VAVASC study: Clinical trial protocol

2021 ◽  
pp. 112972982110426
Author(s):  
Lawrie Katerina ◽  
O’Neill Stephen ◽  
Waldauf Petr ◽  
Balaz Peter
Keyword(s):  
Demographic Data ◽  
International Study ◽  
Venous Access ◽  
Current Status ◽  
Participant Recruitment ◽  
Mapping Parameters ◽  
Vascular Mapping ◽  
Arteriovenous Access ◽  
Clinical Trials Registry ◽  
Vascular Status

Background: VAVASC study (Validation of Arterio Venous Access Stage Classification) is a multicentre, international, prospective study. The study aims to validate the AVAS classification, which is a classification system describing vascular status of patients indicated for creation of arteriovenous access on the upper limb. Methods: Observational, prospective, multicentre, international study starting in March 2021. Participant recruitment has commenced. Basic demographic data, risk factors and vascular mapping parameters are collected via an online platform. The outcome measures are class of AVAS, predicted arteriovenous access, final arteriovenous access that has been created and a functionality of the arteriovenous access. Predictive models will be used for statistical analysis. Current status: A total of 140 patients from 4 centres in Great Britain, Czech Republic, Brazil and Slovakia are already included and undergoing evaluation. Conclusions: The study is registered in the Clinical trials registry (NCT04796558), https://register.clinicaltrials.gov/ . Study is still open for collaboration with other centres that can register via www.vavasc.com .

scholarly journals Estimating the Number of Agricultural Fatal Injuries Prevented by Agricultural Engineering Developments in the United States

Safety ◽  
2019 ◽  
Vol 5 (4) ◽  
pp. 63
Author(s):  
Salah F. Issa ◽  
Kiana Patrick ◽  
Steven Thomson ◽  
Bradley Rein
Keyword(s):  
United States ◽  
Direct Reduction ◽  
Demographic Data ◽  
The United States ◽  
Current Status ◽  
United States Bureau ◽  
Agricultural Engineering ◽  
Agricultural Safety ◽  
The Impact ◽  
Fatal Injuries

Agriculture has been consistently marked as one of the deadliest industries by the United States Bureau of Labor Statistics (BLS). While this statistic is widely used in promoting agricultural safety and health, it does not paint a complete picture on the current status of agricultural safety and the advances that have been made in the last century. For example, even with a stagnant rate of injury, the BLS has reported that fatal incidents decreased from a high of 855 incidents in 1993 to a low of 500 incidents in 2013. The purpose of this study was to analyze the impact that agricultural engineering developments had on reducing fatal injuries. Agricultural engineering developments are defined as any agricultural improvement that results in a direct reduction in the amount of labor needed. This study uses existing federal agricultural statistical, injury and demographic data to calculate the impact that engineering, in contrast to yield improvements and safety enhancements, contributed to a reduction in the number of fatal incidents. The study found that engineering developments could have contributed to the reduction in the number of fatal injuries by about 170 incidents from 1992 to 2015. This represents 63% of the total reduction in the number of fatal injuries. In conclusion, agricultural engineering developments play a substantial role in reducing the number of fatal incidents by removing and reducing labor exposure to hazardous environments.

scholarly journals A Five-Year Data Report of Long-Term Central Venous Catheters Focusing on Early Complications

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Harald Lenz ◽  
Kirsti Myre ◽  
Tomas Draegni ◽  
Elizabeth Dorph
Keyword(s):  
Demographic Data ◽  
Venous Catheter ◽  
Venous Access ◽  
Seldinger Technique ◽  
Published Data ◽  
Main Diagnosis ◽  
Anatomical Landmarks ◽  
Central Venous ◽  
Jugular Veins

