scholarly journals 190 Evaluating the Management of Cephalic Arch Stenosis in A North London Hospital

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Hammad ◽  
A Al Midani
Keyword(s):  
Surgical Repair ◽  
Demographic Data ◽  
High Rate ◽  
High Recurrence Rate ◽  
Stent Grafts ◽  
Arteriovenous Fistulas ◽  
London Hospital ◽  
Cas A ◽  
Median Interval ◽  
North London

Abstract Aim Brachiocephalic fistulas (BCFs) are the most commonly used arteriovenous fistulas (AVFs). They are commonly associated with cephalic arch stenosis (CAS), a leading cause of dysfunction and failure. The 2018 European Society of Vascular Surgery guidelines recommend the consideration of stent grafts for managing CAS. In this study, we sought to evaluate the management of CAS in a North London hospital. Method We carried out a retrospective study of patients who had undergone a fistulogram/fistuloplasty for CAS between May 2014 and May 2020. We extracted demographic data, information about their access, and information regarding surgical management of CAS, from the patients’ records on VitalData. We extracted data about recurrence of CAS from their Cerner records. Results Seventy patients were included. 54.3% were still alive at the time of data collection. The average age of those still alive was 65.8±14.1 years. 78.6% had a left BCF. 66% had previous access. 4.29% underwent stenting for CAS. The rest had fistulopasties alone. 90% required multiple fistulopaslties (mean=3.44±1.51). Median interval between access creation and first fistuloplasty was 1.90 years. 34.3% of patients underwent surgical repair of their AVF. AVF failure rate was 34.3%. Median interval between access creation and failure was 3.05 years. Median interval between first fistuloplasty and access failure was 1.34 years. Conclusions Our data demonstrate a high rate of access failure in patients with CAS treated at our centre. Few of our patients had stent grafts inserted. The majority had fistuloplasties without stenting, which was associated with a high recurrence rate.

Abstract TP410: Early Radiographic Recurrence or Extension Predicts Late Clinical Recurrence in Pediatric Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Wilmot V Bonnet ◽  
Joan Reisch ◽  
Patricia Plumb ◽  
Michael M Dowling
Keyword(s):  
Imaging Finding ◽  
Recurrent Stroke ◽  
Demographic Data ◽  
Retrospective Chart Review ◽  
Late Recurrence ◽  
Early Recurrence ◽  
High Rate ◽  
High Recurrence Rate ◽  
Clinical Recurrence ◽  
Index Stroke

Introduction: Pediatric AIS has a high recurrence rate of 10-25%. We observed a high rate of early radiographic recurrence or extension of stroke on repeat MRI performed within 2 weeks of index stroke and hypothesized that early radiographic extension of stroke or recurrent stroke would predict late clinical recurrence. Methods: IRB approved retrospective chart review of children ages 1 week to 18 years with AIS in our institutional pediatric stroke database who had repeat MRI within two weeks of initial acute presentation. We collected clinical and demographic data and reviewed f/u MRI studies for the presence of extension, new stroke, and hemorrhage. Results: 70 patients had early repeat MRI. 23 (33%) had early extension or new stroke on repeat MRI. Of these, 5 (21.7 %) had late clinical recurrence while only 1/47 (2.2%) who did not have early recurrence/extension went on to have late recurrence. 4/70 (5.7 %) had hemorrhagic conversion (only one was symptomatic -headache). Radiographic extension or new stroke on early repeat MRI was significantly associated with late recurrence (p=0.013). Using logistic regression, early extension/recurrence was found to be predictive of late recurrence, (OR 19.5, 95%CI 1.7-228). Conclusion: Children with AIS have a high rate of ongoing early, clinically silent, ischemic injury despite anticoagulation or antiplatelet therapy, which is associated with late clinical recurrence. This early imaging finding may serve as a biomarker that might prove useful as an endpoint in clinical trials comparing early antithrombotic therapies or to identify patients at higher risk of subsequent recurrent overt stroke who might benefit from intensified therapy. Given the high rate of early and late recurrence and low hemorrhage rates from current antithrombotic therapies, more aggressive therapy with dual antithrombotic agents should be investigated.

