BACKGROUND: Transcatheter Aortic Valve Implantation (TAVI) has changed the treatment paradigm of the aortic stenosis (AS). It has become the treatment of choice in patients with symptomatic AS and surgical high risk, and a valid alternative to surgical aortic valve replacement in patients with low and medium surgical risk. Despite numerous evidence on clinical results, indications and benefits, only a few studies analyse it from patient's perspective and the impact of TAVI on them. The objective of this study is to evaluate the experience of patients undergoing TAVI. METHODS: Cross-sectional, descriptive observational study in two Spanish hospitals, with a establish Nurse TAVI program, with 100 patients undergoing TAVI. A specific questionnaire was designed (VALVEX questionnaire) and a pilot study was conducted by a multidisciplinary team of doctors, nurses and patients. The questionnaire was given to patients at 30 days after TAVI procedure during the follow up at the TAVI nurse clinic. RESULTS: The study demonstrated a mean satisfaction of 9 for the TAVI program, with 96% of patients that would recommend TAVI to other patients. Patients scored a high satisfaction on the information received prior to the procedure. During the procedure and admission, the satisfaction was high in relation to the care received. During the follow up, satisfaction was high in relation to the role of the TAVI nurse, for the information and continuation of care during the procedure, in reducing anxiety, organising their admission and understanding the process. However, questions with less scores were related to hospital catering, delay between diagnosed and treatment, and patient decision-making process. CONCLUSION The evaluation of patient experience allows us to improve the information given to the patient during their TAVI process and it can also allow patients to be more relax, aware and prepared for the procedure. Continuous follow up enables monitoring of patient recovery and helps to discuss any doubts improving patient's satisfaction. The use of PREMs and PROMs associated to TAVI pathway combined with an active participation of the patient on the design of the questionnaire is essential for keeping the patient in the centre of the TAVI pathway.

Background: and Purpose Visual hallucinations (VH) and subjective cognitive complaints (SCC) are associated with cognitive impairment (CI) in Parkinson’s disease. Our aims were to determine the association between VH and SCC and the risk of CI development in a cohort of patients with Parkinson’s disease and normal cognition (PD-NC). Methods: Patients with PD-NC (total score of >80 on the Parkinson’s Disease Cognitive Rating Scale [PD-CRS]) recruited from the Spanish COPPADIS cohort from January 2016 to November 2017 were followed up after 2 years. Subjects with a score of ≥1 on domain 5 and item 13 of the Non-Motor Symptoms Scale at baseline (V0) were considered as “with SCC” and “with VH,” respectively. CI at the 2-year follow-up (plus or minus 1 month) (V2) was defined as a PD-CRS total score of <81. Results: At V0 (n=376, 58.2% males, age 61.14±8.73 years [mean±SD]), the frequencies of VH and SCC were 13.6% and 62.2%, respectively. VH were more frequent in patients with SCC than in those without: 18.8% (44/234) vs 4.9% (7/142), p<0.0001. At V2, 15.2% (57/376) of the patients had developed CI. VH presenting at V0 was associated with a higher risk of CI at V2 (odds ratio [OR]=2.68, 95% confidence interval=1.05–6.83, p=0.039) after controlling for the effects of age, disease duration, education, medication, motor and nonmotor status, mood, and PD-CRS total score at V0. Although SCC were not associated with CI at V2, presenting both VH and SCC at V0 increased the probability of having CI at V2 (OR=3.71, 95% confidence interval=1.36–10.17, p=0.011). Conclusions VH were associated with the development of SCC and CI at the 2-year follow-up in patients with PD-NC.

