Impact of COVID-19 on gynaecological patient care: results of patient’s survey with 327 patients

Purpose The pandemic SARS-CoV-2 poses new and unprecedented challenges for health care systems on a national and global level. Although the current situation has been going on for more than 1 year, there is limited data on the impact of the pandemic on general hospital and medical practice care. This survey captures the perspective of patients with gynaecological diseases of this impact. Methods Using a paper-based questionnaire, 327 patients were asked about medical care and their experiences during the pandemic at the University Hospital Bonn and the University Hospital Charité Berlin. The study was performed from the 1st June to 30th September 2020. Results A total of 327 patients participated in the study: 156 stated to have been tested for coronavirus, and 1 patient reported a positive test. 41.3% of the patients felt insecure about the current situation, 30.4% were concerned about the risk of infection during the hospital stay. The pandemic-specific measures in hospitals and medical practices unsettled 6.8% of patients. 18.1% of patients feared that their gynaecological disease would not be treated adequately due to the pandemic. 55.7% of patients reported that their confidence in their physicians has increased during the pandemic. Conclusion The results show that patients’ confidence in the healthcare system and the physicians acting significantly increased during the COVID-19 crisis. Transparent and comprehensive information policy regarding actions and restrictions within the COVID-19 crisis eases patients concerns and improves patients’ confidence in their physicians, which is crucial for a successful treatment’s outcome.

Evaluation of the accuracy and ease-of-use of Abbott PanBio - A WHO emergency use listed, rapid, antigen-detecting point-of-care diagnostic test for SARS-CoV-2

BackgroundDiagnostics are essential for controlling the pandemic. Identifying a reliable and fast diagnostic is needed to support testing. We assessed performance and ease-of-use of the Abbott PanBio antigen-detecting rapid diagnostic test (Ag-RDT).MethodsThis prospective, multi-centre diagnostic accuracy study enrolled at two sites in Germany. Following routine testing with RT-PCR, a second study-exclusive swab was performed for Ag-RDT testing. Routine swabs were nasopharyngeal (NP) or combined NP/oropharyngeal (OP) whereas the study-exclusive swabs were NP. To evaluate performance, sensitivity and specificity were assessed overall and in predefined sub analyses accordingly to cycle-threshold values, days of symptoms, disease severity and study site. Additionally, an ease-of-use assessment and System Usability Scale (SUS) were performed.Findings1108 participants were enrolled between Sept 28 and Oct 30, 2020. Of these, 106 (9·6%) were PCR-positive. The Abbott PanBio detected 92/106 PCR-positive participants with a sensitivity of 86·8% (95% CI: 79·0% - 92·0%) and a specificity of 99·9% (95% CI: 99·4%-100%). The sub analyses indicated that sensitivity was 95·8% in CT-values <25 and within the first seven days from symptom onset. The test was characterized as easy to use (SUS: 86/100) and considered suitable for point-of- care settings.InterpretationThe Abbott PanBio Ag-RDT performs well for SARS-CoV-2 testing in this large manufacturer independent study, confirming its WHO recommendation for Emergency Use in settings with limited resources.FundingThe Foundation of Innovative New Diagnostics supplied the test kits for the study. The internal funds from the Heidelberg University as well as the Charité Berlin supported this study.

Das Berliner Notfallsieb

Um keine wertvolle Zeit zu verlieren, müssen im Notfall die OP-Instrumente für die unterschiedlichsten Eingriffe übersichtlich und griffbereit sein. Deshalb wurde an der Charité Berlin das Berliner Notfallsieb entwickelt. Die Vorgabe lautete: So wenig wie möglich, aber so viel wie nötig in möglichst wenigen Containern unterzubringen.

