Stent-grafts in the management of life-threatening hemorrhage following inadvertent femoral catheterization in high-risk patients: report of two cases and review of the literature

This chapter illustrates the mental health clinician’s relationship with behavioral emergencies. The chapter begins by distinguishing the terms behavioral emergency and behavioral crisis, and underlying themes among all behavioral emergencies are identified. Given that most clinicians will face a behavioral emergency in their careers, the importance of enhancing the process of educating and training practitioners for such situations far beyond the minimal training that currently exists is highlighted. The chapter continues by exploring various aspects of evaluating and managing high-risk patients (i.e., those who exhibit violent tendencies toward themselves or others, and those at risk for victimization). It includes a discussion of the benefits and limitations to estimating life-threatening risk factors and specific protective factors. The chapter concludes by discussing the emotional impact that working with high-risk patients has on clinicians, and an emphasis is placed on the importance of creating a supportive work environment.

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A ruptured penetrating atherosclerotic ulcer of the ascending aorta: a case report of an endovascular repair with extending the length of the aortic coverage by debranching the innominate artery

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytz043 ◽

2019 ◽

Vol 3 (2) ◽

Cited By ~ 1

Author(s):

Josephine Chenesseau ◽

Pierre-Antoine Barral ◽

Philippe Piquet ◽

Marine Gaudry

Keyword(s):

Cardiac Surgery ◽

High Risk ◽

Endovascular Treatment ◽

Endovascular Repair ◽

Innominate Artery ◽

Ascending Aorta ◽

Stent Grafts ◽

Penetrating Atherosclerotic Ulcer ◽

High Risk Patients ◽

Risk Patients

Abstract Background An endovascular approach to the management of a ruptured plaque in the ascending aorta may be an alternative to open surgery in high-risk patients. This option may become inevitable due to the number of elderly patients unfit for open cardiac surgery. There are very few stent grafts able to fit the ascending aorta and in emergency cases, most medical teams have been limited to current thoracic aortic endografts, the shortest of which measure 10 cm. Case summary We report a case of an endovascular repair of a ruptured penetrating atherosclerotic ulcer of the ascending aorta. The patient was considered for open cardiac surgery but was evaluated at a high mortality risk based on his age, his medical history, and significant calcifications on his aorta. Our vascular surgical team decided then to perform an endovascular repair with extending the length of the aortic coverage by debranching the innominate artery. Discussion Endovascular treatment of an acute ruptured aorta is feasible in high-risk patients with thoracic endovascular stent grafts and coverage of the innominate artery. Endovascular treatment of the ascending aorta is at its infancy and in need of further research. New stent grafts designed for the ascending aorta are in progress and should increase the numbers of interventions in the years to come.

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Colonization and infection with extended spectrum beta-lactamase producing Enterobacteriaceae in high-risk patients – Review of the literature from a clinical perspective

Critical Reviews in Microbiology ◽

10.3109/1040841x.2013.875515 ◽

2014 ◽

Vol 42 (1) ◽

pp. 1-16 ◽

Cited By ~ 53

Author(s):

Lena M. Biehl ◽

Martin Schmidt-Hieber ◽

Blasius Liss ◽

Oliver A. Cornely ◽

Maria J. G. T. Vehreschild

Keyword(s):

High Risk ◽

Beta Lactamase ◽

Clinical Perspective ◽

Review Of The Literature ◽

Extended Spectrum Beta Lactamase ◽

High Risk Patients ◽

Extended Spectrum ◽

Risk Patients

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Behavioral Emergencies and Crises

The Oxford Handbook of Clinical Psychology ◽

10.1093/oxfordhb/9780199328710.013.005 ◽

2014 ◽

pp. 746-770

Author(s):

Phillip Kleespies ◽

Justin M. Hill

Keyword(s):

Mental Health ◽

Risk Factors ◽

High Risk ◽

Work Environment ◽

Emotional Impact ◽

High Risk Patients ◽

Risk Patients ◽

Life Threatening ◽

Behavioral Emergencies ◽

And Training

This chapter illustrates the mental health clinician’s relationship with behavioral emergencies. The chapter begins by distinguishing the terms behavioral emergency and behavioral crisis, and underlying themes among all behavioral emergencies are identified. Given that most clinicians will face a behavioral emergency in their careers, the importance of enhancing the process of educating and training practitioners for such situations far beyond the minimal training that currently exists is highlighted. The chapter continues by exploring various aspects of evaluating and managing high-risk patients (i.e., those who exhibit violent tendencies toward themselves or others, and those at risk for victimization). It includes a discussion of the benefits and limitations to estimating life-threatening risk factors and specific protective factors. The chapter concludes by discussing the emotional impact that working with high-risk patients has on clinicians, and an emphasis is placed on the importance of creating a supportive work environment.

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A novel use of cement as a salvage procedure in patients with complex spinal injuries with proximal junctional failure

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2018.0076 ◽

2018 ◽

Vol 100 (6) ◽

pp. e154-e157 ◽

Cited By ~ 1

Author(s):

K Divani ◽

S Selvadurai ◽

S Molloy

Keyword(s):

High Risk ◽

Major Surgery ◽

Salvage Procedure ◽

Proximal Junctional Kyphosis ◽

High Risk Patients ◽

Pain Scores ◽

Risk Patients ◽

Life Threatening ◽

Proximal Junctional Failure ◽

Junctional Kyphosis

Long-construct fixations can be complicated by proximal junctional kyphosis. In elderly, high-risk patients with numerous comorbidities, lengthy surgical times and increased blood loss associated with revision osteotomies and extension of fusions are not often tolerated and pose serious life-threatening risks. We present a salvage technique used in a patient with proximal junctional failure and demonstrate its role in improving symptoms and functionality in those not deemed fit for major surgery. Pre- and postoperative pain scores in accordance with the visual analogue scale, walking distances and radiographs were reviewed in a patient who underwent the salvage technique to ascertain the subjective and objective difference in pain and functionality. The patient showed marked improvement in pain scores and walking distances postoperatively. Additionally, the degree of proximal junctional kyphosis was lower on postoperative radiographs. While holding risks of its own, our described technique can be performed in select cases and is a good salvage procedure in high-risk patients. It prevents their exposure to the risks that accompany large revision operations and fusion models with further potential to fail. We recommend that our technique is performed only at specialist centres.

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