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Ammar Al-Hassani, Gaby Jabbour, Mohammad ElLabib, Ahad Kanbar, Ayman El-Menyar, Hassan Al-Thani
INTRODUCTION: Delayed bile leak following blunt liver trauma is not common. PRESENTATION OF CASE: We presented a case report and literature review of delayed bile leak in a young male patient who presented with grade IV blunt liver injury following a motor vehicle collision; he was a restrained driver who hit a fixed object. Physical examination was unremarkable except for revelaed tachycardia, right upper quadrant abdominal tenderness, and open left knee fracture...
2015: International Journal of Surgery Case Reports
John B Stokes
The average life expectancy of a person on hemodialysis is less than 3 years and hasn't changed in 20 years. The Hemodialysis (HEMO) trial, a randomized trial to determine whether increasing urea removal to the maximum practical degree through a 3-times-a-week schedule, showed no difference in mortality in the treatment and control groups. Investigators speculated that the increment in functional waste removal in the HEMO study was too small to produce improvements in mortality. To test this hypothesis, the NIDDK funded the Frequent Hemodialysis Network, a consortium of centers testing whether patients randomized to intensive dialysis would demonstrate improved (reduced) left ventricular LV mass and quality of life...
2011: Transactions of the American Clinical and Climatological Association
Enric Vilar, Ken Farrington, Chris Bates, Carol Mumford, Roger Greenwood
Over the last 40 years the technical obstacles which prevented a convective contribution to diffusive dialysis have been overcome. Hemodiafiltration represents a natural evolution of intermittent extracorporeal blood purification and the technology is now available to offer this as standard treatment in-center. The first randomized control trial of dialysis dose (National Cooperative Dialysis Study) showed that for three times weekly dialysis a critical level of urea clearance was necessary to ensure complication-free survival, the effect being noticeable by 3 months...
2011: Contributions to Nephrology
Tom Greene, John T Daugirdas, Thomas A Depner, Frank Gotch, Martin Kuhlman
BACKGROUND: The Frequent Hemodialysis Network (FHN) is conducting 2 randomized clinical trials, a daytime in-center trial ("daily") comparing 6 versus 3 treatments/wk, and a home nocturnal trial comparing 6 nocturnal treatments versus 3 conventional treatments/wk. The goal of this study was to project separation between the treatment and control arms of these studies for measures of dialysis dose by using simulations based on 2-compartment variable-volume models. SETTING & PARTICIPANTS: Data from the most recent hemodialysis treatment in 100 patients dialyzed 3 times/wk at facilities of the Renal Research Institute in New York and from 2 data sets (n = 154 and 115 patients) from the Hemodialysis (HEMO) trial...
May 2009: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Micheal V Rocco
The National Institutes of Health (NIH) sponsored HEMO Study did not demonstrate that an increase in dialysis dose was associated with an improvement in patient mortality rates. Despite this negative result, there is ongoing interest in determining if still higher doses of dialysis may be of benefit to patients receiving chronic hemodialysis therapy. Testing this hypothesis requires the use of more fre-quent hemodialysis and/or a much longer duration for each dialysis session. "Short daily hemodialysis", actually six times per week hemodialysis for 1...
January 2009: Saudi Journal of Kidney Diseases and Transplantation
L Tartaglia, B Infante, G Stallone, P Cirillo, M Liuzzi, M Ktena, M Forcella, M Querques, R Perulli, D A Procaccini, L Gesualdo
The interest of investigators in intensified dialysis regimens has been growing in recent years, especially since the HEMO Study Group showed that a higher dose of thrice-weekly hemodialysis fails to reduce mortality and morbidity but improves clinical outcomes. Alternative hemodialysis strategies including short daily hemodialysis (SDHD), long hemodialysis (LHD) and nocturnal daily hemodialysis (NDHD) have been developed in the hope to improve patients' outcomes. A growing number of investigators are studying patients on alternative dialysis regimens and most publications in this field have reported significant improvements in clinical outcomes including left ventricular hypertrophy, blood pressure control, anemia, calcium-phosphate metabolism, and fluid and electrolyte balance; all of these parameters can be considered as indirect signs of improvement in quality of life...
November 2008: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Robert M Lindsay, Shannon Carter, Christian Awaraji, Rita S Suri, Gihad Nesrallah
Outcomes from conventional thrice-weekly hemodialysis (CHD) are disappointing for a life-saving therapy. The results of the HEMO Study show that the recommended minimum dose (Kt/V) for adequacy is also the optimum attainable with CHD. Interest is therefore turning to alternative therapies exploring the effects of increased frequency and time of hemodialysis (HD) treatment. The National Institutes of Health have sponsored 2 randomized prospective trials comparing short hours daily in-center HD and long hours slow nightly home HD with CHD...
July 2008: Hemodialysis International
Michael V Rocco
An increase in the length of the standard in-center hemodialysis treatment by 30 to 45 minutes per session was not associated with an improvement in mortality in long-term hemodialysis patients enrolled in the HEMO study. Testing the possibility that delivering still higher doses of hemodialysis may have a beneficial effect on patient outcomes will require the use of more frequent hemodialysis or a much longer duration for each dialysis session. "Short-daily hemodialysis," actually 6 times per week hemodialysis for 1...
