Study on prediction of arterio-venous fistula maturation by flow mediated dilatation and AVF blood flow

2021 ◽  
pp. 112972982110335
Author(s):  
Mansi Singh ◽  
Himansu Sekhar Mahapatra ◽  
Lalit Pursnani ◽  
B Muthukumar ◽  
Inamdar Neeraj Anant ◽  
...  
Keyword(s):  
Blood Flow ◽  
Vessel Diameter ◽  
P Value ◽  
Arterial Diameter ◽  
Flow Mediated Dilatation ◽  
The Mean ◽  
Venous Fistula ◽  
Ultrasound Parameters ◽  
Fistula Maturation ◽  
Operator Curve

Background: The physiology and pathology of AVF maturation depends on the vessels characteristics and its ability to remodel. Outcome of AVF using flow mediated dilatation (FMD), AVF blood flow and diameter has been studied. Methodology: Present observational study included single stage AVF (both Radiocephalic and Brachiocephalic) in consecutive CKD five patients ( n = 158) prospectively over 1 year. Demographic and Doppler ultrasound parameters of upper limb (for vessel diameter and FMD) at baseline were recorded. Blood flow, diameter and depth of AVF were studied at 2, 6 and 12 weeks and their association with clinical maturation (usage of fistula with two needles for 75% of dialysis sessions during 15 day period) was studied ( n = 129, after excluding lost to followup and expired patients; accordingly cohort was divided in matured ( M) or non-matured (NM) groups. Clinical and radiological parameters between both groups were compared; receiver operator curve (ROC) and correlation of Doppler parameters were analysed. Results: Of 129 AVF, 67.4% were matured and 32.5% non-matured. Mean age was 40 years with male predominance75% in both the groups. The mean arterial diameter for distal (NM = 1.96 ± 0.58 and M = 2.02 ± 0.41) and proximal AVF (NM = 3.37 ± 0.82 and M = 3.36 ± 0.75) was not statistically different in both the groups. The matured fistula group had a mean FMD of 11.67 ± 4.09 as against FMD value of 9.365 ± 3.55 in the failed fistula group ( p value 0.01). For maturation prediction, sensitivity and specificity of blood flow at 2 weeks were 86.2% and 59.5% and at 6 weeks 96.6% and 64.3%, respectively. In multivariate analysis predictors for AVF maturation were FMD (adjusted odds ratio (AOR) = 1.15) and blood flow (AOR = 1.67). Conclusion: Second and Sixth week AVF blood flow was found to be predicting AVF maturation. Higher baseline FMD correlated with the AVF maturation, but not with vessel diameter.

scholarly journals Evaluation of hemodynamic impact of absorbable sutures in native arteriovenous fistulas: A retrospective study

2019 ◽  
Vol 43 (1) ◽  
pp. 58-61
Author(s):  
Savino Occhionorelli ◽  
Fabio Fabbian ◽  
Yuri Battaglia ◽  
Tommaso Miccoli ◽  
Dario Andreotti ◽  
...  
Keyword(s):  
Blood Flow ◽  
Arteriovenous Fistula ◽  
Flow Rate ◽  
Neointimal Hyperplasia ◽  
Blood Flow Rate ◽  
Absorbable Suture ◽  
Absorbable Sutures ◽  
The Mean ◽  
Fistula Maturation ◽  
Arteriovenous Fistula Maturation

One of the major causes of arteriovenous fistula failure is the venous stenosis due to aggressive neointimal hyperplasia. The aim of the study was to assess the arteriovenous fistula maturation comparing absorbable sutures and non-absorbable ones in native vessels. Surgeries performed during a period of 24 months by a single team of expert surgeons were evaluated. Surgeries that met the inclusion criteria, namely, age ⩾ 18 years and radio-cephalic arteriovenous fistula, were considered. According to type of suture, patients were classified as Max group (absorbable suture) and Prol group (non-absorbable). Data pertaining to 70 patients were collected; 51% were men and the mean age was 73 ± 12 years. In Max group, an increasing blood flow was observed during the first 4 weeks without post-operative complications. In Prol group, six patients had thrombosis that resulted in vascular access failure. After the first week, the duplex Doppler ultrasound of both groups showed a regular arteriovenous fistula maturation, with an increase of blood flow rate. Although pre-operative post-tourniquet mean vein diameters of Max group were not adequate, the mean vein diameter and mean blood flow rate increased after 4 weeks, respectively. On the contrary, in Prol group, mean vein diameters and blood flow rate decreased. The maturation of arteriovenous fistula and its functional performance were not altered by the type of suture (absorbable/non-absorbable). Absorbable sutures were associated with good results considering arteriovenous fistula maturation.

scholarly journals ASSESSMENT OF FLOW MEDIATED DILATATION OF BRACHIAL ARTERY BY ANGIODEFENDER DEVICE AS COMPARED TO BRACHIAL ARTERY ULTRASOUND IMAGING.

