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Hospital Healthcare Europe

Latest issue Hospital Healthcare Europe 2018


HOPE

Hospitals in Europe: Healthcare data

The figures presented provide the most up-to-date comparative picture of the situation of healthcare and hospitals, compared with that at the beginning of the 2000s

For a number of years, hospitals have been required to act more efficiently and to increase productivity. Increased performance is indeed evident. Yet, healthcare systems are facing conflicting trends: short and long-term impacts of financial and economic restrictions; increasing demands of an ever-expanding and ageing population, which leads to more chronic patients; increasing request and availability of technological innovations; new roles, new skills and new responsibilities for the health workforce.

EU hospitals and healthcare services

The figures presented provide the most up-to-date comparative picture of the situation of healthcare and hospitals, compared with that at the beginning of the 2000s

For a number of years, hospitals have been required to act more efficiently and to increase productivity. Increased performance is indeed evident. Yet, healthcare systems are facing conflicting trends: short and long-term impacts of financial and economic restrictions; increasing demands of an ever-expanding and ageing population, which leads to more chronic patients; increasing request and availability of technological innovations; new roles, new skills and new responsibilities for the health workforce.

The challenge of integrated care in Europe

ICT4Life, a Horizon 2020 EU-funded initiative contributing to the challenge of integrated care for patients suffering from Parkinson’s disease, Alzheimer’s disease and other dementias is discussed


Cardiovascular

Sponsored – The importance of vascular access device selection: case study

Interviews were conducted to characterise two healthcare practitioners’ adoption of peripherally inserted central catheters into their clinical practices and the resulting clinical and economic benefits associated with their use

The leadless pacemaker: A new era in cardiac pacing

From the breakthroughs of early pioneers to the present day, the quest to improve outcomes and reduce complications goes on

Cardiac biomarkers: the power of innovation

With new candidates identified from different pathophysiological pathways, new technologies for measurement and more perspectives of data integration, the transformation is ongoing in the field of cardiac biomarkers

Preventing and treating VTE in patients with renal insufficiency

Patients with chronic kidney disease have an elevated risk for bleeding with declining glomerular filtration rate, even in the absence of anticoagulants, but also have an elevated risk of thromboembolism

PCSK9 inhibitors: hope or hype?

The development of PCSK9 inhibitors is a great example of serendipity, clever exploitation of a fascinating genetic observation, and rational drug development using monoclonal antibody technology in the 21st century


Clinical, Nursing and patient care


Emergency and Critical Care

Recent developments in surgical sepsis

Every surgical operation is an experiment in bacteriology – Moynihan

Situation awareness during crisis in the OR

The operating room is a complex environment and knowledge and improvement of situation awareness can increase the performance in this domain, leading to better patient outcomes

Universal, successful and without borders

Emergency medicine has an increasing prominence all over the world and especially in Europe.

Sedation in neurocritical care

Sedation is an essential therapeutic strategy in the care of neurocritical patients. Potential benefits and risks of limiting deep sedation and daily interruption of sedation remain unclear

Sponsored: suPAR in the ED: Should they stay or should they go now?

The biomarker soluble urokinase plasminogen activator receptor is a strong measure of chronic inflammation and underlying risk of negative patient outcomes including short-term mortality


Oncology and Haematology

Perspectives for treating cancer-associated thrombosis

Fixed-dose treatment with the novel direct oral anticoagulants is likely to replace subcutaneous low-molecular-weight heparins for most cancer patients with venous thromboembolism

Implications of licensed standardised chemotherapy doses and their potential impact

The introduction of dose banding and the recent publication of product specifications by NHS England have set the ball in motion for the introduction of licensed standardised chemotherapy doses, the benefits of which are discussed here

CAR T-cell therapy: managing side effects

This article focuses on the most commonly observed toxicities observed in patients treated with chimeric antigen receptor (CAR) T-cell therapy

Oral anticoagulants and cancer-associated thrombosis

Randomised clinical trials comparing prolonged treatment with low molecular weight heparins and non-vitamin K oral anticaogulants in patients with cancer-associated thrombosis are discussed

ESTRO 38: Targeting optimal care, together

On behalf of the ESTRO Scientific Advisory Group, it is our honour and pleasure to invite you to ESTRO 38, the annual congress of ESTRO, that will take place 26–30 April 2019 in Milan, Italy

Anti-GD2 mAbs for the treatment of high-risk neuroblastoma

Anti-GD2 monoclonal antibodies have recently been approved by the EU and US regulatory agencies and are currently the only formally approved drugs for the treatment of high-risk neuroblastoma

Evolving protection in haemophilia

A report from a satellite symposium held at the 11th Annual Congress of the European Association for Haemophilia and Allied Disorders in February 2018, and sponsored by Swedish Orphan Biovitrum


