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Reducing nurse bias about patients with opioid use disorder in the emergency department is critical for providing nonjudgmental care, enhancing patient outcomes, supporting effective communication, and promoting a holistic approach to care. Emergency nurses can make a positive impact on the lives of individuals diagnosed as having opioid use disorder by providing care that is free from stigma and discrimination. The study used an observational, pretest-posttest design to compare educational sessions addressing bias and stigma toward patients with opioid use disorder. The study population consisted of emergency nurses who self-selected into a virtual learning experience consisting of e-modules or simulation-based experience consisting of simulation-based experience consisting of simulation, discussion, and a speaker. After the intervention, the simulation-based experience group showed an increase in total score postintervention from a mean of 118.6 to a mean of 127.1 (P <.001). The virtual learning experience group also showed an increase in total score postintervention from a mean of 116.3 to 120.7 (P <.001). Although both groups showed an increase in scores over time, the simulation-based experience group had a greater increase (P =.0037). Within the simulation-based experience, there was an increase in scores across all age groups (P <.05) but a significantly greater increase in scores among younger nurses (18-29 years) than the older age groups (P =.006). Opioid use disorder is a complex condition that requires a comprehensive and holistic approach to care. Study results indicate that providing an educational experience to address stigma about patients diagnosed as having opioid use disorder can significantly affect nurse perceptions about these patients and their self-efficacy when working with them. However, investing in a simulation-based educational experience provides a stronger experience and results in greater change, particularly for younger, less experienced emergency nurses. [ABSTRACT FROM AUTHOR]

Sediment detention basins are implemented on mountain rivers to trap solid material that may aggravate the flooding of downstream settlements. However, retention structures built in the past may unnecessarily retain sediment during non-hazardous flood events, resulting in high maintenance costs and sediment deficit downstream. In addition, the so-called spontaneous self-flushing of previously retained sediment during floods has occasionally been observed. Recent research suggests to design sediment detention basins for controlling sediment passage with a guiding channel across the deposition area upstream of a hybrid barrier. Such barriers consist of a check dam with a slot orifice and an upstream bar screen with a bottom clearance in order to benefit from a combined mechanical-hydraulic retention control. The present paper enhances this pioneering research with the help of new experimental data, including a wide range of sediment mixtures and large wood, as well as variable barrier heights. Improved design criteria are provided regarding the bar screen and the basin storage capacity. The functionality of the enhanced concept for sediment detention is illustrated by a case study on a physical model: the protection of the Villard-Bonnot village (France) against torrential hazards. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness and durability of intra-arterial aneurysm sac embolization for the treatment of type Ia endoleak after endovascular aneurysm repair (EVAR).Materials and Methods: From February 2011 to December 2016, 22 patients underwent embolization of a type Ia endoleak after EVAR. Four patients (18%) were treated during the index EVAR and 18 (82%) in follow-up. Five patients (23%) were treated urgently and 17 (77%) electively. The embolization was performed with the use of liquid embolic agent, coils, and/or plugs. Adjunctive neck procedures were performed in 55% (n = 12) of the patients. The primary endpoint of this study was freedom from sac enlargement. Key secondary endpoints were technical success and freedom from endoleak-related reinterventions.Results: Technical success was 100%. The 30-day mortality was 5% (n = 1; acute coronary syndrome). At a mean follow-up of 15.4 months (range 0.1-65.4) the freedom from sac enlargement rate was 76% (16 out of 21). Reintervention-free survival rates at 6, 12, and 24 months were 80%, 68% and 68%, respectively.Conclusions: In patients with persistent type Ia endoleak the embolization of the aneurysm sac with or without adjunctive neck procedures can be safely performed, leading to acceptable clinical and radiologic outcomes. [ABSTRACT FROM AUTHOR]

