Considerations for the design of online gaming interventions for the frail elderly: A short communication

Recovery from cardiovascular surgical procedures can be problematic for the frail elderly due to developmental considerations and the way that post-operative education is delivered in hospitals. In this short communication paper, we outline the physical and developmental considerations of this cohort as well as the standard delivery of post-operative education. As an alternative, we introduce online gaming and explore considerations for the design of this intervention related to post-operative, frail elderly cardiovascular surgical patients. Specific strategies and/or techniques for addressing each of these influences are presented.

Considerations for the design of online gaming interventions for the frail elderly: A short communication

Recovery from cardiovascular surgical procedures can be problematic for the frail elderly due to developmental considerations and the way that post-operative education is delivered in hospitals. In this short communication paper, we outline the physical and developmental considerations of this cohort as well as the standard delivery of post-operative education. As an alternative, we introduce online gaming and explore considerations for the design of this intervention related to post-operative, frail elderly cardiovascular surgical patients. Specific strategies and/or techniques for addressing each of these influences are presented.

Implementation of a 3D position detection system for a medical simulator

BACKGOROUND AND OBJECTIVE: Cardiovascular disorders are increasing because of poor eating habits, excessive drinking, and lack of exercise. Some of the typical cardiovascular surgical procedures utilize catheters. Catheter-based procedures require the surgeons to have extensive experience and high proficiency at performing vascular interventions. However, the learning period to acquire such proficiency is lengthy and the opportunities for practical training and mastery are insufficient. Therefore, due to insufficient skill, dangerous situations with damage or rupture of the patient’s blood vessels may occur, thereby increasing the risk of medical accidents. Hence, it is necessary to have experience and proficiency for performing vascular interventions. Thus, it is necessary to develop a simulator to shorten learning time and reduce medical accidents. METHODS: In this study, we developed a position detection system for the simulator to use physical models to learn cardiovascular surgical intervention techniques. The developed system uses changes in the output values of a Hall sensor based on the position of a permanent magnet. RESULTS AND CONCLUSIONS: From the changing output values, the distance calculation equation is derived, and the position of the permanent magnet is effectively estimated from the calculations. The performance of the position detecting system was tested, and the results proved that the system could be sufficiently used as a simulator.

Perfil dos enfermeiros perfusionistas brasileiros atuantes no mercado de trabalho

Objetivo: traçar o perfil dos enfermeiros perfusionistas brasileiros atuantes no mercado de trabalho. Métodos: trata-se de um estudo observacional com delineamento transversal. Foram obtidos dados de perfil sócio demográfico e profissional dos perfusionistas em situação ativa no Brasil através do preenchimento de um questionário eletrônico. A amostra contemplou 70 enfermeiros perfusionistas. Resultados: a maioria dos profissionais é do sexo feminino (44%), possui 38,3±8,62 anos. A formação complementar demonstra um período de transição e aperfeiçoamento nesta especialidade: 84,2% destes possuem pós-graduação. Conclusão: o perfil profissional dos enfermeiros perfusionistas está em franca evolução em termos de qualificação e, nesse enfoque, torna-se necessário o conhecimento da especialidade para o delineamento de novas ações e inserção profissional em diferentes cenários da tecnologia extracorpórea.Descritores: Circulação Extracorpórea; Procedimentos Cirúrgicos Cardiovasculares; Enfermagem. Objective: to profile the Brazilian perfusionist nurses working in the labor market. Methods: This is an observational study with cross-sectional design. Data on socio-demographic and professional profile of perfusionists in active situation in Brazil were obtained by completing an electronic questionnaire. The sample included 70 perfusionist nurses. Results: most professionals are female (44%), 38.3 ± 8.62 years old. Complementary education demonstrates a period of transition and improvement in this specialty: 84.2% of these have postgraduate degrees. Conclusion: the professional profile of perfusionist nurses is clearly evolving in terms of qualification and, in this approach, it is necessary to know the specialty to delineate new actions and professional insertion in different scenarios of extracorporeal technology.Keywords: Cardiopulmonary bypass; Cardiovascular Surgical Procedures; Nursing. Objetivo: perfilar las enfermeras perfusionistas brasileñas que trabajan en el mercado laboral. Métodos: Este es un estudio observacional con diseño transversal. Los datos sobre el perfil sociodemográfico y profesional de perfusionistas en situación activa en Brasil se obtuvieron completando un cuestionario electrónico. La muestra incluyó 70 enfermeras perfusionistas. Resultados: la mayoría de los profesionales son mujeres (44%), 38.3 ± 8.62 años. La educación complementaria demuestra un período de transición y mejora en esta especialidad: 84,2% de ellos tienen títulos de posgrado. Conclusión: el perfil profesional de las enfermeras perfusionistas está evolucionando claramente en términos de calificación y, en este enfoque, es necesario conocer la especialidad para delinear nuevas acciones e inserción profesional en diferentes escenarios de tecnología extracorpórea.Descriptores: Circulacion Extracorporea; Procedimientos quirúrgicos cardiovasculares; Enfermería.