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Mukesh Kumar Sharma ◽  
Chandra Bhanu Chandan ◽  
Abhishek Shukla ◽  
Deepak Ameta ◽  
Pradeep Kurmi
Keyword(s):  
Correlation Coefficient ◽  
Ultrasound Imaging ◽  
Brachial Artery ◽  
Statistical Difference ◽  
P Value ◽  
Positive Correlation ◽  
Significant Statistical Difference ◽  
Flow Mediated Dilatation ◽  
The Mean ◽  
Flow Mediated Vasodilation

Aims & Objectives: To demonstrate, Angiodefender device, is comparable to “Brachial artery ultrasound imaging” (BAUI) in their abilities to quantify percentage flow mediated vasodilation (FMD) of the brachial artery. Methods: Study was conducted on 100 patients, flow mediated vasodilation was measured by BAUI as well as by the Angiodefender device and the results were compared. Results: The mean %FMD measured by the BAUI was found to be 7.46 ±  4.21 whereas mean %FMD measured by the Angiodefender was 8.24 ±  2.46, (p value 0.113). Positive correlation was found between both the tests with correlation coefficient of 0.65, p value < 0.0001 which is highly significant. Conclusion: Results obtained by both the methods were comparable there was no significant statistical difference. Positive correlation was highly significant between both the tests with correlation coefficient of 0.65. Keywords: Brachial artery ultrasound imaging, Angiodefender, Flow mediated vasodilation

Characteristics of non-mature but functional autogenous radiocephalic fistulas in hemodialysis patients: A prospective cohort study

2019 ◽  
Vol 21 (5) ◽  
pp. 636-645
Author(s):  
Dongliang Zhang ◽  
Zhoucang Zhang ◽  
Li Wan ◽  
Jingjing Chang ◽  
Rui Zhao
Keyword(s):  
Blood Flow ◽  
Arteriovenous Fistula ◽  
Resistance Index ◽  
Vessel Diameter ◽  
Flow Volume ◽  
Arteriovenous Fistulas ◽  
Blood Flow Volume ◽  
Fistula Maturation ◽  
Arteriovenous Fistula Maturation ◽  
Baseline Diameter

Target: To compare the ultrasound characteristics between functional, mature arteriovenous fistulas and functional, non-mature arteriovenous fistulas and to identify the predictors of arteriovenous fistula maturation in the forearm. Methods: Patients with newly set-up functional arteriovenous fistulas were enrolled in this prospective cohort study. Ultrasound examinations were conducted pre-operatively and post-operatively. The inner vessel diameter, blood flow volume, and resistance index were measured and compared between the maturation group (Group M) and non-maturation group (Group N). Baseline parameters were calculated to determine the predictors of non-maturation of arteriovenous fistulas. Results: All 52 patients with functional arteriovenous fistulas, who were categorized into Group M (25 patients, 48.08%) and Group N (27 patients, 51.92%), finished 24 weeks of follow-up after arteriovenous fistula surgery. The arteriovenous fistulas displayed a significant and rapid increase in the vessel diameter (mean increase of 1.34 times in the arteries and 1.92 times in the veins) and blood flow volume (mean increase of 9.29 times of the arteries and 43.66 times of the veins) and a decrease in the resistance index (mean decrease in 48.00% in the arteries) 8 weeks after surgery. Group N had a lesser increase in the vessel diameters (1.78 times vs 2.06 times, t = −3.136, p = 0.003) and blood flow volume (33.98 times vs 54.11 times, t = −2.383, p = 0.021) of the cephalic vein draining segments (a6) than Group M. The baseline diameter of a6 was the only independent predictor (regression coefficient = 26.229, p = 0.008) of maturation of the functional arteriovenous fistulas after correcting for sex, age, diabetes kidney disease, weight, and height. Conclusion: The baseline diameter of the cephalic vein was the only predictor of arteriovenous fistula maturation based on the pre-operative ultrasound measurements in Chinese hemodialysis patients.

scholarly journals Relationship between blood velocity and conduit artery diameter and the effects of smoking on vascular responsiveness

2004 ◽  
Vol 96 (6) ◽  
pp. 2139-2145 ◽  
Author(s):  
Lee Stoner ◽  
Manning Sabatier ◽  
Kristy Edge ◽  
Kevin McCully
Keyword(s):  
Blood Flow ◽  
Brachial Artery ◽  
Local Heating ◽  
Blood Velocity ◽  
Vascular Health ◽  
Arterial Diameter ◽  
Arterial Blood ◽  
Vascular Responsiveness ◽  
The Mean ◽  
The Relationship

