The perioperative cardiac benefit of endovascular AAA repair in high cardiac risk patients is sustained during long-term follow-up provided patients are on optimal medical therapy but it is not associated with improved overall long-term survival.
Objective: To examine and compare existing pre-operative risk prediction methods for elective abdominal aortic aneurysm (AAA) repair.Design: Systematic review. Methods: Medline, EMBASE and the Cochrane library were searched for articles that related to risk prediction models used for elective AAA repair.Results: 680 abstracts were reviewed and after exclusions 28 articles encompassing 10 risk models were identified. The most frequently studied of these were the Glasgow Aneurysm Score (GAS), the Physiological and Operative Severity Score for enUmeration of Mortality (POSSUM) predictor equation and the Vascular Biochemistry and Haematology Outcome Model (VBHOM). All models had strengths and weaknesses and some had unique features which were identified and discussed.Conclusion: The GAS appeared to be the most useful and consistently validated score at present for open repair. Other systems were either not validated fully or were not consistently accurate. Some had significant drawbacks which appeared to severely limit their clinical application. Recent work has shown that no scores consistently predicted the risk associated with endovascular aneurysm repair (EVAR). Pre-operative risk stratification is a vital component of modern surgical practice, and we propose the need for a comprehensive new risk scoring method for AAA repair incorporating anatomical and physiological data.
Postgraduate coursework is now delivered to a largely mature age study population, in what may be an unfamiliar mix of online and distance learning to many students. This paper reports on a novel approach to student orientation in this new environment. Orientation is conceptualised as a process of transition between the domain of everyday life and the domain of academic study over a period of time commencing prior to enrolment and continuing into formal studies. A schema addressing three dimensions (interpersonal, technical and reflective) was constructed and operationalised as a staged orientation plan (GettingOnTrack). Students are able to move through the three stages participating in activities which align with their needs before, during and after enrolment. This builds on critical concerns reported in earlier literature, highlighting the need for an extended time line and authentic learning tasks in a risk free environment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.