Healthcare & Economics
Current Data on Minimalist TAVR Care Pathways and Future Research Directions
In June 2022, researchers from Emory University School of Medicine, Division of Cardiology, Department of Internal Medicine, and Division of Cardiothoracic Surgery summarized current data for a minimalist TAVR approach and what future studies need to focus on to optimize TAVR care. The full manuscript by Mariem A. Sawan, Avery E. Calhoun, Kendra J. Grubb, and Chandan M. Devireddy can be found in Current Cardiology Reports. Their review is summarized below.
Since its first application in 2002, transcatheter aortic valve replacement (TAVR) has become a central component in treating aortic stenosis. As TAVR continues to be a preferred treatment option for patients with aortic stenosis, there is an advancement in the "minimalist approach," which places a significant emphasis on early discharge.
Overcoming Complications of Cardiovascular Prevention in Diabetic Patients Through Aspirin
In March 2022, researchers from Université de Montréal (Faculties of Pharmacy and Medicine), Montreal Heart Institute (Department of Medicine and Research Center), and the Institut de Recherche Clinique de Montréal completed a review on the use of aspirin in patients with diabetes and its effect to prevent cardiovascular diseases.
The complete manuscript by Mélina Del Bianco-Rondeau, Maxime Robert Halabi, Samara Bloom, Remi Rabasa-Lhoret, Jean-Clause Tardif, Marie Lordkipanidzé, and Guillaume Marqui-Gravel can be found in Thrombosis and Haemostasis. Their findings are summarized below.
The risk of cardiovascular disease (CVD) is significantly higher in patients with diabetes; therefore, patients with diabetes are recommended healthier lifestyles and pharmacological interventions to prevent CVD, including the regular use of antiplatelet agent such as aspirin. However, recent large-scale trials on antiplatelet agent aspirin have not shown any benefit to its traditional, low-dose usage in those with diabetes.
Updated Guidelines on The Perioperative Management of Diabetes
In January 2022, The Royal London Hospital clinicians provided guidance on perioperative management of diabetes to reduce postoperative complications. The complete manuscript by Bonnie Grant and Tahseen A. Chowdhury can be found in Clinical Medicine. Its summary is described below.
Surgical intervention is more likely in those with diabetes than those without it. In addition, those with diabetes are more likely to develop perioperative complications that can include poor wound healing, infection, or cardiovascular events.
The Centre for Perioperative Care (CPOC) has released new guidance on perioperative management for those with diabetes, an area of critical focus since diabetes in surgical patients increases the risk of unfavorable outcomes. Despite this, though, there has been inadequate diabetes care in the perioperative period.
Factors Affecting the Desire for Disaster Preparedness Training in Healthcare Workers
In February 2022, researchers from the Veterans Emergency Management Evaluation Center within the US Department of Veterans Affairs assessed the desire of healthcare workers for additional workforce preparedness training and the factors that affect this desire. The complete manuscript by Michelle D. Balut, Claudia Der-Martirosian, and Aram Dobalian can be found in Southern Medical Journal. The study findings are detailed below.
The Joint Commission (TJC) accredits around 77% of US hospitals, which requires healthcare organizations to test their emergency plan through an annual exercise.
Healthcare Prioritarianism During the Pandemic
In January 2021, a researcher from the University of Southern Denmark, Department for the Study of Culture, discussed prioritarianism in terms of healthcare, with a particular focus on how the pandemic has shaped these views. The full article by Lasse Nielsen can be found in the Journal of Medical Ethics. Their findings are detailed below.
Prioritarianism refers to a general conception that the worse off someone is, the more it matters to help them. This ideology can be controversial, but it is also considered a widely shared principle applicable to healthcare.
Nielsen identified three forms of healthcare prioritarianism: social justice prioritarianism, severity prioritarianism, and age-weighted prioritarianism.
The COVID-19 Impact on Cardiac Surgical Volume and Hospital Revenue
In April 2022, practitioners from the University of Pittsburgh Department of Cardiothoracic Surgery and the University of Pittsburgh Department of Cardiothoracic Surgery delved further into the observed impact of COVID-19 on the number of cardiac surgeries, the financial burden, and what can be expected as institutions work on recovering. The full manuscript, written by Edgar Aranda-Michel, Derek Serna-Gallegos, George Arnaoutakis, Arman Kilic, James A. Brown, Yancheng Dai, Courtney Dunn-Lewis, and Ibrahim Sultan, can be found in the Seminars in Thoracic and Cardiovascular Surgery website. Their findings are detailed below.
While numerous studies have looked at the economic effects of the COVID-19 pandemic and how the healthcare industry has explicitly been affected, this study is the first to specifically report data concerning revenue lost due to decreases in cardiac surgical volume. With cardiac departments composing a significant portion of a hospital’s income, the impact of these decreases is substantial.
Anesthetic Gases in Cardiac Surgery, A Systemic Review
Isoflurane, sevoflurane, and desflurane are volatile anesthetic agents used to induce and maintain general anesthesia. In cardiac surgery, inhaled anesthetics have an additional use case in providing strong cardioprotective properties during myocardial ischemia. The use of volatile agents at a minimum alveolar concentration (MAC) of 0.5 to 2.0 during cardiac surgery results in fewer individuals needing inotropic support, reduced incidence of myocardial injury, and lower mortality than intravenous anesthesia.
Challenges Facing Women Healthcare Workers in Their Professional Growth
Despite actively striving to be promoted, women healthcare workers remain underrepresented in management and leadership roles. Women are underrepresented across the healthcare industry. This underrepresentation has been a trend for years, but it will not change without action. The industry is facing fierce competition, particularly from within the insurance sector.
Using prediction polling to harness collective intelligence for disease forecasting
During infectious disease epidemics, public health workers require an early warning, situational awareness, and predictive information. Sentinel surveillance, laboratory reporting, and case identification are all traditional methods of infectious disease surveillance that provide crucial information for outbreak response, management, and decision-making.
Educational psychology of medical training
Medical training has high stakes, sometimes higher than other forms of training. It involves working with a very complex subject matter and having to make life and death calls. It is important to provide an education that takes into account the needs of the learner to offer good outcomes. Here is where educational psychology might contribute to medical training, providing better strategies for teaching.
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