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The optimal bridging stent for fenestrations during complex endovascular aortic aneurysm repair (EVAR) has not been defined. At our institution, the Viabahn VBX is frequently used given its availability and mechanical and heparin-bonding characteristics. This study aimed to assess the performance of the Viabahn VBX vs the iCast balloon-expandable covered stents as bridging stents for fenestrations during complex EVAR. A retrospective study of consecutive patients undergoing complex EVAR between 2015 and 2021 was performed. Celiac arteries (CAs), superior mesenteric arteries (SMAs), left renal arteries, and right renal arteries stented with fenestrations were grouped according to the type of bridging stent, VBX vs iCast. Target vessels (TV) stented with a branch or scallop were excluded. The primary end points included primary patency and freedom from TV instability. A total of 292 patients undergoing complex EVAR were treated using VBX or iCast with a mean follow-up of 190 days (interquartile range, 36-384 days) for the VBX cohort and 804 days (interquartile range, 384-1507 days) for the iCast cohort. A total of 677 TVs were stented, including 134 CAs (20%), 175 SMAs (26%), 182 left RAs (27%), 186 right RAs (27%), and 12 additional vessels (2%). Proximal reinforcement was more frequent with VBX than with iCast stent (23% vs 2.4%; P <.0001). There was no difference in primary patency rates at 2 years between VBX and iCast stent for CA (100% vs 96.4%; P =.32), SMA (97.8% vs 100%; P =.14), and the RAs (96.7% vs 99.4%; P =.11). There was no difference between VBX and iCast in the cumulative incidence of type Ic and type IIIc endoleaks (3.2% vs 5.6%; P =.69) or freedom from TV instability at 2 years. Viabahn VBX stents are a safe and effective option as bridging stents in fenestrations during complex EVAR with comparable midterm outcomes to iCast stents. However, proximal stent reinforcement may be required with VBX stent to ensure adequate sealing at the fenestrations. Longer follow-ups and larger series are required to assess long-term outcomes and durability. [ABSTRACT FROM AUTHOR]

Objective: Half of re-interventions after fenestrated and branched endovascular aortic repair (FB-EVAR) are target vessel related. Regarding bridging stent choice, existing data are controversial. This meta-analysis aimed to evaluate the performance of Advanta V12/iCAST as bridging stent in FB-EVAR., Data Sources: The English medical literature was searched through MEDLINE, Embase (via Ovid), and Cochrane databases (end date 15 April 2024)., Review Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and PICO (Patient; Intervention; Comparison; Outcome) model were followed. A predefined protocol was registered to PROSPERO (CRD42024556603). Randomised controlled trials and observational studies (2010 - 2024) reporting on Advanta V12/iCAST related target vessel outcomes were eligible. Risk of bias was assessed using ROBINS-I, and evidence quality was assessed via Grading of Recommendations Assessment, Development and Evaluations (GRADE). Primary outcomes were freedom from instability, stenosis and or occlusion, endoleak type Ic and IIIc, and re-intervention of target vessels bridged with the Advanta V12/iCAST. Prevalence and regression meta-analysis were performed., Results: From 1 439 articles, ten retrospective studies (7 525 target vessels; 3 890 target vessels bridged with Advanta V12/iCAST) were included. According to ROBINS-I, no study was of high quality. Mean follow up was 24.3 (95% confidence interval [CI] 23.9 - 24.7) months. Freedom from instability, stenosis and or occlusion, and endoleak type Ic and IIIc were 94% (95% CI 91 - 96%; p < .010; I 2 = 91%; GRADE certainty, very low), 97% (95% CI 96 - 98%; p =  .070, I 2 = 44%; GRADE certainty, low), and 97% (95% CI 94 - 98%; p < .010; I 2 = 81%; GRADE certainty, very low), respectively. Freedom from target vessel re-intervention was 95% (95% CI 92 - 97%; p < .010; I 2 = 85%; GRADE certainty, very low). Four studies provided extractable data on Advanta V12/iCAST in fenestrations and four in branches. No difference was detected in freedom from instability (p = .47), stenosis and or occlusion (p = .36), and endoleak type Ic and IIIc (p = .90). Freedom from re-intervention was 93% (95% CI 87 - 96%; p < .010; I 2 = 90%) in fenestrations and 95% (95% CI 91 - 97%; p = .060, I 2 = 64%) in branches., Conclusion: Advanta V12/iCAST bridging stent showed high freedom from target vessel instability, stenosis and or occlusion, and endoleak. Freedom from re-intervention was 95%, being similarly high in fenestrations and branches., (Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.)