Background. Long-term venous access has become the standard practice for the administration of chemotherapy, fluid therapy, antibiotics, and parenteral nutrition. The most commonly used methods are percutaneous puncture of the subclavian and internal jugular veins using the Seldinger technique or surgical cutdown of the cephalic vein. Methods. This study is based on a quality registry including all long-term central venous catheter insertion procedures performed in patients >18 years at our department during a five-year period. The following data were registered: demographic data, main diagnosis and indications for the procedure, preoperative blood samples, type of catheter, the venous access used, and the procedure time. In addition, procedural and early postoperative complications were registered: unsuccessful procedures, malpositioned catheters, pneumothorax, hematoma complications, infections, nerve injuries, and wound ruptures. The Seldinger technique using anatomical landmarks at the left subclavian vein was the preferred access. Fluoroscopy was not used. Results. One thousand one hundred and one procedures were performed. In eight (0.7%) cases, the insertion of a catheter was not possible, 23 (2.1%) catheters were incorrectly positioned, twelve (1.1%) patients developed pneumothorax, nine (0.8%) developed hematoma, and three (0.27%) developed infection postoperatively. One (0.1%) patient suffered nerve injury, which totally recovered. No wound ruptures were observed. Conclusions. We have a high success rate of first-attempt insertions compared with other published data, as well as an acceptable and low rate of pneumothorax, hematoma, and infections. However, the number of malpositioned catheters was relatively high. This could probably have been avoided with routine use of fluoroscopy during the procedure.

Simultaneous placement of leadless pacemaker and dialysis catheter in patient with exhausted vasculature

2019 ◽  
pp. 112972981989408
Author(s):  
Dawid Bednarczyk ◽  
Wiktor Kuliczkowski ◽  
Krzysztof Letachowicz ◽  
Marcin Dzidowski ◽  
Tomasz Witkowski ◽  
...  
Keyword(s):  
Vascular Access ◽  
Electronic Device ◽  
Cardiac Pacemaker ◽  
Cardiac Pacing ◽  
Venous Access ◽  
Cardiac Implantable Electronic Device ◽  
Leadless Pacemaker ◽  
Access Problem ◽  
Arteriovenous Access

The problem with limited venous access may occur in patients receiving long-term hemodialysis treatment with no possibility of arteriovenous access or in patients with cardiac implantable electronic device–related infection leading to the removal of cardiac implantable electronic device. We present a case report where both situations occur simultaneously. Using recent development in cardiac pacing—leadless cardiac pacemaker—we manage to overcome the vascular access problem. The described case emphasizes the necessity of multispecialty collaboration and gains of new pacing technology in patients who need placement of vascular access for hemodialysis and cardiac implantable electronic device where vascular access is scarce.

scholarly journals Challenge and hope for parents who have cancer

2021 ◽  
Vol 3 (1) ◽  
pp. 136-147
Author(s):  
Yuko Akagawa ◽  
Sachiko Makabe ◽  
Tomoko Ito ◽  
Yutaka Kimura ◽  
Hideaki Andoh
Keyword(s):  
Disease Duration ◽  
Response Rate ◽  
Demographic Data ◽  
Current Status ◽  
Stress Coping ◽  
Parental Cancer ◽  
Cross Sectional ◽  
Coping Ability ◽  
The Mean ◽  
The Relationship

Parents who have cancer face particular problems in their relationships with children. This study aims to clarify 1) the current status of challenge/hope in parental cancer, 2) the factors related to challenge/hope, and 3) the relationship between challenge/hope and QOL/stress-coping ability. Cross-sectional national survey was conducted at designated cancer hospitals in Japan. Participants were undergoing cancer treatment and have children under 18 years old. The questionnaire included demographic data, QOL, ability to cope with stress, and challenge/hope. From 11 hospitals, 54 patients (response rate: 79.4%) participated. Majority of participants were female (72.2%) with the mean age of 39.3 ± 5.3 (SD). The total score was QOL (FACT-G: 50.4 ± 16.2), stress-coping ability (SOC: 46.7 ± 10.4). The main challenges were an inability to fulfill the parental role and children’s mental suffering due to loneliness. The main aspects of hope were the value of the children’s present self, being a parent, and strengthening family bonds. Gender and disease duration were significantly related with challenge/hope. Challenge was significantly related with QOL/stress-coping ability. Parents who have cancer derive hope from their relationship with their children, although they feel a gap between their ideal role/value as a parent and their current status.

scholarly journals P645 Mental health, work presenteeism and exercise in IBD patients

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S577-S577
Author(s):  
M Sciberras ◽  
C Nascimento ◽  
T Tabone ◽  
K Karmiris ◽  
P Nikolaou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Demographic Data ◽  
International Study ◽  
Poor Quality ◽  
Psychiatric Medication ◽  
Active Involvement ◽  
Significant Difference ◽  
Previous Medication ◽  
History Of

