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Article ; Online: Ruptured Popliteal Artery Aneurysm Complicated with Acute Respiratory Distress Syndrome Secondary to SARS-CoV-2 Infection.

Powezka, Katarzyna / Khan, Taha / Narlawar, Ranjeet / Antoniou, George A

2020 Volume 66, Page(s) 24–27

Abstract: We herein report a rare case of the ruptured popliteal artery aneurysm in an 89-year-old man, whose recovery after surgical treatment was complicated with acute respiratory distress syndrome secondary to confirmed infection with SARS-CoV-2. Presenting ... ...

Abstract	We herein report a rare case of the ruptured popliteal artery aneurysm in an 89-year-old man, whose recovery after surgical treatment was complicated with acute respiratory distress syndrome secondary to confirmed infection with SARS-CoV-2. Presenting symptoms, patient's comorbidities, and postoperative course complicated with cardiac and respiratory failure leading to adverse outcome are discussed in this case report.
MeSH term(s)	Aged, 80 and over ; Aneurysm, Ruptured/diagnosis ; Aneurysm, Ruptured/etiology ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Humans ; Male ; Pandemics ; Pneumonia, Viral/complications ; Popliteal Artery ; Respiratory Distress Syndrome/etiology ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-05-15
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2020.05.012
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Management of Acute Iliofemoral Deep Venous Thrombosis in Inflammatory Bowel Disease - Transitioning From Conservative Management to Early Intervention.

Badesha, Arshpreet Singh / Tamber, Kajal Kaur / Powezka, Katarzyna / Hodge, Stacie / Khan, Taha

Cureus

2021 Volume 13, Issue 8, Page(s) e17426

Abstract: Deep vein thrombosis (DVT) is a frequent complication in patients suffering from inflammatory bowel disease (IBD), especially in those with frequent relapses of the disease or extensive inflammatory lesions. The aetiology for the increased risk is ... ...

Abstract	Deep vein thrombosis (DVT) is a frequent complication in patients suffering from inflammatory bowel disease (IBD), especially in those with frequent relapses of the disease or extensive inflammatory lesions. The aetiology for the increased risk is multifactorial. Current evidence on management of acute iliofemoral DVT in IBD patients is scarce. This case series highlights two cases of active IBD, who developed acute iliofemoral DVTs and were treated with catheter-directed thrombolysis (CDT). This report demonstrates that CDT is effective in clearing the clot burden and producing significant symptomatic improvement in the absence of major complications. An individualised approach must be taken for the management of IBD patients with acute iliofemoral DVT.
Language	English
Publishing date	2021-08-25
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.17426
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A Pilot Study of Heart Rate Variability Synchrony as a Marker of Intraoperative Surgical Teamwork and Its Correlation to the Length of Procedure.

Powezka, Katarzyna / Pettipher, Allan / Hemakom, Apit / Adjei, Tricia / Normahani, Pasha / Mandic, Danilo P / Jaffer, Usman

Sensors (Basel, Switzerland)

2022 Volume 22, Issue 22

Abstract: Objective: Quality of intraoperative teamwork may have a direct impact on patient outcomes. Heart rate variability (HRV) synchrony may be useful for objective assessment of team cohesion and good teamwork. The primary aim of this study was to investigate ...

Abstract	Objective: Quality of intraoperative teamwork may have a direct impact on patient outcomes. Heart rate variability (HRV) synchrony may be useful for objective assessment of team cohesion and good teamwork. The primary aim of this study was to investigate the feasibility of using HRV synchrony in surgical teams. Secondary aims were to investigate the association of HRV synchrony with length of procedure (LOP), complications, number of intraoperative glitches and length of stay (LOS). We also investigated the correlation between HRV synchrony and team familiarity, pre- and intraoperative stress levels (STAI questionnaire), NOTECHS score and experience of team members. Methods: Ear, nose and throat (ENT) and vascular surgeons (consultant and registrar team members) were recruited into the study. Baseline demographics including level of team members’ experience were gathered before each procedure. For each procedure, continuous electrocardiogram (ECG) recording was performed and questionnaires regarding pre- and intraoperative stress levels and non-technical skills (NOTECHS) scores were collected for each team member. An independent observer documented the time of each intraoperative glitch. Statistical analysis was conducted using stepwise multiple linear regression. Results: Four HRV synchrony metrics which may be markers of efficient surgical collaboration were identified from the data: 1. number of HRV synchronies per hour of procedure, 2. number of HRV synchrony trends per hour of procedure, 3. length of HRV synchrony trends per hour of procedure, 4. area under the HRV synchrony trend curve per hour of procedure. LOP was inversely correlated with number of HRV synchrony trends per hour of procedure (p < 0.0001), area under HRV synchrony trend curve per hour of procedure (p = 0.001), length of HRV synchrony trends per hour of procedure (p = 0.002) and number of HRV synchronies per hour of procedure (p < 0.0001). LOP was positively correlated with: FS (p = 0.043; R = 0.358) and intraoperative STAI score of the whole team (p = 0.007; R = 0.493). Conclusions: HRV synchrony metrics within operating teams may be used as an objective marker to quantify surgical teamwork. We have shown that LOP is shorter when the intraoperative surgical teams’ HRV is more synchronised.
MeSH term(s)	Humans ; Heart Rate ; Pilot Projects
Language	English
Publishing date	2022-11-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s22228998
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A novel team Familiarity Score for operating teams is a predictor of length of a procedure: A retrospective Bayesian analysis.