Transient changes in arterial diameter in response to transient ischemia-induced changes in arterial blood velocity have been used as an index of vascular health. The purpose of this study was to determine the relationship between blood velocity and diameter in the brachial artery by different methods of increasing blood velocity. Acute cigarette smoking was used with otherwise healthy young occasional smokers to determine the influence of endothelial-nitric oxide pathways on the arterial diameter-blood velocity relationship. Nine nonsmokers and 12 occasional smokers (<1 pack/wk) were tested. Blood flow to the forearm was manipulated to indirectly investigate the relationship between blood velocity and diameter in the brachial artery. Blood flow to forearm was manipulated through the use of 1) 5-min ischemia; 2) handgrip exercise; 3) indirect local heating; and 4) 5-min ischemia plus indirect local heating. A strong relationship was observed between blood velocity and diameter independent of the method used to increase blood velocity ( R2 = 0.89). The mean slope of the velocity-diameter relationship was not different between nonsmokers and occasional smokers who abstained from smoking at least 2 days. Acute smoking did not alter the slope of the velocity-diameter relationship although the mean intercept was decreased as a result of consistent vasoconstriction (7–10%). The mechanisms by which smoking impairs vascular health are largely unknown. These findings differ from previous smoking studies that used chronic and/or heavier smokers. The velocity-diameter relationship appears independent of the method for increasing velocity. Acute smoking in occasional smokers results in vasoconstriction without altering vascular responsiveness. The velocity-diameter relationship may be a useful measure of the progression of vascular disease.

Effects of NO-Donors on Thrombus Formation and Microcirculation in Cerebral Vessels of the Rat

1996 ◽  
Vol 76 (01) ◽  
pp. 111-117 ◽  
Author(s):  
Yasuto Sasaki ◽  
Junji Seki ◽  
John C Giddings ◽  
Junichiro Yamamoto
Keyword(s):  
Blood Flow ◽  
Thrombus Formation ◽  
Dependent Manner ◽  
Red Cell ◽  
Cell Velocity ◽  
Red Cell Velocity ◽  
The Mean ◽  
Wall Shear ◽  
Dose Dependent

SummarySodium nitroprusside (SNP) and 3-morpholinosydnonimine (SIN-1), are known to liberate nitric oxide (NO). In this study the effects of SNP and SIN-1 on thrombus formation in rat cerebral arterioles and venules in vivo were assessed using a helium-neon (He-Ne) laser. SNP infused at doses from 10 Μg/kg/h significantly inhibited thrombus formation in a dose dependent manner. This inhibition of thrombus formation was suppressed by methylene blue. SIN-1 at a dose of 100 Μg/kg/h also demonstrated a significant antithrombotic effect. Moreover, treatment with SNP increased vessel diameter in a dose dependent manner and enhanced the mean red cell velocity measured with a fiber-optic laser-Doppler anemometer microscope (FLDAM). Blood flow, calculated from the mean red cell velocity and vessel diameters was increased significantly during infusion. In contrast, mean wall shear rates in the arterioles and venules were not changed by SNP infusion. The results indicated that SNP and SIN-1 possessed potent antithrombotic activities, whilst SNP increased cerebral blood flow without changing wall shear rate. The findings suggest that the NO released by SNP and SIN-1 may be beneficial for the treatment and protection of cerebral infarction

PENINGKATAN KUALITAS HIDUP MELALUI LOGOTERAPI PADA KLIEN YANG MENJALANI HEMODIALISIS

2019 ◽  
Vol 11 (1) ◽  
pp. 9-18
Author(s):  
Abdul Wakhid ◽  
Ana Puji Astuti ◽  
Maya Kurnia Dewi
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Test Group ◽  
Sampling Technique ◽  
T Test ◽  
P Value ◽  
Number Of Patients ◽  
Post Test ◽  
The Mean

