scholarly journals End-of-life Management of Leadless Cardiac Pacemaker Therapy

2017 ◽  
Vol 6 (3) ◽  
pp. 129 ◽  
Author(s):  
Niek EG Beurskens ◽  
Fleur VY Tjong ◽  
Reinoud E Knops ◽  
◽  
◽  
...  
Keyword(s):  
End Of Life ◽  
Cardiac Pacemaker ◽  
Life Strategy ◽  
Pacemaker Therapy ◽  
New Device ◽  
Novel Technique ◽  
Leadless Pacemaker ◽  
Novel Technology ◽  
Potential Risks

The clinically available leadless pacemakers for patients with a single-chamber pacing indication have shown to be safe and effective. However, the optimal end-of-life strategy of this novel technique is undefined. Suggested strategies comprise of (a) placing an additional leadless device adjacent to the leadless pacemaker, or (b) retrieving the non-functioning leadless pacemaker and subsequently implanting a new device. Although initial studies demonstrate promising results, early experience of acute and mid-term retrieval feasibility and safety remains mixed. We suggest that the approach of leadless pacemaker retrieval is more appealing to limit the amount of non-functioning intracardiac hardware. In addition, potential risks for device–device interference, and unknown long-term complications associated with multiple intracardiac devices are prevented. The potential inability to retrieve chronically implanted leadless pacemakers limits the application of this novel technology. Therefore, long-term prospective analysis is required to define the most optimal end-of-life strategy.

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 Impact of the COVID-19 pandemic: a perspective from industry

2020 ◽  
Vol 22 (Supplement_P) ◽  
pp. P56-P59
Author(s):  
Nick E J West ◽  
Wai-Fung Cheong ◽  
Els Boone ◽  
Neil E Moat
Keyword(s):  
Care Delivery ◽  
Models Of Care ◽  
Medium Term ◽  
Change Models ◽  
New Device ◽  
Supply Chain Logistics ◽  
Cardiovascular Patients ◽  
Medical Crisis ◽  
Device Industry

Abstract The global COVID-19 pandemic has led to unprecedented change throughout society.1 As the articles in this supplement outline, all segments of the broader cardiovascular community have been forced to adapt, to change models of care delivery, and to evolve and innovate in order to deliver optimal management for cardiovascular patients. The medtech/device industry has not been exempt from such change and has been forced to navigate direct and indirect COVID-associated disruption, with effects felt from supply chain logistics to the entire product lifecycle, from the running of clinical trials to new device approvals and managing training, proctoring and congresses in an increasingly-online world. This sea-change in circumstances itself has enforced the industry, in effect, to disrupt its own processes, models and activities. Whilst some of these changes may be temporary, many will endure for some time and some will doubtless become permanent; one thing is for sure: the healthcare ecosystem, including the medical device industry, will never look quite the same again. Although the pandemic has brought a short- to medium-term medical crisis to many countries, its role as a powerful disruptor cannot be underestimated, and may indeed prove to be a force for long-term good, given the accelerated innovation and rapid adaptation that it has cultivated.

scholarly journals Me & My Wishes Videos: Congruence of End-of-Life Preferences Between Residents With Dementia, Family, and Staff

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 786-786
Author(s):  
Sarah Neller ◽  
Gail Towsley ◽  
Bob Wong
Keyword(s):  
End Of Life ◽  
Life Support ◽  
Medical Intervention ◽  
Treatment Preferences ◽  
Term Care ◽  
Comparison Groups ◽  
Preferences For Care ◽  
Baseline Health ◽  
Support Family

Abstract Me & My Wishes are person-centered videos of long term care residents (ages 65-95) living with dementia discussing their preferences for care including end-of-life (EOL) medical intervention. We evaluated the congruence of six EOL treatment preferences between the residents’ personal videos, medical records (e.g. advance directive), and surveys of family (n= 49) and staff (n=37; 118 responses) knowledge of their preferences. Results were highly discordant. Treatments with the most discordance when comparing videos to comparison groups were IV fluids (medical record, 57.1%) and life support (family, 69.4%; staff, 82.2%). Residents reported EOL treatments were considered acceptable if they were temporary, would relieve suffering, or enabled a return to baseline health. These caveats may lead to discordance if they are not conveyed to family or staff. Our findings highlight the need for conversations among residents living with dementia and their caregivers to improve understanding, congruence and adherence of resident EOL preferences.

scholarly journals Cost of shifting from healthcare to long-term care in later life across major diseases: analysis of end-of-life care during the last 24 months of life

2018 ◽  
Vol 13 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Tomoko Terada ◽  
Keiko Nakamura ◽  
Kaoruko Seino ◽  
Masashi Kizuki ◽  
Naohiko Inase
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Later Life ◽  
Life Care ◽  
Term Care

scholarly journals B-PO03-038 PERMANENT LEADLESS PACEMAKER IMPLANTATION FOR LONG-TERM PACING DURING ACTIVE MRSA BACTEREMIA

