Furthermore, the expected delay in visa processing will make many IMG FITs less attractive options for employment. Since the 1960s, IMGs have constituted 10% of the U.S. physician workforce. ......Syria—a country on the ban—is 1 of the top 10 countries of origin that contribute to the Conrad 30 Waiver Program (3). During the process of the Conrad 30 Waiver Program, IMGs on J-1 obtain an H-1B visa and can use premium processing to join their new jobs on time. ...the suspension of the premium process will affect all current IMG FITs who are planning to join the workforce this year. After adjustment for patient and physician characteristics and hospital-fixed effects, patients treated by IMGs had lower mortality (adjusted mortality 11.2% vs. 11.6%; adjusted odds ratio 0.95; 95% confidence interval: 0.93 to 0.96; p < 0.001) and slightly higher costs of care per admission (adjusted costs $1,145 vs. $1,098; adjusted difference $47; 95% confidence interval: $39 to $55; p < 0.001) (6).
Tele-Cardiology in the Syrian War Alrifai, Abdulah; Alyousef, Tareq; Fanari, Zaher
Journal of the American College of Cardiology,
02/2018, Letnik:
71, Številka:
6
Journal Article
Recenzirano
Odprti dostop
Data-sharing technology in tele-consultation is a low-cost solution that uses already available social media platforms and applications, such as Facebook, Viber, Google Hangout, and WhatsApp, to ...allow communication in text, audio, still images, videos, and online phone calls. The onsite medical personnel (medical students, medical doctor, nurse, and physician assistant) present the case to the U.S.-based specialist with discussions about the ECG, echocardiogram (if available), and chest x-ray, taking into consideration the limited resources and ancillary tests that make physical examination play a vital role in approaching most cases. ...utilizing low-cost, widely available services, such as social media platforms and communication applications, in medicine during disaster and war can produce life-saving initiatives like tele-cardiology.
Patients with concomitant severe aortic stenosis (AS) and severe mitral stenosis (MS) with mitral annular calcification (MAC) constitute an elderly high‐risk population with multiple baseline ...comorbidities that coexist even before they develop severe valvular dysfunction. Transcatheter mitral valve replacements (TMVR) offer an alternative option for high‐risk patient with severe MS with MAC. A simultaneous transfemoral Transcatheter aortic valve replacement (TAVR) and transseptal TMVR is feasible and offers the least invasive approach of management. We are reporting a case of an 83‐year‐old man with very symptomatic severe AS and severe native MS with associated severe MAC and moderate mitral regurgitation with high STS score who underwent a simultaneous transfemoral TAVR and transseptal TMVR with good results and great improvement in symptoms that was maintained on 10 months follow‐up.
Background Although transcatheter aortic valve replacement TAVR provides an important alternative for patients with severe aortic stenosis, it is associated with high cost with potential economical ...burden on hospital performing it. Conclusion Applying lean processes may provide a reasonable approach to identify potential sources of cost waste and reimbursement loss in TAVR procedure and designed a sustainable algorithm to reduce loss and improve potential revenue of TAVR program Categories STRUCTURAL:
To compare the clinical outcomes following transcatheter aortic valve replacement (TAVR) with and without the use of the Sentinel Cerebral Protection System (Sentinel CPS).
Stroke occurs in 2–5% of ...patients at 30 days after TAVR and increases mortality >3 fold. The Sentinel CPS is the only FDA (Food and Drug Administration) approved cerebral embolic protection device.
The Cochrane Library, PubMed and Web of Science were searched for relevant studies for inclusion in the meta-analysis. Two authors independently screened and included studies comparing the clinical outcomes after TAVR with and without the Sentinel CPS. Risk of bias was assessed using the Cochrane tools (RoB2.0 and ROBINS-I).
Four studies comparing 606 patients undergoing TAVR with Sentinel CPS to 724 without any embolic protection device were included. Sentinel CPS use was associated with lower rates of 30-day mortality 0.8% vs 2.7%; RR 0.34 (95% CI 0.12, 0.92) I2 = 0%, 30-day symptomatic stroke 3.5% vs 6.1%; RR 0.51 (95% CI 0.29, 0.90) I2 = 0 and major or life-threatening bleeding 3.3% vs 6.6%; RR 0.50 (0.26, 0.98) I2 = 16%. There was no significant difference between the two arms in the incidence of acute kidney injury 0.8% vs 1%; RR 0.85 (95% CI 0.22, 3.24) I2 = 0% and major vascular complications 5.1% vs 6%; RR 0.74 (0.33, 1.67) I2 = 45%.
The results suggest that Sentinel CPS use in TAVR is associated with a lower risk of stroke, mortality and major or life-threatening bleeding at 30 days.
•Study suggests that Sentinel Cerebral Protection System during TAVR may:•Reduce the risk of 30-day stroke and mortality•Reduce the risk of 30-day major or life-threatening bleeding•Not have a difference in acute kidney injury and major vascular complications
Background While transaortic flow and gradient are important determinant of prognosis in patients with severe AS treated medically or with surgical aortic valve replacement; it is unclear whether ...these echocardiographic values are still predictive of outcomes in patients with severe aortic stenosis with preserved ejection fraction who are undergoing TAVR is less defined. At baseline there was no significant difference in baseline characteristics in regards of age, race, gender, or baseline characteristics including hypertension, hyperlipidemia, diabetes or coronary artery disease.
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