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1.
Article in German | MEDLINE | ID: mdl-39197445

ABSTRACT

The implementation of equal opportunities is a challenge for the staff of an anaesthesia department. At the Department of Anaesthesiology and Intensive Care Medicine at Hannover Medical School, a local Gender Equality plan has been implemented to create a secure and transparent framework for reconciling scientific and clinical careers with family responsibilities. Today, family and career should be equally compatible for men and women. Unfortunately, in medical professions it is often still an either/or decision. At the same time, it is important to offer an attractive workplace in view of the increasing shortage of qualified staff. In order to provide equal opportunities for all employees and to increase satisfaction, it is necessary for employers to address the issues of equality and work-life balance, to identify challenges and to create structures for improvement.


Subject(s)
Gender Equity , Humans , Female , Male , Germany , Anesthesiology/organization & administration , Physicians, Women , Sexism/prevention & control
2.
Eur Heart J Case Rep ; 8(2): ytae035, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38425726

ABSTRACT

Background: The introduction of a transapical transcatheter beating heart replacement system has significantly expanded therapeutic options for patients with severely diseased mitral valves, particularly those ineligibles for traditional surgery or transcatheter repair. However, challenges, such as left ventricular outflow tract obstruction (LVOT-O) and the risk of dynamic systolic anterior motion (SAM) in cases with elongated anterior mitral leaflet (AML) post-prosthesis implantation, impede the widespread adoption of transcatheter mitral valve replacement (TMVR). Case summary: In 2022, a 75-year-old male with severe mixed-genesis mitral regurgitation (MR) underwent Carillon Mitral Contour System annuloplasty. Recurrent heart failure admissions (New York Heart Association IV) and prohibitive risk for open-heart surgery (European System for Cardiac Operative Risk Evaluation II 8.27%) prompted evaluation for Tendyne TMVR with the MitraCut technique. This beating heart transapical approach involved scissor-mediated splitting of the elongated 27 mm AML, essential for mitigating LVOT-O risk and dynamic SAM. The screening echocardiogram revealed the poorly tethered AML near the thickened septum at the simulated neo-LVOT site. Discussion: This case underscores the intricate management challenges associated with severe MR, highlighting the successful application of the MitraCut technique as a viable alternative in high-risk scenarios. The imperative for further research and clinical studies is emphasized to comprehensively elucidate outcomes and safety parameters, providing valuable insights for refining TMVR applications within this context.

3.
Z Evid Fortbild Qual Gesundhwes ; 140: 1-13, 2019 Mar.
Article in German | MEDLINE | ID: mdl-30598287

ABSTRACT

BACKGROUND: Carbon monoxide poisoning (COP) is the most common cause for poisoning by inhalation in Germany. In the past 8 years, a marked increase in the number of COP-related deaths has been registered nationwide. A national German guideline is missing. METHODS: The national and international literature was screened systematically. Existing international guidelines and expert recommendations for the diagnosis and treatment of COP were compared and evaluated. Furthermore, quality of health care was analyzed by a prospective preclinical dataset of emergency rescue services and retrospective analysis of routine data from 2014 to 2016 in Germany. RESULTS: There is not a single evidence-based guideline worldwide. We determined 8 key performance indicators based on the five recommendations available for treatment of COP. These indices were subdivided into prehospital terms, hospital facilities, and diagnostic and therapeutic measures performed; they act as indicators for quality of care. In particular, the key figure "start oxygen" revealed that up to 41 % of the patients had not been treated with inhaled oxygen. In summary, data capture showed considerable incompleteness that is mainly due to missing time stamps. CONCLUSION: In order to achieve a consistent treatment of patients with COP which meets the standard of recommended care, there is an urgent need for a consented national guideline. Another objective is to establish a nationwide prospective registry evaluating the treatment of carbon monoxide poisoning.


Subject(s)
Carbon Monoxide Poisoning , Practice Guidelines as Topic , Quality of Health Care , Carbon Monoxide Poisoning/therapy , Germany , Humans , Hyperbaric Oxygenation , Prospective Studies , Retrospective Studies
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