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S204
Author(s):  
Ashwani Gupta ◽  
Muhammad Zubair Khan ◽  
Steven P. Kutalek
Keyword(s):  
Pacemaker Implantation ◽  
Leadless Pacemaker

Effects of long-term oral administration of silver nanoparticles on the cognitive functions of mammals

2021 ◽  
Vol 29 (6) ◽  
pp. 33-38
Author(s):  
Anna Alexandrovna Antsiferova ◽  
Marina Yurievna Kopaeva ◽  
Vyacheslav Nikolaevich Kochkin ◽  
Pavel Konstantinovich Kashkarov
Keyword(s):  
Silver Nanoparticles ◽  
Oral Administration ◽  
Dietary Supplement ◽  
Cognitive Functions ◽  
High Demand ◽  
Gastrointestinal Infections ◽  
Impaired Cognitive Function ◽  
Potential Risks ◽  
The Brain

Introduction. Since the beginning of the XXI century, silver nanoparticles have been widely used in various industries, medicine and pharmaceuticals due to their pronounced antibacterial, antiviral and fungicidal properties. In connection with such a high demand for the use of silver nanoparticles, it is very important to understand the associated potential risks from their use. Materials and methods. In the course of the work, there has been a study of the effects of the long-term oral administration of a commercially produced dietary supplement based on silver nanoparticles with a size of 34 nm and stabilized with polyvinylpyrrolidone in an amount of 50 μg/day/animal on the cognitive functions of C57Bl/6 mice, as well as their accumulation in the brain by the method of instrumental neutron activation analysis. The dietary supplement used is recommended for people as a treatment for gastrointestinal infections. Results. It was found that after 180 days of administration, silver nanoparticles impair long-term contextual memory, and over time, the content of silver in the brain increases. Conclusion. Presumably impaired cognitive function with accumulation of silver in the brains of mice. This poses the risk of prolonged oral use of the silver nanoparticles.

Conclusion: What academia can contribute to refugee policy

2018 ◽  
Vol 56 (1) ◽  
pp. 146-151 ◽  
Author(s):  
Idean Salehyan
Keyword(s):  
Academic Research ◽  
Forced Migration ◽  
Humanitarian Assistance ◽  
Future Research ◽  
Security Risks ◽  
Individual Level ◽  
The Public ◽  
Level Data ◽  
Potential Risks

This conclusion to the special issue highlights the role of scholars in advancing the public discussion about forced migration. As countries around the world are adopting increasing restrictions on the entry of refugees, academic research can help to dispel some of the myths and apprehensions regarding the risks that forced migration entails. While refugees may be linked to conflict and violence in limited circumstances, the research generally demonstrates that robust international cooperation to manage refugee settlements, provide adequate humanitarian assistance, and integrate refugees into host communities, among other policies, can help to mitigate potential risks. Directions for future research and analysis are also discussed. Forced migration scholars should endeavor to collect more individual-level data; seek to understand factors that exacerbate or reduce security risks associated with cross-border militancy; conduct research on the long-term integration of refugees; and seek to understand the causes and consequences of resettlement and repatriation policies.

scholarly journals What Are Staff Perceptions About Their Current Use of Emergency Departments for Long-Term Care Residents at End of Life?

2017 ◽  
Vol 28 (6) ◽  
pp. 692-707 ◽  
Author(s):  
Sharon Kaasalainen ◽  
Tamara Sussman ◽  
Pamela Durepos ◽  
Lynn McCleary ◽  
Jenny Ploeg ◽  
...  
Keyword(s):  
End Of Life ◽  
Long Term Care ◽  
Hospital Staff ◽  
Clinical Expertise ◽  
Staff Perceptions ◽  
Term Care ◽  
Reflective Process ◽  
Hospital Deaths ◽  
Chart Audits

The goal of this study was to examine current rates of resident deaths, Emergency Department (ED) use within the last year of life, and hospital deaths for long-term care (LTC) residents. Using a mixed-methods approach, we compared these rates across four LTC homes in Ontario, Canada, and explored potential explanations of variations across homes to stimulate staff reflections and improve performance based on a quality improvement approach. Chart audits revealed that 59% of residents across sites visited EDs during the last month of life and 26% of resident deaths occurred in hospital. Staff expressed surprise at the amount of hospital use during end of life (EOL). Reflections suggested that clinical expertise, comfort with EOL communication, clinical resources (i.e., equipment), and family availability for EOL decision making could all affect nondesirable hospital transfers at EOL. Staff appeared motivated to address these areas of practice following this reflective process.

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