Logoterapi merupakan terapi untuk menemukan makna positif dibalik sebuah kejadian yang tidak diharapkan. Logoterapi dilaksanakan secara individu maupun berkelompok dalam bentuk konseling dan berorientasi pada pencarian makna hidup individu. Tujuan logoterapi meningkatkan makna pengalaman hidup individu yang diarahkan kepada pengambilan keputusan yang bertanggung jawab. Penelitian ini dilakukan dengan menggunakan rancangan pre-experiment dengan metode pre and post test group, artinya pengumpulan data dilakukan terhadap responden untuk membandingkan kualitas hidup sebelum dan sesudah dilakukan intervensi. Teknik pengambilan sampel dilakukan dengan metode total sampling yaitu pengambilan seluruh sampel dengan tetap memperhatikan kriteria yang telah ditetapkan. Jumlah pasien yang menjalani hemodialisis di RSUD Ungaran sebanyak 21 orang dan di RSUD Ambarawa sebanyak 25 pasien. Analisis data dilakukan dengan menggunakan uji t test dependent. Hasil penelitian didapatkan bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 60.22 dengan skor terrendah 55 dan skor tertinggi 69. Bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 88.72 dengan skor terrendah 79 dan skor tertinggi 103. Hasil uji statistik dengan uji t test dependent diketahui ada pengaruh logoterapi terhadap kemampuan memaknai hidup pada klien yang menjalani hemodialisis di RSUD Kabupaten Semarang (p value: 0,0001). Saran perlunya peningkatan kemampuan perawat dalam memberikan layanan kesehatan termasuk pemberian atau pemanduan penemuan makna hidup bagi pasien hemodialysis, agar selain dengan hemodialysis, ada faktor internal dari pasien yang dapat dijadikan sebagai motivasi untuk sembuh dari penyakit.   Kata Kunci: Logoterapi, kualitas hidup   IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RENAL FAILURE WHO UNDERWENT HEMODIALYSIS   ABSTRACT Logotherapy is a therapy to discover the positive meaning behind an unexpected event. Logotherapy is carried out individually or in groups in the form of counseling and oriented to the search for the meaning of individual life. This study aims to improve the quality of life of patients with renal failure who underwent hemodialysis. This research was conducted by using pre-experiment with pre-post test study. The sampling technique was done by the convenience sampling. The number of patients undergoing hemodialysis as many as 46 respondents. Data analysis was done by using test t test dependent. The result showed that from 46 respondents got the mean of quality of life of patients who had hemodialysis 60.22 with lowest score 55 and highest score 69. Whereas from 46 respondents got the mean score of life quality of patients who had hemodialysis 88.72 with score the lowest score 79 and the highest score 103. The result of statistical test with t test dependent is known there is influence of logoterapi to the ability of meaningful life on client who undergo hemodialysis at Semarang Regency hospitals (p value: 0.0001). Advice on the need to improve the nurse's ability to provide health services, including the provision or guidance of the discovery of the meaning of life for hemodialysis patients, in addition to hemodialysis, there are internal factors of the patient that can be used as a motivation to recover from illness.   Keywords: Logotherapy, quality of life, kidney failure.  

Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
Mohammad Enayet Hussain ◽  
Bithi Debnath ◽  
AFM Al Masum Khan ◽  
Md Ferdous Mian ◽  
Md Nahidul Islam ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Clinical Diagnosis ◽  
Optic Neuropathy ◽  
Cross Sectional Study ◽  
P Value ◽  
Pattern Reversal ◽  
Cross Sectional ◽  
The Mean ◽  
Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

Employing Personal Reading Logs through Short Stories to Enhance Students’ L2 Reading Comprehension Achievement

2019 ◽  
Vol 3 (2) ◽  
pp. 1
Author(s):  
Eliyas Sulaiman Mohandas ◽  
Nik Mastura Nik Ismail Azlan ◽  
Salwa Othman ◽  
Muhammad Aizat Azhari
Keyword(s):  
Short Stories ◽  
Reading Comprehension ◽  
P Value ◽  
L2 Reading ◽  
Reading Score ◽  
Paired Samples ◽  
Significant Difference ◽  
Post Test ◽  
The Mean ◽  
L2 Reading Comprehension

This study aims to investigate whether the use of six selected short stories throughout the duration of a 14-week course could enhance students’ reading comprehension achievement at the end of the semester. Out of the six short stories read, three were chosen as in-class assignments known as ‘Personal Reading Logs’ (hereafter, PRLs). One group of semester two Diploma students taking a reading skills course was selected through a convenience sampling method. A pre-test was conducted by having the students answer a past semester reading quiz of which the results would then be compared to their post-test (final reading exam) results. A paired samples t-test revealed no significant difference in the reading scores of the pre-test and the post-test, t (17) = -.265, p > .05. Since the p-value was bigger than 0.05, this indicated that the mean reading score of the post-test (M = 50.556) was not significantly higher than the mean reading score of the pre-test (M = 49.722). Therefore, the null hypothesis which stated that there was no difference in the mean score of the pre-test and post-test was retained. Overall, the result refuted the findings of other studies promoting the effectiveness of using short stories to enhance L2 reading comprehension achievement.

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