scholarly journals Cardiology in the COVID-19 Era - The Changing Paradigms

2020 ◽  
Vol 4 (1) ◽  
pp. 021-030
Author(s):  
Amal Paul ◽  
Shone Chacko ◽  
Arya Mukundan
Keyword(s):  
Health Care ◽  
Treatment Modalities ◽  
System Management ◽  
Health Care Environment ◽  
Care Environment ◽  
Global Pandemic ◽  
Cv Disease ◽  
The Impact

Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has attained the distinction of a global pandemic, aff ecting more than 185 countries. The impact of COVID-19 in the practice of cardiology extends beyond the clinical Cardiovascular (CV) manifestations of the disease. Many treatment modalities used in the treatment of COVID-19 have direct or indirect eff ects on the CV system. Management of CV disease in patients with proven or suspected COVID-19 infection warrants modifi cation of existing practices and guidelines so as to suit the changed health care environment. The safety of health care personnel becomes an important consideration in the setting of this highly contagious pandemic. Furthermore, long-term cardiovascular consequences of COVID-19 need to be determined for appropriate follow-up of patients recovering from the infection. We review the data available till date on the various aspects of the impact of COVID-19 on the heart and the practice of cardiology.

scholarly journals The Impact of the Changing Health Care Environment on the Health and Well-Being of Faculty at Four Medical Schools

2006 ◽  
Vol 81 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Barbara A. Schindler ◽  
Dennis H. Novack ◽  
Diane G. Cohen ◽  
Joel Yager ◽  
Dora Wang ◽  
...  
Keyword(s):  
Health Care ◽  
Well Being ◽  
Medical Schools ◽  
Health Care Environment ◽  
Care Environment ◽  
The Impact ◽  
Health And Well Being

scholarly journals EP.TU.833The F2 Cohort of COVID19: The impact on Career development – a survey analysis

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Charlotte Whitton
Keyword(s):  
Career Development ◽  
Online Survey ◽  
Survey Analysis ◽  
Personal Lives ◽  
Global Pandemic ◽  
Foundation Trusts ◽  
The Impact ◽  
Main Influence

Abstract In March 2020 the coronavirus outbreak was announced as a global pandemic by WHO, in response to the pandemic the NHS underwent huge changes. This included recalling foundation doctors and cancelling the changeover into their final rotations. There have been studies into the impact of the pandemic on junior doctor training and wellbeing, however none looking specifically at their career development. An online survey was distributed to a cohort of Foundation Year 2 Doctors (F2s) in one NHS trust. This specifically asked about the impact of not rotating, specialty tasters, courses and the overall impact of the pandemic. The results of this study show that F2 doctors report weaker specialty applications alongside missed career development opportunities. However, the main influence of COVID-19 was reported to be on the cohort’s personal lives. This study concluded that the COVID-19 pandemic negatively affected both F2 doctor’s professional and personal lives, and it would be useful to follow up the cohort’s career development in the long-term as well as investigate the impacts in other NHS foundation trusts in the country.

scholarly journals Anemia impact on non-fatal outcomes in chronic and acute coronary syndromes: results of local long-term registry

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
L Malinova ◽  
K H Radzhabov ◽  
P Dolotovskaya ◽  
N Furman
Keyword(s):  
Health Care ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Event ◽  
Cardiovascular Events ◽  
Prognostic Value ◽  
Cardiology Department ◽  
The Impact

