Aortic intramural hematoma (AIH) is a life-threatening emergency that involves aortic wall integrity and is characterized by either a direct rupture of the vasa vasorum or spontaneous bleeding of an arterial plaque located in the tunica media of the aortic wall. A notable difference between AIH and acute aortic dissection is the absence of an intimal flap, a finding discernable on computed tomography angiography (CTA). Follow-up imaging allows for the monitoring of disease progression or early findings of impending complications. While some patients may require surgical intervention, medical management with blood pressure control remains the mainstay in treatment. Our case describes a patient who was found to be in cardiac arrest secondary to ventricular fibrillation and was then found to have presumed Stanford Type A aortic dissection on CTA. After reviewing the scans, the diagnosis was reclassified to AIH due to the absence of an intimal flap, the patient was then managed medically for AIH with antihypertensive medications.

/pdf/a-rare-initial-presentation-of-aortic-intramural-hematoma-a-24ewtjow.pdf

A Rare Initial Presentation of Aortic Intramural Hematoma: A Case Report and Literature Review

BACKGROUND
Brown Buttabean Motivation (BBM) is an organization providing support for Pacific people and Indigenous Māori to manage their weight, mainly through community-based exercise sessions and social support. It was started by DL, a man of Samoan and Māori descent, following his personal weight loss journey from a peak weight of 210 kg to less than half that amount. DL is a charismatic leader with a high media profile who is successful in soliciting donations from corporations in money and kindness. Over time, BBM's activities have evolved to include healthy eating, food parcel provision, and other components of healthy living. A co-design team of university researchers and BBM staff are evaluating various components of the program and organization.


OBJECTIVE
The purpose of this study is to build culturally centered system dynamics logic models to serve as the agreed theories of change for BBM and provide a basis for its ongoing effectiveness, sustainability, and continuous quality improvements.


METHODS
A systems science approach will clarify the purpose of BBM and identify the systemic processes needed to effectively and sustainably achieve the study's purpose. Cognitive mapping interviews with key stakeholders will produce maps of their conceptions of BBM's goals and related cause-and-effect processes. The themes arising from the analysis of these maps will provide the initial indicators of change to inform the questions for 2 series of group model building workshops. In these workshops, 2 groups (BBM staff and BBM members) will build qualitative systems models (casual loop diagrams), identifying feedback loops in the structures and processes of the BBM system that will enhance the program's effectiveness, sustainability, and quality improvement. The Pacific and Māori team members will ensure that workshop content, processes, and outputs are grounded in cultural approaches appropriate for the BBM community, with several Pacific and Māori frameworks informing the methods. These include the Samoan fa'afaletui research framework, which requires different perspectives to be woven together to create new knowledge, and kaupapa Māori-aligned research approaches, which create a culturally safe space to conduct research by, with, and for Māori. The Pacific fonofale and Māori te whare tapa whā holistic frameworks for interpreting people's dimensions of health and well-being will also inform this study.


RESULTS
Systems logic models will inform BBM's future developments as a sustainable organization and support its growth and development beyond its high dependence on DL's charismatic leadership.


CONCLUSIONS
This study will adopt a novel and innovative approach to co-designing culturally centered system dynamics logic models for BBM by using systems science methods embedded within Pacific and Māori worldviews and weaving together a number of frameworks and methodologies. These will form the theories of change to enhance BBM's effectiveness, sustainability, and continuous improvement.


TRIAL REGISTRATION
Australian New Zealand Clinical Trial Registry ACTRN 12621-00093-1875; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382320.


INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
PRR1-10.2196/44229.

Building Culturally Centered System Dynamics Logic Models for the Brown Buttabean Motivation Organization: Protocol for a Systems Science Approach.

Management of acute type B aortic intramural haematoma (AIH) still represents a challenging issue. Although most resolve spontaneously or with conservative therapy, several cases of AIH may complic...

https://www.birpublications.org/doi/pdf/10.1259/bjrcr.20210019

Aortic intramural hematoma and classic aortic dissection: two sides of the same coin within the acute aortic syndrome for an interventional radiologist

Spontaneous transverse colon volvulus in a patient with Duchenne muscular dystrophy: An unreported complication

Objectives: To discuss the non-surgical strategies for the management of cervical lymphangiomas in children, with particular attention to sclerotherapy.
Methods: A literature review of the last fifteen years about sclerotherapy of cervical lymphangiomas in children was performed and the main sclerosing agents were reported, highlighting the nature, the mechanism of action and the rates of success, recurrences and complications related to each and every substance; furthermore, the several steps of the procedure are illustrated. Alternative approaches are also mentioned.
Results: 47 articles were collected, mostly dealing with sclerotherapy with OK-432, bleomycin/pingyangmycin and doxycycline; other potential substances include, above all, sodium tetradecyl-sulphate and ethanol. Laser therapy and radio-frequency ablation are valid options in case of mucosal micro-cystic lesions; oral medications (e.g. Sirolimus) and the newest target-therapies are added to local treatments in some Series.

Cervical Lymphangiomas in Children: Non-Surgical Treatment with Focus on Sclerotherapy. Literature Review

/pdf/an-unusual-bilateral-groin-pain-after-covid-19-infection-in-il78kdsi.pdf

An unusual bilateral groin pain after COVID-19 infection in an 82-year-old man

Corrigendum to “Spontaneous transverse colon volvulus in a patient with Duchenne muscular dystrophy: An unreported complication” [Radiol Case Rep 2023;18:1306–10]

Italo Giuseppe Bellone

Papers

Aortic intramural hematoma and classic aortic dissection: two sides of the same coin within the acute aortic syndrome for an interventional radiologist

Spontaneous transverse colon volvulus in a patient with Duchenne muscular dystrophy: An unreported complication

Cervical Lymphangiomas in Children: Non-Surgical Treatment with Focus on Sclerotherapy. Literature Review

An unusual bilateral groin pain after COVID-19 infection in an 82-year-old man

Corrigendum to “Spontaneous transverse colon volvulus in a patient with Duchenne muscular dystrophy: An unreported complication” [Radiol Case Rep 2023;18:1306–10]