Abstract Background IBD has been shown to increase the rates of anxiety and depression amongst diagnosed individuals, with a prevalence rate of approximately 15- 20%. Chronic diseases such as IBD can have a significant impact on productivity at work (presenteeism). This can lead to emotional distress, poor quality of life and cost effects on employers. The primary aim of the study was to assess the prevalence of psychological problems, exercise levels and presenteeism at work among IBD patients. Methods This was a multicentre international study whereby IBD patients (>18 years) in clinical remission over the last year, were asked to answer an anonymous questionnaire. Demographic data, type of IBD, current and previous medication, admissions to hospital, history of psychiatric referrals, Stanford Presenteeism Scale (SPS-6), Godin Score (exercise related score) were collected. Exclusion criteria included patients with IBD flares requiring corticosteroids in the previous 12 months. Results 573 patients (CD: n=318) from 8 European Centres and Israel participated in the study. The mean patient age was 39.9 years (SD+/- 13.0). 21.6% were smokers and 48.5% were non-smokers. The rest were ex-smokers. 10.9% of patients had a diagnosis of depression/anxiety prior to the diagnosis of IBD, whereas this increased to 20.6% post-IBD diagnosis, this being significantly commoner in the CD cohort (23.0%, p<0.05) and in females (55.8%, p<0.05). 37.7% of patients had been to a psychiatrist or a psychologist (41% of CD, p<0.05) with 11.7% of patients being on psychiatric medication (14.5% of CD, p<0.05). Low presenteeism at work was evident in 34.7%, with no statistically significant difference between UC and CD patients (p=0.5). 39.9% had a Godin Exercise Score being in the active range, 38.8% had a sedentary/insufficient exercise score. The rest were moderately active. Patients diagnosed with depression/anxiety had a more sedentary lifestyle. Conclusion In our study 37.7% of patients were referred for psychological help. This can have several effects including poor presenteeism at work (34.7%) and reduced efficiency. These issues are commoner in patients with CD than in UC. Active involvement of a psychologist/ psychiatrist as part of the IBD team should be routine as to improve the patient’s quality of life.

FO019FERUMOXYTOL MR ANGIOGRAPHY VS DOPPLER US FOR VASCULAR MAPPING BEFORE HAEMODIALYSIS ARTERIOVENOUS ACCESS CREATION

2019 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Sokratis Stoumpos ◽  
Alfred Tan ◽  
Martin Hennessy ◽  
Ram Kasthuri ◽  
Aleksandra Radjenovic ◽  
...  
Keyword(s):  
Mr Angiography ◽  
Doppler Us ◽  
Vascular Mapping ◽  
Arteriovenous Access

scholarly journals Exploring the Impact of Obesity on Health Care Resources and Coding in the Acute Hospital Setting: A Feasibility Study

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 459
Author(s):  
Winnie S. Y. Tan ◽  
Adrienne M. Young ◽  
Alexandra L. Di Bella ◽  
Tracy Comans ◽  
Merrilyn Banks
Keyword(s):  
Health Care ◽  
Hospital Care ◽  
Demographic Data ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Anthropometric Measurements ◽  
Participant Recruitment ◽  
Orthopaedic Ward ◽  
The Impact ◽  
Care Costs

Obesity is costly, yet there have been few attempts to estimate the actual costs of providing hospital care to the obese inpatient. This study aimed to test the feasibility of measuring obesity-related health care costs and accuracy of coding data for acute inpatients. A prospective observational study was conducted over three weeks in June 2018 in a single orthopaedic ward of a metropolitan tertiary hospital in Queensland, Australia. Demographic data, anthropometric measurements, clinical characteristics, cost of hospital encounter and coding data were collected. Complete demographic, anthropometric and clinical data were collected for all 18 participants. Hospital costing reports and coding data were not available within the study timeframe. Participant recruitment and data collection were resource-intensive, with mobility assistance required to obtain anthropometric measurements in more than half of the participants. Greater staff time and costs were seen in participants with obesity compared to those without obesity (obesity: body mass index ≥ 30), though large standard deviations indicate wide variance. Data collected suggest that obesity-related cost and resource use amongst acute inpatients require further exploration. This study provides recommendations for protocol refinement to improve the accuracy of data collected for future studies measuring the actual cost of providing hospital care to obese inpatients.

