scholarly journals Late postoperative complications of arteriovenous fistula for hemodialysis

2021 ◽  
Vol 12 (1) ◽  
pp. 69-80
Author(s):  
Zlatko Maksimović ◽  
Nenad Lalović ◽  
Siniša Maksimović
Keyword(s):  
Postoperative Complications ◽  
Arteriovenous Fistula ◽  
Blood Vessels ◽  
Underlying Disease ◽  
Diagnostic Methods ◽  
Careful Examination ◽  
Pseudoaneurysm Formation ◽  
First Choice ◽  
Weak Points

The vascular approach is a prerequisite for performing hemodialysis, but their "weak points" are different and frequent complications. Modern guidelines recommend native arteriovenous fistula (AVF) as the first choice of vascular approach because it is characterized by the longest survival and the least complications compared to other vascular approaches. All complications of AVF can be divided into intraoperative, early, and late postoperative. This paper presents the late postoperative complications of AVF, their frequency, causes, diagnosis and treatment. The most important late postoperative complications are: stenosis, thrombosis, aneurysm or pseudoaneurysm formation, infection, hand edema, hematoma, ischemic steal syndrome, ischemic neuropathy, congestive heart failure. Large differences in the frequency of each complication in earlier studies can be explained by differences in surgical technique, localization of AVF, diagnostic methods, but, above all, differences between the presented groups of patients. It is described that the age of patients, sex, underlying disease, the presence of comorbid conditions and various metabolic and immune disorders characteristic of chronic renal failure, as well as the way of using and caring for AVF significantly affect the occurrence of AVF complications. One of the main predictors of AVF success and survival is the quality of the patients' blood vessels, and therefore careful examination of blood vessels before approaching AVF creation is of particular importance. The creation, use and care of AVF is the task of the team of health professionals who take part in the treatment of these patients, and successful treatment requires their good cooperation, as well as cooperation with patients.

Travel to altitude with neurological disorders — recommendation of the UIAA Medical Commission

2021 ◽  
Vol 15 (2) ◽  
pp. 29-39
Author(s):  
Corrado Angelini ◽  
Guido Giardini ◽  
Marika Falla
Keyword(s):  
High Altitude ◽  
Vascular Malformations ◽  
Neuromuscular Disorders ◽  
Epileptic Seizures ◽  
Underlying Disease ◽  
Diagnostic Methods ◽  
Careful Examination ◽  
Medical Evaluation ◽  
Prophylactic Measures ◽  
Neurological Conditions

The present review examines several neurological conditions and the problems posed by travelling to high altitude, and in particular whether the underlying disease is likely to worsen. The neurological conditions include migraine and other types of headaches, transient ischemia of the brain, occlusive cerebral artery diseases, intracranial haemorrhage and vascular malformations, intracranial space occupying mass, multiple sclerosis, peripheral neuropathies, neuromuscular disorders, epileptic seizures, dementia and Parkinson’s disease. Attempts will be made to classify the risk posed by each condition and to provide recommendations regarding medical evaluation, advice for or against travelling to altitude and effective prophylactic measures. Some individual cases should only be advised after careful examination and risk evaluation either in an outpatient mountain medicine service or by a physician with knowledge of travelling and high altitude risks. Recent developments in diagnostic methods and treatment of neurological conditions are also mentioned.

Reduction of number of postoperative complications depends on quality of dressing material and wound treatment

2020 ◽  
pp. 61-63
Author(s):  
Larisa Katkasova ◽  
Svetlana Kropotova
Keyword(s):  
At Risk ◽  
Wound Healing ◽  
Postoperative Complications ◽  
Wound Treatment ◽  
Postoperative Wound ◽  
Speed Up ◽  
Modern Technologies

Operated patients suffering from diabetes are at risk of developing postoperative complications. Modern technologies of postoperative wound treatment and modern dressings allow to avoid complications and speed up the process of postoperative wound healing.

Chronic Ischemic Monomelic Neuropathy after Arteriovenous Fistula Creation: A Unique Presentation of Vascular Steal

2020 ◽  
Vol 3 (2) ◽  
pp. 147-150
Author(s):  
Kaczynski RE ◽  
Asaad Y ◽  
Valentin-Capeles N ◽  
Battista J
Keyword(s):  
Arteriovenous Fistula ◽  
Complete Loss ◽  
Dialysis Access ◽  
Loss Of Function ◽  
Access Site ◽  
Surgical Ligation ◽  
Arteriovenous Access ◽  
Vascular Steal ◽  
Steal Syndrome

We discuss a case of a 58 year old male who presented for left upper extremity steal syndrome including ischemic monomelic neuropathy (IMN) 1.5 months after arteriovenous fistula creation. He presented after three surgical attempts to salvage his fistula with rest pain, complete loss of function with contracture of the 4th and 5th digits, and loss of sensation in the ulnar distribution for more than three weeks. At our institution, he underwent surgical ligation of the distal fistula and creation of a new fistula proximally, resulting in complete resolution of his vascular steal symptoms almost immediately despite the chronicity prior to surgical presentation. Our patient provides a unique perspective regarding dialysis access salvage versus patient quality of life. The patients’ functional status and pain levels should take precedence over salvage of an arteriovenous access site, and early ligation of the access should be completed prior to chronic IMN development. However, if a patient presents late along the IMN course, we recommend strong consideration of access ligation in order to attempt to regain the full neurovascular function of the extremity as we experienced in our patient.

