Journal of Clinical Medicine

Background/Objectives: Transvaginal ultrasound is one of the basic diagnostic methods used during gynecological examination. Lack of care during such an examination can lead to a risk of dangerous infection for both the patient and medical staff. Therefore, a crucial part of the preparation for the test is its proper disinfection. The aim of this study was to test the effectiveness of ultraviolet (UV-C) disinfection of ultrasound probes used in transvaginal examination for the prevention of infections in patients and healthcare personnel in ambulatory care settings. Methods: The eradication of microorganisms present (as a microbiota or etiological factors of infections) in the female reproductive tract was tested. They were the following: Staphylococcus aureus, Staphylococcus haemolyticus, Streptococcus agalactiae, Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, Pseudomonas aeruginosa, Candida albicans, and Trichomonas vaginalis. The study consisted of contaminating the ultrasound transducer with microbial strains of known density, then performing disinfection and assessing the number of surviving microbial cells. Results: Almost complete eradication of all tested pathogenic microorganisms was achieved, except T. vaginalis. But for this protozoa eradication of mobile forms reaches around 80%. Conclusions: Although the sample size in our study was limited and statistical significance was not reached, the substantial logarithmic reduction strongly indicates the effectiveness of this method.

Background and Objectives: Degenerative aortic stenosis has become the most common primary valve lesion referred for intervention, with thousands of transcatheter aortic valve implantation (TAVI) procedures being performed annually. To date, there are no quantitative tools capable of evaluating patient experience adapted to percutaneous procedures of this nature. The goal of this study is to propose and validate the VALVEX questionnaire as the reference tool to assess patient experience throughout the TAVI process and to identify areas for improvement in healthcare. Methods: This was a cross-sectional observational study with a 30-day follow-up that included consecutive patients > 18 years of age undergoing elective TAVI in two Spanish hospitals. A multidisciplinary panel including patients was constituted to design, refine, and pilot the VALVEX questionnaire. During its completion 30 days after the procedure, the dimensions assessed were the care provided before, during, and after TAVI, as well as the facilities and overall patient satisfaction. Reliability, validity, and feasibility were analysed during the validation phase. Results: A total of 335 patients were enrolled and filled out the VALVEX questionnaire (mean age 81.1 ± 5 years, 52% female). Evaluation of feasibility showed a mean completion time of 7.8 ± 2.3 min, with a 2.1% rate of unanswered questions. Cronbach’s alpha index was 0.912, with high internal reliability measurements for all the assessed dimensions. An intraclass correlation coefficient (ICC) of 0.851 was determined as an indicator of stability. The Delphi panel achieved a consensus of over 85% in clarity, coherence, relevance, and sufficiency. Conclusions: We have successfully validated the VALVEX questionnaire as the first quantitative tool specifically designed to measure and evaluate patient experience throughout the TAVI procedure and recovery. This questionnaire is a valid, reliable, simple, and easy-to-use resource that could be used as a reference tool to assess patient experience for TAVI or other percutaneous cardiac interventions.

Background: J-sign assessment is increasingly important for decision-making in patients with patellar instability. However, the low interrater reliability of the J-sign evaluation has raised concerns. The aim of this study was to investigate whether haptic visual assessment or superimposed digital imaging analysis might improve interrater reliability. Methods: In 51 patients with ≥ 1 patellar dislocation, J-sign grading was assessed by two experienced observers via three different methods: (i) plain visual evaluation; (ii) combined haptic visual assessment, including palpation of the medial and lateral patellar facets with the thumb and index finger during active knee joint motion; and (iii) a digital photo application tool using superimposed digital imaging analysis obtained at 90° of flexion–knee joint flexion and full extension. Results: For the visual assessment of the J-sign, the interrater reliability was fair, with κ = 0.39 ± 0.11 [0.18–0.6]. The interrater reliability of the haptic visual assessment and the photo application reached a good level of agreement, with κ = 0.89 ± 0.05 [0.8–0.98] and κ = 0.85 ± 0.05 [0.74–0.95], respectively. Conclusions: Plain visual evaluation of the J-sign revealed fair interrater reliability. The haptic visual assessment of the J-sign and the digital photo application tool yielded good interrater reliability. The results indicate that haptic visual assessment of J-sign should be implemented in daily clinical practice and used to communicate findings between and among physicians and studies.