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Ethical Issues01:27

Ethical Issues

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Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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Issues in Medicine.

J A Shaw1, T J John2, C F N Koegelenberg3

  • 1DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research; South African Medical Research Council Centre for Tuberculosis Research; Biomedical Research Institute, Division of Molecular Biology and Human Genetics, and Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa. janeshaw@sun.ac.za.

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Summary
This summary is machine-generated.

Rasmussen aneurysms causing severe bleeding can be treated by blocking the affected pulmonary artery with an Amplatzer vascular plug. This minimally invasive procedure offers a feasible option for managing this life-threatening condition in tuberculosis-endemic areas.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Interventional Radiology

Background:

  • Rasmussen aneurysms, a complication of tuberculosis (TB), pose a high mortality risk due to life-threatening hemoptysis.
  • High TB prevalence regions face a significant burden of hemoptysis, often with limited healthcare resources.

Purpose of the Study:

  • To evaluate the efficacy of transcatheter Amplatzer vascular plug placement in the pulmonary artery for treating Rasmussen aneurysms causing life-threatening hemoptysis.
  • To assess the feasibility and outcomes of this endovascular approach in patients with current or previous TB.

Main Methods:

  • A series of 25 patients with life-threatening hemoptysis and radiologically confirmed Rasmussen aneurysms underwent transcatheter Amplatzer vascular plug placement in the feeder pulmonary artery.
  • Computed tomography pulmonary angiography (CTPA) was used to identify abnormal pulmonary arteries, with concomitant bronchial or systemic vasculature addressed as needed.
  • The procedure involved immediate occlusion of the culprit pulmonary artery lesion.

Main Results:

  • Immediate technical success was achieved in all 25 patients.
  • Four patients experienced intraoperative hemoptysis due to dislodgement of the occluding plug.
  • At 48 hours post-procedure, 18 patients (72%) were free of hemoptysis, with six experiencing recurrence within one year.

Conclusions:

  • Pulmonary artery Amplatzer vascular plug placement is a feasible endovascular technique for managing bleeding Rasmussen aneurysms.
  • A combined approach addressing all suspected culprit vascular lesions across pulmonary, bronchial, and systemic systems is recommended for optimal outcomes.