The Use of Fibrin-based Tissue Adhesives for Breast in Reconstructive and Plastic Surgery

2020 ◽  
Vol 19 (32) ◽  
pp. 2985-2990 ◽  
Author(s):  
Kuo Chen ◽  
Mikhail Y. Sinelnikov ◽  
Vladimir N. Nikolenko ◽  
Igor V. Reshetov ◽  
Yu Cao ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Postoperative Complications ◽  
Plastic Surgery ◽  
Fibrin Glue ◽  
Reconstructive Surgery ◽  
Tissue Adhesives ◽  
Tissue Adhesion ◽  
Advanced Technologies ◽  
Breast Plastic Surgery

Background: Breast plastic surgery is a rapidly evolving field of medicine. The modern view of surgical trends reflects the desire to minimize complications and introduce advanced technologies. These always will be priorities for surgeons. Reconstructive surgery, a branch of plastic surgery focusing on restoration of lost functional and aesthetic component, seeks to enhance psychological rehabilitation and improves the quality of life, as well as aesthetic recovery. Objective: This review addresses the action of fibrin agents and their effect on the quality of surgical hemostasis. Discussion and Conclusion: The fundamental goals for the surgeon are to perform a minimally traumatic intervention and to prevent any form of complication. Achieving complete hemostasis is an intraoperative necessity. Timely prevention of bleeding and hemorrhagic phenomena can affect not only the outcome of the operation, but also the incidence of postoperative complications. Topics include the integrity of microvascular anastomoses, tissue adhesion, and the incidence of seromas and hematomas associated with fibrin glue usage. The literature on fibrin adhesives with respect to prevention of postoperative complications, and the effectiveness with active drainage also are analyzed.

DIAGNOSING QUALITY OF FRICTION SYSTEMS OF MECHANISMS OF DEVICES

2019 ◽  
Vol 1 (7) ◽  
pp. 10-13
Author(s):  
D. Yu. Ershov ◽  
I. N. Lukyanenko ◽  
E. E. Aman
Keyword(s):  
Surface Defects ◽  
Diagnostic Methods ◽  
Design Parameters ◽  
Diagnostic Model ◽  
Mechanical Assemblies ◽  
Local Defects ◽  
Relationship Of ◽  
The Relationship ◽  
Production And Operation

The article shows the need to develop diagnostic methods for monitoring the quality of lubrication systems, which makes it possible to study the dynamic processes of contacting elements of the friction systems of instrument mechanisms, taking into account roughness parameters, the presence of local surface defects of elements and the bearing capacity of a lubricant. In the present article, a modern diagnostic model has been developed to control the quality of the processes of production and operation of friction systems of instrument assemblies. With the help of the developed model, it becomes possible to establish the relationship of diagnostic and design parameters of the mechanical system, as well as the appearance of possible local defects and lubricant state, which characterize the quality of friction systems used in many mechanical assemblies of the mechanisms of devices. The research results are shown in the form of nomograms to assess the defects of the elements of friction mechanisms of the mechanisms of the devices.

Accuracy analysis in borders description for municipal entities in the Republic Bashkortostan

2017 ◽  
Vol 924 (6) ◽  
pp. 2-5
Author(s):  
V.N. Puchkov ◽  
R.S. Musalimov ◽  
D.S. Zavarnov
Keyword(s):  
Russian Federation ◽  
Input Data ◽  
Accuracy Analysis ◽  
Rural Settlements ◽  
Regulatory Requirements ◽  
Republic Of Bashkortostan ◽  
Weak Points ◽  
The Republic

In this work the analysis on description of rural settlements boundaries of the Republic of Bashkortostan, based on the experience of other sub-federal units of Russian Federation was made. A range of weak points in collected input data was defined. In total, of 54 municipal districts of the Republic of Bashkortostan (818 rural settlements), 44 districts showed nonconformity of feed data details to regulatory requirements. And the main reason for this is a low quality of input materials such as base maps at scale 1

Prophylaxis in people with haemophilia

2009 ◽  
Vol 101 (04) ◽  
pp. 674-681 ◽  
Author(s):  
Massimo Franchini ◽  
Annarita Tagliaferri ◽  
Antonio Coppola
Keyword(s):  
Quality Of Life ◽  
Cost Benefit ◽  
Primary Prophylaxis ◽  
Secondary Prophylaxis ◽  
Severe Haemophilia ◽  
Duration Of Treatment ◽  
First Choice ◽  
Long Term Treatment

