SAME DAY DISCHARGE VIA A DEDICATED RADIAL LOUNGE-RESULTS of 1-YEAR EXPERIENCE during the COVID-19 PANDEMIC

Background: Same day discharge (SDD) is a validated option for selected patients (pts) undergoing coronary angiography (CAG) and percutaneous coronary interventions (PCI). We analyzed how the COVID-19 pandemic influenced patients' admissions to and discharges from our SDD radial lounge. We focused on safety and complications. Method(s): In 2021, 817 pts (age 65+/-11 years, 28% female) were admitted to the lounge. CAG was performed in 729 pts, and 176 (24%) underwent ad hoc PCI. Furthermore, 88 pts were admitted for implantable device replacement procedures. Result(s): Out of 729 transradial CAGs 621 were performed by using the proximal radial approach (PRA) and 108 (15%) via the distal radial approach (DRA). Ninety % of all these procedures (n = 655) were performed from the nondominant left hand. PRA was associated with one radial artery occlusion (RAO) and longer compression time (92+/-24 min vs 75+/-26 min, p <0.05). In the PRA group 23 postprocedural local hematomas <5 cm (3%) and 17 hematomas <10 cm (2%) were observed but did not require specific treatment. DRA was associated with only 4 super-ficial hematomas <2 cm and no RAO. No other relevant complications occurred in the rest of pts. Ninety % of all pts (n = 732) were discharged home on the same day (<=6 hours after procedures) and none of them was readmitted within the next 24 hours. The remaining 10% of the patients (n = 85) were hospitalized after CAG and PCI, mostly because of severe coronary artery disease findings. Conclusion(s): During COVID-19 pandemic, CAG and PCI together with device replacement procedures in our SDD program were associated with a one-year saving of more than 700 overnight stays, minimal complications and 0,1% RAO rate. Supported by the Charles University Research program "Cooperatio-Cardiovascular Science" and by MH CZ-DRO (Faculty Hospital in Pilsen-FNPl, 00669806).

Refining the Ecosystems Services Model: Integrating Animal Behavior into Ecotourism Management

As life on Earth has entered a sixth mass extinction driven by pervasive human impacts, there is a growing need for research that effectively identifies and resolves potential conflicts between wildlife and humans. While developing solutions on how to mitigate adverse interactions between humans and wildlife is of critical importance, there is notably less research on the impact of animal behavior shifts on the quality of ecosystem services that humans benefit from, such as those derived from ecotourism activities, that are fundamentally based on people's ability to witness natural animal behaviors. These human-wildlife interactions can lead to valuable contributions to conservation and economic opportunities for local communities. However, studies have revealed that drastic behavior changes occur when wildlife populations are subjected to high levels of anthropogenic disturbance. Building on the understanding that human and animal behaviors are strongly linked through complex social-ecological feedback systems and utilizing the existing ecosystem frameworks, this chapter highlights the need for better understanding of the current wildlife-based ecotourism models and how they might become better adapted into the future. The year-long COVID-19 pandemic provided a unique opportunity for the current practices to be adapted, and emerging questions about the on-going relationship between humans and wildlife need to be investigated to establish more effective ecosystem management interventions. © 2022 Elsevier Inc. All rights reserved

Same-day discharge cardiac cathteterizations and interventional procedures during covid-19 pandemic in 2021

Background: One-year analysis of same-day discharge (SDD) coronary catheterizations, interventions and device replacement procedures during the covid-19 pandemic at the Complex Cardiovascular Center of the University Hospital in Pilsen. Methods: In 2021, 53 to 87 patients were admitted monthly and 817 in total to the SDD specialized Radial Lounge at the Department of Cardiology. Coronary angiography (CAG) was performed in 729 patients and percutaneous coronary intervention (PCI) in 176 (24%). Fifty-five patients were admitted for permanent pacemaker exchange and in 33 of them an implantable cardioverter-defibrillator exchange. Results: Out of 729 transradial CAGs 621 were performed by using the conventional proximal radial approach and 108 (15%) via the distal radial approach, 90 % of all procedures (n = 655), were performed from the nondominant left hand. Only one asymptomatic postprocedural radial artery occlusion was diagnosed by the reverse Barbeau test on the wrist (1/729 = 0.1%). No other relevant complications occured. The distal radial approach was associated with a shorter compression with time in comparison to the proximal puncture site at the wrist – 75 ± 26 min vs. 92 ± 24 (p < 0.05) and there were only four superficial hematomas smaller than 2 cm. In the proximal radial approach subcutaneous hematomas also did not require any specific treatment. Of the total of 817 patients, 90% (n = 732) were discharged home on the same day of admission in the afternoon and none of them was readmitted within the next 24 hours. The remaining 10% of the patients (n = 85) were hospitalized after the procedure, mostly because of severe findings on the coronary arteries. Conclusions: Coronary catheterizations and interventions together with device replacement procedures in the SDD program at the University Hospital in Pilsen were associated with a one-year saving of more than 700 overnight stays, minimal complications, and 99.9% radial artery patency rate after transradial procedures. © 2022 SOLEN s.r.o.. All rights reserved.

Working in the cathlab during COVID-19 pandemic

The review reflects attitude of the Czech Interventional Cardiology Association to the invasive treatment of heart diseases during COVID-19 pandemic. Primary angioplasty is preferred for the treatment of STEMI and NSTEMI with ongoing ischemia without considering patient’s COVID status. All other patients are tested for COVID minimally 48 hours before hospital or outpatient department admission. In view of the fact that pandemic development in the Czech Republic seems to be favorable, most of the cathlabs are progressively returning to standard care to shorten the period of badly accessible invasive procedures. © 2020 Czech Society of Cardiology Z.S. All rights reserved.