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Major MM, Guóth M, Balogh S, Simon J, Bényei AC, Bakos J, Farkas G. Novel Pd(PN,S)-complexes: Highly active catalysts designed for asymmetric allylic etherification. MOLECULAR CATALYSIS 2021. [DOI: 10.1016/j.mcat.2021.111763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hahn V, Simon J, Kolossvary M, Szilveszter B, Kardos AS, Boussoussou M, Vattay B, Merkely B, Maurovich Horvat P. The presence of adverse atherosclerotic coronary plaque features is associated with diabetes. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The grant was given to the Bioimaging field of Semmelweis University by the Excellence Program of the Ministry of Innovation and Technology in Hungary.
On Behalf of
Cardiovascular Imaging Research Group (CIRG)
Introduction
Diabetes mellitus (DM) is associated with increased cardiovascular morbidity and mortality. However, there is a lack of data about the prevalence of high-risk coronary artery plaques in patients with DM.
Purpose
In our study we aimed to compare the prevalence of adverse atherosclerotic coronary artery plaque features between patients with and without DM.
Methods
We have analyzed the data of patients who underwent coronary computed tomography angiography (CCTA) between October 2012 and December 2020. Our exclusion criteria were coronary anomaly, congenital or other structural heart disease, previous revascularization or heart transplantation, non-diagnostic image quality and no available data on the presence of DM. Patients were divided into two groups based on the presence of DM.
Results
In total, 11357 patients (47.6% men) were included in our study. Prevalence of DM was 14.5%. There were significant differences in age (63.2 ± 9.5 vs 58.1 ± 12.2 years, p < 0.001) and major cardiovascular risk factors such as hypertension, dyslipidemia and smoking between the two groups (all p < 0.05). We have measured higher coronary artery calcium score in patients with DM vs. without DM (424.3 ± 744.0 vs 174.2 ± 794.6, p < 0.001). Luminal stenosis >70% was more frequent in the DM group (24.6% vs 10.5%, p < 0.001). While 29.6% of patients without DM had at least one high risk plaque, this rate was 38.9% in those with DM (positive remodeling: 19.6% vs 26.1%, low attenuation: 7.6% vs 10.2%, spotty calcium: 16.9% vs 21.6%, napkin-ring sign: 1.7% vs 2.6%, all p < 0.05).
Conclusions
The prevalence of severe coronary artery stenosis and coronary plaques with adverse characteristics was higher in patients with DM.
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Vecsey-Nagy M, Szegedi N, Simon J, Szilveszter B, Kolossvary M, Boussoussou M, Vattay B, Delgado V, Jeroen B, Maurovich-Horvat P, Merkely B, Geller L. Orientation of the right superior pulmonary vein affects outcome after pulmonary vein isolation. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Aims
Controversial results have been published regarding the influence of pulmonary vein (PV) anatomical variations on outcomes after pulmonary vein isolation (PVI). However, no data is available on the impact of PV orientation on the long-term success rates of point-by-point PVI. We sought to determine the impact of PV anatomy and orientation on atrial fibrillation (AF)-free survival in patients undergoing PVI using the radiofrequency point-by-point technique.
Methods and results
We retrospectively included 448 patients who underwent initial point-by-point radiofrequency ablation for AF at our department. Left atrial CT-angiography (CTA) was performed before each procedure. PV anatomical variations, ostial parameters (area, effective diameter and eccentricity), orientation and their associations with 24-month AF-free survival were analyzed. PV anatomical variations and ostial parameters were not predictive for AF-free survival (all p > 0.05). Univariate analysis showed that female sex (p = 0.025) was associated with higher rates of AF recurrence, ventral-caudal (p = 0.002), dorsal-cranial (p = 0.034) and dorsal-caudal (p = 0.042) orientation of the right superior PV (RSPV), on the other hand, showed an association with lower rates of AF recurrence, as compared to the reference ventral-cranial orientation. On multivariate analysis, both female sex [odds ratio(OR) 1.83, 95% CI 1.15-2.93, p = 0.011] and ventral-caudal RSPV orientation, compared with ventral-cranial orientation, proved to be independent predictors of 24-month AF recurrence (OR 0.37, 95% CI 0.19-0.71, p = 0.003).
