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https://www.readbyqxmd.com/read/28067467/coronal-mode-ultrasound-guided-hemodialysis-cannulation-a-pilot-randomized-comparison-with-standard-cannulation-technique
#1
Lalathaksha Kumbar, Vivek Soi, Elizabeth Adams, Cheryl Brown Deacon, Mohamed Zidan, Jerry Yee
Background Infiltrations from cannulation result in significant morbidity including loss of hemodialysis (HD) vascular access (VA). Cannulation is dependent on personnel skill and VA characteristics. Surface marking of VA lacks real-time information and traditional ultrasound (US) devices are large, expensive, requiring skilled operators. Sonic Window© (Analogic Ultrasound, Peabody, MA, USA) is a coronal mode ultrasound device (CMUD) approved for VA cannulation. Methods Single center randomized, prospective pilot study comparing handheld US-guided cannulation of new arteriovenous fistula (AVF) to standard cannulation practices...
January 9, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28066927/dialysate-composition-for-hemodialysis-changes-and-changing-risk
#2
Rita L McGill, Daniel E Weiner
Dialysate composition is a critical aspect of the hemodialysis prescription. Despite this, trial data are almost entirely lacking to help guide the optimal dialysate composition. Often, the concentrations of key components are chosen intuitively, and dialysate composition may be determined by default based on dialysate manufacturer specifications or hemodialysis facility practices. In this review, we examine the current epidemiological evidence guiding selection of dialysate bicarbonate, calcium, magnesium, and potassium, and identify unresolved issues for which pragmatic clinical trials are needed...
January 8, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28043083/lung-ultrasound-in-the-management-of-fluid-volume-in-dialysis-patients-potential-usefulness
#3
EDITORIAL
Carmine Zoccali
Volume overload is a hidden, pervasive complication in dialysis patients with dyspnea and pulmonary edema being its main clinical manifestations. Measuring lung water has clinical potential because it allows timely treatment of lung congestion at a preclinical stage. Chest ultrasound (US) is a novel, well-validated technique that allows reliable estimates of lung water in clinical practice. The application of this technique in dialysis patients has shown that an unsuspectedly high proportion of these patients have moderate to severe lung congestion which is usually asymptomatic...
January 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28041783/thermal-resistance-anastomosis-device-for-the-percutaneous-creation-of-arteriovenous-fistulae-for-hemodialysis
#4
Jeffrey E Hull, Guillermo Elizondo-Riojas, Wendy Bishop, Yesenia L Voneida-Reyna
PURPOSE: To evaluate the safety and efficacy of arteriovenous fistula (AVF) creation with a thermal resistance anastomosis device (TRAD). MATERIALS AND METHODS: From January 2014 to March 2015, 26 patients underwent ultrasound (US)-guided percutaneous creation of proximal radial artery-to-perforating vein AVFs with a TRAD that uses heat and pressure to create a fused anastomosis. Primary endpoints were fistula creation, patent fistula by Doppler US, two-needle dialysis at the prescribed rate, and device-related complications...
December 29, 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28031703/evaluation-of-individual-quality-of-life-among-hemodialysis-patients-nominated-themes-using-seiqol-adapted
#5
Hossein Matlabi, Sharareh Ahmadzadeh
BACKGROUND: Quality of life (QoL) has become an important issue for patients with chronic renal failure diseases who are permanently undergoing hemodialysis. In this study, an adapted schedule for the evaluation of individual quality of life (SEIQoL-adapted) was used to evaluate QoL among hemodialysis patients, to explore their views about the most important aspects of life satisfaction. METHODS AND RESULTS: A multiple approach design and convenience sampling were applied to recruit 53 patients from a hemodialysis unit in Iran...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28027819/mortality-and-readmission-of-outcomes-after-discharge-from-the-surgical-intensive-care-unit-to-long-term-acute-care-hospitals
#6
Michelle C Nguyen, David S Strosberg, Teresa S Jones, Ankur Bhakta, Edward L Jones, Michael R Lyaker, Cindy A Byrd, Carly Sobol, Daniel S Eiferman
BACKGROUND: Patients with prolonged hospitalizations in the surgical intensive care unit often have ongoing medical needs that require further care at long-term, acute-care hospitals upon discharge. Setting expectations for patients and families after protracted operative intensive care unit hospitalization is challenging, and there are limited data to guide these conversations. The purpose of this study was to determine patient survival and readmission rates after discharge from the surgical intensive care unit directly to a long-term, acute-care hospital...
