Central venous access ports in the interventional radiology suite : one-centre experience

Purpose: Central venous access ports (CVAP) are widely used to provide long-term vascular access for the delivery of chemotherapeutic medications. The aim of this study was to evaluate the clinical outcomes and complications following CVAP implantation in the interventional radiology suite. Material and methods: A retrospective analysis was conducted on 937 oncology patients who underwent CVAP implantation between January 2009 and June 2017. Information regarding patient characteristics, operative data, and procedural outcomes was collected and analysed. Results: A total of 937 patients scheduled for CVAP were included in the final analysis. Initial success was achieved in 930 patients (99.3%), and overall completion was achieved in 933 patients (99.6%). There were 63 complications overall. Among these, 19 (2.0%) occurred during the intra- and perioperative period and 44 were late complications (4.7%). No CVAP-related mortalities were observed. Conclusions: The analysis in the present study revealed that the CVAP is a safe and effective route for long-term administration of chemotherapy with an overall complication rate of 6.7% throughout the entire device duration. The CVAP implantation procedure carried out in the interventional radiology suite provides an advantage in the management of procedural, vascular and catheter-related complications

Endovascular therapy of arteriovenous malformation in a male patient with severe post-coital pelvic pain

Purpose: Congenital pelvic arteriovenous malformations (AVMs) are high-flow vascular lesions consisting of abnormal shunts between arteries and veins within a nidus. The rare presentation and extensive network of vasculature contributes to the difficulty in effective treatment. Optimal therapeutic options are determined based on the clinical presentation, the location of the lesion, and possible complications. Case report: A 24-year-old male patient with a history of recurrent pain following sexual intercourse presented with complaints of intense pelvic pain radiating to the perineal area. Computed tomography angiography (CTA) revealed a large venous aneurysm as an outflow vein of a right-sided pelvic AVM. Embolisation of the outflow veins was established along with direct percutaneous delivery of fibre coils and thrombin to the venous aneurysm of the AVM. With recurring symptoms and AVM recanalisation on angiography, another direct puncture and placement of pushable coils was made. Total AVM occlusion was achieved with no recanalisation on follow-up digital subtraction angiography (DSA), and the patient remained asymptomatic. Conclusions: Endovascular embolisation of the nidus area may result in a complete occlusion of an AVM. Therefore, a thorough understanding of the vascular anatomy of the AVM is essential in choosing an effective embolisation strategy and to minimise the risk of possible complications

Parkinsonism in Inherited Metabolic Disorders: Key Considerations and Major Features

Parkinson's Disease (PD) is a common neurodegenerative disorder manifesting as reduced facilitation of voluntary movements. Extensive research over recent decades has expanded our insights into the pathogenesis of the disease, where PD is indicated to result from multifactorial etiological factors involving environmental contributions in genetically predisposed individuals. There has been considerable interest in the association between neurological manifestations in PD and in inherited metabolic disorders (IMDs), which are genetic disorders characterized by a deficient activity in the pathways of intermediary metabolism leading to multiple-system manifestations. In addition to the parallel in various clinical features, there is increasing evidence for the notion that genetic mutations underlying IMDs may increase the risk of PD development. This review highlights the recent advances in parkinsonism in patients with IMDs, with the primary objective to improve the understanding of the overlapping pathogenic pathways and clinical presentations in both disorders. We discuss the genetic convergence and disruptions in biochemical mechanisms which may point to clues surrounding pathogenesis-targeted treatment and other promising therapeutic strategies in the future

Enhancing Organizational Resilience through Mindful Organizing

Organizational resilience and mindfulness are inextricably connected and have specific characteristics related to responding to challenging events. This mixed-method research study aimed to explore the relationship between mindful organizing and organizational resilience. A qualitative critical incident analysis was conducted with executives to explore insights into mindfulness and resilience at the organizational level. Using the analysis of a moment structures (AMOS) program, the structural equation modeling method was employed to assess the relationships between mindfulness, mindful organizing, and organizational resilience. A total of 639 usable cross-sectional questionnaires from diverse organizations in Thailand were used for data analysis. The findings of the current study reveal that mindful organizing has a positive influence on organizational resilience. This paper discusses the implications and limitations of these findings, along with suggestions for future research

Enhancing employee resilience through Eastern spirituality and Western scientific mindfulness

