Predictors for Nonhome Patient Discharge following Lower Extremity Arterial Interventions.

PURPOSE: To identify the variables associated with patient discharge disposition to optimize postprocedural care and discharge planning following lower extremity arterial interventions for peripheral artery disease (PAD). MATERIALS AND METHODS: The 2014-2017 American College of Surgeons National Surgical Quality Improvement Program database was queried using current procedural terminology codes for endovascular infrainguinal interventions for PAD. The main outcome variable of interest was nonhome discharge. Covariates included patient sociodemographic variables, age quartile (upper quartile, ≥77 years), comorbidities (diabetes, renal disease, bleeding disorder, congestive heart failure [CHF], and chronic obstructive pulmonary disease), presence of an open wound before a procedure, type of procedure, operative time, symptom severity, American Society of Anesthesiologists class, and baseline functional status. Univariate analysis and multivariate logistic regression were performed on Stata/SE 15.1. RESULTS: A total of 3,190 patients met the inclusion criteria, of whom 664 (20.8%) had nonhome discharge. Multivariate regression revealed that age (odds ratio [OR], 1.9 for the upper age quartile [>77 years]; 95% confidence interval [CI], 1.46-2.50), operative time (OR, 1.2 per increase in quartile; 95% CI, 1.09-1.30), preoperative wound (OR, 1.5; 95% CI, 1.24-1.90), renal failure (OR, 1.7; 95% CI, 1.30-2.14), CHF (OR, 2.2; 95% CI, 1.51-3.24), symptom severity (OR, 1.7; 95% CI, 1.46-1.98), and independent functional status (OR, 0.74; 95% CI, 0.59-0.92; P = .007) were associated with nonhome discharge. All P values were ≤.001 unless otherwise stated. CONCLUSIONS: Prolonged procedural time, the presence of preprocedural wound and patient comorbidities, symptomatology, and baseline functional status may be used to identify patients who will require a nonhome discharge and early discharge planning.

Interventional Radiology in Renal Trauma.

Traumatic injuries to the kidney and collecting system can range widely from small lacerations to significant bleeding and its sequelae. Urinary obstruction can occur in the renal pelvis, ureters, or urethra. Interventional radiology plays a significant role in treatment and management, in many cases requiring emergent action. Endovascular embolization is frequently the first-line approach to treating hemorrhage. Percutaneous interventions for urinary obstruction include nephrostomy and suprapubic catheter placement. In this article, we outline the clinical approach and interventional methods used in the evaluation and treatment of renal trauma. Several case presentations demonstrate the role of interventional radiology in renal trauma.

Low-Temperature Dielectric Anisotropy Driven by an Antiferroelectric Mode in SrTiO_{3}.

Strontium titanate (SrTiO_{3}) is the quintessential material for oxide electronics. One of its hallmark features is the transition, driven by antiferrodistortive (AFD) lattice modes, from a cubic to a ferroelastic low-temperature phase. Here we investigate the evolution of the ferroelastic twin walls upon application of an electric field. Remarkably, we find that the dielectric anisotropy of tetragonal SrTiO_{3}, rather than the intrinsic domain wall polarity, is the main driving force for the motion of the twins. Based on a combined first-principles and Landau-theory analysis, we show that such anisotropy is dominated by a trilinear coupling between the polarization, the AFD lattice tilts, and a previously overlooked antiferroelectric (AFE) mode. We identify the latter AFE phonon with the so-called "R mode" at ∼440 cm^{-1}, which was previously detected in IR experiments, but whose microscopic nature was unknown.

Size dependence of domain pattern transfer in multiferroic heterostructures.

Magnetoelectric coupling in multiferroic heterostructures can produce large lateral modulations of magnetic anisotropy enabling the imprinting of ferroelectric domains into ferromagnetic films. Exchange and magnetostatic interactions within ferromagnetic films oppose the formation of such domains. Using micromagnetic simulations and a one-dimensional model, we demonstrate that competing energies lead to the breakdown of domain pattern transfer below a critical domain size. Moreover, rotation of the magnetic field results in abrupt transitions between two scaling regimes with different magnetic anisotropy. The theoretical predictions are confirmed by experiments on CoFeB/BaTiO3 heterostructures.

Intra-articular osteoid osteoma simulating a painful fabella syndrome.

We present a case of an intra-articular osteoid osteoma in the knee that was mistaken for a painful fabella syndrome after unsuccessful knee arthroscopy for the treatment of postero-lateral knee pain. In this case both the initial clinical presentation and the imaging proved to be deceiving. The diagnosis of intra-articular osteoid osteoma was considered only once typical clinical features appeared and a Computerized Tomography scan was performed. We discuss the difficult of diagnosing an intra-articular osteoid osteoma and the imaging of choice.