Sulfinpyrazone or Acetylsalicylic Acid to Prevent Postoperative Thrombus Formation in Arteriovenous Fistulas of Haemodialysis Patients

1979 ◽  
Author(s):  
F Albert ◽  
U Schmidt
Keyword(s):  
Side Effects ◽  
Acetylsalicylic Acid ◽  
Thrombus Formation ◽  
Significant Inhibition ◽  
High Rate ◽  
Controlled Clinical Trial ◽  
Arteriovenous Fistulas ◽  
Arteriovenous Shunts ◽  
Gastrointestinal Side Effects ◽  
Antithrombotic Efficacy

The effect of sulfinpyrazone (200 mg three times a day) and acetylsalicylic acid (500 mg three times a day) on the incidence of thrombosis of arteriovenous shunts was investigated in a controlled clinical trial. In 36 patients with chronic renal failure scheduled to begin haemodialysis the same operating team constructed a subcutaneous fistula in the distal forearm. During the first six weeks after the operation the antithrombotic efficacy proved to be good for both substances. No differences of thrombotic events between the two treatment groups were statistically significant. But in contrast to acetylsalicylic acid sulfinpyrazone made no significant inhibition of platelet - aggregation; sulfinpyrazone probably will prevent the clot formation by prolonging the shortened platelet survival in uraemic patients. In a high rate of patients given acetylsalicylic acid (10 out of 17) there were local bleeding and gastrointestinal side effects. In consequence we should prefer sulfinpyrazone, because in the sulfinpyrazone group side effects were minimal and in none patient withdrawal from the study was necessitated.

Socio Demographic and Clinical Profile of Indoor Female Patients of RINPAS

2017 ◽  
Vol 8 (1) ◽  
pp. 33
Author(s):  
Rajni Suri ◽  
Anshu Suri ◽  
Neelam Kumari ◽  
Amool R. Singh ◽  
Manisha Kiran
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mentally Ill ◽  
Mental Health Problems ◽  
Demographic Data ◽  
Relevant Information ◽  
Health Problems ◽  
High Rate ◽  
Physical And Mental Health ◽  
Cross Sectional

The role of women is very crucial in our society. She cares for her parents, partner, children and other relatives. She performs all types of duties in family and also in the society without any expectations. Because of playing many roles, women often face many challenges in their life including both physical and mental. Mental health problems affect women and men equally, but some problems are more common among women including both physical and mental health problems. Aim of the study - The present study is aimed to describe and compare the clinical and socio-demographic correlates of female mentally ill patients. Methods and Materials: The study includes 180 female mentally ill patients based on cross sectional design and the sample for the study was drawn purposively. A semi structured socio-demographic data sheet was prepared to collect relevant information as per the need of the study. Result: The present study reveals that the socio-demographic factors contribute a vital role in mental illness. Findings also showed that majority of patients had mental problems in the age range of 20-30 have high rate. Illiterate and primary level of education and daily wage working women as well as low and middle socio-economic status women are more prone to have mental illness. Other factors like marital status, type of family and religion etc also important factors for mental illness. Keywords: Socio demographic profile, female, psychiatric patient

scholarly journals EPIDEMIOLOGY, BACTERIAL PROFILE, AND ANTIBIOTIC SENSITIVITY OF LOWER RESPIRATORY TRACT INFECTIONS IN SANA’A AND DHAMAR CITY, YEMEN

2020 ◽  
Author(s):  
Abdulrahman Y. Al-Haifi ◽  
Abdul Salam Mohamed Al Makdad ◽  
Mohammed Kassim Salah ◽  
Hassan A. Al-Shamahy ◽  
Wadee Abdullah Abdulwahid Al Shehari
Keyword(s):  
Peer Review ◽  
High Resistance ◽  
Bacterial Pathogens ◽  
Demographic Data ◽  
Antibiotic Sensitivity ◽  
High Rate ◽  
Diffusion Method ◽  
Sensitivity Testing ◽  
Tract Infections ◽  
E Mail

