Experience with a Continuous Education Program for Clinical, Regulatory and Quality Affairs in Northwestern Switzerland

The European Medical Device and In-Vitro Diagnostic Medical Device industry is currently facing a highly challenging situation, as applied regulations have changed significantly over the last year. To cope with this, a novel continuing education program for employees from these sectors provides knowledge and hands-on experience in clinical, regulatory and quality affairs. Since 2020 two classes have been successfully completed at the University of Applied Sciences and Arts Northwestern Switzerland: this paper describes the concept and content, the students, and the benefits both for participants and their employers.

Automated fastener versus manually tied knots in minimally invasive mitral valve repair: impact on operation time and short- term results

Background

This study compares the influence of two different annuloplasty attachment suture applications, namely the use of an automated fastener versus manually tied knots using a traditional knot pusher, on total operation time, on cardiopulmonary-bypass time and on cross-clamp time, and on short-term outcome.

Methods

Sixty patients underwent isolated minimally invasive mitral valve repair in Carpentier Type-II mitral disease with implantation of an annuloplasty ring in combination with correction of the prolapsing leaflet using artificial chords. The first 30 patients after implementation of a novel automated fastener were compared with the last 30 patients corrected with a traditional knot pusher. No significant differences with regard to demographic data (age, gender, NYHA class, ejection fraction, BMI, cardiovascular risk factors) between the two groups were found. All patients received isolated mitral valve repair in the first run. Bretschneider HTK was used for cardioplegic cardiac arrest in all patients.

Results

Transesophageal and transthoracic echocardiography at the end of operation and at discharge revealed no (n = 25), trace (n = 28) or mild (n = 7) residual regurgitation with no evidence of ring dehiscence and without any significant clinical differences between the groups. Cross-clamp, cardiopulmonary-bypass and total- operation time were significantly reduced in the automated fastener group compared to the group using a traditional knot pusher (87.1 ± 17.9 vs. 101.3 ± 17.8; p < 0.01, 138.1 ± 25.6 vs. 152.7 ± 24.9; p < 0.05, and 203.9 ± 31.02 vs. 223.8 ± 29.01; p < 0.01, respectively).

Conclusion

Our short-term results indicate a safe, reliable and fast application of the novel automated fastener device in combination with significant time savings in cardioplegic arrest and cardiopulmonary bypass.

Nucleoside diphosphate kinase, a source of GTP, is required for dynamin-dependent synaptic vesicle recycling

Nucleoside diphosphate kinase (NDK), an enzyme encoded by the Drosophila abnormal wing discs (awd) or human nm23 tumor suppressor genes, generates nucleoside triphosphates from respective diphosphates. We demonstrate that NDK regulates synaptic vesicle internalization at the stage where function of the dynamin GTPase is required. awd mutations lower the temperature at which behavioral paralysis, synaptic failure, and blocked membrane internalization occur at dynamin-deficient, shi(ts), mutant nerve terminals. Hypomorphic awd alleles display shi(ts)-like defects. NDK is present at synapses and its enzymatic activity is essential for normal presynaptic function. We suggest a model in which dynamin activity in nerve terminals is highly dependent on NDK-mediated supply of GTP. This connection between NDK and membrane internalization further strengthens an emerging hypothesis that endocytosis, probably of activated growth factor receptors, is an important tumor suppressor activity in vivo.