Port-A-Cath Catheter Embolization to Distal Pulmonary Artery Branches: Two Tailored Percutaneous Retrieval Approaches

2018 ◽  
Vol 52 (5) ◽  
pp. 361-366
Author(s):  
Ana Rita G. Francisco ◽  
José Duarte ◽  
Eduardo Infante de Oliveira
Keyword(s):  
Myocardial Injury ◽  
Foreign Bodies ◽  
Pulmonary Vasculature ◽  
Catheter Embolization ◽  
Oncological Patients ◽  
Percutaneous Extraction ◽  
Intravascular Devices ◽  
Routine Chest ◽  
The Ideal

Several types of intravascular devices and catheters are frequently used for long-term drug therapy, especially for oncological patients. As a result, complications are becoming increasingly common, namely catheter embolization. Retrieving these devices is important, as embolized fragments may lead to serious consequences, such as arrhythmias, myocardial injury, thrombosis, infection, and even perforation and death. We describe 2 cases of long-term drug catheter (Port-A-Cath) fracture, incidentally documented in a routine chest radiograph. In both cases, percutaneous extraction was attempted, yet the procedure was complicated by embolization of smaller fragments into the arterial pulmonary vasculature. We describe unusual approaches in successfully retrieving the remaining fragments. The ideal approaches for removal of foreign bodies from the cardiovascular system differ from case to case, but percutaneous extraction should be preferred in most of the cases. Less common techniques may be helpful in challenging cases.

On the long-term strength of metals and the ideal-creep model

2007 ◽  
Vol 52 (7) ◽  
pp. 388-390
Author(s):  
A. M. Kovrizhnykh
Keyword(s):  
Creep Model ◽  
Term Strength ◽  
The Ideal

Precision in Central Venous Catheter Tip Placement: A Review of the Literature

2010 ◽  
Vol 15 (3) ◽  
pp. 112-125 ◽  
Author(s):  
Russell Hostetter ◽  
Nadine Nakasawa ◽  
Kim Tompkins ◽  
Bradley Hill
Keyword(s):  
Central Venous Catheter ◽  
Selection Criteria ◽  
Weighted Average ◽  
Venous Catheter ◽  
Central Venous ◽  
Catheter Tip ◽  
Tip Position ◽  
Landmark Technique ◽  
The Ideal

Abstract Background: Long term venous catheters have been used to deliver specialized therapies since 1968. The ideal tip position of a central venous catheter provides reliable venous access with optimal therapeutic delivery, while minimizing short-and long-term complications. Ideal position limits have evolved and narrowed over time, making successful placement difficult and unreliable when depending exclusively on the landmark technique. Objective: To review and analyze contemporary literature and calculate an overall accuracy rate for first attempt placement of a PICC catheter in the ideal tip position. Methods: Key PICC placement terms were used to search the database PubMED-indexed for MEDLINE in June and October, 2009. The selection of studies required: a patient cohort without tip placement guidance technology; a documented landmark technique to place catheter tips; data documenting initial catheter placement and, that the lower third of the SVC and the cavo-atrial junction (CAJ) were included in the placement criteria. With few exceptions, articles written between 1993 and 2009 met the stated selection criteria. A composite of outcomes associated with tip placement was analyzed, and an overall percent proficiency of accurate catheter tip placement calculated. Results: Nine studies in eight articles met the selection criteria and were included for analysis. Rates of first placement success per study ranged from 39% to 75%, with the majority (7/9) being single center studies. The combined overall proficiency of these studies calculated as a weighted average was 45.87%.

Compliance versus adherence in serious and persistent mental illness

2010 ◽  
Vol 17 (1) ◽  
pp. 77-85 ◽  
Author(s):  
Paula K Vuckovich
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Psychiatric Nurses ◽  
Ethical Implications ◽  
Persistent Mental Illness ◽  
Term Basis ◽  
Nursing Literature ◽  
Compliance Versus ◽  
The Ideal

Failure to follow prescribed treatment has devastating consequences for those who are seriously and persistently mentally ill. Nurses, therefore, try to get clients to take psychotropic medication on a long-term basis. The goal is either compliance or adherence. Although current nursing literature has abandoned the term compliance because of its implications of coercion, in psychiatric nursing practice with patients suffering from serious long-term mental illness compliance and adherence are in fact different goals. The ideal goal is adherence, which requires the patient to be an active participant in the team. This goal is consistent with nurses’ ethical values, but for such patients this is frequently unrealistic. If the person is severely psychotic, treatment may be involuntary and the goal compliance. Psychiatric nurses participate in involuntary treatment and thus should acknowledge the ethical implications of compliance as a goal and not obscure the issue by calling compliance adherence.