Conclusion
Female sex and ventral-caudal RSPV orientation have an impact on long-term arrhythmia-free survival. Assessment of PV orientation may be a useful tool in predicting AF-free survival and may contribute to a more personalized management of AF.
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Szegedi N, Simon J, Szilveszter B, Sallo Z, Herczeg S, Nagy VK, Szeplaki G, Tahin T, Merkely B, Geller L. Abutting left atrial appendage and left superior pulmonary vein predicts recurrence of atrial fibrillation after point-by-point pulmonary vein isolation. Europace 2021. [DOI: 10.1093/europace/euab116.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Catheter ablation is the cornerstone for rhythm control in patients with drug-refractory atrial fibrillation (AF). Baseline predictors of AF recurrence after catheter ablation are well established, such as female gender and left atrial enlargement. The role of the spatial relationship between the left superior pulmonary vein (LSPV) and left atrial appendage (LAA) is unknown.
Purpose
We sought to evaluate whether juxtaposed LSPV and LAA plays a role in AF recurrence after catheter ablation for paroxysmal AF.
Methods
Consecutive patients, who underwent point-by-point radiofrequency catheter ablation for paroxysmal AF at our hospital between January of 2014 and December of 2017, were enrolled in the study. All patients underwent pre-procedural cardiac CT-angiography (CTA) for the assessment of left atrial (LA) and pulmonary vein (PV) anatomy. Abutting LAA-LSPV was defined as cases when LSPV touched the posterior aspect of LAA (distance less than 2 mm).
Results
We included 428 patients (60.7 ± 10.8 years, 35.5% female). AF recurrence rate was 33.4% with a median recurrence-free time of 21.2 (IQR = 8.8-43.0) months. In the univariate analysis, female sex (HR = 1.45; 95%CI = 1.04-2.01; p = 0.028), LA volume (HR = 1.01; 95%CI = 1.00-1.01; p = 0.042), and cases when LSPV touched the posterior wall of LAA (HR = 1.53; 95%CI = 1.09-2.14; p = 0.013) were associated with AF recurrence. In the multivariate analysis, female sex (adjusted HR = 1.55; 95%CI = 1.06-2.28; p = 0.024), LA volume (adjusted HR = 1.01; 95%CI = 1.00-1.02; p = 0.028), and abutting LAA-LSPV (adjusted HR = 1.60; 95%CI = 1.13-2.50; p = 0.008) remained significant predictors of AF recurrence.
Conclusion
Female gender, higher LA volume, and abutting LSPV and LAA predispose patients to have a higher chance for arrhythmia recurrence after catheter ablation for paroxysmal AF.
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Major MM, Balogh S, Simon J, Bakos J, Farkas G. New chiral thioether-phosphite ligands and their rhodium-coordination chemistry: steric and electronic properties, dynamic processes and application in catalysis. J COORD CHEM 2021. [DOI: 10.1080/00958972.2021.1892086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Costa J, Vanhove P, George E, Simon J, Horrer I, Metz D. High furosemide doses and survival in heart failure patients: A propensity score study. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2020.10.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Jacob J, Ribeiro M, Benadjaoud M, Jenny C, Feuvret L, Simon J, Bernier M, Antoni D, Hoang-Xuan K, Psimaras D, Carpentier A, Ricard D, Maingon P. OC-0696: Development of dose constraints to the brain areas implied in cognition: a prospective study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00718-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Simon J, Konnopka A, Brodszky V, Evers S, Hakkaart-van Roijen L, Serrano-Pérez P, vador-Carulla LSAL, Park AL, Hollingworth W. (Pharmaco)economic evaluations for mental health related services: the PECUNIA project. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Mental health disorders affect large proportions of the general public resulting in serious cost consequences even beyond the health care sector. The PECUNIA project (EU H2020 grant agreement No 779292) aims to establish standardised costing and outcome assessment measures for optimised healthcare provision in the EU for multi-sectoral, multi-national and multi-person (pharmaco)economic evaluations using selected mental health disorders as illustrative examples.
Methods
Harmonised Identification, Definition, Measurement and Valuation of service costs in multiple sectors (health care, social care, criminal justice, education, productivity, patient, family). Reviews and surveys of mental health related services and other resource use in six European countries (AT, DE, ES, HU, NL, UK) to develop a new harmonised costing concept and related tools.
