Renal artery embolisation: indications and utilisation at Tygerberg Hospital

BACKGROUND

To evaluate the indications, efficacy and outcomes of endovascular renal artery embolisation (RAE) in the management of renal haemorrhage, specifically in cases of non-iatrogenic origin.

METHOD

This is a retrospective case note review of 92 patients who underwent RAE in the period from August 1999 to August 2014 at Tygerberg Hospital.

RESULTS

Renal artery embolisation was performed in a total of 92 patients. The indication was traumatic renal injury in 60 patients (65.2%), with mean age 28.2 years. The mechanism of injury was stabbing (55.4%), blunt trauma (7.6%) and gunshot (2.2%). Digital subtraction angiography (DSA) showed pseudo-aneurysm in 32.6%, arteriovenous fistula in 19.6% and segmental artery injury in 13%. Embolisation success: 85% after one, 88.9% after a second attempt, with an overall success rate of 98.3% after two attempts. In 20 of the 92 patients (mean age 50.2 years) the indication was malignancy (21.7%). Other cases included iatrogenic haematuria (4.3%) and angiomyolipoma (3.3%). Embolisation was repeated in 16.3%, with eventual success rate of 93.8%. Post-embolisation syndrome was the most common complication, seen in 9.8% of all cases. Of the 9 patients who returned for follow-up with renogram imaging, 4 had a differential function of > 20% of the embolised kidney.

CONCLUSION

Renal artery embolisation remains a very successful method of managing renal haemorrhage at this hospital, whether this results from trauma, malignancy, iatrogenic or other causes.

The reliability and factorial validity of the career decision profile for a sample of afrikaans-speaking students

The purpose of this study was to examine the utility of the Career Decision Profile (CDP; Jones, 1989) for a sample of 133 Afrikaans-speaking students. The scores obtained on all six subscales showed acceptable reliability. The factor structure proposed by Jones for the Career Decision Needs dimension of the CDP was confirmed by means of a confirmatory factor analysis. In conclusion it appears that the CDP may be profitably used for the multidimensional assessment of career indecision with Afrikaans-speaking students. Opsomming Die doel van hierdie studie was om die bruikbaarheid van die Career Decision Profile (CDP; Jones, 1989) vir 'n steekproef van 133 Afrikaanssprekende studente te ondersoek. Al ses subskale het tellings met bevredigende betroubaarheidskoeffisiente opgelewer. Die faktorstruktuur wat deur Jones vir die Career Decision Needs-dimensie van die CDP gepostuleer is, is aan die hand van 'n bevestigende faktorontleding ondersteun. Ten slotte blyk dit dat die CDP nuttig aangewend kan word vir die multi-dimensionele taksering van loopbaanbesluiteloosheid by Afrikaanssprekende studente.

Die faktorstruktuur van die 19 veld-belangstellings-vraelys en Holland se struktuur van belangstellings

The 19 Field Interest Inventory (19FII) has been used for the assessment of the interests of white South Africans for more than twenty years. This inventory gives a detailed but uneconomical description of a person's interests in terms of 19 fields. A further shortcoming is that the inventory is not based on any specific theory. Holland offers a theoretically sound and more economical description of interests in terms of six fields. A factor analysis of the 19 fields of the 19FII was undertaken to determine to what extent the factors would correspond with Holland's fields. Three Holland fields received strong support, whilst the remaining three received tentative support. The discrepancies may be ascribed to the restricted nature of the sample, namely prospective white male university students. Opsomming Die 19 Veld-belangstellingsvraelys (19VBV) word al vir langer as twintig jaar gebruik vir die taksering van blanke Suid-Afrikaners se beroepsbelangstellings. Hierdie vraelys bied 'n gedetailleerde, maar onekonomiese beskrywing van 'n persoon se belangstellings in terme van 19 velde. Hierdie vraelys is ook nie op enige onderliggende teoretiese rasionaal gebaseer nie. Hierteenoor bied Holland 'n teoreties verantwoorde en meer ekonomiese beskrywing van belangstellings in terme van ses velde. 'n Faktorontleding is op 'n datastel wat aan die hand van die 19VBV verkry is uitgevoer om te sien tot watter mate die faktore sal ooreenstem met Holland se velde. Sterk bevestiging vir drie van Holland se velde is gevind/ terwyl die ander drie velde tentatiewe ondersteuning verkry het. Die afwykings kan moontlik aan die geselekteerde aard van die steekproef, naamlik voornemende blanke manlike universiteitstudente, toegeskryf word.