Percutaneous extraction of two deeply lodged foreign bodies

1994 ◽  
Vol 17 (2) ◽  
Author(s):  
StevenJ. Smith ◽  
Carl Vyborny ◽  
RobertL. Vogelzang
Keyword(s):  
Foreign Bodies ◽  
Percutaneous Extraction

scholarly journals Analysis of full disc Ca II K spectroheliograms

2018 ◽  
Vol 609 ◽  
pp. A92 ◽  
Author(s):  
Theodosios Chatzistergos ◽  
Ilaria Ermolli ◽  
Sami K. Solanki ◽  
Natalie A. Krivova
Keyword(s):  
Synthetic Data ◽  
Calibration Method ◽  
Poor Quality ◽  
Average Error ◽  
Photometric Calibration ◽  
Solar Observations ◽  
Relative Errors ◽  
Long Term Variations ◽  
The Ideal

Context. Historical Ca II K spectroheliograms (SHG) are unique in representing long-term variations of the solar chromospheric magnetic field. They usually suffer from numerous problems and lack photometric calibration. Thus accurate processing of these data is required to get meaningful results from their analysis. Aims. In this paper we aim at developing an automatic processing and photometric calibration method that provides precise and consistent results when applied to historical SHG. Methods. The proposed method is based on the assumption that the centre-to-limb variation of the intensity in quiet Sun regions does not vary with time. We tested the accuracy of the proposed method on various sets of synthetic images that mimic problems encountered in historical observations. We also tested our approach on a large sample of images randomly extracted from seven different SHG archives. Results. The tests carried out on the synthetic data show that the maximum relative errors of the method are generally <6.5%, while the average error is <1%, even if rather poor quality observations are considered. In the absence of strong artefacts the method returns images that differ from the ideal ones by <2% in any pixel. The method gives consistent values for both plage and network areas. We also show that our method returns consistent results for images from different SHG archives. Conclusions. Our tests show that the proposed method is more accurate than other methods presented in the literature. Our method can also be applied to process images from photographic archives of solar observations at other wavelengths than Ca II K.

scholarly journals Dental management in Oncology patient: osteonecrosis related osteonecrosis of the Jaw (MRONJ)

2020 ◽  
Vol 4 (1) ◽  
pp. 01-02
Author(s):  
Picardo Noemi
Keyword(s):  
Task Force ◽  
Health Assessment ◽  
Osteonecrosis Of The Jaw ◽  
Oncology Patient ◽  
Stomatognathic System ◽  
Oncological Patients ◽  
Dental Management ◽  
Antiresorptive Drugs ◽  
Antiangiogenic Drugs

It is essential that oncological patients treated with antiresorptives or antiangiogenic drugs diagnosed Medication Related Osteonecrosis of the Jaw (MRONJ) must be treated in an interdisciplinary fashion. The patient’s stomatognathic system should be examined preventatively prior to the initiation of antiresorptive drugs in order to avoid pathological buccal manifestations, following the same healthcare clinical protocols used for patients receiving head and neck radiotherapy. Additionally, patients should be informed of the precautions to be taken, including regular dental appointments for oral health assessment. The risk of developing MRONJ should be evaluated according to the type of antiresorptives or antiangiogenic drugs administered and treatment duration. In the case of MRONJ, its fundamental characteristic is positioned in the biochemical particularity of the pharmacokinetic expression of antiresorptive drugs, reversibly (DS) or irreversibly (BPs) inhibiting the functionality of the osteoclast. Therefore, the consideration of invading bone tissue as little as possible and performing resective therapies in cases of systemic infectious spread follows, since its long-term resolution would not be effective because the drug (BPs) has frank accumulation at a distance, a characteristic used by treating doctors and it would not have clinical relevance to suggest its suspension. According to the recommendations of AAOMS; Task Force and AOCMF coincide with the sharing of consensus on minimally invasive manipulations once the necrotic foci have been installed and the preventive attitude prevails of eliminating all septic foci prophylactically before starting therapy with antiresorptive drugs. There are positions with a trend more committed to frank bone manipulation with the aim of evacuating the infectious problem and other more conservative positions in order not to expand drug necrosis volumetrically due to bone accumulation of BPs or DS.

