18 research outputs found

    sj-docx-1-cpt-10.1177_10742484231224536 - Supplemental material for Assessment of Dofetilide or Sotalol Tolerability in the Elderly

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    Supplemental material, sj-docx-1-cpt-10.1177_10742484231224536 for Assessment of Dofetilide or Sotalol Tolerability in the Elderly by Nikitha Yagnala, Lindsay Moreland-Head, Joseph J Zieminski, Kristin Mara and Shea Macielak in Journal of Cardiovascular Pharmacology and Therapeutics</p

    Assessment of Dofetilide or Sotalol Tolerability in the Elderly

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    Background: Dofetilide and sotalol are potassium channel antagonists that require inpatient QTc monitoring during initiation, due to increased risk of fatal arrhythmias. Elderly patients are especially subject to an increased risk of fatal arrhythmias due to polypharmacy, comorbidities, and physiologic cardiac changes with aging. This study will describe the tolerability and risk factors associated with the initiation of sotalol or dofetilide in patients ≥80 years of age. Methodology: This is a multicenter, retrospective, descriptive study of patients ≥80 years old who were initiated on either dofetilide or sotalol between May 8, 2018 and July 31, 2021 at institutions within the Mayo Clinic Health System. The percentage of patients who received nonpackage insert recommended doses was identified. Incidence of and reasons for dose reductions or discontinuations due to safety-related events or clinical concerns during the initial loading period were collected. Results: The final analysis included 104 patients. The majority of patients (75%) received nonstandard initial doses of dofetilide or sotalol based on baseline estimated creatinine clearance or QTc. Overall, 39% ( N  = 41) of patients experienced a dose reduction or discontinuation due to a safety-related event or concern. Patients who received nonstandard initial doses of dofetilide or sotalol had 4.7 times greater odds of experiencing a safety-related event requiring dose reduction or discontinuation. Conclusion: Following package insert dosing in elderly patients increases safety and tolerability relative to more aggressive dosing of dofetilide or sotalol

    Single‐use versus reusable rhinolaryngoscopes for inpatient otorhinolaryngology consults: Resident and patient experience

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    Abstract Objectives Single‐use rhinolaryngoscopes were brought to market in 2019 as an alternative to traditional reusable scopes and have garnered interest across settings given portability and potential cost advantages. While single‐use was previously evaluated compared to traditional devices, the overall impact to the consult experience for both users and patients has not been captured. Methods Eighteen residents performed consults with both single‐use and reusable rhinolaryngoscope systems on alternating weeks. A five‐question cumulative survey administered across three assessment points over a 12‐week period using a five‐point rating system to rate favorability. Residents and patients also completed four‐point scale surveys following procedure(s) to capture the consult experience. Statistical analyses were performed to measure significance differences between survey responses between the two systems. Results Single‐use rhinolaryngoscopes received higher overall ratings compared with reusables across each metric captured including overall consult time (4.3 vs. 2.2, p < .001), multiscope consults (4.4 vs. 3.1, p < .001), patient communication (4.6 vs. 2.1, p < .001), teaching opportunities (4.6 vs. 2.1, p < .001), and overall ease of use (4.7 vs. 2.6, p < .001). Residents rated single‐use higher than reusable after each procedure in terms of ease of use (1.07 vs. 2.68, p < .001) and visual clarity (1.27 vs. 1.89, p = .003), while patients rated single‐use higher for understanding of illness (3.9 vs. 3.1, p < .001) and understanding of treatment rationale (3.9 vs. 3.1, p < .001). Conclusion Resident and patient experience feedback favored single‐use rhinolaryngoscopes compared to reusable scope technology across multiple surveyed measurables. Single‐use rhinolaryngoscopes provide a viable tool for otorhinolaryngologist and other clinicians to perform rhinolaryngoscopy consults. Level of Evidence 4

    Influence of post-deposition selenium supply on Cu(In,Ga)Se2-based solar cell properties

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    International audienceCu(In,Ga)Se2 (CIGSe) layers have been deposited by the 3-stage process and once the growth was completed, the structures have been kept at high temperature for 50 min with or without Se supply. Both the resulting CIGSe layer and related device properties are compared with those obtained when the substrate is cooled down right after the deposition. Moreover, such experiments have been performed with and without alkali availability. The results show that keeping the absorber at high temperature differently impacts [Ga] / ([In + Ga]) atomic ratio distribution and crystalline preferential orientation depending on whether Se is supplied. Moreover, this work shows that chalcogen supply can be detrimental for cell performance when the CIGSe contains alkali and in contrast be beneficial when the CIGSe is free of alkali. These observations suggest an intimate relationship between alkali and Se
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