Treatment of locally advanced pancreatic cancer using localized trans-arterial micro perfusion of gemcitabine: combined analysis of RR1 and RR2.

Background: Locally advanced pancreatic cancer (LAPC) comprises 40% of pancreatic cancer diagnoses and has a relatively poor prognosis. Trans-arterial micro perfusion (TAMP)-mediated chemotherapy delivery to the primary tumor is a novel approach worthy of investigation. The RR1 (dose escalation) and RR2 (observational) studies examined the safety and preliminary efficacy of TAMP-delivered gemcitabine for LAPC.

Assessment of serum tumor markers CEA, CA-125, and CA19-9 as adjuncts in non-small cell lung cancer management.

Conventional tumor markers may serve as adjuncts in non-small cell lung cancer (NSCLC) management. This study analyzed whether three tumor markers (CEA, CA19-9, and CA-125) held associations with radiographic and clinical outcomes in NSCLC. It constituted a single-center study of NSCLC patients treated with systemic therapy at the London Regional Cancer Program.

The influence of adjuvant chemotherapy dose intensity on overall survival in resected colon cancer: a multicentered retrospective analysis.

Background: Colorectal cancer remains the second leading cause of cancer death in North America. Fluorouracil and oxaliplatin based adjuvant chemotherapy for resected colon cancer (CC) reduces cancer recurrence, but also causes significant toxicity requiring dose reductions. The effect of dose intensity on survival outcomes is not fully understood and strengthening the evidence supports informed decision making between patients and oncologists.

Evaluating specimen pooling for , , and screening in asymptomatic men who have sex with men.

Background: Screening for and is recommended for individuals at high-risk for sexually transmitted infections (STIs), while the role of screening is still unclear. We evaluated whether specimen pooling is an effective alternative for sexually transmitted infection testing during resource shortages.

Methods: This 2-year prospective study enrolled 135 asymptomatic patients from a community outreach site who identified as men who have sex with men.

Porphyromonas gingivalis infection alters Nrf2-phase II enzymes and nitric oxide in primary human aortic endothelial cells.

Background: Periodontal disease (PD) is known to be associated with endothelial dysfunction in patients with coronary artery and/or cardiovascular disease. In our study, we sought to explore the virulence of P. gingivalis (Pg) affecting glycogen synthase kinase 3 beta (GSK-3β)/nuclear factor (erythroid-derived 2)-like 2 (Nrf2)/tetrahydrobiopterin (BH )/ nitric oxide synthase (NOS) expression in primary human aortic endothelial cells (pHAECs).

ACR Appropriateness Criteria Radiologic Management of Biliary Obstruction.

Biliary obstruction is a serious condition that can occur in the setting of both benign and malignant pathologies. In the setting of acute cholangitis, biliary decompression can be lifesaving; for patients with cancer who are receiving chemotherapy, untreated obstructive jaundice may lead to biochemical derangements that often preclude continuation of therapy unless biliary decompression is performed (see the ACR Appropriateness Criteria® topic on "Jaundice"). Recommended therapy including percutaneous decompression, endoscopic decompression, and/or surgical decompression is based on the etiology of the obstruction and patient factors including the individual's anatomy.

ACR Appropriateness Criteria Radiologic Management of Uterine Leiomyomas.

Uterine fibroids, also known as leiomyomas, are the most common benign tumor in women of reproductive age. When symptomatic, these patients can present with bleeding and/or bulk-related symptoms. Treatment options for symptomatic uterine leiomyomas include medical management, minimally invasive treatment such as uterine artery embolization, and surgical options, such as myomectomy.

Leadership line care rounds: Application of the engage, educate, execute, and evaluate improvement model for the prevention of central line-associated bloodstream infections in children with cancer.

To prevent central line-associated bloodstream infections (CLABSIs), leadership line care rounds (LLCRs) used the engage, educate, execute, and evaluate improvement model to audit compliance, identify barriers and opportunities, empower patients and families, and engage leadership. Findings of excellence and improvement opportunities were communicated to unit staff and managers. LLCRs contributed to compliance with CLABSI prevention interventions.

Efficacy of fibrin glue therapy for abscess-associated enteric fistulas.

Background: Abdominal abscess that result from bowel injury may require treatment with percutaneous drainage. In some cases, an abscess-associated fistula develops between the injured bowel and the drainage catheter. Fistulas that fail to resolve may require surgery; however, fibrin glue therapy (FGT) may be a suitable alternative.

ACR Appropriateness Criteria Radiologic Management of Hepatic Malignancy.

Management of primary and secondary hepatic malignancy is a complex problem. Achieving optimal care for this challenging population often requires the involvement of multiple medical and surgical disciplines. Because of the wide variety of potential therapies, treatment protocols for various malignancies continue to evolve.

Intravascular US-Guided Portal Vein Access: Improved Procedural Metrics during TIPS Creation.

Purpose: To evaluate transjugular intrahepatic portosystemic shunt (TIPS) outcomes and procedure metrics with the use of three different image guidance techniques for portal vein (PV) access during TIPS creation.