BACKGROUND: Sacral nerve stimulation is a therapeutic option with demonstrated efficacy for conditions presenting with perineal pain caused by different etiologies. We aimed to assess whether a sacral electrode (InterStim(R), Medtronic, Minneapolis, MN, USA) inserted through the caudal pathway is able to offer an acceptable level of sacral stimulation and rate of catheter migration. METHODS: We present 12 patients with pelvic pain who received sacral neuromodulation via the sacral hiatus with the InterStim electrode. We evaluated patient satisfaction as well as migration and removal of the electrode, if necessary. RESULTS: Our experience included 12 patients, 10 women and two men, with a mean age of 60 years. In eight of the 12 patients, the initial therapy was effective, and the final system implantation was performed. During subsequent follow-up, patient satisfaction was good. To date, there have been no cases of electrode displacement or migration. CONCLUSIONS: The caudal insertion of the InterStim electrode, with its own fixation system, and initially designed for transsacral insertion, appears in our experience to be a satisfactory option which can minimize electrode displacements, achieving similar results in therapeutic efficacy and causing no difficulties in removal.
Catheters ; Electrodes* ; Female ; Follow-Up Studies ; Humans ; Implantable Neurostimulators ; Male ; Pain Clinics* ; Patient Satisfaction ; Pelvic Pain ; Perineum ; Sacrococcygeal Region ; Sacrum ; Spinal Cord Stimulation

Methods such as real time (RT)-PCR have not been developed for the rapid detection and diagnosis of Dermatophilus (D.) congolensis infection. In the present study, a D. congolensis-specific SYBR Green RT-PCR assay was evaluated. The detection limit of the RT-PCR assay was 1 pg of DNA per PCR reaction. No cross-reaction with nucleic acids extracted from Pseudomonas aeruginosa, Mycobacterium tuberculosis, Staphylococcus aureus, or Austwickia chelonae was observed. Finally, the RT-PCR assay was used to evaluate clinical samples collected from naturally infected animals with D. congolensis. The results showed that this assay is a fast and reliable method for diagnosing dermatophilosis.
Actinomycetales/*isolation & purification ; Actinomycetales Infections/diagnosis/microbiology/*veterinary ; Animals ; Cattle ; Cattle Diseases/*diagnosis/microbiology ; Fluorescent Dyes/*diagnostic use ; Horse Diseases/*diagnosis/microbiology ; Horses ; Limit of Detection ; Real-Time Polymerase Chain Reaction/*methods/veterinary ; Reproducibility of Results ; Sheep ; Sheep Diseases/*diagnosis/microbiology

The distribution of red-spotted grouper nervous necrosis virus (RGNNV) antigens was examined by immunohistochemistry in the nervous and non-nervous organs of juvenile European seabass (Dicentrarchus labrax) during the course of an intramuscular infection. Histological changes resulting from the infection were evaluated from 3 days to 2 months post-infection. The specific antibody response was also studied 2 months post-challenge. Viral proteins were present throughout the experimental period in the retina (inner nuclear layer, ganglion layer, outer limiting membrane, and outer plexiform layer), brain (cerebellum and tectum opticum), and liver (hepatocytes and endothelial cells). These proteins were also observed in the renal tubular cells, white pulp of spleen, and in fibroblasts and cartilage of caudal fin. This is the first report of RGNNV proteins appearing in these organs, where the immunostaining was only detected at certain sampling times after the onset of mortality. Brain and retina of virus-exposed fish showed high levels of vacuolation, while accumulation of fat vacuoles was observed in the liver. RGNNV infection also induced a specific antibody response as measured by an ELISA. In summary, this is the first study demonstrating the presence of viral proteins in cells of caudal fin, kidney and spleen of European seabass.
Antibody Formation ; Brain ; Cartilage ; Enzyme-Linked Immunosorbent Assay ; European Continental Ancestry Group ; Fibroblasts ; Ganglion Cysts ; Humans ; Immunohistochemistry ; Kidney ; Liver ; Membranes ; Necrosis ; Proteins ; Retina ; Spleen ; Vacuoles ; Viral Proteins ; Viruses

No abstract available.
Hepatic Encephalopathy/*congenital ; Humans ; Liver Neoplasms/*congenital ; Male ; Portal Vein/*abnormalities ; *Septal Occluder Device