December 24, 2016: Surgery
https://www.readbyqxmd.com/read/28003829/cardiac-arrest-as-a-consequence-of-air-embolism-a-case-report-and-literature-review
#7
Zia Ur Rahman, Ghulam Murtaza, Mohsin Pourmorteza, Wael K El Minaoui, Pooja Sethi, Peyman Mamdouhi, Timir Paul
Air embolism is an infrequent but potentially catastrophic complication. It could be a complication of invasive procedures including surgery, central line placement, positive pressure ventilation, trauma, hemodialysis, pacemaker placement, cardiac ablation, and decompression sickness. Usually, it does not cause any hemodynamic complication. In rare cases, it could lodge in the heart and cause cardiac arrest. We present a case of an 82-year-old white female who underwent computed tomography (CT) guided biopsy of right lung pulmonary nodule...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/28001173/patient-in-chronic-hemodialysis-with-right-atrial-mass-thrombus-fungal-endocarditis-or-atrial-myxoma
#8
Talita G Salani, Cynthia de Moura Borges, Carolina S Urbini, Patrícia Schincariol, Kélcia Rosana da Silva Quadros, Maria Almerinda Ribeiro-Alves, Rodrigo Bueno de Oliveira
We present the case report of a 19-year-old patient with chronic kidney disease due to chronic glomerulonephritis, in hemodialysis (HD) by central catheter, with the incidental finding of a mass of 28x16 mm in right atrium (RA). The diagnosis of thrombus, infective endocarditis or myxoma were considered. Given the context of immunosuppression and difficult access vascular therapeutic practice has proved complex. Although Doppler echocardiography suggested thrombus in RA, nuclear magnetic resonance imaging (MRI) indicated for the diagnosis of myxoma in RA...
December 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27986390/severe-thrombocytopenia-induced-by-iodinated-contrast-after-coronary-angiography-the-use-of-gadolinium-contrast-and-intravascular-ultrasound-as-an-alternative-to-guide-percutaneous-coronary-intervention
#9
José María Cubero-Gómez, Francisco J Guerrero Márquez, Luis Diaz-de la-Llera, Mónica Fernández-Quero, Agustín Guisado-Rasco, Manuel Villa-Gil-Ortega
Acute contrast-induced thrombocytopenia is a rare event with the use of modern low osmolarity iodinated contrast media. The pathophysiological mechanism that causes platelet counts to drop has not been identified, but an immunological mechanism is suspected due to cytotoxicity after previous exposure to contrast. We report the case of a 47-year-old male patient with acute severe thrombocytopenia due to iodinated contrast media exposure. His platelet count after the procedure with the highest amount of contrast was zero, which is the lowest reported platelet count to date...
January 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/27940458/blood-calcification-propensity-cardiovascular-events-and-survival-in-patients-receiving-hemodialysis-in-the-evolve-trial
#10
Andreas Pasch, Geoffrey A Block, Matthias Bachtler, Edward R Smith, Wilhelm Jahnen-Dechent, Spyridon Arampatzis, Glenn M Chertow, Patrick Parfrey, Xiaoye Ma, Juergen Floege
BACKGROUND AND OBJECTIVES: Patients receiving hemodialysis are at risk of cardiovascular events. A novel blood test (T50 test) determines the individual calcification propensity of blood. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: T50 was determined in 2785 baseline serum samples of patients receiving hemodialysis enrolled in the Evaluation of Cinacalcet Therapy to Lower Cardiovascular Events (EVOLVE) trial and the T50 results were related to patient outcomes...