Objective Primary stenting is a well-established treatment option for femoropopliteal arterial disease. However, there is a paucity of data concerning the performance of this modality at ≥5 years. This study evaluated the long-term clinical and radiologic outcomes of primary stent therapy in patients with femoropopliteal arterial disease. Methods A prospective data collection and analysis was conducted in patients undergoing primary stent placement in femoropopliteal lesions between September 2006 and September 2007. The EverFlex (Medtronic/Covidien, Plymouth, Minn) bare-metal stent was used. The primary outcome of this study was the primary patency rate. Secondary outcomes were secondary patency rate, amputation-free-survival (AFS), and freedom from target lesion revascularization (TLR). A Cox regression analysis identified risk factors for the primary and the secondary measure outcomes. Results Included were 89 patients (102 stents). The prevalence of critical limb ischemia was 34% (n = 30). The initial angiography revealed a TransAtlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease C/D lesion in 31 patients (35%). Occlusions were present in 49 patients (55%), and the mean lesion length was 116 ± 33 mm. Popliteal artery disease was present in 39 treated limbs (35%). The primary patency rate at 1, 3, 5, and 7 years was 73%, 64%, 47%, and 33% respectively. At 7 years, secondary patency rate was 67%, freedom from TLR was 47%, and the AFS was 73%. Cox regression analysis revealed a decreased AFS among diabetic patients (hazard ratio [HR], 2.6; 95% confidence interval [CI], 1.08-6.28; P = .03), whereas secondary endovascular interventions showed a protective effect for AFS (HR, 0.14; 95% CI, 0.03-0.65; P = .01). Popliteal artery disease was identified as independent risk factor for secondary interventions (HR, 2.07; 95% CI, 1.05-4.06; P = .04) and TLR (HR, 1.99; 95% CI, 1.03-3.83; P = .04). Critical limb ischemia was associated with an increased incidence of surgical conversion owing to endovascular treatment failure (HR, 5.46; 95% CI, 2.44-12.17; P < .001). Conclusions This study found primary stenting was associated with acceptable clinical and radiologic long-term outcomes. Diabetes was associated with poor AFS, and popliteal artery involvement correlated with an increased need for reinterventions. AFS was better among patients undergoing secondary procedures. [ABSTRACT FROM AUTHOR]

• Determing training features that work best when implementing new clinical practices is recommended for future studies. • Training nurses with supervisory responsibilities may require more preparatory education in implementation methods. • Multiple training methods are recommended to enhance SBIRT implementation methods. [ABSTRACT FROM AUTHOR]