July 2007: Advances in Chronic Kidney Disease
Ulla Hedner
PURPOSE OF REVIEW: To examine the development of recombinant FVIIa (rFVIIa); a new concept of inducing hemostasis. It was developed for use in hemophilia patients with inhibitors against FVIII or FIX with the vision to provide these patients with a therapeutical option to be used instead of FVIII or FIX. For the first time it was shown that pharmacological doses of FVIIa induced hemostasis. RECENT FINDINGS: Hemostasis was achieved by rFVIIa in major surgery (repeated doses) as well as in a home-treatment setting (one single injection) in severe hemophilia patients with inhibitors...
May 2007: Current Opinion in Hematology
A Pierratos, P McFarlane, C T Chan, S Kwok, G Nesrallah
The need to improve the dialysis outcomes, the negative results from the HEMO and ADEMEX studies as well reports of clinical benefits have rekindled the interest in daily hemodialysis. Although no randomized controlled studies have been published, a large number of manuscripts have described significant benefits from both the short or nocturnal forms of daily (quotidian) dialysis or hemo(dia)filtration. They include improved quality of life, hemodynamic stability, blood pressure control with minimal number of medications, anemia control, regression of cardiac hypertrophy and improved nutrition...
June 2006: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Giorgina B Piccoli, Elisabetta Mezza, Manuel Burdese, Valentina Consiglio, Silvia Vaggione, Claudia Mastella, Alberto Jeantet, Emanuela Maddalena, Guido Martina, Massimo Gai, Daria Motta, Giuseppe Paolo Segoloni, Giuseppe Piccoli
BACKGROUND: Predialysis care is vital for the patient and is crucial for dialysis choice: empowered, early referred patients tend to prefer out-of-hospital and self-care treatment; despite these claims, early referral remains too often a program more than a reality. Aim of the study was to evaluate the pattern and reasons for RRT choice in patients treated in a long-standing outpatient network, presently following 850 chronic patients (about 80% diabetics), working with an early referral policy and offering a wide set of dialysis options (home hemo and PD; self care and limited care hemodialysis; hospital hemodialysis)...
May 2005: Journal of Nephrology
Andreas Pierratos, Phil McFarlane, Christopher T Chan
PURPOSE OF REVIEW: The interest in quotidian hemodialysis has increased further after the HEMO study reported that high-dose thrice-weekly hemodialysis failed to improve clinical outcomes. This, in combination with a significant volume of newly published data, made a review of the topic of quotidian hemodialysis timely. RECENT FINDINGS: The published research has revealed further evidence of cardiovascular and quality-of-life improvements as well as financial benefits with quotidian hemodialysis...
March 2005: Current Opinion in Nephrology and Hypertension
J J Keys
No abstract text is available yet for this article.
November 1999: Nephrology News & Issues
M Ikeda, Y Yamane, N Hagiwara, K Ohnumi, M Hasuike
Spontaneous pneumothorax has been managed on an outpatient basis by intercostal tube drainage and a portable flutter valve device (pneumothorax set). In a series of 111 selected patients, from 14 to 75 years of age, who had no complaints such as dyspnea, had neither tension-nor hemo-pneumothorax, and could promptly return to hospital in an emergency, intercostal tube insertion and continuous negative pressure drainage were instituted at the outpatient department. After approximately one hour of suction, if an air leak ceased and the lung was re-expanded, the patient was allowed to return home with a pneumothorax set connected to the chest tube...
August 1994: Nihon Kyōbu Shikkan Gakkai Zasshi
S B Smith, D G Wombolt, R L Hurwitz, J R Wheeler, M Goldberg
We report our experience with the subclavian vein as a route for temporary vascular access. By modifying the technique described by Uldall one can place these catheters at the bedside without the need of a separate exit tunnel. They are easily maintained in place and allow for early discharge home while awaiting permanent vascular access maturation. The results of approximately 600 dialysis treatments showed adequate clearence with a mean postdialysis drop in creatinine of 5.0mg./dl. and BUN of 46mg./dl. Complication rates were minimal with no hemo or pneumothorax...
1981: Clinical and Experimental Dialysis and Apheresis
I G Miasnikov
The paper is concerned with the data on 147 subjects who underwent magnetotherapy with the unit "Magniter-AMT-01" applied to the cervical area. The main group included 102 subjects, 45 person served as control. The purpose of the work was to base the application of MT under inpatient and home conditions with the use of the above-indicated unit. In view of this fact, a study was made of cerebral hemo- and thermodynamics with the aid of rheoencephalography and encephaloradiothermography under the action of different modes of the functioning of the unit "Magniter-AMT-01" (pulse and variable magnet induction fields 12-15 mTl and 30-35 mTl)...
1992: Zhurnal Nevropatologii i Psikhiatrii Imeni S.S. Korsakova
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