Preliminary Results of Aorfix™ Stent Graft to Treat Infrarenal Abdominal Aortic Aneurysms with Severe Proximal Aortic Neck Angulation.

BACKGROUND: We report a preliminary experience about endovascular aortic repair (EVAR) of infrarenal abdominal aortic aneurysm (iAAA) with severe proximal aortic neck angulation (NA) using the Aorfix™ stent graft. METHODS: Data of consecutive patients with iAAA with severe proximal NA submitted to endovascular repair between September 2012 and December 2014 in 2 Italian centers of Vascular and Endovascular Surgery were retrospectively reviewed, and outcomes were analyzed using the software JMP 5.1.2. RESULTS: A total of 26 patients were treated. Median proximal NA was 87.5° (range 68-108°), and 3 patients were treated outside the instruction for use of Aorfix because of a proximal NA > 90°. Eleven patients (42.3%) had severe iliac tortuosity. The primary success rate was 92.3%, as 2 patients required intraoperative correction of a type Ia endoleak. Within 30 days, a right limb occlusion was successfully resolved with endovascular recanalization. The median follow-up period was 14 months (range 1-48 months): 1 patient died for neoplasm and 1 patient presented a type II endoleak from lumbar arteries at 3 months, which is still under surveillance. No other complications were reported during the follow-up period. CONCLUSIONS: Preliminary results with the Aorfix stent graft seemed to be promising in the aim of reducing endoleak and migration rates in presence of iAAA with severe proximal aortic NA.

Functioning of family system in pediatric oncology during treatment phase.

The study focuses on parents' psychological implications caused by the treatment of their children suffering from tumor. It investigates some specific mothers' resource factors such as their strategies of coping and the perception of their own family functioning in terms of cohesion and adaptability. The study was performed with 34 mothers of children suffering from acute lymphoblastic leukemia (ALL), during the treatment phase. The used tools were the Coping Orientation to Problem Experienced--New Italian Version, to investigate coping strategies, and the Family Adaptability and Cohesion Evaluation Scale-III, to analyze both real and ideal perception of family functioning. The data related to coping, show how the involved mothers tend to mainly use the strategies of positive aptitude, orientation toward problem and social support (F = 99.88, df = 4, P < .01). The family functioning, in terms of adaptability, is described as chaotic relating to both the real (χ(2) = 13.29, df = 3, P = .004) and ideal (χ(2) = 11.52, df = 2, P = .003) family, whereas in terms of cohesion, it is perceived as chiefly disengaged in the real family (χ(2) = 12.3, df = 3, P = .006) and as enmeshed in the ideal one (χ(2) = 12.58, df = 3, P = .006). Statistically positive correlations were only detected between adaptability and avoidance (r = 0.49, P < .01); adaptability and orientation toward problem (r = 0.36, P < .05); and adaptability and transcendent orientation (r = -0.04, P < .05). Despite the critical situation, the mothers have shown optimistic view, care for problem management and capability to ask for help. These coping strategies allow the therapeutic alliance between families and health care workers, so useful for the quality of childcare.

The successful use of ondansetron in a boy with both leukemia and Tourette syndrome.

This article reports an 8-year-old boy with both acute lymphoblastic leukemia and Gilles de la Tourette syndrome. Initially, for his leukemia, he was treated with chemotherapy, which resulted in severe nausea and vomiting for which he was given ondansetron. This not only relieved the target symptoms, but also those of his Gilles de la Tourette syndrome. Following a reduction of the ondansetron dosage, his Gilles de la Tourette syndrome symptoms reemerged.

[Surgical treatment of extracranial carotid aneurysms]. / Il trattamento chirurgico degli aneurismi delle arterie carotidi extracraniche.

The incidence of aneurysm ranges from 0.1 to 3.7 of all carotid artery diseases requiring surgery. The aim of the study was to describe our personal experience with the surgical therapy of aneurysms of the carotid artery. Over the period from 1980 to 2000 we observed 19 aneurysms of the extracranial carotid tract in 17 patients. Eleven patients were subjected to surgical treatment (M/F: 2:1; mean age: 59 years). The sizes of the lesion ranged from 2 to 5.5 cm. The locations of the lesions were: common carotid 5; internal carotid 4; bifurcation 4. A shunt was utilised in one patient. No mortality was recorded. In 2 patients there was a transitory central neurological deficit, and in 4 patients a transitory peripheral neurological deficit. A definitive peripheral deficit was recorded in one patient (9%). The authors recommend prompt surgical treatment, in view of the low morbidity and almost total absence of mortality.