December 9, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27928711/dry-weight-assessment-by-combined-ultrasound-and-bioimpedance-monitoring-in-low-cardiovascular-risk-hemodialysis-patients-a-randomized-controlled-trial
#11
Dimitrie Siriopol, Mihai Onofriescu, Luminita Voroneanu, Mugurel Apetrii, Ionut Nistor, Simona Hogas, Mehmet Kanbay, Radu Sascau, Dragos Scripcariu, Adrian Covic
PURPOSE: Fluid overload is associated with adverse outcomes in hemodialysis (HD) patients. The precise assessment of hydration status in HD patients remains a major challenge for nephrologists. Our study aimed to explore whether combining two bedside methods, lung ultrasonography (LUS) and bioimpedance, may provide complementary information to guide treatment in specific HD patients. METHODS: In total, 250 HD patients from two dialysis units were included in this randomized clinical trial...
January 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/27911460/retrospective-comparison-of-two-different-approaches-for-ultrasound-guided-internal-jugular-vein-cannulation-in-hemodialysis-patients
#12
Antonio Treglia, Dario Musone, Francesco Amoroso
BACKGROUND: Prevalent hemodialysis patients with vascular access consisting of a central venous catheter (CVC) are continuously increasing over the years. Improvement in evolution and CVC placement procedures represents therefore an essential tool to enhance performance and reduce intraoperative and long-term CVC complications. Internal jugular vein (IJV) catheterization techniques are different according to ultrasound probe position in relation to vein axis and to needle direction in relation to ultrasound beam...
December 2, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27886366/utility-of-blind-percutaneous-jugular-venous-cannulation-in-resource-limited-settings
#13
Opeyemi Komolafe, Olalekan Olatise
BACKGROUND: For the nephrologist practicing in resource-limited settings, vascular ultrasound is often unavailable; consequently, blind percutaneous puncture of large veins is often employed to establish vascular access for hemodialysis. METHODS: To examine the efficacy and safety of this approach we evaluated 53 consecutive patients in whom central vascular access was required. The vascular access route utilized was primarily the right internal jugular vein. In the majority of cases, the indication for central vascular access was hemodialysis...
November 14, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27886364/ultrasound-guided-angioplasty-for-treatment-of-peripheral-stenosis-of-arteriovenous-fistula-a-single-center-experience
#14
Sunil Kumar, Nikhil Mahajan, Shivakumar S Patil, Navdeep Singh, Soham Dasgupta, Seetharam Tejavath, Sarbpreet Singh, Deepesh B Kenwar, Ashish Sharma, Mukut Minz
PURPOSE: In patients with end-stage renal disease, arteriovenous fistulas (AVFs) are the access of choice for hemodialysis but are often complicated by stenosis. We present single-center experience of 78 ultrasound-guided angioplasty procedures for treating peripheral stenoses of AVFs. METHODS: Between January 2013 and November 2015, 78 angioplasties were performed under ultrasound guidance in 53 patients with end-stage renal disease who were referred from dialysis centers with low flow rate, difficult cannulation, increased cannulation site bleeding, immature or thrombosed AVF...
November 22, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27847651/ethylene-glycol-poisoning-an-unusual-cause-of-altered-mental-status-and-the-lessons-learned-from-management-of-the-disease-in-the-acute-setting
#15
R Singh, E Arain, A Buth, J Kado, A Soubani, N Imran
Ethylene glycol is found in many household products and is a common toxic ingestion. Acute ingestions present with altered sensorium and an osmolal gap. The true toxicity of ethylene glycol is mediated by its metabolites, which are responsible for the increased anion gap metabolic acidosis, renal tubular damage, and crystalluria seen later in ingestions. Early intervention is key; however, diagnosis is often delayed, especially in elderly patients presenting with altered mental status. There are several laboratory tests which can be exploited for the diagnosis, quantification of ingestion, and monitoring of treatment, including the lactate and osmolal gaps...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27798201/selection-of-peritoneal-dialysis-among-older-eligible-patients-with-end-stage-renal-disease
#16
Ben Wong, Lorraine Venturato, Matthew J Oliver, Robert R Quinn, Pietro Ravani, Jayna Holroyd-Leduc
BACKGROUND: Older patients with end-stage renal disease (ESRD) are less likely to choose peritoneal dialysis (PD) over hemodialysis (HD). The reasons behind their choice of dialysis modality are not clear. This study seeks to determine the patient-perceived factors that influence ESRD patients' choice of dialysis modality among older ESRD patients who are deemed eligible for both PD and HD. METHODS: All patients had completed a multidisciplinary modality assessment, were deemed eligible for both PD and HD, and had received modality education...