Background The Society for Vascular Surgery Lower Extremity Guidelines Committee developed the Wound, Ischemia, foot Infection (WIfI) a classification system to predict the amputation risk in patients with critical limb ischemia (CLI). A number of published studies have already evaluated its prognostic value. However, most of the included patients were diabetic, and the validation was done independent of the revascularization procedure. This single-center study evaluated the prognostic value of WIfI stages in nondiabetic patients treated by endovascular means. Methods A retrospective analysis was performed of prospectively collected data of nondiabetic patients treated by endovascular means between January 2013 and September 2014. All patients were classified according to their wound status, ischemia index, and extent of foot infection to four classes: very low risk, low risk, moderate risk, and high risk. Comorbidities and vascular lesions for each group were analyzed. The prognostic value of WIfI was analyzed based on the amputation-free survival, overall survival rate, and freedom from amputation at 12 months. Results Data from 302 CLI patients treated in the study period were reviewed. A total of 219 patients (73%) underwent an endovascular intervention, and among them, 126 nondiabetic patients (58%) were enrolled in this study. Most patients were classified as low risk (33%), and the prevalence of very low-risk, moderate-risk, and very high-risk patients was 23%, 23%, and 21%, respectively. The modified Edifoligide for the Prevention of Infrainguinal Vein Graft Failure (PREVENT III) score was statistically significantly higher in the high-risk group (5.2 ± 2.4) than in the very low-risk, low-risk, and moderate-risk groups (4.3 ± 2.5, 3.5 ± 2.3, 4.5 ± 2.2, respectively; P = .048). One major amputation (1%) was performed during the hospital stay in a high-risk patient. Mean follow-up was 14 ± 8 months. The amputation-free survival at 12 months was 87%, 81%, 81%, and 62%, in the very low-risk, low-risk, moderate risk, and very high-risk groups, respectively ( P = .106). The difference was statistically significant between the very low-risk and high-risk groups (hazard ratio, 3.4; 95% confidence interval, 1.1-10.3; P = .029). A similar trend was also observed for 1-year survival between the very low-risk and the high-risk groups (87%, 84%, 81%, 65%; P = .166). The amputation rate during the follow-up time was 0%, 2% (n = 6), 3% (n = 5), and 12% (n = 9) for the very low-risk, low-risk, moderate-risk, and very high-risk groups, respectively ( P = .033). Conclusions The WIfI classification system predicted the amputation risk and survival in this highly selected group of nondiabetic CLI patients treated by endovascular means, with a statistically significant difference between very low-risk and high-risk patients already at 1 year. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was the evaluation of the clinical and radiologic outcomes of parallel grafts in the treatment of patients with failed prior endovascular aneurysm repair and type Ia endoleak. Methods Prospectively collected clinical and radiologic data of consecutive patients with prior endovascular aneurysm repair and evidence of type Ia endoleak were analyzed. All patients were treated between January 2009 and November 2014 by use of parallel grafts, ie, chimney/snorkel or periscope grafts and abdominal endovascular devices. Primary outcome of the study was the technical success. Secondary outcomes were patency of the chimney grafts and shrinkage of aneurysm morphology. Results Technical success was 94.4% (17 of 18). One patient showed evidence of persistent type Ia endoleak after triple chimney graft placement and treated by Onyx embolization (Covidien, Plymouth, Minn) successfully. The mean preoperative and postoperative aneurysm diameters were 7.1 ± 1.7 and 7.0 ± 2 cm. Primary patency of the chimney grafts was 96.7% and assisted patency was 100% after successful retrograde recanalization of an acute occlusion of the superior mesenteric artery from the celiac trunk and the gastroduodenal artery. One patient who had undergone the sandwich technique with transfemoral placement of the flexible Viabahn (W. L. Gore & Associates, Flagstaff, Ariz) due to impossible catheterization of the target vessel from the upper extremity presented with contained rupture caused by gutter-associated endoleak and underwent urgent embolization with Onyx successfully. No procedure-related death or open conversion was observed in the entire follow-up period. Conclusions Use of parallel grafts showed midterm safety and feasibility with low incidence of persistent endoleaks requiring intervention or progression of aneurysm diameter. Reproducible results from other vascular centers will establish the chimney technique in the treatment of type I endoleaks as a viable endovascular modality. [ABSTRACT FROM AUTHOR]

The aim of this study is to analyze the development of plastic heterogeneity in low carbon steel sheets when they are subjected to different loading paths, typical of forming process operations. Nakajima type tests are performed and employed to determine the Forming Limit Curve. This study attempts to characterize, at polycrystalline level, the plastic heterogeneity and its gradients, enabling the definition of correlations between the dislocation structure, grain size and crystallographic orientations. Geometrically Necessary Dislocations (GND) is estimated by calculating the curvature tensor from the measured orientation field. The results are compared with the Kernel Average Misorientation factor (KAM), normally available in the TSL- OIM EBSD software. The Quantification of the distribution of disorientations in each grain is performed by evaluating the second-order central moment of crystal misorientations ( Q tensor). Finally, the evaluation of the isotropic and anisotropic factors of the Q tensor and the distribution of the misorientation preferential axes allow characterizing the microstructure dependent on the applied loading, the grain size or the crystal orientation. [ABSTRACT FROM AUTHOR]

In the present work, the forming limit curve (FLC) of a 1.1 mm thick DP-780 steel sheet is evaluated. The full FLC determination involved tensile tests of planar samples with different notch geometries – providing data in the tension-compression range – and Nakajima tests with a 40 mm diameter hemispherical punch and different notch geometries, covering the full loading zone of the forming limit diagram. The proposed Nakajima tool geometry reduces the standard test dimensions (ISO 12004-2) by 60%. Results show that the reduced diameter Nakajima test, in the particular case of Dual-Phase steels, overestimates limit strains when compared to the tensile test. This observed difference is explained in terms of the presence of a strain gradient through the sheet thickness imposed by the 40 mm diameter Nakajima punch, leading to the conclusion that this reduced sample type is not suitable for FLC determination when the DP-780 steel sheet is more than a millimeter thick. [ABSTRACT FROM AUTHOR]

