ABSTRACT
Background: There is increasing evidence that COVID-19 survivors are at increased risk of experiencing a wide range of cardiovascular complications post infection; however, there are no validated models or clear guidelines for remotely monitoring the cardiac health of COVID-19 survivors. Objective: This study aims to test a virtual, in-home healthcare monitoring model of care for detection of clinical symptoms and impacts on COVID-19 survivors. It also aims to demonstrate system usability and feasibility. Methods: This open label, prospective, descriptive study was conducted in South Western Sydney. Included in the study were patients admitted to the hospital with the diagnosis of COVID-19 between June 2021 and November 2021. Eligible participants after consent were provided with a pulse oximeter to measure oxygen saturation and a S-Patch EX to monitor their electrocardiogram (ECG) for a duration of 3 months. Data was transmitted in real-time to a mobile phone via Bluetooth technology and results were sent to the study team via a cloud-based platform. All the data was reviewed in a timely manner by the investigator team, for post COVID-19 related symptoms, such as reduction in oxygen saturation and arrhythmia. Outcome measure: This study was designed for feasibility in real clinical setting implementation, enabling the study team to develop and utilise a virtual, in-home healthcare monitoring model of care to detect post COVID-19 clinical symptoms and impacts on COVID-19 survivors. Results: During the study period, 23 patients provided consent for participation. Out of which 19 patients commenced monitoring. Sixteen patients with 81 (73.6%) valid tests were included in the analysis and amongst them seven patients were detected by artificial intelligence to have cardiac arrhythmias but not clinically symptomatic. The patients with arrhythmias had a higher occurrence of supraventricular ectopy, and most of them took at least 2 tests before detection. Notably, patients with arrhythmia had significantly more tests than those without [t-test, t (13) = 2.29, p < 0.05]. Conclusions: Preliminary observations have identified cardiac arrhythmias on prolonged cardiac monitoring in 7 out of the first 16 participants who completed their 3 months follow-up. This has allowed early escalation to their treating doctors for further investigations and early interventions.
ABSTRACT
OBJECTIVES: This multicentre, prospective, open label, randomised controlled trial was to determine whether buttonhole cannulation technique in new and established haemodialysis fistula reduced complications and prolonged the access life compared to usual practice. METHOD: Seventy subjects were recruited for this study. Subjects randomised to the buttonhole group had their fistula cannulated by the same staff member for two to four weeks at the same angle and direction with sharp needles. Once the tunnel was developed, blunt needles were used. The control group continued with usual practice (rope ladder rotation technique). RESULTS: Infection at the cannulation site occurred in four patients in the buttonhole group and one in the rope ladder rotation group (p = 0.11). Haematomas at the cannulation site and site pain experienced during the dialysis session were more often recorded for the buttonhole group (p < 0.05). CONCLUSIONS: This study showed that buttonhole cannulation resulted more infections, haematoma formation and site pain during dialysis than with the rope ladder rotation group. A further larger scale longitudinal study is recommended.
Subject(s)
Catheterization/methods , Renal Dialysis/methods , Adult , Aged , Arteriovenous Shunt, Surgical , Australia , Catheterization/adverse effects , Catheters, Indwelling , Female , Humans , Kidney Failure, Chronic/therapy , Male , Middle Aged , Prospective Studies , Renal Dialysis/adverse effectsABSTRACT
The aim of this project was to evaluate the introduction of Assistant in Nursing (AINs) in the haemodialysis units at a major tertiary Area Health Service in Sydney, Australia. All nursing staff were asked to complete a baseline and follow-up survey to determine changes to their attitudes to the new skill mix model and their satisfaction with the new organization of care delivery in their dialysis units. Comparison of the baseline and follow-up surveys in the paired data was favourable with nurses acknowledging that they would cope well with the introduction of AINs, and they were more likely to disagree with the statement that their workload would increase after the introduction of AINs in the follow-up survey. There was little difference in (i) the workload of the dialysis units before and during the intervention; and (ii) the incidence of patient and nursed related adverse outcome events.
Subject(s)
Nursing Assistants , Renal Dialysis , Adaptation, Psychological , Humans , New South WalesABSTRACT
La toxocarosis es una parasitosis causada por la ingesta accidental de huevos de Toxacara canis/cati (el primero especialmente), sobre todo en niños de corta edad. Se manifiesta de dos maneras distintas: larva migrans visceral (VLM) y larva migrans ocular(OLM). Los signos y síntomas de la VLM van desde un cuadro totalmente asintomático con leve eosinofilia, a uno severo con distintas manifestaciones clínicas. Los pacientes con OLM varían ampliamente en su presentación; pueden ser sintomáticos o no. Uno de los signos marcadores es la presencia de eosinofilia (valores mayores de 700 elementos/mm al cubo). El objeto de éste estudio es analizar la relación entre eosinofilia y toxocarosis. Para ello se estudiaron 33 niños con eosinofilia. Se les realizó un parasitológico seriado de material fecal y un test serológico para detectar anticuerpos anti Toxacara canis/cati, mediante el método de ELISA. Se consideró la prueba positiva con valores de lectura mayores de 0,7. Se encontraron 19 pacientes (58 por ciento) con toxocarosis (lecturas mayores de 0,7), 7 (21 por ciento) con resultados dudosos (lecturas entre 0,3 y 0,7) y 7 (21 por ciento) negativos (lecturas menores de 0,3). Esta situación lleva a tener presente la importancia de realizar un exámen de rutina; y ante la presencia de eosinofilia, solicitar un test de ELISA para Toxocara, que ayudará a descartar (o no) otras patologías. Por otro lado, en caso de un examen positivo, se estaría contribuyendo a cortar la cadena de transmisión de ésta parasitosis no muy conocida y sin embargo tan común en niños de corta edad
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Adolescent , Eosinophilia , Toxocariasis , Enzyme-Linked Immunosorbent Assay , Feces , Toxocara canisABSTRACT
La toxocarosis es una parasitosis causada por la ingesta accidental de huevos de Toxacara canis/cati (el primero especialmente), sobre todo en niños de corta edad. Se manifiesta de dos maneras distintas: larva migrans visceral (VLM) y larva migrans ocular(OLM). Los signos y síntomas de la VLM van desde un cuadro totalmente asintomático con leve eosinofilia, a uno severo con distintas manifestaciones clínicas. Los pacientes con OLM varían ampliamente en su presentación; pueden ser sintomáticos o no. Uno de los signos marcadores es la presencia de eosinofilia (valores mayores de 700 elementos/mm al cubo). El objeto de éste estudio es analizar la relación entre eosinofilia y toxocarosis. Para ello se estudiaron 33 niños con eosinofilia. Se les realizó un parasitológico seriado de material fecal y un test serológico para detectar anticuerpos anti Toxacara canis/cati, mediante el método de ELISA. Se consideró la prueba positiva con valores de lectura mayores de 0,7. Se encontraron 19 pacientes (58 por ciento) con toxocarosis (lecturas mayores de 0,7), 7 (21 por ciento) con resultados dudosos (lecturas entre 0,3 y 0,7) y 7 (21 por ciento) negativos (lecturas menores de 0,3). Esta situación lleva a tener presente la importancia de realizar un exámen de rutina; y ante la presencia de eosinofilia, solicitar un test de ELISA para Toxocara, que ayudará a descartar (o no) otras patologías. Por otro lado, en caso de un examen positivo, se estaría contribuyendo a cortar la cadena de transmisión de ésta parasitosis no muy conocida y sin embargo tan común en niños de corta edad (AU)