Nora Systems: Architektur statt Antibiotika

Welche Bakterien leben auf den Oberflächen in Patientenzimmern? Kann eine neue Raumplanung Infektionen in Kliniken verhindern? Damit beschäftigten sich Architekten der Technischen Universität Braunschweig zusammen mit Molekularbiologen sowie Mediziner im Projekt Karmin („Krankenhaus, Architektur, Mikrobiom und Infektion“). Gemeinsam mit einem bayerischen Unternehmenspartner entwickelten die Projektpartner einen Prototyp für ein neuartiges infektionspräventives Patientenzimmer. Der Demonstrator für ein optimiertes Patientenzimmer wird im Oktober 2020 beim „WorldHealth Summit“ in Berlin präsentiert. In einer Studie haben die Wissenschaftler der Charité Berlin zunächst ein Jahr lang Abstriche in Patientenzimmern sowie Proben direkt von Patienten genommen. „So können wir zum ersten Mal zeigen, wie sich das Mikrobiom, also die Gesamtheit der Mikroorganismen, auf den Oberflächen im Krankenhaus aufbaut“, sagt Dr. Rasmus Leistner vom Institut für Hygiene und Umweltmedizin an der Charité Berlin. Reinigungsmittel und anwesende Personen könnten demnach durch ihr eigenes Mikrobiom die Mikroben-Konstellation des Zimmers verändern. Einerseits vernichten Reinigungsmittel Bakterien, schaffen andererseits aber auch Nischen für gefährliche Erreger.

DEUTSCHLAND IM AUSNAHMEZUSTAND: Veranstaltungen in Zeiten von Corona

Angesichts der Pandemie muss die Messebranche weltweit umdisponieren. In Deutschland sind alle Veranstaltungen bis auf Weiteres abgesagt, dass gilt auch für die Gesundheitswirtschaft. Die Prognosen von Professor Dr. Christian Drosten, Deutschlands gefragtestem Virologen und Direktor des Instituts für Virologie der Charité Berlin, fallen für die nahe Zukunft eher düster aus. Dennoch scheinen die meisten Veranstalter von Messen, Tagungen und Kongressen derzeit darauf zu bauen, dass sich die Lage zumindest ab Mai wieder ändern könnte. Bleibt zu hoffen, dass sie Recht behalten.

Association of simple renal cysts and chronic kidney disease with large abdominal aortic aneurysm

Abdominal aortic aneurysms (AAA) primarily affect elderly men who often have many other diseases, with similar risk factors and pathobiological mechanisms to AAA. The aim of this study was to assess the prevalence of simple renal cysts (SRC), chronic kidney disease (CKD), and other kidney diseases (e.g. nephrolithiasis) among patients presenting with AAA. Two groups of patients (100/group), with and without AAA, from the Surgical Clinic Charité, Berlin, Germany, were selected for the study. The control group consisted of patients who were evaluated for a kidney donation (n = 14) and patients who were evaluated for an early detection of a melanoma recurrence (n = 86). The AAA and control groups were matched for age and sex. Medical records were analyzed and computed tomography scans were reviewed for the presence of SRC and nephrolithiasis. SRC (73% vs. 57%; p<0.001) and CKD (31% vs. 8%; p<0.001) were both more common among AAA than control group patients. On multivariate analysis, CKD, but not SRC, showed a strong association with AAA. Knowledge about pathobiological mechanisms and association between CKD and AAA could provide better diagnostic and therapeutic approaches for these patients.

Fenestrierte endovaskuläre Aortenreparatur

ZusammenfassungMit der dreifach fenestrierten endovaskulären Aortenreparatur – kurz FEVAR – können Patienten mit einem Aneurysma risikoärmer operiert werden, da im Vergleich zur offenen OP die lange Klemmzeit an der Aorta wegfällt. Unsere Autoren von der Charité Berlin schildern den minimalinvasiven Eingriff und seine Besonderheiten.

Charité: „Berlin bietet ein einmaliges Umfeld“

Zum 1. September tritt Prof. Heyo Kroemer seinen Posten als neuer Vorstandsvorsitzender der Berliner Charité an. Im Interview mit kma erzählt der derzeitige Chef der Uniklinik Göttingen, warum es ihn an die Spree zieht, welche Herausforderungen er dort erwartet und warum die Digitalisierung für ihn eine Schlüsselfrage ist.