Powezka, Katarzyna / Normahani, Pasha / Standfield, Nigel J / Jaffer, Usman

Journal of vascular surgery

2019 Volume 71, Issue 3, Page(s) 959–966

Abstract: Objective: The aim of our retrospective study was to assess whether a novel team Familiarity Score (FS) is associated with the length of procedure (LOP), postoperative length of stay (LOS), and complication rate after vascular procedures.: Methods: ... ...

Abstract	Objective: The aim of our retrospective study was to assess whether a novel team Familiarity Score (FS) is associated with the length of procedure (LOP), postoperative length of stay (LOS), and complication rate after vascular procedures. Methods: We retrospectively analyzed 326 vascular procedures performed at a tertiary care vascular surgery center between April 2012 and September 2014. Data collected included patients' age, American Society of Anesthesiologists grade, LOP, type and urgency of procedure, LOS, and complications. Familiarity Score (FS) was defined as the sum of the number of times that each possible pair of the team (vascular consultant, vascular registrar, scrub nurse, anesthetic consultant) within the team had worked together during the previous 6 months, divided by the number of possible combinations of pairs in the team. Bayesian statistics was used to analyze the data. Results: FS was significantly associated with type and urgency of the procedure (Bayes factor [BF] >1000). Emergency procedures were performed by less familiar teams, and the least familiar teams were involved in the emergency aortic procedures-endovascular and open. FS was strongly associated with LOP (BF = 37) but not with LOS (BF = 4.0) and complication rate. Conclusions: FS in vascular teams was shown to be strongly associated with LOP, suggesting that more familiar teams might collaborate more efficiently.
MeSH term(s)	Aged ; Bayes Theorem ; Clinical Competence ; Female ; Humans ; Length of Stay/statistics & numerical data ; Male ; Operative Time ; Patient Care Team ; Postoperative Complications ; Retrospective Studies ; Vascular Surgical Procedures
Language	English
Publishing date	2019-08-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/j.jvs.2019.03.085
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Article ; Online: Ruptured Popliteal Artery Aneurysm Complicated with Acute Respiratory Distress Syndrome Secondary to SARS-CoV-2 Infection

Powezka, Katarzyna / Khan, Taha / Narlawar, Ranjeet / Antoniou, George A.

Annals of Vascular Surgery

2020 Volume 66, Page(s) 24–27

Keywords	Surgery ; Cardiology and Cardiovascular Medicine ; General Medicine ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2020.05.012
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Ruptured Popliteal Artery Aneurysm Complicated with Acute Respiratory Distress Syndrome Secondary to SARS-CoV-2 Infection

Powezka, Katarzyna / Khan, Taha / Narlawar, Ranjeet / Antoniou, George A

Ann Vasc Surg

Abstract	We herein report a rare case of the ruptured popliteal artery aneurysm in an 89-year-old man, whose recovery after surgical treatment was complicated with acute respiratory distress syndrome secondary to confirmed infection with SARS-CoV-2. Presenting symptoms, patient's comorbidities, and postoperative course complicated with cardiac and respiratory failure leading to adverse outcome are discussed in this case report.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #477881
Database	COVID19

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Article ; Online: Arterial spectral waveform analysis in the prediction of diabetic foot ulcer healing.