Perfil epidemiológico de pacientes submetidos à cirurgia cardíaca

RESUMO Objetivo: descrever o perfil sociodemográfico e clínico dos pacientes submetidos à cirurgia cardíaca. Método: trata-se de estudo quantitativo, transversal e descritivo, realizado em um hospital universitário. Compôs-se a amostra por 200 pacientes submetidos à cirurgia cardíaca. Coletaram-se os dados por meio de um formulário específico, de dados secundários contidos nos prontuários. Utilizaram-se para a tabulação o programa Microsoft Office Excel, versão 2010 e analisaram-se os dados pelo programa estatístico Stata 14.0. Apresentaram-se os resultados em tabela. Resultados: avaliaram-se os prontuários de 200 pacientes submetidos à cirurgia cardíaca e, destes, a maior parte era do sexo masculino, composta por maiores de 60 anos e pardos, sendo a hipertensão arterial sistêmica, a dislipidemia e o Diabetes Mellitus as comorbidades mais prevalentes. Identificaram-se, como as principais complicações, as pulmonares e as arritmias cardíacas. Conclusão: possibilita-se, a partir do conhecimento acerca do perfil dos pacientes que realizaram cirurgia cardíaca, ampliar as ações educativas e de prevenção à saúde, subsidiando estratégias para a adesão ao tratamento e ao controle das complicações. Descritores: Tempo de Internação; Procedimentos Cirúrgicos Cardiovasculares; Perfil de Saúde; Regulação e Fiscalização em Saúde; Cirurgia Toráxica; Enfermagem.ABSTRACT Objective: to describe the sociodemographic and clinical profile of patients undergoing cardiac surgery. Method: this is a quantitative, cross-sectional and descriptive study carried out in a university hospital. The sample was composed of 200 patients submitted to cardiac surgery. The data was collected by means of a specific form, of secondary data contained in the medical records. The Microsoft Office Excel program, version 2010 was used for the tabulation and the data was analyzed by the Stata 14.0 statistical program. The results were presented in the table. Results: the medical records of 200 patients submitted to cardiac surgery were evaluated, and of these, the majority were male, composed of patients older than 60 years and pardos, systemic arterial hypertension, dyslipidemia and Diabetes Mellitus being the most common comorbidities prevalent. The main complications were identified as pulmonary and cardiac arrhythmias. Conclusion: it is possible, based on the knowledge about the profile of the patients that underwent cardiac surgery, to expand educational and health prevention actions, subsidizing strategies for adherence to treatment and control of complications. Descriptors: Length of hospitalization; Cardiovascular Surgical Procedures; Health Profile; Health Regulation and Surveillance; Thoracic Surgery; Nursing.RESUMENObjetivo: describir el perfil sociodemográfico y clínico de los pacientes sometidos a la cirugía cardiaca. Método: se trata de un estudio cuantitativo, transversal y descriptivo, realizado en un hospital universitario. Se compuso la muestra por 200 pacientes sometidos a la cirugía cardiaca. Se recolectaron los datos a través de un formulario específico, de datos secundarios contenidos en los prontuarios. Se utilizaron para la tabulación el programa Microsoft Office Excel, versión 2010 y se analizaron los datos por el programa estadístico Stata 14.0. Se presentaron los resultados en tabla. Resultados: se evaluaron los prontuarios de 200 pacientes sometidos a la cirugía cardiaca y, de éstos, la mayor parte era del sexo masculino, compuesta por mayores de 60 años y pardos, siendo la hipertensión arterial sistémica, la dislipidemia y la Diabetes Mellitus las comorbilidades más prevalente. Se identificaron, como las principales complicaciones, las pulmonares y las arritmias cardíacas. Conclusión: se permite, a partir del conocimiento acerca del perfil de los pacientes que realizaron cirugía cardiaca, ampliar las acciones educativas y de prevención a la salud, subsidiando estrategias para la adhesión al tratamiento y al control de las complicaciones. Descriptores: Tiempo de internación; Procedimientos Quirúrgicos Cardiovasculares; Perfil de Salud; Regulación y Fiscalización em salud; Cirugía Torácica; Enfermería.

