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91 Trends in PCI – an insight into the increasing complexity of contemporary PCI
IntroductionCollection of real-world data on percutaneous coronary intervention (PCI) procedures and associated outcomes is useful from both quality assurance and clinical research perspectives. We sought to evaluate our PCI registry database for any emerging trends in PCI practice across the 3-year period 2022 to 2024.MethodsBaseline data was prospectively collected from hospital records, clinical events to discharge were collected in hospital and clinical events to 1 month were collected either at clinic visit or via telephone interview as standard as part of our hospital PCI database. All data was inpu ed into the “DENDRITE” pla orm. Data collected included: patient demographics, baseline characteristics, interventional devices used, X-ray and contrast media usage, catheterisation lab reporting data, PCI procedural data and 30-day outcomes. The data was collected across two centres, Mater Private Dublin and Mater Private Cork.ResultsA total of 3,118 PCI procedures (3,913 treated lesions) were performed across the two centres in the 3-year period, 2022 to 2024. The mean age of the patients treated was 69 ±10 years, the majority of patients (82%) were male and 27.3% of PCI procedures were performed for acute coronary syndromes. Intravascular imaging use increased year-on-year, from 36% of cases in 2022, 43.5% in 2023, and 51.7% of PCI cases in 2024. There was a rise in lesion complexity (ACC/AHA type), and a higher use of advanced calcium modification techniques (rotational atherectomy and intravascular lithotripsy) across the 3-year period (figure 1). Baseline characteristics and clinical outcomes are demonstrated in figure 2. Through to 30-day follow up, myocardial infarction and unplanned revascularization were most common adverse events, but event rates were low. Data on 30-day outcomes was collected for all patients (100%).Abstract 91 Figure 1[Image Omitted. See PDF.]Abstract 91 Figure 2[Image Omitted. See PDF.]ConclusionsTrends seen in our PCI registry reflect contemporary PCI practice with greater use of calcium modification therapies, rising lesion complexity and increasing intravascular imaging use.
Journal Article
Technologies for global health
Mechanical ventilation and intravenous sedation were initiated. Because of continuing spasms, intrathecal baclofen (1200 µg per day) was started on day 3 with a good clinical response. No recommendations about tetanus prophylaxis procedures for wound man agement in patients with blood diseases are available, except for bone-marrow transplantation.
Journal Article
Countdown to 2015: a decade of tracking progress for maternal, newborn, and child survival
Conceived in 2003 and born in 2005 with the launch of its first report and country profiles, the Countdown to 2015 for Maternal, Newborn, and Child Survival has reached its originally proposed lifespan. Major reductions in the deaths of mothers and children have occurred since Countdown's inception, even though most of the 75 priority countries failed to achieve Millennium Development Goals 4 and 5. The coverage of life-saving interventions tracked in Countdown increased steadily over time, but wide inequalities persist between and within countries. Key drivers of coverage such as financing, human resources, commodities, and conducive health policies also showed important, yet insufficient increases. As a multistakeholder initiative of more than 40 academic, international, bilateral, and civil society institutions, Countdown was successful in monitoring progress and raising the visibility of the health of mothers, newborns, and children. Lessons learned from this initiative have direct bearing on monitoring progress during the Sustainable Development Goals era.
Journal Article
The new public health
The book provides a unified approach to public health appropriate for all masters' level students and practitioners-specifically for courses in MPH programs, community health and preventive medicine programs, community health education programs, community health nursing programs.
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Correction: Kamalov et al. Internet of Medical Things Privacy and Security: Challenges, Solutions, and Future Trends from a New Perspective. Sustainability 2023, 15, 3317
Author Contributions was not included in the original publication [...]
Journal Article
Twelve-Month Outcomes of a Group-Randomized Community Health Advocate-Led Smoking Cessation Intervention in Public Housing
Lower rates of smoking cessation are a major reason for the higher prevalence of smoking among socioeconomically disadvantaged adults. Because barriers to quitting are both more numerous and severe, socioeconomically disadvantaged smokers may benefit from more intensive intervention. We sought to determine whether a smoking cessation intervention delivered by public housing residents trained as Tobacco Treatment Advocates (TTAs) could increase utilization of cessation resources and increase abstinence.
We conducted a group-randomized trial among Boston public housing residents who were interested in quitting smoking. Participants at control sites received standard cessation materials and a one-time visit from a TTA who provided basic counseling and information about cessation resources. Participants at intervention sites were eligible for multiple visits by a TTA who employed motivational interviewing, cessation counseling, and navigation to encourage smokers to utilize cessation treatment (Smokers' Quitline and clinic-based programs). Utilization and 7-day and 30-day point prevalence abstinence were assessed at 12 months. Self-reported abstinence was biochemically verified.
Intervention participants (n = 121) were more likely than control participants (n = 129) to both utilize treatment programs (adjusted odds ratio [aOR]: 2.15; 95% confidence interval [CI]: 0.93-4.91) and 7-day and 30-day point prevalence abstinence (aOR: 2.60 (1.72-3.94); 2.98 (1.56-5.68), respectively). Mediation analysis indicated that the higher level of utilization did not explain the intervention effect.
An intervention delivered by peer health advocates was able to increase utilization of treatment programs and smoking abstinence among public housing residents. Future studies of similar types of interventions should identify the key mechanisms responsible for success.
In order to narrow the large and growing socioeconomic disparity in smoking rates, more effective cessation interventions are needed for low-income smokers. Individual culturally-relevant coaching provided in smokers' residences may help overcome the heightened barriers to cessation experienced by this group of smokers. In this study among smokers residing in public housing, an intervention delivered by peer health advocates trained in motivational interviewing, basic smoking cessation skills, and client navigation significantly increased abstinence at 12 months. Future research should address whether these findings are replicable in other settings both within and outside of public housing.
Journal Article