Normahani, Pasha / Agrawal, Rishi / Sounderajah, Viknesh / Tsinaslanidis, Prodromos / Musonda, Patrick / Mehar, Zaheer / Powezka, Katarzyna / Bravis, Vasiliki / Aslam, Mohammed / Jaffer, Usman

Perfusion

2020 Volume 36, Issue 7, Page(s) 751–756

Abstract: Objective: We assessed the association between (1) severity of vessel wall calcification, (2) number of patent vessels at the ankle and (3) arterial spectral waveform features, as assessed on a focused ankle Duplex ultrasound (DUS), and healing at 12- ... ...

Abstract	Objective: We assessed the association between (1) severity of vessel wall calcification, (2) number of patent vessels at the ankle and (3) arterial spectral waveform features, as assessed on a focused ankle Duplex ultrasound (DUS), and healing at 12-months in a cohort of patients who had their diabetic foot ulcers conservatively managed. Research design and methods: Scans performed on 50 limbs in 48 patients were included for analysis. Patient health records were prospectively reviewed for 12-months to assess for the outcome of ulcer healing. Results: We identified that the number of waveform components, peak systolic velocity, systolic rise time and long forward flow as well as the number of vessels patent at the ankle on DUS, may be useful independent predictors of healing, as noted by the trend towards statistical significance. Conclusion: Arterial spectral waveform features may be useful in predicting the chance of diabetic foot ulcer healing.
MeSH term(s)	Arteries ; Cohort Studies ; Diabetes Mellitus ; Diabetic Foot ; Humans ; Ultrasonography, Doppler, Duplex ; Wound Healing
Language	English
Publishing date	2020-09-21
Publishing country	England
Document type	Journal Article
ZDB-ID	645038-6
ISSN	1477-111X ; 0267-6591
ISSN (online)	1477-111X
ISSN	0267-6591
DOI	10.1177/0267659120957849
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A pilot study of preoperative heart rate variability predicting pain during local anesthetic varicose vein surgery.

Powezka, Katarzyna / Adjei, Tricia / von Rosenberg, Wilhelm / Normahani, Pasha / Goverdovsky, Valentin / Standfield, Nigel J / Mandic, Danilo P / Jaffer, Usman

Journal of vascular surgery. Venous and lymphatic disorders

2019 Volume 7, Issue 3, Page(s) 382–386

Abstract: Objective: Local anesthetic endovenous procedures were shown to reduce recovery time, to decrease postoperative pain, and to more quickly return the patient to baseline activities. However, a substantial number of patients experience pain during these ... ...

Abstract	Objective: Local anesthetic endovenous procedures were shown to reduce recovery time, to decrease postoperative pain, and to more quickly return the patient to baseline activities. However, a substantial number of patients experience pain during these procedures. The autonomic nervous system modulates pain perception, and its influence on stress response can be noninvasively quantified using heart rate variability (HRV) indices. The aim of our study was to evaluate whether preoperative baseline HRV can predict intraoperative pain during local anesthetic varicose vein surgery. Methods: Patients scheduled for radiofrequency ablation were included in the study. They had their electrocardiograms recorded from a single channel of a custom-made amplifier. Each patient preoperatively filled in forms Y-1 and Y-2 of Spielberger's State and Trait Anxiety Inventory, completed the Aberdeen Varicose Vein Questionnaire, and rated anxiety level on a numeric scale. Postoperatively, patients filled in the pain they felt during the procedure on the numeric pain intensity scale. MATLAB software (MathWorks, Natick, Mass) was used to extract R waves and to generate HRV signals, and a mathematical model was created to predict the pain score for each patient. Results: In multivariable analysis, we looked into correlation between reported patient's pain score (rPPS) and Aberdeen Varicose Vein Questionnaire score, preoperative forms Y-1 and Y-2, preoperative anxiety level, and predicted patient's pain (pPPS) score. Multivariable analysis found association only between rPPS and pPPS. The pPPS was significantly correlated with rPPS (R = 0.807; P < .001) with accuracy of prediction of 65.2%, which was calculated from R Conclusions: This preliminary study shows that preoperative HRV can accurately predict patients' pain, allowing patients with higher predicted score to have the procedure under general anesthesia.
MeSH term(s)	Adult ; Anesthesia, Local/adverse effects ; Electrocardiography ; Female ; Heart Rate ; Humans ; Male ; Middle Aged ; Pain Measurement ; Pain Threshold ; Pain, Postoperative/diagnosis ; Pain, Postoperative/etiology ; Pain, Postoperative/physiopathology ; Pilot Projects ; Predictive Value of Tests ; Preoperative Care ; Prospective Studies ; Radiofrequency Ablation/adverse effects ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Varicose Veins/diagnosis ; Varicose Veins/physiopathology ; Varicose Veins/surgery
Language	English
Publishing date	2019-01-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2213-3348
ISSN (online)	2213-3348
DOI	10.1016/j.jvsv.2018.08.008
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Podiatry Ankle Duplex Scan: Readily Learned and Accurate in Diabetes.