Neurology

Mechanical thrombectomy in acute ischaemic stroke

Mechanical thrombectomy using state of the art devices has revolutionised the treatment of patients with severe disabling strokes due to large vessel occlusion with proven efficacy in re-establishing intracranial circulation and improving patient outcomes

Treating spinal muscular atrophy

Nusinersen is a novel, antisense oligonucleotide for the treatment of spinal muscular atrophy, a rare, genetic neuromuscular disease characterised by progressive muscular wasting and loss of function

Managing refractory seizures in tuberous sclerosis complex

TSC-related epilepsy is highly refractory and represents a challenge for clinicians. Recently, some therapies have proved to be effective, acting not only on seizures but also on the underlying mechanisms

2018 NICE Guidelines for Parkinson’s disease

Clinicians will be trying to adhere to the updated NICE guidelines, but what are the implications for commissioners and providers of services for people with Parkinson’s disease?


Pathology and Diagnostics

Point of care testing in virology

The increasing range and scope of point of care tests in virology means that these assays have the potential to make a valuable contribution to diagnostic virology services

The new kid on the block

Next generation sequencing is practical and reliable to use on tissue specimens and potentially on liquid biopsies, which potentially will further revolutionise the diagnostic landscape of lung cancer

Predictive biomarker analysis in NSCLC

This manuscript highlights the results of the 2016 External Quality Assurance scheme for EGFR, ALK and ROS1 biomarker analysis in non-small cell lung cancer


Radiology and Imaging

Sponsored: New evidence for digital mammography plus tomosynthesis

Digital breast tomosynthesis, the latest generation technology in breast imaging, uses a three-dimensional, limited-angle tomographic breast imaging technique to provide multiple projection views, thus reducing interference from overlapping tissues

Artificial intelligence and radiology

Artificial intelligence enables content aggregation that extracts information from diverse healthcare data silos to help radiologists create actionable imaging reports

Radiological treatments for uterine fibroids

Options for treating uterine fibroids have increased, including uterine artery embolisation and MRI-focused high intensity ultrasound, but patient preference and tailored treatment still remain key

Ensuring safety in nuclear medicine

Hospital Healthcare Europe spoke with Jilly Croasdale of the UK Radiopharmacy Group about guidance on safe drawing up of radiopharmaceuticals in nuclear medicine departments

Value-based radiology

Creating value and contributing to patient outcome in radiology departments starts with well-organised utilisation plans, shorter waiting times, appropriateness criteria, structured and timely reporting and continuous research for better imaging, intervention and therapy

Sponsored: Managing the risks of contrast agents in imaging

Contrast carries a small, and controversial, risk of acute kidney injury, and the use of a screening tool and point of care testing may provide the greatest opportunity to streamline the imaging pathway and provide assurance of patient safety


Rheumatology

JAK inhibitors in the treatment of rheumatoid arthritis

Progress in treating rheumatoid arthritis has been achieved with Janus kinase inhibitors, orally available disease-modifying anti-rheumatic drugs targeting the intracellular kinase JAK and having similar efficacies to biologics

International updates and 2017 criteria of the Ehlers-Danlos syndromes

In March 2017, the landscape changed significantly for the Ehlers-Danlos syndromes and the newly described hypermobility spectrum disorders

Treating giant cell arteritis

Giant cell arteritis remains a clinical emergency, which can lead to irreversible sight loss. New ‘Fast Track Pathways’, diagnostics and treatments are improving the standard of care and outcomes

Optimising management of systemic lupus erythematosus

There is now a better understanding of autoimmunity in systemic lupus erythematosus, which has led to improved therapeutic strategies, but revolutionary treatments have yet to be discovered

Novel treatments in the management of myositis

This review focuses on novel treatments in the management of myositis, incuding recent clinical trial data

Challenges in the management of psoriatic arthritis

The ability to understand and manage psoriatic arthritis has progressed enormously over the past few years and we are thus approaching a more personalised approach


Theatre and Surgery

Stress immunity in surgeons

Stress immunity is an important personality trait of doctors, with a high representation seen in surgery. With one in five surgeons dropping out of training and 80% reporting burnout symptoms, methods to increase job satisfaction and reduce burnout are required

Optimal analgesia for major open surgery

This article aims to explore the various modalities available for providing analgesia for major open abdominal surgery and the evidence surrounding their use, risks and benefits

Severe adverse events in the operating theatre

Unexpected patient harm occurs more frequently than expected in the operating theatre. Learning to deal with these situations, as well as using available resources, might effectively prevent future harm as well as improve the quality of the attention provided during serious adverse events

Monitoring during anaesthesia and recovery

The 2015 Association of Anaesthetists and Great Britain and Ireland standards of monitoring during anaesthesia and recovery is a landmark guideline that builds upon previous recommendations