1,721,152 research outputs found
Long-term outcome and pre-interventional predictors for late intervention after uterine fibroid embolization
No full textOBJECTIVES: To assess the long-term freedom of surgical conversion after uterine fibroid embolization (UFE) and to define predictors for better clinical outcome. Additionally, the potential of pregnancy after UFE is assessed. STUDY DESIGN: Single-center retrospective cohort study including 190 patients who underwent UFE between 2001 and 2016. Data were obtained by postal questionnaire including symptom severity, late reintervention rate and post procedural fertility. Patient characteristics were extracted from the patients' electronic medical records. The cumulative rate of freedom from treatment failure was determined by Kaplan-Meier analysis. Cox regression models were used for univariate analyses of the association between patient preinterventional characteristics and late surgical conversion. Secondary outcome measures were patient specific predictors of treatment failure and evaluation of post-procedural fertility. RESULTS: Long-term follow-up was available for a median of 6.1 years (range 1.2-15.2 y) in 95 out of 190 patients (50 %). Freedom from treatment failure showed a cumulative rate of 72.9 % after 10 years and stable until end of follow-up. A 63.8 % reduction in symptoms and a 23.3% increase in quality of life was found. Significant increase of treatment failure was found in patients with increasing pre-interventional uterine volume (p = 0.0003) or dominant fibroid volume (p = 0.0042); 9 out of 23 patients (39.13 %) with child-bearing wish became pregnant and conceived one or more children after UFE. CONCLUSION: UFE is associated with sustained long-term symptom control. Larger size uterus or dominant fibroma are correlated with higher late surgical conversion rate. Last, women can become pregnant and deliver after UFE.status: Publishe
Safety and efficacy of embolotherapy for severe hemorrhage after partial nephrectomy
No full textBackground : Partial nephrectomy may be complicated by postoperative hemorrhage, which may be treated by transcatheter embolization
Purpose : To assess the safety and efficacy of embolotherapy for hemorrhagic complications of partial nephrectomy and to analyze the potential correlation between multiple bleeding sites on angiography and surgical complexity
Material and Methods : A cohort of 25 patients presenting with severe, postoperative bleeding after partial nephrectomy and treated with catheter-directed superselective embolization was included. Patients' demographics, radiological investigations before the embolization, and clinical outcome after embolization were analyzed. Mann-Whitney U test was used to analyze the potential difference in the RENAL score between patients with one or more bleeding sites in the resection area.
Results : Selective renal angiography revealed multiple bleeding sites at the resection bed in 8 (32%) patients with amorphous contrast extravasation in 10 (40%) patients. Embolization with use of a microcatheter and microcoils was effective to stop the bleeding in all but one patient, the latter requiring a second embolization two days later. Transient decrease in renal function was noted in 3/25 (12%) patients with full recovery in two of the three. Patients with multiple bleeding sites did not show significantly different RENAL scores compared to patients with a single bleeding site (P = 0.148).
Conclusion : Embolotherapy for postoperative partial nephrectomy-related bleeding is safe and effective with a low rate of recurrent bleeding. The number of bleeding sites at the resection area did not correlate to the RENAL score.Maleux, G (reprint author), Univ Hosp Leuven, Dept Radiol, Herestr 49, B-3000 Leuven, Belgium.
[email protected]
A Five-Year Computed Tomography Follow-up Study of Proximal Aortic Neck Dilatation After Endovascular Aortic Repair Using Four Contemporary Types of Endograft Reply
No full textstatus: Publishe
Latest selective internal radiation therapy recommendations from EU proctors
No full textsponsorship: The author would like to thank Rae Hobbs (of Scribe Medical) for her editorial assistance in the development of this paper, funded by Sirtex Medical Ltd. (Sirtex Medical Ltd.)status: Publishe
Prospective Study Comparing Different Indirect Methods to Measure Portal Pressure
No full textPurpose: To compare the accuracy of wedged hepatic venous pressure (WHVP) measurement with use of an end-hole catheter or an occlusion-balloon catheter versus direct portal pressure (PP) measurement in patients with cirrhosis with sinusoidal portal hypertension and to investigate the factors that affect the results of these indirect measurements. Materials and Methods: In a cohort of 174 patients with cirrhosis referred for transjugular intrahepatic portosystemic shunt creation, indirect PP was measured with an end-hole catheter and an occlusion-balloon catheter placed in the right hepatic vein. Direct PP was measured by a pigtail catheter in the main branch of the portal vein. Results: PP was more accurately estimated by the occlusion-balloon technique: mean WHVP measurements were 25.5 mm Hg +/- 7.9 and 30.6 mm Hg +/- 13.9, respectively, for the occlusion-balloon and end-hole catheter techniques, and the direct PP measurement was 25.0 mm Hg +/- 7.0. The median absolute differences between direct and the indirect methods were 6.0 mm Hg with the end-hole catheter and 2.0 mm Hg with the occlusion-balloon catheter (P < .0001, signed-rank test). Relative to direct PP measurements, the occlusion-balloon technique overestimated pressures in cases of higher Model for End-Stage Liver Disease (MELD) scores (Spearman rho = -0.24; P = .0005). Conclusions: Compared with direct PP measurements, agreement was clearly higher for indirect WHVP measurement with occlusion-balloon catheters versus end-hole catheters. However, in patients with a high MELD score, there was an overestimation of PP with the occlusion-balloon method
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Endovascular revascularization in patients with acute obstructive mesenteric ischemia
No full textstatus: Publishe
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Multicenter, randomized trial of conventional balloon angioplasty versus paclitaxel-coated balloon angioplasty for the treatment of dysfunctioning autologous dialysis fistulae
No full textTo investigate the potential added value of paclitaxel-coated balloon (PCB) angioplasty to reduce fistula dysfunction related to recurrent stenoses in patients undergoing hemodialysis.status: Publishe
- …