Tobacco dependence is a major health problem for persons with a serious mental illness (SMI). Nurses working with psychiatric clients often lack the knowledge, ability, and confidence to offer their clients meaningful, effective help to quit smoking. The purpose of this study was to evaluate the effects of a tobacco education program on the perceived competence and motivation of baccalaureate nursing students (BSN) to intervene with SMI clients who use tobacco. The education program significantly improved the competence and motivation of BSN students to deliver cessation interventions to this vulnerable population of smokers. [ABSTRACT FROM AUTHOR]

Tobacco use and dependence is a serious public health issue that disproportionately affects the mentally ill client population. Mental health professionals, including psychiatric/mental health advanced practice nurses (PMHAPNs), are disinclined to integrate tobacco cessation interventions into their practice, due in part, to a general lack of tobacco-related knowledge (C. Essenmacher, C. Karvonen-Gutierrez, J. Lynch-Sauer, & S. A., Duffy, 2008; A. J. Molina, T. Fernandez, D. Fernandez, M. Delgado, S. de Abajo, & V. Martin, 2012; L. Sarna, L. L. Danao, S. Chan, S. Shin, L. Baldago, E. Endo, & M. E. Wewers, 2006); D. Sharp, S. Blaakman, R. Cole, & J. Evinger, 2009). This paper provides an in-depth literature review of tobacco education in nursing curricula and proposes the systematic integration of theory-based tobacco content into psychiatric/mental health graduate nursing programs. [ABSTRACT FROM AUTHOR]

Abstract: Microstructural alterations of the putamen were recently reported in patients with partial and generalized epilepsy disorders. However, it is unknown whether these alterations pre-exist or are secondary to recurrent seizures. Here we investigated the progression of putamen fractional anisotropy (FA) alterations in a case of recurrent psychomotor seizures using longitudinal diffusion tensor imaging (DTI) shortly before (DTI-1) and after a psychomotor seizure (DTI-2). We obtained FA values of a hypothesis-guided putamen region-of-interest (ROI) and seven exploratory ROIs. FA values from both DTIs were compared with reference values from 19 controls. Relative to controls, the patient''s putamen FA was increased at DTI-1 (13% left putamen, 7% right putamen), an effect that was exacerbated at DTI-2 (24% left putamen (p <0.05), 20% right putamen). In the exploratory ROIs we found FA reductions in the corticospinal tract, temporal lobe, and occipital lobe (p <0.05) relative to controls at DTI-1 and DTI-2. In contrast to the putamen, all exploratory ROIs showed no relevant FA change between DTI-1 and DTI-2. These results suggest that recurrent seizures may lead to progressive microstructural putamen alterations. [Copyright &y& Elsevier]

Background: This study evaluated the durability of nitinol stent placement in high-risk patients with chronic critical limb ischemia (CLI) and infrapopliteal lesions after suboptimal balloon angioplasty. Methods: Between January 2006 and January 2009, 53 high-risk patients (24 women; mean age, 71.8 ± 5.1 years) with CLI underwent infragenicular stent placement with a 4F sheath-compatible self-expanding nitinol stent. Patients had three or more serious cardiopulmonary comorbidities, including chronic obstructive pulmonary disease, congestive heart failure, coronary artery occlusive disease, American Society of Anesthesiologists score ≥3, previous myocardial infarction, coronary stent or bypass, or infection after peripheral revascularization. Endovascular therapy was performed in 30 stenoses and 23 occlusions in 53 patients. The mean stenosis length was 5.5 ± 1.9 cm. The mean occlusion length was 6.5 ± 2.9 cm. The mean follow-up was 24.1 ± 7.3 months and consisted of clinical examination, ankle-brachial index (ABI) measurements, and duplex ultrasound imaging. Digital subtraction angiography was performed if restenosis or reocclusion was suspected. Results: The technical success rate was 98.1%. The 24-month cumulative primary patency rate was 75.5%. During the follow-up, two patients underwent successful repeat angioplasty, and four patients required crural bypass. The 24-month secondary patency and freedom from amputation rates were 88.7% and 88.7%, respectively. The mean ABI increased significantly at 12 and 24 months (P < .001). Risk stratification to detect predictors that influenced the patency rate showed that proximal lesions had significant better patency than distal crural lesions (83.3% vs 65.2%, P = .04). The morphology of the lesions (stenoses vs occlusions, P = .88) did not seem to influence primary patency. Four patients died from nonprocedure-related causes during the follow-up, including lung cancer, myocardial infarction, and glioblastoma multiforme. No procedure-related deaths were recorded. Conclusions: The 2-year outcome of our series underscores the value of infrapopliteal nitinol stent placement as a durable bailout treatment option in high-risk CLI patients with suboptimal angioplasty. [Copyright &y& Elsevier]

