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        Radial access for percutaneous coronary procedure: relationship between operator expertise and complications

        Simona Susanu,Marco Angelillis,Cristina Giannini,Rossella Binella,Anna Matteoni,Rita Bellucci,Sandro Balestri,Nicola Ferrara,Federico Falchi,Giuliano Micheletti,Anna Sonia Petronio 대한응급의학회 2018 Clinical and Experimental Emergency Medicine Vol.5 No.2

        Objective The aim of this study was to investigate (1) whether the learning curve of new catheterization laboratory operators increases the incidence of complications of transradial access during percutaneous coronary interventions and (2) whether manual compression with a two-step approach is safe and efficient for radial access hemostasis. Methods We performed a prospective study with all consecutive patients who underwent a coronary diagnostic or intervention procedure with radial access. The primary end point was a composite of pulseless radial artery of the wrist and hematoma evaluated after 24 hours. The secondary end point of efficacy was defined as the presence of bleeding or hematoma after 30 seconds. Results From March 2016 to June 2016, 150 consecutive patients, of whom 147 underwent coronary angiography and/or percutaneous coronary intervention through radial access, were included in the present study. The primary end point was present in 33%, but pulseless radial artery of the wrist was present only in 5.3%. We found that the incidence of primary end point was statistically different according to the number of puncture attempts, with a cutoff of two punctures with blood. The secondary end point of safety was present only in 4.7% of the cases. Conclusion Radial access is feasible and safe even if performed by training physicians. Manual compression with early evaluation after 30 seconds is a safe technique for managing the radial access after sheath removal.

      • 일반부인과학

        이택상 ( Taek Sang Lee ),( Smita Kothari-talwar ),( Puneet K Singhal ),( Karen Yee ),( Amit Kulkarni ),( Nuria Lara ),( Montserrat Roset ),( Anna R Giuliano ),( Suzanne M Garland ),( Woong Ju ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

        Objectives: To estimate self-reported human papillomavirus (HPV) disease-related psychosocial impact among male and female patients in South Korea. Design: In this multicentre cross-sectional study, psychosocial impacts were estimated using a onetime survey capturing HPV Impact Profile (HIP) results, CuestionarioEspecifico en Condilomas Acuminados (CECA; in Spanish)―‘Specific questionnaire for Condylomata Acuminata’ and the EuroQol-5 Dimension (EQ-5D) surveys. Student’s t-tests or Mann-Whitney U tests were used for continuous comparisons; χ<sup>2</sup> or Fisher’s exact tests were applied for categorical comparisons. Setting: 5098 clinics throughout Seoul, Busan, Daegu, Kwangju and Daejeon (South Korea). Participants: Patients with and without genital warts (GW) (males) and selected HPV diseases (females) visiting primary care physicians, obstetricians/gynaecologists, urologists and dermatologists with 2-30 years experience. Results: Of 150 male and 250 female patients, HIP scores showed 85.3% of male patients with GW and 32.0% without reported moderate psychological impact (p<0.0001). In categorised total scores, 88.5% of female patients with and 66.0% without selected HPV-related diseases reported moderate or high psychological impacts (p=0.0004). In the CECA questionnaire, male patients had mean (SD) scores of 10.51 (3.79) in ‘emotional health’ and 15.90 (6.13) in ‘sexual activity’. Female patients with GW reported lower scores in both dimensions with mean scores of 7.18 (4.17) in ‘emotional health’ and 10.97 (5.80) in ‘sexual activity’ (p<0.0001), indicating worse health-related quality of life (HRQoL). For the EQ-5D, male patients with GW reported lower mean Visual Analogue Scale (VAS) scores than those without (75.1 vs 81.13, p<0.0135). Mean VAS score and utility values were lower for females with HPV-related diseases than those without (72.18 vs 76.86 and 0.90 vs 0.94, respectively). Conclusion: In South Korea, GW in men and HPV-related diseases in women negatively impact patient well-being and HRQoL scores. Among women, those with GW suffered a greater psychosocial impact than those with other selected HPV-related diseases.

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