Evaluation of BioFoam for Anastomotic Bleeding in Cardiovascular Surgery

Background Hemostatic agents are increasingly used as an adjunct to standard methods of controlling anastomotic bleeding in surgical procedures. The purpose of this study was to investigate the safety and effectiveness of BioFoam Surgical Matrix used as an adjunct for anastomotic hemostasis following cardiovascular surgery. Methods A prospective, multicenter, single arm study was conducted with 75 subjects treated with BioFoam following a total of 105 elective cardiovascular surgical procedures. Time to hemostasis was recorded following a single application of BioFoam in 74 subjects. Safety evaluations included intraoperative administration of a blood product, requirement for alternative means to achieve hemostasis, and the incidence of reoperation for bleeding. Results Hemostasis within 3 minutes was achieved in 62 (84%) of the 74 subjects and within 10 minutes in 69 (93%) of these subjects. BioFoam was well tolerated. Twelve (16%) of the 75 enrolled subjects each experienced one adverse event, and 13 serious adverse events were reported in 10 (13.3%) of the subjects. None of the adverse events was considered by the Investigators to be related to BioFoam. Blood products were administered to 14 (18.6%) of the 75 subjects, banked autologous blood was given to 5 (6.6%) subjects, and 57 (75.7%) subjects required only a cell saver. Four (5.3%) of the 75 subjects required reoperation for bleeding within 24 hours of surgery. There were no observations of bleeding in any subject at discharge and no reoperation for bleeding following discharge. The mean operation time was 218.2 (±72.2) minutes. Conclusions This study demonstrates the effectiveness of BioFoam Surgical Matrix when used as an adjunct for anastomotic hemostasis following a broad range of cardiovascular surgical procedures. The safety outcomes were within the normal limits for the types of procedures performed.

Perioperative Coagulation Management of a Hemophilia A Patient During Cardiac Surgery

Perioperative management of cardiovascular surgical procedures requiring cardiopulmonary bypass (CPB) in patients with hemophilia A poses a clinical challenge in coagulation management. Use of CPB requires the administration of an anticoagulant, usually unfractionated heparin, and also causes dilutional coagulopathy, platelet dysfunction or platelet consumption coagulopathy. Hypothermia and activation of the inflammatory cascade also affect coagulation. The effects of CPB on circulating levels of factor VIII have not been clearly defined. In this review, the effects of CPB and hemodilution on FVIII are shown in a case presentation, and perioperative laboratory testing in patients with hemophilia A having cardiac surgery is discussed along with perioperative and postoperative coagulation management.

POSTNATAL IMPLICATIONS FOR PRENATAL DIAGNOSED TETRALOGY OF FALLOT

Over the last few years, prenatal diagnosis of congenital heart diseases experienced an important development. Overall survival of patients with congenital heart disease was improved in the last decade due to the advanced diagnostic methods and progression of cardiovascular surgical procedures in this field. Due to the significant increase of the long-term survival rate, currently, in most developed countries, there are departments dedicated to monitoring the adults with congenital heart malformation due to the particularities and special needs of this type of patients, compared with the regular cardiac pathology of adults. This article proposes a review of existing data at this moment related to the prenatal and postnatal diagnosis and their impact on the evolution regarding the most common cyanotic congenital malformation – Tetralogy of Fallot. In the following pages, we is emphasize the importance of knowing the precise fetal pathology for early determination of medical behavior in the postnatal period for the best care of these children.

Computational Modeling of a Novel Mitral Valve Stent

Although percutaneous heart valve replacement is getting known amongst cardiovascular surgical procedures, as it was recently introduced, and reports of early clinical experience been published, this technique is limited to the replacement of pulmonary and aortic valves in old patients who cannot undergo open heart surgery. One of the reasons is the uphill challenges in the generation of an ideal design that would address anchorage and leakage issues. Stent anchorage and paravalvular leaks prove to the greatest challenge posed to biomedical design engineers. This paper describes a novel Nitinol based mitral valve stent that addresses migration and paravalvular leaks associated with the bioprosthetic mitral valve. The geometry-based model presented here specifically addresses issues of valve migration and paravalvular leaks This is of great interest to designers of new prosthetic heart valve models, as well as to surgeons involved in valve sparing surgery. Simulation results show that the studied stent design seemed to be good by virtue of its acceptable maximum crimping strain.