Effect of Augmented Reality (AR) Models on Patient Education in Preventing Non-steroidal Anti-inflammatory Drug (NSAID)-Induced Acute Kidney Injury.

Acute kidney injury (AKI) is a prevalent condition, particularly affecting critically ill patients. Nonsteroidal anti-inflammatory drugs (NSAIDs) are a significant contributor to this condition. Traditional educational methods often fail to effectively convey the risks associated with NSAID use. This study investigated the application of augmented reality (AR) models to enhance patient education in NSAID-induced AKI within an outpatient clinic. The study, conducted over four months with 67 participants, employed a questionnaire-based approach to assess knowledge levels before and after exposure to AR models. The results demonstrated a substantial increase in patient knowledge, and a majority of the participants expressed a willingness to modify their behavior to safeguard their kidneys. The findings suggest that AR holds enormous potential in improving patient comprehension and promoting positive health behaviors. However, limitations such as variations in patient education levels and technology proficiency were acknowledged. Further research is necessary to explore the long-term impact of AR-based education in broader clinical settings.

A Case of Budd-Chiari Syndrome Secondary to Tumor Thrombosis.

Budd-Chiari syndrome (BCS) is a rare constellation of conditions due to obstruction of venous flow from anatomical levels ranging from the hepatic veins to the confluence of the inferior vena cava (IVC) and right atrium. The resulting retrograde flow of blood leads to hepatomegaly, ascites, and liver failure among other features. Our case highlights the clinical features, diagnostic challenges, and management of a patient with a tumor thrombus from a metastatic prostate adenocarcinoma in a 67-year-old male leading to BCS. This patient, with a past history of prostate adenocarcinoma and aortic valve replacement on chronic warfarin anticoagulation, presented with acutely worsening abdominal pain and a distended abdomen, and imaging revealed an IVC filling defect. Subsequent imaging with a piflufolastat prostate-specific PET showing increased uptake in the IVC elucidated the diagnosis of tumor thrombosis. Management considerations include aggressive therapy and optimization of quality of life. The patient was offered both options, and options including surgical shunting, bypasses, and anticoagulation were discussed. After shared decision-making, the patient and family opted to choose the pathway of palliative radiation and anticoagulation.

Competitive Flow: Closure of Internal Thoracic Artery Graft After Successful Coronary Artery Bypass Graft Surgery.

The internal thoracic artery has a patency rate of 85%-95% at 10-15 years post coronary artery bypass graft surgery. Development of total occlusion of the internal thoracic artery within a short period (< 6 months) after the surgery is exceedingly rare. However, competitive flow between the native vessel and the conduit internal thoracic artery, or competitive flow between the 2 conduit internal thoracic arteries in a multiple arterial grafting procedure can jeopardize 1 of the 2 conduit internal thoracic arteries. We report the cases of 2 patients who had bilateral internal thoracic artery grafts, with total occlusion of 1 of the 2 grafts within a short period (6 months) after successful coronary artery bypass graft surgery.

L'artère thoracique interne a un taux de perméabilité des greffons de 85 % à 95 % 10 à 15 ans après un pontage aortocoronarien. L'apparition d'une occlusion totale de l'artère thoracique interne dans un court délai (< 6 mois) après l'intervention est extrêmement rare. Cependant, le flux compétitif entre le vaisseau natif et l'artère thoracique interne de conductance ou le flux compétitif entre les 2 artères thoraciques internes de conductance dans une procédure de greffe artérielle multiple peuvent menacer l'une des 2 artères thoraciques internes de conductance. Nous rapportons les cas de 2 patients ayant subi une greffe bilatérale de l'artère thoracique interne et présenté une occlusion totale de l'un des 2 greffons peu (6 mois) après un pontage aortocoronarien réussi.