Normahani, Pasha / Powezka, Katarzyna / Aslam, Mohammed / Standfield, Nigel J / Jaffer, Usman

Angiology

2017 Volume 69, Issue 3, Page(s) 220–227

Abstract: We aimed to train podiatrists to perform a focused duplex ultrasound scan (DUS) of the tibial vessels at the ankle in diabetic patients; podiatry ankle (PodAnk) duplex scan. Thirteen podiatrists underwent an intensive 3-hour long simulation training ... ...

Abstract	We aimed to train podiatrists to perform a focused duplex ultrasound scan (DUS) of the tibial vessels at the ankle in diabetic patients; podiatry ankle (PodAnk) duplex scan. Thirteen podiatrists underwent an intensive 3-hour long simulation training session. Participants were then assessed performing bilateral PodAnk duplex scans of 3 diabetic patients with peripheral arterial disease. Participants were assessed using the duplex ultrasound objective structured assessment of technical skills (DUOSATS) tool and an "Imaging Score". A total of 156 vessel assessments were performed. All patients had abnormal waveforms with a loss of triphasic flow. Loss of triphasic flow was accurately detected in 145 (92.9%) vessels; the correct waveform was identified in 139 (89.1%) cases. Participants achieved excellent DUOSATS scores (median 24 [interquartile range: 23-25], max attainable score of 26) as well as "Imaging Scores" (8 [8-8], max attainable score of 8) indicating proficiency in technical skills. The mean time taken for each bilateral ankle assessment was 20.4 minutes (standard deviation ±6.7). We have demonstrated that a focused DUS for the purpose of vascular assessment of the diabetic foot is readily learned using intensive simulation training.
MeSH term(s)	Aged ; Clinical Competence ; Diabetic Angiopathies/diagnostic imaging ; Female ; Humans ; Male ; Peripheral Arterial Disease/diagnostic imaging ; Podiatry/education ; Simulation Training ; Tibial Arteries/diagnostic imaging ; Ultrasonography, Doppler, Duplex
Language	English
Publishing date	2017-02-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	80040-5
ISSN	1940-1574 ; 0003-3197
ISSN (online)	1940-1574
ISSN	0003-3197
DOI	10.1177/0003319717695994
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Pain Prediction From ECG in Vascular Surgery.

Adjei, Tricia / Von Rosenberg, Wilhelm / Goverdovsky, Valentin / Powezka, Katarzyna / Jaffer, Usman / Mandic, Danilo P

IEEE journal of translational engineering in health and medicine

2017 Volume 5, Page(s) 2800310

Abstract: Varicose vein surgeries are routine outpatient procedures, which are often performed under local anaesthesia. The use of local anaesthesia both minimises the risk to patients and is cost effective, however, a number of patients still experience pain ... ...

Abstract	Varicose vein surgeries are routine outpatient procedures, which are often performed under local anaesthesia. The use of local anaesthesia both minimises the risk to patients and is cost effective, however, a number of patients still experience pain during surgery. Surgical teams must therefore decide to administer either a general or local anaesthetic based on their subjective qualitative assessment of patient anxiety and sensitivity to pain, without any means to objectively validate their decision. To this end, we develop a 3-D polynomial surface fit, of physiological metrics and numerical pain ratings from patients, in order to model the link between the modulation of cardiovascular responses and pain in varicose vein surgeries. Spectral and structural complexity features found in heart rate variability signals, recorded immediately prior to 17 varicose vein surgeries, are used as pain metrics. The so obtained pain prediction model is validated through a leave-one-out validation, and achieved a Kappa coefficient of 0.72 (substantial agreement) and an area below a receiver operating characteristic curve of 0.97 (almost perfect accuracy). This proof-of-concept study conclusively demonstrates the feasibility of the accurate classification of pain sensitivity, and introduces a mathematical model to aid clinicians in the objective administration of the safest and most cost-effective anaesthetic to individual patients.
Language	English
Publishing date	2017-09-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2696555-0
ISSN	2168-2372
ISSN	2168-2372
DOI	10.1109/JTEHM.2017.2734647
Database	MEDical Literature Analysis and Retrieval System OnLINE

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