The Infections of Cardiac Implantable Electronic Devices: Four Year Experience of the Center

Abstract

Cardiac implantable electronic devices (CIED) have been increasingly used in recent years. The incidence of infection has ranged from 0.5 % to 12% in the literature. The purposes of this study was to investigate the frequency of CIED infection and to find the causes of infection. Patients and methods: Totally, 211 patients with CIED infection were retrospectively evaluated. For each patient, all the following data were recorded; age, sex, CIED type, accompanying diseases, complete blood count, serum biochemistry, echocardiographic findings and whether first implantation or replacement. In addition, wound culture, antibiotic regime, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), glomerular filtration rate (GFR) and anticoagulation test results were recorded in infected patients. Results: CIED infection was detected in 18 of the 211 patients (8.5%). 15 cases developed infection following the first implantation (10%), and 3 cases after replacement (5%). Infection was detected within 60 days in 5 patients. CIED pocket cultures were positive in 12 patients (66.7%). 13 of 18 infected devices were removed (72.2%). Diabetes mellitus [Odds Ratio, OR: 4.56 (1.449-14.408)] (p=0.010), male sex [OR: 3.84 (1.034-14.232)] (p=0.045) and increasing age [OR: 0.96 (0.932-0.998)] (p=0.038) were found as significant independent variables on development of CIED; but, pacemaker, implantable cardioverter defibrillator and cardiac resynchronization were not independent variables [OR: 1.66 (0.469-5.929)] (p=0.43). Conclusions: Increasing age, male sex, diabetes mellitus were related to increased frequency of CIED infections. Identification of comorbid conditions prior to CIED implantations may be important in reducing risk of CIED infections.

Creative Competence as a Component of the Professional Competence of a Future Engineer

“…Cognitive component design expertise technical university students presented knowledge system to facilitate the efficient identification of said future professional competence in the activity of the expert knowledge and includes the totality of the features of the creative process, creative activity and its characteristics and implementation technology of selfknowledge and reflection; understanding of the requirements for the individual technical specialists; acquired skills in solving problems requiring creative approach, the level of subject knowledge, which allows them to operate at the creative level. The activity component of the creative competence determines the readiness to implement creative activities, the level of development of students of technical colleges, ability to creatively solving professional tasks, skills effectively to exercise creativity in a variety of standard and non-standard situations, professional, hands-on experience of using them [13][14][15][16]. By the activity component of the components include a set of such qualities and skills as the ability to formulate the problem, a creative approach to the development of its solutions plan and its implementation; ability to establish logical links between the facts and phenomena; Search is intuitive; possession of techniques of their own creative abilities and experience of their implementation; ability to make creative use of the accumulated knowledge and practical skills; the ability to self-organization activities; ability to structuring, the manifestations of the imagination, develop hypotheses; ability to carry out the transfer of knowledge and skills in other subject areas; the ability to generate new creative ideas, originality, the ability to refrain from taking a typical conventional solution to the problem, propose solutions and different ways to choose the best; ability to identify creative competence in professional non-standard situations.…”