Abstract: Background: To evaluate the therapeutic value of endovascular techniques for the treatment of profunda femoris artery obstructive disease (PFAOD) in critical limb ischaemia (CLI) patients, with technically demanding open profunda repair. Design: Retrospective study of prospectively collected data of 15 consecutive CLI patients with technically demanding surgical treatment of PFAOD, that were treated by endovascular means in two European Centers of Vascular Surgery. Materials: All patients had critical limb ischaemia with a history of at least two previous vascular reconstructions in the ipsilateral groin and severe co-morbid conditions. All patients had good common femoral artery flow, long occlusion of the superficial femoral and popliteal arteries and impairment of crural arteries. Methods: Twelve patients underwent balloon angioplasty alone and, in the other three cases, an additional stent placement was necessary, due to flow-limiting dissection. The follow-up (mean 29.2±10 months) included a surveillance protocol with the best medical treatment and duplex scanning at 1, 3, 6, 12 months and yearly thereafter. Results: The endovascular approach was technically successful in all cases and the procedure-related morbidity and mortality rates were 0% for the entire follow-up period. The 3-year primary and secondary patency rates of the treated segment were 80% and 86.7%, respectively. The limb salvage rate was 93.3%. Conclusions: The outcome of our series underscores the therapeutic value of balloon angioplasty in cases of severe PFAOD, as bailout treatment in critical limb ischaemia patients with technically demanding open profunda repair. This procedure can be repeated easily if significant restenosis occurs and provides a useful tool in selected cases. [Copyright &y& Elsevier]

Persons living with a mental illness represent an especially vulnerable and disadvantaged subgroup of smokers. Compared to those in the general population, they smoke more, die younger, and suffer disproportionately from cardiovascular disease, diabetes, stroke, and cancer, all diseases and conditions directly associated with, and exacerbated by, smoking. Despite strong evidence that tobacco cessation counseling by a health professional can approximately double patients' odds of quitting, clinicians across disciplines are reluctant to offer these individuals effective means by which to quit smoking. This disinclination is due, at least in part, to inadequate tobacco cessation training during degree education. The purpose of this qualitative study was to assess undergraduate nursing students' perceptions of a tobacco education intervention. Findings support the integration of tobacco education into undergraduate nursing curricula. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To evaluate the effectiveness of nitinol stent placement in long infrapopliteal lesions in patients with critical limb ischaemia. Materials and methods: Between January 2005 and January 2008, 34 high-risk patients (18 female; mean age: 73.8±6.1 years) with critical limb ischaemia underwent infragenicular stenting. They had serious cardiovascular co-morbidities (>3, such as chronic obstructive pulmonary disease (COPD), congestive heart failure and coronary artery occlusive disease), American Society of Anaesthesiologists score of 3 or more, previous myocardial infarction, coronary stent or bypass. The mean stenosis length was 6.5±0.9cm (range: 2.2–8cm), and the mean occlusion length was 7.5±2.9cm (range: 3–9.6cm). Primary stent implantation was performed for long stenosis or occlusion based on the TransAtlantic InterSociety Consensus (TASC) C and D classification, secondary stenting for flow-limiting dissections or elastic recoil after balloon dilatation. All patients who returned to the outpatient clinic were assessed for claudication by clinical examination, ankle–brachial index (ABI) measurements, colour flow and duplex Doppler ultrasound (US). Digital subtraction angiography was performed if restenosis or re-occlusion was identified by Doppler US or transcutaneous measurement of partial oxygen pressure (TcpO2) measurements, when appropriate. Results: The technical success rate was 97.1% (33 of 34 cases). The crude rate of primary patency rate was 91.1% during a follow-up period of 10.4±7.3 months. The mean ankle–brachial index increased significantly following intervention (0.45±0.25–0.92±0.13, p <0.001). Two patients underwent successful redo angioplasty after tibioperoneal interventions due to in-stent restenosis (>70%) with relevant limitation of pain-free walking distance. In another patient, bypass surgery to the anterior tibial artery 6 months after primary intervention was necessary due to rest pain. Two patients required surgical revision of the femoral artery after antegrade access. No procedure-related death was recorded in the entire follow-up period. Conclusions: The mid-term outcome underscores infrapopliteal stent placement as a reliable treatment option in patients with critical limb ischaemia. In patients at high risk for crural bypass, with no flow-limiting supragenicular lesions, below-knee stent-supported angioplasty should be considered as a first choice of treatment. [Copyright &y& Elsevier]

