Volume 8, Issue 1

  • 2021, April

    original research

    A Comparison of Efficacy, Safety and Cost Between MANTATM and Proglide Vascular Closure Devices Following Transfemoral Transcatheter Aortic Valve ImplantationOpen Access

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    Abstract [+]

    Aims
    Access site vascular complications remain a recognised complication following transcatheter aortic valve implantation (TAVI). Suture-based vascular closure devices (VCDs) such as ProGlide® (Abbott Vascular Inc., Santa Clara, CA, USA) are widely used in order to achieve rapid haemostasis. The MANTATM (Essential Medical Inc., Malvern, PA, USA) is a collagen plug-based VCD which can be used as an alternative to traditional suture-based devices, but is significantly more expensive per-unit. We compare the efficacy, safety and total cost associated with the use of the MANTATM and ProGlide® VCDs.
    Methods
    This retrospective study included all consecutive patients who underwent transfemoral (TF) TAVI between November 2017-June 2018. The primary endpoints were primary access site-related VARC-2 vascular complications, VARC-2 bleeding and the overall per-patient cost incorporating treatment for complications or use of additional VCDs.
    Results
    A total of 136 patients were included in this study; 86 in the ProGlide® group and 50 in the MANTATM group. Baseline characteristics of the two groups were well-matched. Three patients in the ProGlide® group required surgical repair compared to none in the MANTATM group. However, no significant differences were observed with respect to overall primary access site-related VARC-2 vascular complications (10.5% vs. 10%; p=0.93) or VARC-2 bleeding (9.3% vs. 4.0%; p=0.25). There was no significant difference in the mean cost per patient when taking into consideration the use of additional VCDs and treatments for vascular complications (£568.79 vs. £599.95; p=0.90).
    Conclusion
    The use of the MANTATM VCD following TF TAVI is cost-neutral compared to ProGlide® VCDs, whilst being associated with no increase in VARC-2 vascular or bleeding complications.
    Keywords
    Transcatheter valve interventions; Vascular complications; Vascular closure devices (VCD).


  • 2021, April

    systematic review

    Cardiovascular Health and Healthcare Use of United States-Born and African-Born Blacks: A ReviewOpen Access

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    Abstract [+]

    Cardiovascular disease (CVD) is the leading cause of death globally, with Blacks in the United States (U.S.) disproportionately affected. Healthcare access and utilization have been reported as risk factors for poorer cardiovascular health among several U.S.
    populations.
    Aims and Objectives
    The purpose of this systematic literature review was to examine the results of existing studies reporting on cardiovascular health and healthcare utilization by African-born compared to U. S. -born Blacks.
    Methods
    A systematic literature review was conducted using keywords and medical subject headings (MESHs) in the PUBMED, Web of Science and CINAHL electronic databases. Exclusion and inclusion criteria determined articles to be reviewed for eligibility and methodological soundness. A pooled analysis was performed on all studies.
    Results
    Only seven studies met inclusion criteria. Four compared U. S. -born with African-born Blacks residing in the United States, while three compared U. S. -born Blacks with Blacks residing elsewhere. None of the studies examined the associations between healthcare utilization and cardiovascular health for these populations.
    Conclusion
    The results of this review indicate a need to examine the impact of healthcare utilization for increasing awareness, prevention and treatment of CVD in Blacks who reside in the United States regardless of their nativity.
    Keywords
    Cardiovascular health; African-born Blacks; U.S-born blacks; Healthcare utilization.
    Abbreviations
    CVD: Cardiovascular disease; US: United States; MESHs: Medical subject headings; sBP: Systolic blood pressure; dBP: Diastolic blood pressure; BMI: Body mass index; BP: Blood pressure.


  • 2021, December

    original research

    Assessment of Level of Awareness Towards Radiation Protection Among the Staff Working at Angiography Suite at Public HospitalsOpen Access

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    Abstract [+]

    Introduction
    Several challenges with radiation protection and safety culture in radiology departments needs to be addressed as few studies done in this aspect in our country. Especially with regard to the awareness about radiation protection, hazards, dosimetry usage and measurement.
    Objective
    The objective of this study is to find knowledge about radiation exposure hazard and practices among various auxiliary staff working in radiation units.
    Material and Methods
    Cross-sectional study done by using stratified random sampling method. A questionnaire made to check the awareness level of the radiological staff regarding radiation protection working in angiography suite. The questionnaire had two parts with various questions about radiation protection measures and safety related knowledge for staff and patient. Data collected from angiography suite of three public sector hospitals of Lahore, Pakistan. All the data entered in statistical package for the social science (SSPS) version 16 and analyzed for statistically significant outcomes.
    Results
    Total of 67 staff members were included in this study from three different public sector hospitals, 55.2% were males 44.77% were females. Twenty-nine (29) persons belonged to the age group of 20-30-years. Twenty (20) doctors, 21 nurses, 12 radiographers and 14 paramedical staff were included. 89.55% staff members were aware of radiation hazard. 55.22% had training on radiation protection and 44.77%. 56.71% were aware of dosimeter. Only 16% were aware of as low as reasonably achievable (ALARA).
    Conclusion
    The radiological staff members were partially aware about radiation hazards and radiation safety. They were lacking from training and workshops. Essential steps required to develop nationwide strategies for improving the situation and maintaining a safe working environment.
    Keywords
    Angiography; Radiation hazards; Radiation protection; X-ray; Radiation protection devices.