Employee resilience is closely linked to well-being, happiness, and workplace performance. Many studies have suggested a connection between mindfulness and employee resilience. However, a notable distinction arises between Eastern spiritual mindfulness and Western scientific mindfulness, prompting an investigation into the specific elements of each perspective that contribute to supporting employee resilience. This study aims to clarify whether Eastern mindfulness, characterized by awareness and attention, or Western mindfulness, characterized by qualities like novelty seeking, novelty producing, and engagement, exerts a more apparent influence on enhancing employee resilience. Furthermore, it seeks to explore any correlation between Eastern spiritual mindfulness and Western scientific mindfulness. This research employs a mixed-method approach utilizing critical incident analysis to gain profound insights of mindfulness perspectives. Furthermore, it applies structural equation modeling to rigorously examine the relationship between mindfulness and employee resilience. The findings reveal a positive association between Eastern and Western mindfulness. Surprisingly, while Eastern mindfulness does not directly impact on employee resilience positively, Western mindfulness demonstrates a favorable effect on employee resilience. Moreover, Western mindfulness emerges as a mediator in the relationship between Eastern mindfulness and employee resilience. This study contributes to both theoretical and practical realm of knowledge. Additionally, it acknowledges its limitations and offers recommendations for future research

Pseudoaneursym of the common hepatic artery treated with coil and thrombin embolization.

<p>(A) Contrast-enhanced CT scan and (B) DSA image showing the pseudoaneursym arising from the distal common hepatic artery (arrow). (C) DSA image showing initial thrombin injection. (D) Persistent perfusion despite additional placement of coils. (E) Final DSA depicting procedural success after the deployment of an additional coil and thrombin.</p

Endovascular management of pancreatitis-related pseudoaneurysms: A review of techniques

<div><p>Objectives</p><p>To present the various techniques used in the management of pancreatitis-related pseudoaneurysms of visceral vessels.</p><p>Methods</p><p>The retrospective clinical study was carried out at the Department of Diagnostic and Interventional Radiology at Poznan University of Medical Sciences from 2011 to 2016. The fifteen patients included in the study were diagnosed with pseudoaneurysms of visceral arteries, as a complication of chronic pancreatitis. The diagnosis was made using contrast-enhanced computed tomography, followed by angiography. On admission, all patients were symptomatic, with varying degrees of abdominal pain. One patient was haemodynamically unstable. Treatments with endovascular techniques were analysed, along with their efficacy and outcomes. Coil embolisation was performed in 5 patients. Stent graft was used in 1 patient. Liquid embolic agents were used in 7 cases, of which 5 patients were treated with thrombin injection and 2 with Squid. A combination of techniques was used in 2 patients.</p><p>Results</p><p>The most common artery affected by pseudoaneurysm formation was the splenic artery (7/15; 46.7%), and the size of the pseudoaneurysms ranged from 27 mm to 85 mm. Primary technical success was achieved in 14 out of 15 patients (93.3%). One patient required reintervention. Two patients required splenectomy after embolisation due to splenic ischemia. No recanalisation was present at the follow-up computed tomography performed after 1 to 3 weeks, and no mortality was observed within 30 days.</p><p>Conclusion</p><p>Vascular complications of pancreatitis require accurate diagnosis and immediate treatment. Endovascular intervention is highly effective and is the preferred treatment option. The technique used is determined based on vascular anatomy and the patient’s haemodynamic status.</p></div

Pseudoaneurysm of the gastroduodenal artery pre- and post-coil embolization.

<p>(A) Pseudoaneurysm of the gastroduodenal artery visible on the contrast-enhanced CT (arrow). (B) Digital Subtraction Angiography (DSA) image showing vasospasm and thrombosis of the gastroduodenal artery with no active bleeding (arrow). (C) Post-embolisation DSA image showing successful coil embolisation of the gastroduodenal artery (arrow).</p

Superior mesenteric artery pseudoaneurysm treated with stent graft implantation.

<p>(A) Contrast-enhanced CT scan showing the pseudoaneurysm arising from the SMA (arrow). (B) DSA showing pseudoaneurysm. (C) Final selective DSA confirming the exclusion of the pseudoaneurysm following stent graft implantation and post-dilation.</p

Arterial site of involvement, size of pseudoaneurysms, and treatment administered.

<p>Arterial site of involvement, size of pseudoaneurysms, and treatment administered.</p