Background: This study evaluated the therapeutic value of endovascular techniques in patients with buttock claudication caused by stenosis or occlusion of the internal iliac artery. Methods: The records of patients with buttock claudication who had undergone endovascular treatment for internal iliac artery stenosis or occlusion were analyzed retrospectively, and any associated arterial lesions, morbidity, restenosis, or recurrent buttock claudication was noted. Outcomes were compared with published reports. Iliac artery duplex scans and aortoiliac angiography were performed to detect and confirm the internal iliac artery obstructive disease. The iliac duplex scanning surveillance protocol was set at 3, 6, and 12 months and yearly thereafter to detect eventual restenosis or occlusion. Results: Between September 2006 and September 2008, 21 consecutive patients (19 men; mean age, 67 years) with 22 cases of buttock claudication (1 bilateral localization) underwent percutaneous transluminal angioplasty alone (14 cases) or additional stent placement in case of elastic recoil (8 cases). Buttock claudication was associated with impotence, thigh claudication, or calf claudication in seven patients. The endovascular approach was successful in all patients, without morbidity or mortality. During a mean follow-up of 14.7 ± 5.7 months, 50% restenosis occurred in one 80-year-old patient. The patient had a pain-free walking distance of 110 meters and was treated conservatively. Conclusions: To our knowledge, the present study is the largest published report concerning endoluminal treatment of buttock claudication due to internal iliac artery obstructive disease. The midterm results are very encouraging and underscore the value of stent-supported angioplasty as first-line treatment. The procedure can be repeated should significant restenosis occur and does not compromise the option of surgical repair of the lesions. [Copyright &y& Elsevier]

Summary: Transient focal lesions in the splenium of the corpus callosum (SCC) have been associated with antiepileptic drug (AED) treatment. However, the aetiology is widely unknown. We describe a transient SCC lesion in an epilepsy patient after abrupt AED reduction. Whole head high-field diffusion tensor imaging (DTI) including fully automated quantitative fractional anisotropy (FA) analysis was used to get insight into the pathophysiology of transient SCC lesions. Our results demonstrate that a reversible loss of directional fibre organisation in the splenium, likely due to intramyelinic oedema, is the morphological correlate of transient SCC lesions. We conclude that DTI provides a highly sensitive and quantitative tool to detect subtle and transient loss of fibre integrity associated with AED treatment. [Copyright &y& Elsevier]

Abstract: To better appreciate the mechanisms underlying the physiology of the stress response, an oligonucleotide microarray and real-time RT-PCR (QRT-PCR) were used to study gene expression in the livers of rainbow trout (Oncorhynchus mykiss). For increased confidence in the discovery of candidate genes responding to stress, we conducted two separate experiments using fish from different year classes. In both experiments, fish exposed to a 3 h stressor were compared to control (unstressed) fish. In the second experiment some additional fish were exposed to only 0.5 h of stress and others were sampled 21 h after experiencing a 3 h stressor. This 21 h post-stress treatment was a means to study gene expression during recovery from stress. The genes we report as differentially expressed are those that responded similarly in both experiments, suggesting that they are robust indicators of stress. Those genes are a major histocompatibility complex class 1 molecule (MHC1), JunB, glucose 6-phosphatase (G6Pase), and nuclear protein 1 (Nupr1). Interestingly, Nupr1 gene expression was still elevated 21 h after stress, which indicates that recovery was incomplete at that time. [Copyright &y& Elsevier]