Objective: This study determined the prevalence of child abuse in first year medical students in a Turkish university using the ICAST-R, as well as the relationships between sociodemographic data and abuse. Methods: First-year medical students in a Turkish university have been surveyed between 15th-30th June 2012, using ISPCAN Child Abuse Screening Tool-Retrospective Version (ICAST-R) and a questionnaire to collect sociodemographic data. Data analysis was performed with SPSS 15.0. Results: This study was included 192 students, 56.8% female and 43.2% male. Physical, emotional and sexual abuses were found in 14.6%; 32.3%; and 8.9% of participants, respectively. No significant relation between gender and emotional abuse was found (p= 0.775), whereas both physical and sexual abuse were more common in males (p= 0.04; p= 0.018 respectively). There was a statistically significant relation between emotional abuse and parental separation (p= 0,014). Conclusions: Abuse is not rare among the medical student participants, and several preventable factors could worsen it. The findings have implications on how medical students are taught about these issues. [ABSTRACT FROM AUTHOR]

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Researchers are increasingly using parental report measures in population-based surveys of violence against children. No research thus far has examined the factor structure of the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool Parent Version (ICAST-P), a non-commercialized measure for prevalence studies. This paper uses secondary data from the Balkan Epidemiological Study on Child Abuse and Neglect (BECAN) which included 25,202 primary caregivers of school-going children in three grades (aged 11, 13 and 16). Primary caregivers completed the ICAST-P 2010–2011, which measures children's exposure to physical and psychological violence and neglect by caregivers and sexual violence by any perpetrator. Confirmatory factor analysis (CFA) was used to assess the reliability and the factor structure of the ICAST-P for a four-dimensional model and a bifactor model, with one general factor and four group factors representing the specific components of each set of items. Measurement invariance could not be tested. Lifetime prevalence for physical violence was 66.7 %, for psychological violence 66.6 %, for sexual violence 3.1 % and for neglect 9.1 %. CFA showed adequate fit for the hypothesized four-dimensional model, however, improved fit was shown for a bifactor model with abuse as the general factor. Internal consistency was good for physical and psychological violence, but not neglect and sexual violence. Hierarchical omega showed good internal consistency for the general factor. Parents report that their children experience high levels of violence. The factor structure of the ICAST-P is best captured using a bifactor modelling approach. [ABSTRACT FROM AUTHOR]

While the link between childhood experiences of physical, emotional, and sexual abuse and mental health problems has been largely studied, there is limited information regarding the prevalence of child maltreatment in developing countries, particularly in South America. The present study is an effort to investigate the prevalence of child maltreatment in Ecuador using the ISPCAN Child Abuse Screening Tool Retrospective version (ICAST-R). A student sample (males = 1579; females = 1554) from the seven largest universities in Quito, Ecuador, completed the ICAST-R. Our findings indicate that 69.6 % of participants experienced child maltreatment. Physical abuse was reported by 47.6 % of respondents; this commonly involved being beaten by parents. Emotional maltreatment was reported by 53 % of the participants; mostly through insults by same-sex peers and parents. Sexual abuse was reported by 15.5 % of the participants. The most prevalent forms of sexual abuse included being coerced into touching another person's genitals, having their genitals touched by others, or having someone expose their genitals to them. Sexual abuse was more prevalent amongst females (males = 12.9 %; females = 18.1 %, OR = 1.49; CI = 1.22–1.81), and physical abuse was more prevalent amongst males (males = 50.5 %; females = 44.6 %, OR = 0.79; CI = 0.69-0.91). Our study shows evidence of a high prevalence of child maltreatment in Ecuador. We also identify significant gender differences in the type of abuse experienced, and in the context in which this abuse takes place. These results are important given the negative consequences of child maltreatment. More research applying ICAST to different populations is recommended to further validate the present findings and facilitate international comparisons. [ABSTRACT FROM AUTHOR]