Three-Dimensional Rotational Angiography during Catheterization of Congenital Heart Disease - A ten Years' experience at a single center.

This paper aims to assess the usability and advantages of three-dimensional rotational angiography (3DRA) in patients with congenital heart disease (CHD) and its application in the cath lab. Up to now, its use in CHD is not widespread or standardized. We analyzed all patients with CHD who underwent a 3DRA at our facility between January 2010 and May 2019. The 3DRAs were evaluated for radiation exposure, contrast dye consumption, diagnostic utility and image quality. We performed 872 3DRAs. 3DRA was used in 67.1% of the cases for interventional procedures and in 32.9% for diagnostic purposes. Two different acquisition programs were applied. The median dose-area product (DAP) for all 872 rotations was 54.1 µGym2 (21.7-147.5 µGym2) and 1.6 ml/kg (0.9-2.07 ml/kg) of contrast dye was used. Diagnostic utility of the generated 3D-model was rated superior to the native 3D angiography in 94% (819/872). 3DRA is an excellent and save diagnostic and interventional tool. However, 3DRA has not become a standard imaging procedure in pediatric cardiology up to now. Effort and advantage seems to be unbalanced, but new less invasive techniques may upgrade this method in future.

Health-related quality of life in health care workers with work-related skin diseases.

BACKGROUND: Occupational skin diseases (OSDs) are common among health care workers (HCWs). Little is known about how OSD impacts on health-related quality of life (HRQoL) in HCWs with suspected OSD and associated factors. OBJECTIVES: To describe HRQoL in 278 HCWs with suspected OSD, compare data with the general and populations with skin diseases and analyse HRQoL's associations with clinical and demographic variables. METHODS: HCWs with suspected OSD completed a generic (SF-36) and specific (Skindex-29) instrument. RESULTS: Seven of 8 SF-36 dimensions were significantly lower in HCWs than the general population. Compared with norms for patients with skin disease and cleaning and kitchen employees (CKEs) with suspected OSD, physical functioning (PF) and general health perception were less impaired in HCWs. Skindex-29 scores were similar to CKEs' while they appeared better than patients' norms. Multivariate analysis found severity unrelated to SF-36, apart from pain but associated with all Skindex-29 scales. CONCLUSIONS: Although HCWs with suspected OSD display considerable HRQoL impairments, (general) PF and general health perception appear less affected than expected. Severity appears to affect specific and to a lesser extent general HRQoL. Clinical and demographic variables contributed moderately to the prediction of specific and little to the prediction of general HRQoL.

The impact of measures for secondary individual prevention of work-related skin diseases in health care workers: 1-year follow-up study.

BACKGROUND: Specific instruction courses as a tool for secondary prevention of occupational skin disease (secondary individual prevention, SIP courses) affecting individuals have been introduced in Germany. Little is yet known about the outcome of occupational disease and related behavioural patterns following these courses. OBJECTIVES: To investigate the outcome of occupational skin disease in health care workers (HCW) 1 year after attendance of a SIP course. PATIENTS/METHODS: Two hundred and fifty-three HCW participated in SIP courses and were contacted by telephone 1 year after attendance. Patients were interviewed about skin lesions, medical treatment, sick leave, change of occupation, skin protection, skin care and skin cleansing, and the impact of skin disease. RESULTS: The follow-up rate was 81%. The proportion of participants reporting skin lesions decreased significantly (68% at follow-up compared with 77% at baseline; P = 0.02). Seventy-two per cent reported that their skin lesions had improved. Nine per cent reported having left their occupation due to their skin disease. Skin care and skin protection had improved, while the frequency of reported hand washing was reduced. Twenty-seven per cent said their quality of life was impaired due to the skin disease, compared with 54% at baseline (P < 0.001). CONCLUSIONS: Outcome parameters, including behavioural parameters, indicate a positive impact of courses for SIP on skin health of HCW 1 year after attendance.

Occupational skin diseases in cleaning and kitchen employees: course and quality of life after measures of secondary individual prevention.

BACKGROUND: Cleaning and kitchen employees have an increased risk of suffering from occupational dermatoses. Prevention including improving individual skin care and skin protection behavior, health education, optimizing diagnostics and therapy as well as avoidance of occupational skin disease (BK 5101) is important. PATIENTS AND METHODS: Participants in the courses were patients suspected of having an occupational skin disease. Besides socio-demographic and disease-related data, health-related quality of life (QL) was measured using the SF-36 and Skindex-29. One year later all participants were interviewed by telephone about the course of their skin disease. RESULTS: Out of 212 participants, 84.0 % were female. The mean age was 41.6 (SD = 10.8) years.168 patients (79.2 %) suffered from hand dermatitis,with irritant contact dermatitis being the predominant diagnosis (46.2 %,n = 98). One year later 65.4 % (n = 85) of the patients interviewed still suffered from hand dermatitis.9.2 % (n = 12) had meanwhile quit their job due to the skin disease. QL was impaired in all age groups being lower with increasing age of the patients. CONCLUSIONS: The follow-up confirmed the positive impact of the skin protection courses on patients' skin disease and well-being. Occupational skin diseases impair health-related quality of life in these professions but disease severity does not seem to play a key role.

Secondary individual prevention of occupational skin diseases in health care workers, cleaners and kitchen employees: aims, experiences and descriptive results.

OBJECTIVES: Due to increased occupational dermatoses in certain professions such as health care workers (HCW), cleaning and kitchen employees (CKE), measures of prevention and skin protection are of high significance. Skin protection courses focus on educational aims (e.g. improving skin care habits, influencing the participants' attitudes towards health) and medical aims (e.g. optimising diagnostic procedures, complementing individual therapy). METHODS: Participants are patients who have been suspected to suffer from an occupational skin disease and are insured with the German Accident Prevention & Insurance Association (BGW). Teaching units of the skin protection courses focus on basics of skin functioning and important aspects of occupational skin diseases. Practical parts include information and instructions about the correct implementation of skin protection, skin care and skin cleansing. Every participant is seen by a dermatologist obtaining a precise patient's history and performing a skin examination. All this results in working out individually adapted and professional skin protection strategies. RESULTS: In total, 791 participants (93 men and 698 women) completed the skin protections courses. Six hundred and sixty-seven patients (mean age: 36.9 years, SD = 11.6) were HCW and 124 patients (mean age: 40.4 years, SD = 10.8) were CKE. In HCW 82.5% (n = 550) and in CKE 86.3% (n = 107) suffered from hand eczema of the atopic, irritant or allergic type. Irritant contact dermatitis as a single diagnosis was the most frequent one in both groups (HCW: 34.5.%, n = 230; CKE: 49.2% n = 61). According to regularly performed evaluations, the participants rated the course as good to excellent. Nearly 80% of the participants had skin lesions while attending the course, in 27% the dermatosis was severe. CONCLUSIONS: There is a high need for health education, advisory services, diagnostics and additional therapy in occupational dermatology. Prevention of occupational skin diseases and maintenance of health through educational programmes are important complementary measures for dermatological care but still missing in endangered professions.