Results
We identified many taxonomical and conceptual discrepancies which currently hinder harmonized costing efforts and comparability of economic evaluations/HTAs across countries and sectors. The 'PECUNIA care atom', a new multi-sectoral costing concept forms the basis of resource item classification and international coding of mental health related services using the DESDE-PECUNIA system. Linked, harmonized tools such as the PECUNIA-European Resource Use Measurement instrument and the PECUNIA-European Reference Unit Costing Templates have been developed and are currently deployed in six countries to establish a PECUNIA-European Unit Cost Compendium alongside pan-European outcome evaluation methods.
Conclusions
The PECUNIA tools will lead to better understanding of the variations in costs and outcomes of mental health services/interventions within and across countries, and improve the feasibility, quality, comparability and transferability of (pharmaco)economic evaluations and HTAs in Europe. They also allow the harmonized measurement of broader economic and societal impacts of mental health services.
Key messages
The PECUNIA project developed compatible European multi-sectoral, multi-national and multi-person costing and outcome assessment tools. Methods & tools allow the harmonised measurement of broader economic & societal impacts of mental health related services, and improve the transferability & comparability of economic evaluations/HTAs.
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Perić N, Ullmann T, Hofmarcher MM, Or Z, Simon J. Is the EU ready for a generic set of indicators for health system performance? A qualitative study. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
As part of the EU funded BRIDGE Health project, 23 headline indicators for assessing and comparing the performance of public health systems were proposed. They were shortlisted out of the currently existing and often overlapping pool of over 2000 health system performance assessment (HSPA) indicators. In this qualitative study, we explored their validity and perceived national-level utility for policy making and factors affecting the potential uptake of an indicator hierarchy (headline, operational & explanatory levels) at Member States' and EU levels.
Methods
Semi-structured interviews with a purposive sample of 24 policy makers and senior policy advisors from 15 EU Member States and one candidate country were performed between July and November 2018. All interviews were transcribed and coded using summative and directed content analysis to generate thematic categories in MAXQDA.
Results
Preliminary results suggest that experts positively perceived the overall balance of the shortlist across performance domains reflecting most of the important policy areas. However, some further amendments to the generic set of indicators were recommended to increase their policy relevance and measurement validity while keeping the size manageable. The concept and usage of headline HSPA indicators is mostly viewed as a communication tool whereas more granular information at explanatory levels is perceived to be more appropriate for data driven policymaking and cross-country learning.
Conclusions
Interviews showed a considerable heterogeneity in the feasibility of applying a generic HSPA framework in an EU-wide health strategy as a compass for improvement through comparisons of health systems. Factors such as flexibility in adaptation to the national context, improvement in building knowledge capacity, potential misinterpretation in the 'European Semester' context, as well as lack of appropriately defined benchmarks were recurrent themes in hindering its uptake.
Key messages
Policy makers assess explanatory level indicators to be more actionable than headline level indicators. To facilitate the use of headline indicators at EU-level as a navigation tool for health systems, the list has to be stable to create trends and sufficiently flexible in adapting to new priorities.
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Karim S, Lupichuk S, Tan A, Sinnarajah A, Simon J. 1516P Real world implementation of Serious Illness Care Program (SICP) in cancer care. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Moick S, Hiesmayr M, Mouhieddine M, Kiss N, Bauer P, Sulz I, Singer P, Simon J. Reducing the knowledge to action gap in hospital nutrition care - Developing and implementing nutritionDay 2.0. Clin Nutr 2020; 40:936-945. [PMID: 32747205 DOI: 10.1016/j.clnu.2020.06.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND & AIMS In hospital nutrition care the difficulty of translating knowledge to action often leads to inadequate management of patients with malnutrition. nutritionDay, an annual cross-sectional survey has been assessing nutrition care in healthcare institutions in 66 countries since 2006. While initial efforts led to increased awareness of malnutrition, specific local remedial actions rarely followed. Thus, reducing the Knowledge-to-action (KTA) gap in nutrition care requires more robust and focused strategies. This study describes the strategy, methods, instruments and experience of developing and implementing nutritionDay 2.0, an audit and feedback intervention that uses quality and economic indicators, feedback, benchmarking and self-defined action strategies to reduce the KTA gap in hospital nutrition care. METHODS We used an evidence based multi-professional mixed-methods approach to develop and implement nutritionDay 2.0 This audit and feedback intervention is driven by a Knowledge-to-Action framework complemented with robust stakeholder analysis. Further evidence was synthesized from the literature, online surveys, a pilot study, World Cafés and individual expert feedback involving international health care professionals, nutrition care scientists and patients. RESULTS The process of developing and implementing nutritionDay 2.0 over three years resulted in a new audit questionnaire based on 36 nutrition care quality and economic indicators at hospital, unit and patient levels, a new action-oriented feedback and benchmarking report and a unit-level personalizable action plan template. The evaluation of nutritionDay 2.0 is ongoing and will include satisfaction and utility of nutritionDay 2.0 tools and short-, mid- and long-term effects on the KTA gap. CONCLUSION In clinical practice, nutritionDay 2.0 has the potential to promote behavioural and practice changes and improve hospital nutrition care outcomes. In research, the data generated advances knowledge about institutional malnutrition and quality of hospital nutrition care. The ongoing evaluation of the initiative will reveal how far the KTA gap in hospital nutrition care was addressed and facilitate the understanding of the mechanisms needed for successful audit and feedback. TRIAL REGISTRATION Registration in clinicaltrials.gov: Identifier: NCT02820246.
