Techniques for Embolization of the Ovarian Vein and Pelvic Reservoir.

Pelvic venous disorders are a common and under diagnosed cause of chronic pelvic pain in women, presenting with chronic, noncyclical pelvic pain for greater than 6 months and the presence of pelvic varicosities. Pelvic varices and ovarian vein reflux are a strong indicator of venous origin chronic pelvic and may benefit from embolization. This most commonly occurs in multiparous, premenopausal women with symptoms of gravity dependent pelvic pain and postcoital pain. Additional causes of pelvic venous disorders include iliac vein compression, internal iliac vein reflux, and renal vein compression, however for the purposes of this article we will focus on ovarian vein insufficiency. The mainstay of treatment for pelvic venous insufficiency is Ovarian Vein Embolization and embolization of the pelvic venous reservoir. This article will focus on the patient presentation and workup, followed by a detailed summary of how to perform this procedure, current research to support treatment, possible technical challenges and complications, and finally future research priorities.

Pilot Cap Acoustic Transparency for Pediatric Amplification Devices.

PURPOSE: Consistent hearing device use in young children with hearing loss is challenging for families. A hearing aid accessory, called a pilot cap, is often recommended to families to help mitigate the issues around device retention. Although pilot caps are commonly suggested to families, there is sparse data available about how acoustically transparent they are when used with a hearing aid. The purpose of this study was to measure the acoustic transparency when a hearing aid functions under a pilot cap accessory. METHOD: The Verifit 2 Hearing Aid Analyzer and the Speech Intelligibility Index (SII) were used to measure acoustic transparency related to access of aided speech. Measurements involved four hearing aids that are commonly fit on pediatric patients and four different commercially available pilot caps. SII data were collected at two intensity levels for four simulated sensorineural hearing losses (SNHLs). Response differences between acoustic measurements with a hearing aid plus a pilot cap compared with the hearing aid alone (control) were collected. RESULTS: A total of 80 SII measurements were made. There were 16 SII measurements of the hearing aid alone (control conditions) and 64 SII measurements with combinations of the hearing aids and pilot caps selected for this study. For each hearing aid, there was no significant difference between the SII measurements collected for the hearing aid alone and the hearing aid plus a pilot cap. Additionally, there was no significant difference between the different pilot caps used with each hearing aid tested. CONCLUSIONS: Pilot cap use with the four types of hearing aids in this study results in no significant differences in acoustic transparency compared with the control condition. The data in this study support the use of the pilot caps for hearing device retention in children with hearing loss. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.22647217.

Evaluation and Management of Patients with Leg Swelling: Therapeutic Options for Venous Disease and Lymphedema.

Lower extremity swelling is a common condition which has a variety of etiologies and can be challenging to diagnose and manage. Swelling is usually the result of the accumulation of interstitial fluid in the subcutaneous tissues. Common etiologies include systemic, superficial, and deep venous, and lymphatic disorders. Leg swelling can occur bilaterally or unilaterally, with venous disorders being one of the most common causes of unilateral lower extremity edema.

Multidisciplinary Team Training Simulation in Interventional Radiology.

Efficient teamwork and communication is critical for the delivery of safe and high quality patient care. Studies have shown that medical errors can occur as a result of poor communication. Simulation scenarios can help improve communication and teamwork, therefore decreasing errors and improving team morale. Simulation is best employed through a multidisciplinary approach, including all members of the team involved in the patient's care. Team simulation can be difficult to plan and execute, therefore we will review the steps to planning an effective multidisciplinary team simulation, as well as the barriers to overcome when implementing these programs. In addition, the structure and value of debriefing sessions will be discussed. Debriefing has been shown to help participants identify latent errors and voice concerns in a safe, confidential setting. Lastly, we will review the value of multidisciplinary team simulation, focusing on the current literature among multiple medical disciplines. There has been a push for implementation of team simulation in healthcare in recent years, yet there is still a need for future research on this subject to demonstrate the direct effect of team simulation on patient care, especially in the dynamic field of Interventional Radiology.