Abstract   Anemia is the most common clinical condition worldwide known to increase risk of adverse cardiovascular events in patients with coronary heart disease. Randomized clinical trials often exclude patients with anemia and therefore do not offer accurate evidence about the effect of studied interventions and treatments on this population. At the same time, we need more evidence regarding anemia impact on non-fatal outcomes of coronary heart disease. The purpose of the study was to evaluate the impact of anemia on non-fatal outcomes of chronic and acute coronary syndrome and to assess prognostic value of hematological parameters. Methods We used data of the local long-term registry of coronary heart disease with total number of patients 31 410. The registry contained data from patients admitted to intensive care unit (ACS-ICU) and cardiology department (CCS-in-hospital) of teaching hospital, emergency cardiology department of regular municipal hospital (ACS-ECD) and outpatient cardiology clinic (CCS-outpatient). In current analysis anemia was defined as hemoglobin (HB) level less than 120 g/L in both male and female patients. Data from patients with anemia at admission (n=598) were used in this analysis. Every cardiovascular event required admission or outpatient consultation was considered as non-fatal outcome. Median of follow-up period was 17 months. Results Anemia in ACS was more severe that in CCS: HB in ACS-ICU 108 (100; 117) g/L vs 116 (109; 119) g/L in CCS-outpatient, p=0.002; and more frequently accompanied with leukocytosis (p=0.019) and thrombocytopenia (p=0.000). Despite those potentially unfavorable hematological finding ACS_ICU patients were characterized by the maximal amount of event-free patients during the follow-up period: 91.1% vs 87.0% (ACS-ECD) vs 76.5% (CCS-outpatient), Log Rank Mantel-Cox p=0.001, and maximal event-free time. The major difference between those health care facilities was in cardiologists' adherence to optimal medical therapy according to recent guidelines and frequency of antiplatelet prescriptions in anemic patients. We failed to detect significant hematological predictor of nonfatal adverse cardiovascular event in studied sample, at the same time logistic regression analysis demonstrated prognostic value of MPV (Wald 7.167, p=0.007), WBC (Wald 4.339, 0.037) and MCH (Wald 3.555, p 0.049) referring to event-free subpopulation. Similar results were obtained with classification tree method (7 nodes, 1st - MPV). Conclusion In this registry involving CCS and ACS patients, presence of anemia had influence on clinical management and antiplatelet therapy. The type of health care facility was associated with non-fatal outcomes rate in anemic patients with ACS / CCS. The severity of anemia does not affect the risk of non-fatal cardiovascular events both in ACS and CCS patients; at the same time, inflammation and platelet production parameters could improve risk stratification in anemic patients with ACS and CCS. FUNDunding Acknowledgement Type of funding sources: None.

Development and Maintenance of a Pleural Disease Service: Role of the “Pleurologist”

2019 ◽  
Vol 40 (03) ◽  
pp. 297-304 ◽  
Author(s):  
Kelsey Cameron ◽  
Dana Teodoro ◽  
Azam Kasis ◽  
Matthew Evison
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Current Medical ◽  
Pleural Disease ◽  
Health Care Environment ◽  
Care Environment ◽  
Pleural Diseases ◽  
Service Role ◽  
The Impact

AbstractChanges in the health care environment, increasing specialization, and the use of ultrasound have led to pleural diseases being managed by a select few. This article aims to look at the impact of current medical education paradigms, service structure, procedural education and role of the “pleurologist” in providing care to patients with pleural disease.

scholarly journals Postoperative Complication Burden, Revision Risk, and Health Care Use in Obese Patients Undergoing Primary Adult Thoracolumbar Deformity Surgery

2020 ◽  
pp. 219256822090434
Author(s):  
Kunal Varshneya ◽  
Dhiraj J. Pangal ◽  
Martin N. Stienen ◽  
Allen L. Ho ◽  
Parastou Fatemi ◽  
...  
Keyword(s):  
Health Care ◽  
Postoperative Complication ◽  
Spinal Deformity ◽  
The United States ◽  
Health Care Use ◽  
Obese Patients ◽  
Nonobese Patients ◽  
The Impact

Study Design: This is a retrospective cohort study using a nationally representative administrative database. Objective: To identify the impact of obesity on postoperative outcomes in patients undergoing thoracolumbar adult spinal deformity (ASD) surgery. Background: The obesity rate in the United States remains staggering, with approximately one-third of all Americans being overweight or obese. However, the impact of elevated body mass index on spine surgery outcomes remains unclear. Methods: We queried the MarketScan database to identify patients who were diagnosed with a spinal deformity and underwent ASD surgery from 2007 to 2016. Patients were then stratified by whether or not they were diagnosed as obese at index surgical admission. Propensity score matching (PSM) was then utilized to mitigate intergroup differences between obese and nonobese patients. Patients <18 years and those with any prior history of trauma or tumor were excluded from this study. Baseline demographics and comorbidities, postoperative complication rates, and short- and long-term reoperation rates were determined. Results: A total of 7423 patients met the inclusion criteria of this study, of whom 597 (8.0%) were obese. Initially, patients with obesity had a higher 90-day postoperative complication rate than nonobese patients (46.1% vs 40.8%, P < .05); however, this difference did not remain after PSM. Revision surgery rates after 2 years were similar across the 2 groups following primary surgery (obese, 21.4%, vs nonobese, 22.0%; P = .7588). Health care use occurred at a higher rate among obese patients through 2 years of long-term follow-up (obese, $152 930, vs nonobese, $140 550; P < .05). Conclusion: Patients diagnosed with obesity who underwent ASD surgery did not demonstrate increased rates of complications, reoperations, or readmissions. However, overall health care use through 2 years of follow-up after index surgery was higher in the obesity cohort.

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