scholarly journals INVEST ASI, EKSPOR DAN MASALAH DE-INDUSTRIALISASI DI INDONESIA

2017 ◽  
Vol 5 (2) ◽  
pp. 179
Author(s):  
Anton Agus Setyawan ◽  
Fatchurrohman Fatchurrohman
Keyword(s):  
Direct Investment ◽  
Econometric Model ◽  
Slow Growth ◽  
Policy Implications ◽  
Economic Recovery ◽  
Investment Climate ◽  
Short Term ◽  
Investment Rate ◽  
The Ideal

There are two constraints in the process of economic recovery in Indonesia. First, investment rate is decreasing in the last five years. This matter happens due to the bad investment climate in Indonesia. Second, slow growth of export rate in Indonesia. At the present, investment rate in Indonesia is only 22 percent of GDP, while the ideal rate is 30 percent of GDP. Another problem, which may be interrupting the economic recovery, is de-industrialization. The sign of de-industrialization occur by relocation phenomena of FDIfrom Indonesia. This research analyze the effects of direct investment and export to GDP. The tool of analyses of this research is econometric model known as Error Correc­tion Models. The results shows that in a long term and short term, export and direct investment do not have a significant effect to GDP. It shows that Indonesia do not have a clear policy about export and investment. The policy implications of this research are government should have a deregulation policy in the industry and recover investment climate.

The ‘ideal perpetrator’: The French National Railways and the social construction of accountability

2018 ◽  
Vol 49 (5) ◽  
pp. 327-344 ◽  
Author(s):  
Sarah Federman
Keyword(s):  
World War Ii ◽  
Social Construction ◽  
World War ◽  
The Social ◽  
Mass Atrocity ◽  
The Many ◽  
The Ideal

Mass atrocity requires the participation of numerous individuals and groups, yet only a few find themselves held accountable. How are these few selected? This article offers a framework that is useful for understanding how the condemned often embody attributes that keep them in the spotlight. Because norms used to identify perpetrators can set the context for future violence, long-term security requires interrupting both the actions of perpetrators and the discourses about them. A form of praxis, this study of the contemporary conflict over the French National Railways’ (SNCF) amends-making for its World War II transport of deportees towards death camps considers how certain perpetrators come to stand for the many. The SNCF remains in the spotlight not because of greater culpability or an unwillingness to make amends but because it embodies attributes of an ‘ideal’ perpetrator: it is (1) strong, (2) abstractable, (3) representative of the nature of the crime, and (4) has a champion-opponent who focuses attention on the perpetrator. Understanding the labeling process makes visible who and what we ignore at our own peril.

Meritocracy and its Enemies: Is There an Alternative to the “Tyranny of the Merit”?

2021 ◽  
pp. 30
Author(s):  
Dmitriy Davydov
Keyword(s):  
Technological Development ◽  
Social Institutions ◽  
Practical Application ◽  
Skilled Workers ◽  
Highly Educated ◽  
Technical Competencies ◽  
State Of Affairs ◽  
The Ideal

The article examines  the idea of meritocracy, now increasingly criticized. It is shown that the relevance of the discourse on meritocracy is due to the objectively increased role of education and various creative and technical talents in the context of rapid technological development. At the same time, critics rightly point out that meritocracy today has become largely a myth that plutocrats turn to justify their privileges, status and wealth. The very idea of a meritocracy that focuses exclusively on the technical competencies and abilities demanded by the neoliberal economy is also criticized. Many authors talk about the need to fairly reward and respect low-skilled workers, who often (especially in the context of the COVID-19 pandemic) bring more public benefit than highly educated financiers or bankers. Nevertheless, the article shows that this criticism is a hidden apology for meritocracy. In this case, critics justify deeper inequalities associated with long-term prospects and self-realization. It leads to cementing the “secondary” status of workers of the “hand” and “heart”, whose fate in the context of automation and the development of artificial intelligence technologies may turn out to be unenviable. In the author&apos;s opinion, the only alternative to this state of affairs is the rejection of meritocracy as a normative concept. It should be recognized as an inevitable evil associated with the imperfection of social institutions and, in part, human nature. Accordingly, the author contrasts the meritocratic pursuit of status and power with the ideal of universal striving for the maximum possible and, what is remarkable, all-round development and practical application of the talents of all without exception.

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