developing countries. b) Methods A nationwide self-administered questionnaire was sent to Spanish members of the XXXX1 (n=1110), between December 2020 and January 2021. c) Results Forty-three responses were obtained (response rate 4%). There was a strong preference to donate explanted devices for reuse in humans (61.9%). The group of age younger than average was more against storing explanted CIEDs (p= 0.014). 57.1% considered it would be beneficial for patients to have a document so they could reflect their wishes regarding device handling after their death. 88.1% indicated that they would strongly agree or to implant postmortem resterilized pacemakers or ICDs (Implantable cardioverter defibrillator) containing >70% of the original battery life in patients who were unable to obtain a new one, the older than average age group was showed more agreement with this statement (p=0.02). The most mentioned concerns were device malfunction (57.1%) and infection (54.8%). d) Conclusions The majority of respondents support reusable CIEDs donation to developing countries. It would be interesting to study the feasibility of a nationwide CIED reutilization programme.

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