Electronic patient-reported outcomes from home in patients recovering from major gynecologic cancer surgery: A prospective study measuring symptoms and health-related quality of life

We previously reported on the feasibility of a Web-based system to capture patient-reported outcomes (PROs) in the immediate postoperative period. The purpose of this study was to update the experience of these patients and assess patient and provider satisfaction and feedback regarding the system

The impact of COVID-19 pandemic on vascular registries and clinical trials.

Quality improvement programs and clinical trial research experienced disruption due to the coronavirus disease 2019 (COVID-19) pandemic. Vascular registries showed an immediate impact with significant declines in second-quarter vascular procedure volumes witnessed across Europe and the United States. To better understand the magnitude and impact of the pandemic, organizations and study groups sent grass roots surveys to vascular specialists for needs assessment. Several vascular registries responded quickly by insertion of COVID-19 variables into their data collection forms. More than 80% of clinical trials have been reported delayed or not started due to factors that included loss of enrollment from patient concerns or mandated institutional shutdowns, weighing the risk of trial participation on patient safety. Preliminary data of patients undergoing vascular surgery with active COVID-19 infection show inferior outcomes (morbidity) and increased mortality. Disease-specific vascular surgery study collaboratives about COVID-19 were created for the desire to study the disease in a more focused manner than possible through registry outcomes. This review describes the pandemic effect on multiple VASCUNET registries including Germany (GermanVasc), Sweden (SwedVasc), United Kingdom (UK National Vascular Registry), Australia and New Zealand (bi-national Australasian Vascular Audit), as well as the United States (Society for Vascular Surgery Vascular Quality Initiative). We will highlight the continued collaboration of VASCUNET with the Vascular Quality Initiative in the International Consortium of Vascular Registries as part of the Medical Device Epidemiology Network coordinated registry network. Vascular registries must remain flexible and responsive to new and future real-world problems affecting vascular patients

COVID-19 surveillance in fragile health systems, armed conflict and humanitarian crisis, the case of Yemen

Background Yemen is a poor country facing armed conflict which significantly disrupted the Health System. Yemen reported fewer COVID-19 cases than neighbouring countries, yet the case fatality rate (19.6%) remained five times the global average. Conflict typically hinders surveillance, however obtaining representative mortality and morbidity indicators remains essential to efficacious epidemic planning. We aimed to explore challenges hindering COVID-19 surveillance in Yemen and opportunities for addressing them, to increase surveillance effectiveness in such conflict and resource-constraint settings. Methods Qualitative study question guide was used for in-depth interviewswith 30 healthcare workers who worked in Yemen’s surveillance system during the pandemic. Participants were recruited through in-country gatekeepers using a ‘snowball’ sampling technique. Thematic framework analysiswas used. Findings A basic level of preparedness existed following responses to previous epidemics, including activating Rapid Response Teams (RRTs), and electronic disease surveillance. Key challenges included the ongoing conflict, an unstable health system, minimal infrastructure restorations, misinformation, community incompliance, and inadequate laboratory diagnostics or transportation capabilities. Participants recommended addressing these barriers through strengthening RRTs, transportation and laboratory testing capacities, implementing community awareness campaigns, alongside improving primary health care services and inter-governorate governance. Conclusion Active community surveillance by RRTs supplemented with community volunteers is imperative and necessary nationwide. National community awareness campaigns on case detection, reporting, and addressing misinformation are essential to implementing such community surveillance. Increased utilization of mobile laboratories could enhance laboratory testing capacity in underserved areas. For each recommendation to be effectively implemented, the international community must provide sufficient resources and financial aid

Better outcome of ablation for sustained outflow-tract ventricular tachycardia when tachycardia is inducible.

AIMS In patients presenting with spontaneous sustained ventricular tachycardia (VT) from the outflow-tract region without overt structural heart disease ablation may target premature ventricular contractions (PVCs) when VT is not inducible. We aimed to determine whether inducibility of VT affects ablation outcome. METHODS AND RESULTS Data from 54 patients (31 men; age, 52 ± 13 years) without overt structural heart disease who underwent catheter ablation for symptomatic sustained VT originating from the right- or left-ventricular outflow region, including the great vessels. A single morphology of sustained VT was inducible in 18 (33%, SM group) patients, and 11 (20%) had multiple VT morphologies (MM group). VT was not inducible in 25 (46%) patients (VTni group). After ablation, VT was inducible in none of the SM group and in two (17%) patients in the MM group. In the VTni group, ablation targeted PVCs and 12 (48%) patients had some remaining PVCs after ablation. During follow-up (21 ± 19 months), VT recurred in 46% of VTni group, 40% of MM inducible group, and 6% of the SM inducible group (P = 0.004). Analysis of PVC morphology in the VTi group further supported the limitations of targeting PVCs in this population. CONCLUSION Absence of inducible VT and multiple VT morphologies are not uncommon in patients with documented sustained outflow-tract VT without overt structural heart disease. Inducible VT is associated with better outcomes, suggesting that attempts to induce VT to guide ablation are important in this population