October 25, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27793122/acute-pancreatitis-associated-with-everolimus-after-kidney-transplantation-a-case-report
#17
Francesco Fontana, Gianni Cappelli
BACKGROUND: Acute pancreatitis (AP) following KT is a rare and often fatal complication of the early post-transplant period. Common causative factors for AP are rare after KT; anti-rejection drugs as CyA, prednisone and MMF have been implicated, although evidence is not strong and we found no reports on possible causative role for mTOR inhibitors. CASE PRESENTATION: A 55-year-old Caucasian man with end-stage renal disease due to idiopathic membrano-prolipherative glomerulonephritis underwent single kidney transplantation (KT) from cadaveric donor...
October 28, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27660305/the-agreement-between-auscultation-and-lung-ultrasound-in-hemodialysis-patients-the-lust-study
#18
Claudia Torino, Luna Gargani, Rosa Sicari, Krzysztof Letachowicz, Robert Ekart, Danilo Fliser, Adrian Covic, Kostas Siamopoulos, Aristeidis Stavroulopoulos, Ziad A Massy, Enrico Fiaccadori, Alberto Caiazza, Thomas Bachelet, Itzchak Slotki, Alberto Martinez-Castelao, Marie-Jeanne Coudert-Krier, Patrick Rossignol, Faikah Gueler, Thierry Hannedouche, Vincenzo Panichi, Andrzej Wiecek, Giuseppe Pontoriero, Pantelis Sarafidis, Marian Klinger, Radovan Hojs, Sarah Seiler-Mussler, Fabio Lizzi, Dimitrie Siriopol, Olga Balafa, Linda Shavit, Rocco Tripepi, Francesca Mallamaci, Giovanni Tripepi, Eugenio Picano, Gérard Michel London, Carmine Zoccali
BACKGROUND AND OBJECTIVES: Accumulation of fluid in the lung is the most concerning sequela of volume expansion in patients with ESRD. Lung auscultation is recommended to detect and monitor pulmonary congestion, but its reliability in ESRD is unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In a subproject of the ongoing Lung Water by Ultra-Sound Guided Treatment to Prevent Death and Cardiovascular Complications in High Risk ESRD Patients with Cardiomyopathy Trial, we compared a lung ultrasound-guided ultrafiltration prescription policy versus standard care in high-risk patients on hemodialysis...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27646643/evaluation-of-anatomy-and-variations-of-superficial-palmar-arch-and-upper-extremity-arteries-with-ct-angiography
#19
Hatice Kaplanoglu, Osman Beton
AIM: To evaluate the abnormalities and variations of the arterial system of upper extremities and superficial palmar arch with computed tomography angiography and to guide the clinician during this procedure. METHODS: A total of 156 upper extremities of 78 cases were retrospectively analyzed using computed tomography angiography. The study was approved by the local ethics committee of the hospital. From the analysis of the computed tomography angiography images, the following information was recorded; the diameters and abnormalities of radial, ulnar and brachial arteries in both upper extremities, the presence of atherosclerotic changes or stenosis in these arteries, whether the superficial palmar arch was complete or incomplete, and arterial dominance...
September 19, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27538060/toxic-alcohol-ingestion-prompt-recognition-and-management-in-the-emergency-department
#20
Gillian A Beauchamp, Matthew Valento
Identifying patients with potential toxic alcohol exposure and initiating appropriate management is critical to avoid significant patient morbidity. Sources of toxic alcohol exposure include ethylene glycol, methanol, diethylene glycol, propylene glycol, and isopropanol. Treatment considerations include the antidotes fomepizole and ethanol, and hemodialysis for removal of the parent compound and its toxic metabolites. Additional interventions include adjunctive therapies that may improve acidosis and enhance clearance of the toxic alcohol or metabolites...
September 2016: Emergency Medicine Practice
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