A modified approach for ultrasound-guided axillary venipuncture in the infraclavicular area: A retrospective observational study

2019 ◽  
Vol 20 (6) ◽  
pp. 630-635
Author(s):  
Minmin Yao ◽  
Wanxia Xiong ◽  
Liying Xu ◽  
Feng Ge
Keyword(s):  
Observational Study ◽  
Success Rate ◽  
Central Venous Access ◽  
Demographic Data ◽  
Venous Access ◽  
Axillary Vein ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Venous Catheterization ◽  
Out Of Plane

Background: Catheterization of the axillary vein in the infraclavicular area has important advantages in patients with long-term, indwelling central venous catheters. The two most commonly used ultrasound-guided approaches for catheterization of the axillary vein include the long-axis/in-plane approach and the short-axis/out-of-plane approach, but there are certain drawbacks to both approaches. We have modified a new approach for axillary vein catheterization: the oblique-axis/in-plane approach. Methods: This observational study retrospectively collected data from patients who underwent ultrasound-guided placement of an axillary vein infusion port in the infraclavicular area at the Central Venous Access Clinics of Zhongshan Hospital at Fudan University between March 2014 and May 2017. The patients’ demographic data, success rate of catheterization, venous catheterization site, and immediate complications associated with catheterization were recorded. Results: Between March 2014 and May 2017, a total of 858 patients underwent placement of an axillary vein infusion port in the infraclavicular area at our center. The ultrasound-guided oblique-axis/in-plane approach was used for all patients, and the venipuncture success rate was 100%. Two cases of accidental arterial puncture and one case of local hematoma formation were reported, and no other complications, such as pneumothorax or nerve damage, were reported. Conclusion: The ultrasound-guided oblique-axis/in-plane approach is a safe and reliable alternative to the routine ultrasound-guided approach for axillary venous catheterization.

scholarly journals Unruptured intracranial aneurysms in the Familial Intracranial Aneurysm and International Study of Unruptured Intracranial Aneurysms cohorts: differences in multiplicity and location

2012 ◽  
Vol 117 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Jason Mackey ◽  
Robert D. Brown ◽  
Charles J. Moomaw ◽  
Laura Sauerbeck ◽  
Richard Hornung ◽  
...  
Keyword(s):  
Family History ◽  
Intracranial Aneurysm ◽  
Intracranial Aneurysms ◽  
Demographic Data ◽  
Positive Family History ◽  
International Study ◽  
Study Cohort ◽  
Familial Predisposition ◽  
Unruptured Intracranial Aneurysms ◽  
Patient Demographic Data

Object Familial predisposition is a recognized nonmodifiable risk factor for the formation and rupture of intracranial aneurysms (IAs). However, data regarding the characteristics of familial IAs are limited. The authors sought to describe familial IAs more fully, and to compare their characteristics with a large cohort of nonfamilial IAs. Methods The Familial Intracranial Aneurysm (FIA) study is a multicenter international study with the goal of identifying genetic and other risk factors for formation and rupture of IAs in a highly enriched population. The authors compared the FIA study cohort with the International Study of Unruptured Intracranial Aneurysms (ISUIA) cohort with regard to patient demographic data, IA location, and IA multiplicity. To improve comparability, all patients in the ISUIA who had a family history of IAs or subarachnoid hemorrhage were excluded, as well as all patients in both cohorts who had a ruptured IA prior to study entry. Results Of 983 patients enrolled in the FIA study with definite or probable IAs, 511 met the inclusion criteria for this analysis. Of the 4059 patients in the ISUIA study, 983 had a previous IA rupture and 657 of the remainder had a positive family history, leaving 2419 individuals in the analysis. Multiplicity was more common in the FIA patients (35.6% vs 27.9%, p < 0.001). The FIA patients had a higher proportion of IAs located in the middle cerebral artery (28.6% vs 24.9%), whereas ISUIA patients had a higher proportion of posterior communicating artery IAs (13.7% vs 8.2%, p = 0.016). Conclusions Heritable structural vulnerability may account for differences in IA multiplicity and location. Important investigations into the underlying genetic mechanisms of IA formation are ongoing.

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