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Bakos V, Szombathy P, Simon J, Jobbágy A. Implementing Cost-effective Co-treatment of Domestic and Food-industrial Wastewater by Novel Methods for Estimating Industrial Load. PERIODICA POLYTECHNICA-CHEMICAL ENGINEERING 2020. [DOI: 10.3311/ppch.15306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Detection and characterization of hidden industrial inflows causing high fluctuations of the inlet load, is a challenging issue pushing plant operators for a cost-effective solution at regional wastewater treatment plants (WWTPs). On the other hand, carbon source of food industrial origin may have a good use at WWTPs facing otherwise inlet carbon source deficiency.In a case study of a regional domestic WWTP receiving seasonally organic carbon-rich discharge from a fruit juice factory, a new method combining on-site measurements and mathematical modelling was developed and successfully applied for estimating the quality and quantity of both industrial influent load and incoming domestic wastewater streams properly. The originally un-staged bioreactor system operated at low dissolved oxygen (low DO) concentration was unable to meet effluent nitrogen requirements with an additional constant risk of encouraging filament growth. A novel screening method based on special sampling campaigns for estimating carbon availability and C:N ratios of influent wastewater streams coming separately from the large catchment area, was developed and applied. Staging of the previously low DO basins into a flexible system containing non-aerated selectors proved to be efficient for enhancing both biological nitrogen removal and sculpturing appropriately settling biomass.
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Simon J, Clayton A, Kingsberg S, Portman D, Jordan R, Lucas J, Williams L, Krop J. 038 Effect Size of Bremelanotide Treatment in the Phase 3 RECONNECT Studies. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Simon J, Száraz L, Szilveszter B, Merkely B, Maurovich-Horvat P, Kolossváry M. Coronary Artery Calcium Score May Select Patients In Whom Coronary Ct Angiography Is Discouraged Due To The Need For Downstream Testing. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Vattay B, Borzsák S, Kolossváry M, Ruzsa Z, Boussoussou M, Simon J, Merkely B, Maurovich-Horvat P, Szilveszter B. The Impact Of Iterative Reconstrustion Algorhitms On Dynamic Computed Tomography Myocardial Perfusion Parameters. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Simon J, Millheiser L, Clayton A, Kingsberg S, Kim N. 084 Improvements in Female Sexual Function Index (FSFI) Domains Over Time after Flibanserin Treatment in Premenopausal Women with Hypoactive Sexual Desire Disorder (HSDD). J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Szilveszter B, Vattay B, Boussoussou M, Simon J, Merkely B, Maurovich-Horvat P, Kolossváry M. Characteristics, Predictors And Prognostic Value Of Coronary Artery Plaque Progression Using Serial Computer Tomography Imaging. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chapel A, Semont A, Linard C, Mathieu N, Demarquay C, Squiban C, Voswinkel J, Rouard H, Gorin N, Lataillade J, Benderitter M, Simon J, Mothy M. Clinical trial evaluating the efficacy of systemic mesenchymal stromal cell injections for the treatment of severe and chronic radiotherapy-induced abdomino-pelvic complications refractory to standard therapy. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Simon J, Anderson R, Craig S. Early Post-Operative Atrial Fibrillation after Lung Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Kardos P, Geiss F, Simon J, Franken C, Butt U, Worth H. Duplicate Prescriptions of Inhaled Medications for Obstructive Lung Diseases. Pneumologie 2020; 74:149-158. [PMID: 32143230 DOI: 10.1055/a-1083-7961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Inhalative treatments with metered dose aerosols and dry powder inhalers are the backbone of the pharmacotherapy for asthma and COPD. In the last decade many new and generic inhalative bronchodilators were launched at the German market, both monotherapies and fixed dose double bronchodilator (LABA/LAMA, beta adrenergic and antimuscarinic) or LABA and inhaled corticosteroid (ICS) and triple (LABA/LAMA/ICS) combinations. According to two surveys in 2015 among respiratory physicians we expected a high proportion of patients receiving duplicate prescriptions, e. g. a fixed dose new LABA/LAMA combination in addition to an existing ICS/LABA fixed dose combination. METHODOLOGY We searched the database of a large mail order pharmacy (DocMorris) to identify duplicate prescriptions of inhalative drugs for a patient by the same or by two or more different physicians during a 3 months period. RESULTS Unexpectedly, we found as little as around 1 % duplicate prescriptions for the same patient. Duplicate prescriptions involving combination products were found to be much more common than duplicate prescriptions of different mono-products. Irrespective the low percentage number of all prescriptions we saw in just one large mail order pharmacy several thousands of erroneous prescriptions. CONCLUSION At least in the setting of this mail order pharmacy duplicate (i. e. contraindicated and potentially dangerous) prescriptions are relatively rare. Prescribers and pharmacists should be aware of the issue of duplicates - especially when prescribing or filling prescriptions with combination products.
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Partridge JSL, Rogerson A, Joughin AL, Walker D, Simon J, Swart M, Dhesi JK. The emerging specialty of perioperative medicine: a UK survey of the attitudes and behaviours of anaesthetists. Perioper Med (Lond) 2020; 9:3. [PMID: 31988744 PMCID: PMC6971857 DOI: 10.1186/s13741-019-0132-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 11/25/2019] [Indexed: 12/02/2022] Open
Abstract
Background In 2014, the Royal College of Anaesthetists (RCoA) launched the Perioperative Medicine Programme to facilitate the delivery of best preoperative, intraoperative and postoperative care through implementation of evidence-based medicine to reduce variation and improve postoperative outcomes. However, variation exists in the establishment of perioperative medicine services in the UK. This survey explored attitudes and behaviours of anaesthetists towards perioperative medicine, described current anaesthetic-led perioperative medicine services across the UK and explored barriers to anaesthetic involvement in perioperative medicine. Methods Survey content based on the RCoA vision document was refined and validated using an expert panel. An anonymous electronic survey was then sent by email to the members of the RCoA. Results Seven hundred fifty-eight UK anaesthetists (4.5% of the RCoA mailing list) responded to the survey. Of these, 64% considered themselves a perioperative doctor, with 65% having changed local services in response to the RCoA vision. Barriers to developing perioperative medicine included insufficient time (75%) and inadequate training (51%). Three quarters of respondents advocate anaesthetists leading the development of perioperative medicine. Conclusions Despite evidence of emerging services, this survey describes barriers to ongoing development of perioperative medicine. Facilitators may include increased clinical exposure, targeted education and training and collaborative working with other specialties.
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Simon J, Clayton A, Kingsberg S, Portman D, Jordan R, Williams L, Krop J. 194 Effect Size of Bremelanotide Treatment in the Phase 3 RECONNECT Studies. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2019.11.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Nagy AI, Bartykowszki AI, Varga AI, Suhai F, Apor AA, Szilveszter B, Kolozsvary M, Karady J, Panajotu AA, Jermendy A, Molnar L, Simon J, Papp R, Merkely B, Maurovich Horvat P. P1831 Predictors and clinical consequences of silent ischaemic brain lesions following transcatheter aortic valve implantation. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
This study was supported by the János Bolyai Scholarship of the Hungarian Academy of Sciences
Background
A number of studies aimed to identify the predictors of periprocedural cerebral embolizations related to transcatheter aortic valve implantation (TAVI). Much less investigated is the prevalence and determinants of subacute ischaemic brain lesions that develop following TAVI.
