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Highlights •Two hospitals implemented booster vaccination programmes in response to suspected staff exposure to pertussis. •Perceived vulnerability of patients was the single most important reason for healthcare workers accepting vaccination. •Pertussis vaccine uptake was high among those who had not received influenza vaccination the previous year. •Self-reported adverse effect profile following vaccination was reassuring. •Fourteen percent of staff reported a recent illness compatible with pertussis but had not notified occupational health.

Purpose: This case series describes the early radiographic and clinical results of attempted transcatheter ovarian vein (OV) embolization in 11 women with symptoms that were suggestive of the pelvic congestion syndrome (PCS). Methods: Eleven women (mean age, 33.1 years) who were multiparous were referred for lower extremity or vulvar varicosities (n = 8) or for tubo-ovarian varicosities (n = 3). After a clinical diagnosis of PCS was established, the women underwent ovarian (n = 5) or ovarian and iliac vein (n = 6) venography. Enlarged or incompetent OVs were embolized with 0.035-inch stainless steel coils or with 0.018-inch platinum microcoils and absorbable gelatin sponge. Incompetent tributaries to hypogastric veins were embolized as well (n = l). Symptoms before embolization and after embolization were recorded with a standard questionnaire, and the post-embolization symptoms were expressed as individual and overall percent relief. Results: Nine of the 11 women underwent embolization. Embolization of both OVs (n = 4), of the left OV alone (n = 4), or of a left obturator vein that communicated with vulvar varices (n = l) was performed. Eight of the 9 women (88.9%) had more than 80% immediate relief. Overall and individual symptom relief varied from 40% to 100% at the mean 13.4-month follow-up. One woman with variant anatomy and one woman with evidence of prior left OV thrombosis were not treated. There were no major complications. Two women had a mild to moderate return of the symptoms at 6 and 22 months. Conclusions: Transcatheter embolization provides excellent initial and variable midterm relief in women with typical PCS symptoms and with OV or OV and internal iliac (hypogastric) tributary vein incompetence. This interventional technique may replace or complement the traditional surgical approaches to this rarely recognized and poorly understood disease. (J Vasc Surg 1998;28:862-8.)

A series of six hemodialysis vascular access patients was evaluated with duplex Doppler sonography and angiography to identify Doppler sonographic parameters that are predictors of venous outflow stenosis. This preliminary series indicates that no venous outflow stenosis was present angiographically when the resistive index gradient across the venous anastomosis is less than or equal to zero and a significant venous outflow stenosis (50 to 100%) was present when the resistive index gradient is 0.15 or greater (P = 0.002, r = 0.963). Doppler acquisition of resistive index gradients across regions of venous outflow is a promising, noninvasive means of rapid radiologic evaluation of hemodialysis graft patients, especially when the need for angiography is equivocal.