Considerations in the management of trans patients.

It is essential to raise awareness of the health and social needs of trans individuals. This article presents the barriers that trans people may encounter when accessing healthcare services and offers practical recommendations on how holistic care may be achieved.

Engineering Pt in ceria for a maximum metal-support interaction in catalysis.

Conventional supported metal catalysts are metal nanoparticles deposited on high surface area oxide supports with a poorly defined metal-support interface. Typically, the traditionally prepared Pt/ceria catalyzes both methanation (H2/CO to CH4) and water-gas shift (CO/H2O to CO2/H2) reactions. By using simple nanochemistry techniques, we show for the first time that Pt or PtAu metal can be created inside each CeO2 particle with tailored dimensions.

Transradial coronary angiography in patients with contraindications to the femoral approach: an analysis of 500 cases.

The transradial approach to coronary angiography is considered by some to be a route of choice, by others to be a route that should be used only where there are relative contraindications to the femoral approach. We present the largest series to date of patients in whom transradial coronary angiography was undertaken specifically because of contraindications to the femoral approach. Since 1995, patients at this cardiothoracic center have been considered for a transradial approach to coronary angiography if there were relative contraindications to the femoral route.

Permanent pacemakers: should straightened atrial leads be repositioned?

The aim of this study was to assess if atrial leads whose "J" configuration has straightened significantly on the postprocedural chest X ray should be repositioned. Between January 1996 and December 1997, 445 patients underwent dual chamber pacemaker implantation at the Papworth Hospital. Postprocedural chest X rays were available in 410 of these.

Coronary angiography in the fully anticoagulated patient: the transradial route is successful and safe.

The radial approach to coronary angiography is intuitively attractive for fully anticoagulated patients (INR > 2) but no data exist concerning efficacy or safety of this procedure. The consensus view is that the femoral approach is contraindicated in fully anticoagulated patients, and though some operators undertake femoral catheterization in such patients and use closure devices, there are no data to suggest that it is safe to do so. At our institution, the radial approach for coronary angiography is reserved for patients in whom there is a relative contraindication to the femoral route.

Occasional-operator percutaneous brachial coronary angiography: first, do no arm.

The percutaneous brachial approach to coronary angiography is perceived, rightly or wrongly, to be the easiest of the arm approaches. Predominantly femoral operators may therefore be encouraged to use the percutaneous brachial approach as an occasional procedure. We decided to investigate prospectively whether this was a reasonable strategy by examining outcome in patients who underwent percutaneous brachial cardiac catheterization by occasional brachial operators.

Manpower in cardiology in Europe. The Cardiology Monospeciality Section of the UEMS.

This is the first systematic survey of cardiology manpower in Europe. Hitherto, there has been no published information on the number of cardiologists in the different European nations and whether it was growing or stable. Important differences in the number of cardiologists and trainees are observed, with the highest figures in Greece, Italy and France (more than 80/10(6)inhabitants) and the lowest in the Scandinavian nations, Austria, Germany and the U.

Syncope after effort.

A 29-year-old man developed recurrent syncope following exertion. Cardiac investigations revealed no evidence of structural heart disease, but during exercise testing, in the recovery phase, he sustained a bradycardia and then asystole for a prolonged period. Before cardiac massage could be instituted a tonic-clonic fit occurred, and this initiated a return to sinus rhythm.

Coronary angiography in the presence of peripheral vascular disease: femoral or brachial/radial approach?

Peripheral vascular disease is considered a relative contraindication to the femoral approach for coronary angiography, but no data exist comparing the femoral and brachial/radial routes under these circumstances. We examined the influence of vascular approach on outcome. Two hundred and ninety-seven patients, mean age 67.

Late complications following permanent pacemaker implantation or elective unit replacement.

Objective: To determine the rate of late complications following first implantation or elective unit replacement of a permanent pacemaker system.

Design: Analysis of pacemaker data and complications prospectively acquired on a computerised database. Complications were studied over an 11 year period from January 1984 to December 1994.

Coronary angiography from the radial artery--experience, complications and limitations.

Aims: to assess the outcomes, complications and limitations of coronary angiography performed via percutaneous radial artery puncture.

Methods And Results: two hundred and fifty patients underwent diagnostic coronary angiography from the radial artery, 182 (72.8%) of whom had contraindications to the femoral approach, for example due to peripheral vascular disease (n=85), therapeutic anticoagulation (29), or failed femoral approach (17).

Ventricular pacemaker upgrade: experience, complications and recommendations.

Objective: To assess outcomes of pacemaker upgrade from single chamber ventricular to dual chamber.

Design: Retrospective analysis of patients undergoing the procedure.

Setting: Specialist cardiothoracic unit.

Comparison of radial versus brachial approaches for diagnostic coronary angiography when the femoral approach is contraindicated.

One hundred patients with contraindications to the femoral approach were randomized to undergo diagnostic coronary angiography via percutaneous radial puncture or brachial artery cutdown. Procedure duration, fluoroscopy time, and total radiation dose were significantly less via the radial route, whereas procedural success, complication rates, and pain scores were comparable; we conclude that the radial technique should be the arm approach of choice for new trainees, although there will be occasions when radial access fails and a brachial approach is required.