RESUMO
Traumatic scalp arteriovenous fistula (AVF) is a relatively rare complication of scalp trauma. Patients most commonly present with a growing pulsatile head mass. History of trauma, clinical presentation, and diagnostic imaging, including digital subtraction angiography, aid in establishing the diagnosis. Endovascular embolization is the preferred treatment modality which may be combined with surgical excision for larger complex lesions. In this case, we report the clinical and radiological features of a traumatic scalp AVF in a middle-aged man with a remote history of trauma that was treated with a two-step hybrid approach combining transarterial embolization with surgical resection. We also present a brief overview of the various treatment modalities currently employed to treat scalp AVFs.
RESUMO
Background: Telelactation, a virtual lactation support platform, is a convenient and effective way of providing virtual breastfeeding support services and communicating proper breastfeeding techniques to new mothers to address any breastfeeding challenges and boost overall maternal breastfeeding confidence all from the comfort of their homes. This Ontario Health Insurance Plan (OHIP) covered service benefits more mothers in the remote areas where in-person LC service is not easily accessible. Objective: The objective of this cross-sectional survey study is to explore the feasibility, potential benefits, and challenges, and level of patient satisfaction in virtual lactation consultation services along with virtual paediatrician consultation available in Ontario, Canada. Method: Patient satisfaction was assessed using a structured online survey as a part of a cross-sectional observational study that asked questions relevant to several independent demographic variables as well as specific Likert type scale questions to gauge patient satisfaction with virtual lactation consultation. Results: Data were analyzed from 177 survey responses (n=177), of which study revealed that 86.44% (153/177) were satisfied with the virtual lactation services they received. Patient satisfaction was found to be higher in the first-time mothers with high school or undergraduate education between the age group of 26 to 35 years living in the Greater Toronto Area (GTA). In terms of connectivity, participants from the GTA had a better experience overall compared those living outside the GTA. Conclusion: OHIP covered telelactation with a paediatrician consultation is an innovative and feasible health care delivery platform for providing remote professional breastfeeding support to mothers of all socio-economic strata with great potential to further improve both patient experience and efficiency in patient care.