Objective The amplitude-integrated EEG (aEEG) is becoming more important to monitor brain activity in premature infants. Studies have shown that early aEEGs correlate with later neurodevelopmental outcome. Various scoring systems for the assessment of aEEGs are being used, which complicates the comparison of published data. The aim of our study was to compare two scoring systems for aEEG and correlate with the neurodevelopmental outcome. Methods 114 preterm infants (gestational age (GA) <30 weeks of gestation) who had an aEEG within the first 14 days of life and a neurodevelopmental outcome at the age of 2 were retrospectively included into the study. The aEEGs had been analyzed with the aEEG sum score (background activity (BA) = percentage of different background patterns based on gestational age related standard values), the occurrence of sleep-wake cycles (SWC) and seizure activity) and the Burdjalov score (continuity (Co), cyclicity (Cy), amplitude of lower border (LB) and bandwidth span and amplitude of lower border (B) of the aEEGs – regardless of gestational age) and the results had been correlated with the outcome (Bayley Scales (MDI and PDI) at the age of 2). Results Both total scores (p<0.0001) and the different subscores correlated statistically significant (p <0.0001) with each other. Both total scores showed significant correlation (Burdjalov score p=0.003 and aEEG sum score p≤0.0001) with the outcome. The Burdjalov score showed increasing values with increasing GA, while the aEEG sum score showed no differences in the various GA. Conclusion Both scoring systems allow a simple classification of aEEGs. The Burdjalov score shows specific differences for the GA, while the aEEG sum score correlates better with the later outcome. [ABSTRACT FROM AUTHOR]

Objective The amplitude-integrated EEG (aEEG) is becoming more important to monitor brain activity in premature infants. Studies have shown that early aEEGs correlate with later neurodevelopmental outcome. Various scoring systems and missing gestational age related reference values for the aEEGs complicate the comparison of published data. The aim of our study was to establish gestational age related reference values for the aEEGs using the Burdjalov score in preterm infants <30 weeks of gestation. Methods 114 preterm infants (gestational age (GA) <30 weeks of gestation) who had an aEEG within the first 14 days of life were retrospectively included into the study. The aEEGs had been analyzed using the Burdjalov score (continuity (Co), cyclicity (Cy), amplitude of lower border (LB) and bandwidth span and amplitude of lower border (B)) and correlated with the gestational age. Results The analysis of aEEGs showed increasing Total Burdjalov Scores at higher GA. The subscores (continuity (Co), cyclicity (Cy), amplitude of lower border (LB) and bandwidth span and amplitude of lower border (B)) also increased with increasing GA. Conclusion Gestational age related reference values for the Burdjalov Score were determined in preterm infants <30 weeks GA. Increasing Total Burdjalov Scores correlate with increasing GA. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to report the early and late results of primary stenting for focal atherosclerotic lesions of the infrarenal aorta. Methods: A retrospective analysis of 52 consecutive patients treated for infrarenal occlusive aortic disease with primary stenting between January 2002 and November 2009 was performed. Original angiographic imaging, medical records, and noninvasive testing were reviewed. Primary stenting was the first line of treatment. Perioperative technical success and Kaplan-Meier estimates for patency and survival were calculated. Results: The majority of the patients (43) were treated for severe claudication (Rutherford III; 82.7%), 5 for ischemic rest pain (Rutherford IV; 9.6%), and 4 for minor tissue loss (Rutherford V; 7.7%). Aortic stenosis was found in 40 cases (76.9%) and occlusion in 12 (23%). Perioperative hemodynamic success was 100%. All patients had an improvement of ankle brachial index (ABI) >0.10. Clinical improvement was found in 96%. Early surgical revision was necessary for aortic rupture in 1 patient. One death occurred for pneumonia. The mean follow-up time was 39.4 ± 27.2 months. Ten reinterventions (19%) were needed for symptom recurrence. The estimated assisted primary patency at 9 years was 96% and the mean survival time was 86.6 months. Conclusion: Primary stenting offers safe and durable results and should be considered as the first line of treatment for focal aortic lesions. [ABSTRACT FROM AUTHOR]