Objectives:  Lower respiratory infections (LRTIs) are the leading reason of death infectious diseases in the world and the fifth leading cause of death in general. The study aimed to identify the general characteristics of LRTI, the causative bacteria and the results of sensitivity to antibiotics. Subjects and methods:  A multicentre prospective study was performed at 3 University hospitals. The study included 555 clinical diagnostic cases as LRTI cases, 328 male and 227 female, aged 3 to 69 years. Clinical and demographic data were collected in the standard questionnaire, and samples included sputum or bronchial lavage (BAL) staining and culture. Samples were cultured in 3 different bacterial media, blood agar and LJ slope, chocolate agar with Co2; cultures were then examined for possible bacterial pathogens of LRTI. Possible bacterial pathogens were isolated and identified by standard laboratory techniques, and microbial sensitivity testing was carried out by disc diffusion method. Results:  LRTI was recorded among all age groups and with less frequency in children less than 16 years of age. A large number of LRTI (36.2%) was not diagnosed, most in CAP (52.4%), followed by HAP (33.9%) while unidentified cases were lower in AECOPD (22.8%). CAP isolates are K. pneumoniae (26.2%), S. pyogens (12.3%), and S. pneumoniae (9%); in HAP are MSSA (24%), E. Coli (12.9%), MRAS (11.1%), K. pneumoniae (10.5%) and P. aeruginosa (7%); and in AECOPD are M. catarrhalis (47.2%), K. pneumoniae (17.2%), H. influnzae (10.7%) and P. aeruginosa (2%). In Gram-positive bacteria, high resistance to ampicillin/sulbactam (100%) and amoxicillin/clavulanate (100%) was recorded, while moderate resistance to amikacin, vancomycin, cefepime and moxifloxacin was recorded. In Gram-negative bacteria, a high resistance to 3rd g Cephalosporin’s  (68.5%) was recorded, while a moderate sensitivity to the other antibiotics tested was recorded. Conclusion:  There is a high rate of undiagnosed LRTI in Yemen and this highlights the need for health authorities to develop strategies to diagnose most of the causes of LRTI, including Mycoplasma, Chlamydia, and viral causes. No antibiotics are completely effective in treating LRTI in our area and antibiotic sensitivity should be performed in all cases. Peer Review History: Received 22 April 2019; Revised 4 May; Accepted 9 May, Available online 15 May 2020 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Name: Dr. Michael Otakhor Erhunmwunse Affiliation: St. Philomena Catholic Hospital, Nigeria E-mail: [email protected]   Name: Dr. Amany Mohamed Alboghdadly Affiliation: Princess Nourah bint abdulrahman university, Riyadh E-mail: [email protected] Comments of reviewer(s): Similar Articles: BIOFILM FORMATION AND ANTIBIOTIC SUSCEPTIBILITY OF UROPATHOGENS IN PATIENTS WITH CATHETER ASSOCIATED URINARY TRACT INFECTIONS IN IBB CITY -YEMEN PREVALENCE, ANTIMICROBIAL SUSCEPTIBILITY PATTERN AND RISK FACTORS OF MRSA ISOLATED FROM CLINICAL SPECIMENS AMONG MILITARY PATIENTS AT 48 MEDICAL COMPOUND IN SANA'A CITY-YEMEN

scholarly journals High rate of native arteriovenous fistulas: How to reach this goal?

2015 ◽  
Vol 143 (3-4) ◽  
pp. 226-229
Author(s):  
Tamara Jemcov ◽  
Marija Milinkovic ◽  
Igor Koncar ◽  
Ilija Kuzmanovic ◽  
Nenad Jakovljevic ◽  
...  
Keyword(s):  
Vascular Access ◽  
Continuous Process ◽  
Venous Catheter ◽  
Medical Personnel ◽  
High Rate ◽  
Central Venous ◽  
Vascular Surgeon ◽  
Arteriovenous Fistulas ◽  
Clinical Center

The types of vascular accesses for hemodialysis (HD) include the native arteriovenous fistula (AVF), arteriovenous graft (AVG) and central venous catheter (CVC). Adequately matured native AVF is the best choice for HD patients and a high percentage of its presence is the goal of every nephrologist and vascular surgeon. This paper analyses the number and type of vascular accesses for HD performed over a 10-year period at the Clinical Center of Serbia, and presents the factors of importance for the creation of such a high number of successful native AVF (over 80%). Such a result is, inter alia, the consequence of the appointment of the Vascular Access Coordinator, whose task was to improve the quality of care of blood vessels in the predialysis period as well as of functional vascular accesses, and to promote the cooperation among different specialists within the field. Vascular access is the ?lifeline? for HD patients. Thus, its successful planning, creation and monitoring of vascular access is a continuous process that requires the collaboration and cooperation of the patient, nephrologist, vascular surgeon, radiologist and medical personnel.

Percutaneous closure of giant ascending aortic pseudoaneurysm: 22 years after modified BlalockTaussig shunt with a septal occluder device

2021 ◽  
pp. 1-4
Author(s):  
Ikram Massoud ◽  
Atef Yehia
Keyword(s):  
Standard Treatment ◽  
Surgical Repair ◽  
Ascending Aorta ◽  
Stent Grafts ◽  
Fatal Complication ◽  
Aortic Pseudoaneurysm ◽  
Septal Occluder Device ◽  
Occluder Device ◽  
Aortopulmonary Fistula ◽  
Ascending Aortic Pseudoaneurysm

Abstract Pseudoaneurysm of the ascending aorta is rare (1–2%) and a potentially fatal complication following cardiac surgeries. Surgical repair is still the gold standard treatment of ascending aortic pseudoaneurysm. However, endovascular repair methods including stent grafts and Septal Occluder devices have been reported. We report a case of 38-year-old female patient who presented with giant ascending aortic pseudoaneurysm, and aortopulmonary fistula 22 years after modified BlalockTaussig shunt was managed by the transcatheter method. Septal Occluder device 20 mm diameter was delivered to seal the ostium.

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