Purpose
We sought to identify predictors of subacute clinically silent ischaemic brain lesions in patients following TAVI.
Methods
Patients were included from the Rule out Transcatheter Aortic Valve Thrombosis with Post Implantation Computed Tomography (RETORIC) prospective trial. Echocardiography and brain MRI were performed after TAVI procedure, before hospital discharge. Cardiac CT was performed 6 months later to identify subclinical leaflet thrombosis (HALT), as well as repeat brain MRI, to identify any silent ischaemic lesions that appeared since the intervention. The cognitive trajectory of patients was assessed using the Addenbrookes cognitive test (ACE), performed shortly after TAVI and at 6-month follow-up (FU). All-cause mortality data was retrieved from the National Mortality Database.
Results
79 consecutive patients were included in the present analysis. 28% had known history of atrial fibrillation (AF). 33% of the cohort was treated with oral anticoagulant, of these 56% with single and 25% with dual antiplatelet therapy (DAPT). The mean CHA2DS2VASC score was 4. From discharge to the 6-month FU, 20 patients (25%) developed new silent ischaemic brain lesions on MRI. Clinically manifest stroke did not occur. On the 6-month CT, HALT was identified in 6 patients (8%). Clinical and imaging parameters, including age, body mass index, hypertension, dyslipidaemia, diabetes, smoking, statin-, OAC- and DAPT therapy, history of AF, history of stroke, echocardiographic metrics of left ventricular (ejection fraction, stroke volume index) and atrial (left atrial strain) function as well as HALT were analysed for association with ischaemic brain lesions. Of the above, only HALT showed significant association (OR:6,58; p = 0.04) with silent brain embolizations. The cognitive trajectory from discharge till 6-month FU did not differ between patients with or without ischaemic focuses (ΔACEscore: 1.0 vs. 0.1; p = NS). Over a median FU of 553 (IQR 453 – 665) days, 8 patients died; 2 with and 6 without ischaemic lesions. Kaplan-Meyer analysis showed no difference in outcome between the two groups (p = 0.68)
Conclusion
Subclinical leaflet thrombosis was identified as a significant predictor of subacute silent ischaemic brain lesions after TAVI. These lesions did not affect the overall cognitive performance or outcome of the patients.
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Feldsine PT, Mui LA, Forgey RL, Kerr DE, Al-Hasani S, Arling V, Beatty S, Bohannon J, Brannan J, Brown N, Bryant J, Burford M, Chavez C, Chinault K, Cooan N, Copeland F, Dixon L, Fitzgerald S, Franke W, Frissora R, Gailbreath K, Godon S, Good M, Ha T, Hagen H, Hanson S, Johnson K, Koch S, Leung S, Lienau A, Lin J, Lin S, Marolla B, Maycock L, McDonagh S, Miller L, Otten N, Post R, Resutek J, Rice B, Richter D, Ritger C, Schwantes D, Simon J, Smith J, Smith S, Stokes R, Thibideau J, Tuncan E, Uber D, Van Landingham V, Vrana D, West D. Equivalence of Assurance® Gold Enzyme Immunoassay for Visual or Instrumental Detection of Motile and Nonmotile Salmonella in All Foods to AOAC Culture Method: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/83.4.871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Six foods representative of a wide variety of processed, dried powder processed, and raw food types were analyzed by the Assurance® Gold Salmonella Enzyme Immunoassay (EIA) and AOAC INTERNATIONAL culture method. Paired samples of each food type were simultaneously analyzed; one sample by the Assurance method and one by the AOAC culture method. The results for Assurance method were read visually and instrumentally with a microplate reader. A total of 24 laboratories representing federal government agencies and private industry, in the United States and Canada, participated in this collaborative study. Food types were inoculated with species of Salmonella with the exception of raw ground chicken, which was naturally contaminated. No statistical differences (p < 0.05) were observed between Assurance Gold Salmonella EIA with either visual or instrumental interpretation and the AOAC culture method for any inoculation level of any food type or naturally contaminated food. The Assurance visual and instrumental options of reading sample reactions produced the same results for 1277 of the 1296 sample and controls analyzed.
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Al-Hendy A, Simon J, Hurtado S, Bradley LD, Owens C, Liu R, Barnhart K, Gillispie V. Effect of Fibroid Location and Size on Efficacy of Elagolix: Results from Phase 3 Clinical Trials. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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