Ultrasound guided port implantation via the IJV results in low periprocedural complication rates.
The purpose was to assess the satisfaction and quality of life in patients with a totally implantable central venous port system using a questionnaire-based survey. A self-designed questionnaire to assess patient satisfaction and the impact of the port on daily life was dispatched 180 days after implantation. The questionnaire was combined with the commonly used short form (SF)-12 Health Survey quality of life questionnaire. Of the 98 patients who received a port system, 75 were contacted, and 42 (56%) returned the questionnaire. Most of the responding patients reported high overall satisfaction. The impact of the system on daily life was widely perceived not to be negative. The physical component summary (PCS) and the mental component summary (MCS) scores from the SF-12 were 35.5 and 45.23 respectively (general German population: PCS = 49.6, MCS = 52.3). The multiple stepwise regression showed that the cosmetic result was a predictor of overall satisfaction; the cosmetic result and a painful port together were predictors of the MCS. Overall, it was found that the cosmetic result of the implantation procedure was a predictor of satisfaction and quality of life and should thus not be underestimated.
Purpose: Analysis, evaluation and classification of hepatic arterial supply variants and determination of their frequency distribution in CT-angiographies. Materials and Methods: CT-angiographies of 1,568 patients were evaluated retrospectively for the period between January 1, 2010 and August 30, 2012. The hepatic arterial anatomy was assessed and categorized according to Michels?s classification. So far unclassified variants were considered separately. Results: CT-angiographies of 1297 patients were included in the study. Type I according to Michels was seen in 937 cases (72.2?%), followed by type V in 114 patients (8.8?%) and type III in 83 patients (6.4?%). Type X could not be found in any of the patients. Not yet classified variants were discovered in 26 patients. The most frequent variant in this connection was a right hepatic artery originating from the superior mesenteric artery with the left hepatic artery originating from the left gastric artery (n?=?10). Conclusion: Michels?s classification could be largely confirmed on the basis of a radiologically examined patient population. Not yet classified variants were categorized into subgroups of the existing classification. Key points: ??Imaging of hepatic arterial supply variants using CT-angiography ??Distribution of variations of arterial liver supply in a general patient population ??Expansion of Michels?s classification to include new variations of the arterial liver supply Citation Format: ??L?schner C, Nagel SN, Kausche S et?al. Hepatic Arterial Supply in 1297 CT-Angiographies. Fortschr R?ntgenstr 2015; 187: 276???282
BackgroundSepsis sequelae include critical illness polyneuropathy, myopathy, wasting, neurocognitive deficits, post-traumatic stress disorder, depression and chronic pain. Little is known howlong-term sequelae following hospital discharge are treated. The aim of our study is to determine the effect of a primary care-based, long-term program on health-related quality of life in sepsis survivors.Methods/DesignIn a two-armed randomized multicenter interventional study, patients after sepsis (n = 290) will be assessed at 6, 12 and 24 months. Patients are eligible if severe sepsis or septic shock (ICD-10), at least two criteria of systemic inflammatory response syndrome (SIRS), at least one organ dysfunction and sufficient cognitive capacity are present. The intervention comprises 1) discharge management, 2) training of general practitioners and patients in evidence-based care for sepsis sequelae and 3) telephone monitoring of patients. At six months, we expect an improved primary outcome (health-related quality of life/SF-36) and improved secondary outcomes such as costs, mortality, clinical-, psycho-social- and process-of-care measures in the intervention group compared to the control group.DiscussionThis study evaluates a primary care-based, long-term program for patients after severe sepsis. Study results may add evidence for improved sepsis care management. General practitioners may contribute efficiently to sepsis aftercare.Trial registrationU1111-1119-6345. DRKS00000741, CCT-NAPN-20875 (25 February 2011).
Purpose: Evaluation of correlations between underlying disease and port complications. Materials and Methods: Retrospective analysis of a data set of 3160 port systems, which had been interventionally implanted over a period of 10 years. Of these, 1393 were included in the final evaluation. The 7 most common underlying diseases and port-induced complications were considered. Port-related thrombotic events, port pocket infections as well as the port-induced sepsis were evaluated and classified as either early or late complications. Results: In 1393 ports, 131 experienced complications. Of these, 22.1?% (n?=?29) were early and 79.6?% (n?=?102) late complications. The overall incidence rate of late complications was 0.253/1000 observed days. It differed significantly between the underlying diseases (p?0.001) and was significantly lower in colon carcinoma when compared with pancreatic (p?=?0.049), gastric (p?=?0.012) and bronchial carcinoma (p?=?0.042). The incidence rate of the port sepsis between the underlying diseases also differed significantly (p?=?0.006) and had the highest rate in gastric and bronchial carcinoma. The occurrence of a thrombotic event also showed a significant difference in the incidence rates between the underlying diseases (p?=?0.045) and was highest in pancreatic and gastric carcinoma. Conclusion: There are significant differences in the incidences of complications between the underlying diseases. Knowledge about this can help to improve the port-care and to take specific preventive measures. Key Points: ??significant differences in the incidences of port complications between underlying diseases ??incidence rate of late complications significantly lower in colon carcinoma compared to pancreatic, gastric and bronchial carcinoma ??highest incidence rate of port sepsis in gastric and bronchial carcinoma ??highest incidence rate of thrombotic events in pancreatic and gastric carcinoma ??studies on specific prophylactic measures required Citation Format: Teichgr?ber U, Nagel SN, Kausche S Evaluation of Correlations between Underlying Disease and Port Complications. Fortschr R?ntgenstr 2014; 186: 496???500
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