Materials And Methods: A retrospective review of consecutive patients who underwent TIPS procedures for a range of indications during a 28-month study period identified a population of 68 patients. This was stratified by PV access techniques: fluoroscopic guidance with or without portography (n = 26), PV marker wire guidance (n = 18), or intravascular ultrasound (US) guidance (n = 24).

ACR appropriateness criteria radiologic management of infected fluid collections.

The best management of infected fluid collections depends on a careful assessment of clinical and anatomic factors as well as an up-to-date review of the published literature, to be able to select from a host of multidisciplinary treatment options. This article reviews conservative, radiologic, endoscopic, and surgical options and their best application to infected fluid collections as determined by the ACR Appropriateness Criteria Expert Panel on Interventional Radiology. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel.

Skin Necrosis Resulting from Nontarget Embolization of the Falciform Artery during Transarterial Chemoembolization with Drug-Eluting Beads.

Intra-arterial embolic therapies are a mainstay of liver-directed therapies to palliate symptoms, improve survival, and bridge patients to transplantation. Vascular anatomy and type of embolic used can lead to complications of nontarget embolization with varying clinical consequences. This case report describes a rare, nontarget embolization of the falciform artery leading to supraumbilical skin necrosis.

Acute pancreatitis after transarterial chemoembolization of hepatocellular carcinoma with drug-eluting beads.

Nontarget embolization is a relatively common cause of post-chemoembolization complications. Clinical presentation following nontarget embolization varies from minimal to fatal, and oftentimes relates to the vascular distribution embolized rather than the amount or type of embolic agent. Post-chemoembolization pancreatitis is an uncommon complication, but one that is known to occur.

Smart device use and burnout among health science educators.

Purpose: This study examines the perceived level of stress and burnout among health science educators related to smart device use.

Methods: An interdisciplinary health science research team was created to perform a literature review and design a survey and assessment instrument to investigate the level of stress and burnout among health science educators as a result of excessive connectivity to the workplace through smart device use. A total of 977 assessments were completed through distribution by program directors in athletic training, nursing, radiologic sciences, and respiratory care.

Pelvic vascular malformations.

Vascular malformations (VMs) comprise a wide spectrum of lesions that are classified by content and flow characteristics. These lesions, occurring in both focal and diffuse forms, can involve any organ and tissue plane and can cause significant morbidity in both children and adults. Since treatment strategy depends on the type of malformation, correct diagnosis and classification of a vascular lesion are crucial.

Endovascular therapies for primary postpartum hemorrhage: techniques and outcomes.

Interventional radiologists are often consulted for acute management of hemorrhagic complications in obstetric and gynecologic patients. The aim of this article is to review the common indications for vascular embolization in obstetric and gynecologic emergencies, specifically in the setting of primary postpartum hemorrhage, and to discuss the technique and outcomes of endovascular treatment.

Risk of hernia incarceration following transjugular intrahepatic portosystemic shunt placement.

Purpose: Hernia complications after creation of a transjugular intrahepatic portosystemic shunt (TIPS) have been reported, although the incidence of this complication is unknown. This study was designed to determine the incidence, morbidity, and outcome of hernia complications in patients with preexisting abdominal or inguinal hernias after TIPS creation.

Materials And Methods: The medical records of 244 consecutive patients undergoing TIPS creation between 1999 and 2007 at a single institution were reviewed.

Enhancing learning: A comparison of lecture and gaming outcomes.

Contrary to what we anticipated, our outcomes indicated that learning and satisfaction with learning were no different between the traditional lecture group and the educational gaming group. Learners in the gaming group scored on the examination just as well as, but no higher than, did those in the lecture group. Similarly, students in the gaming group were just as, but no more, satisfied with their learning than were students in the lecture group.

Metaanalysis of survival, complications, and imaging response following chemotherapy-based transarterial therapy in patients with unresectable intrahepatic cholangiocarcinoma.

Purpose: Unresectable intrahepatic cholangiocarcinoma represents a devastating illness with poor outcomes when treated with standard systemic therapies. Several smaller nonrandomized outcomes studies have been reported for such patients undergoing transarterial therapies. A metaanalysis was performed to assess primary clinical and imaging outcomes, as well as complication rates, following transarterial interventions in this patient population.

Management of lymphoceles after renal transplant: case report of a novel percutaneous image-guided treatment technique.

A 65-year-old African American man with end-stage renal disease underwent renal transplantation and developed a perigraft lymphocele with an associated progressive increase in serum creatinine 6 weeks after surgery, which failed to resolve with percutaneous drainage and surgical therapy. Fluoroscopic and ultrasound-guided percutaneous transperitoneal balloon fenestration with a 22-mm, 2-cm-long balloon catheter resulted in resolution of the lymphocele as shown by ultrasound at 3 and 5 months.

Student engagement through podcasting.

Nursing faculty investigated the use of a preclass podcast compared with lecture to deliver electrocardiogram interpretation content to facilitate student learning through learner-centered, faculty-guided practice during scheduled class time. Pretest-posttest comparisons of 2 groups revealed the podcast/engaged group scored just as high, but no higher, than the lecture group. However, further analysis determined that only 28% of the engaged group had actually watched the podcast in its entirety.