SummaryA four-decade clinical experience and recent evidence from randomised controlled studies definitively recognised primary prophylaxis, i.e. the regular infusion of factor concentrates started after the first haemarthrosis and/or before the age of two years, as the first-choice treatment in children with severe haemophilia. The available data clearly show that preventing bleeding since an early age enables to avoid or reduce the clinical impact of muscle-skeletal impairment from haemophilic arthropathy and the related consequences in psycho-social development and quality of life of these patients. In this respect, the aim of secondary prophylaxis, defined as regular long-term treatment started after the age of two years or after two or more joint bleeds, is to avoid (or delay) the progression of arthropathy. The clinical benefits of secondary prophylaxis have been less extensively studied, especially in adolescents and adults; also in the latter better outcomes and quality of life for earlier treatment have been reported. This review summarises evidence from literature and current clinical strategies for prophylactic treatment in patients with severe haemophilia, also focusing on challenges and open issues (optimal regimen and implementation, duration of treatment, long-term adherence and outcomes, cost-benefit ratios) in this setting.

scholarly journals Advances in Plant Disease Detection and Monitoring: From Traditional Assays to In-Field Diagnostics

Sensors ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 2129 ◽  
Author(s):  
Ilaria Buja ◽  
Erika Sabella ◽  
Anna Grazia Monteduro ◽  
Maria Serena Chiriacò ◽  
Luigi De Bellis ◽  
...  
Keyword(s):  
Emerging Diseases ◽  
Diagnostic Methods ◽  
Preventive Actions ◽  
Initial Symptoms ◽  
New Frontier ◽  
Information And Communication ◽  
Instruments And Techniques ◽  
The Difference ◽  
Asymptomatic Individuals

Human activities significantly contribute to worldwide spread of phytopathological adversities. Pathogen-related food losses are today responsible for a reduction in quantity and quality of yield and decrease value and financial returns. As a result, “early detection” in combination with “fast, accurate, and cheap” diagnostics have also become the new mantra in plant pathology, especially for emerging diseases or challenging pathogens that spread thanks to asymptomatic individuals with subtle initial symptoms but are then difficult to face. Furthermore, in a globalized market sensitive to epidemics, innovative tools suitable for field-use represent the new frontier with respect to diagnostic laboratories, ensuring that the instruments and techniques used are suitable for the operational contexts. In this framework, portable systems and interconnection with Internet of Things (IoT) play a pivotal role. Here we review innovative diagnostic methods based on nanotechnologies and new perspectives concerning information and communication technology (ICT) in agriculture, resulting in an improvement in agricultural and rural development and in the ability to revolutionize the concept of “preventive actions”, making the difference in fighting against phytopathogens, all over the world.

scholarly journals Impact of Diabetes Mellitus on Cervical Spine Surgery for Ossification of the Posterior Longitudinal Ligament

2021 ◽  
Vol 10 (15) ◽  
pp. 3375
Author(s):  
Atsushi Kimura ◽  
Katsushi Takeshita ◽  
Toshitaka Yoshii ◽  
Satoru Egawa ◽  
Takashi Hirai ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cervical Spine ◽  
Postoperative Complications ◽  
Spine Surgery ◽  
Posterior Longitudinal Ligament ◽  
Lower Extremity Function ◽  
Cervical Spine Surgery ◽  
The Impact

Ossification of the posterior longitudinal ligament (OPLL) is commonly associated with diabetes mellitus (DM); however, the impact of DM on cervical spine surgery for OPLL remains unclear. This study was performed to evaluate the influence of diabetes DM on the outcomes following cervical spine surgery for OPLL. In total, 478 patients with cervical OPLL who underwent surgical treatment were prospectively recruited from April 2015 to July 2017. Functional measurements were conducted at baseline and at 6 months, 1 year, and 2 years after surgery using JOA and JOACMEQ scores. The incidence of postoperative complications was categorized into early (≤30 days) and late (>30 days), depending on the time from surgery. From the initial group of 478 patients, 402 completed the 2-year follow-up and were included in the analysis. Of the 402 patients, 127 (32%) had DM as a comorbid disease. The overall incidence of postoperative complications was significantly higher in patients with DM than in patients without DM in both the early and late postoperative periods. The patients with DM had a significantly lower JOA score and JOACMEQ scores in the domains of lower extremity function and quality of life than those without DM at the 2-year follow-up.

scholarly journals Perceived quality of surgical care in association with patient-related factors and correlation to reported postoperative complications in Finland: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037708
Author(s):  
Ira Helena Saarinen ◽  
Jaana-Maija Koivisto ◽  
Antti Kaipia ◽  
Elina Haavisto
Keyword(s):  
Quality Of Care ◽  
Postoperative Complications ◽  
Cross Sectional Study ◽  
Perceived Quality ◽  
Living Alone ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Perceived Quality Of Care

ObjectiveTo study if patient-related factors are associated with patient-evaluated quality of care in surgery. To examine if there is an association with postoperative complications and patient-evaluated low quality of care.DesignA correlation cross-sectional study, in addition, a phone call interview at 30 days postoperatively to examine complications.SettingThe data on patients admitted for non-cardiac general and orthopaedic surgery at a central hospital in Southwestern Finland were collected in two phases during an 8-month period.Participants436 consecutive consenting and eligible in-ward non-cardiac general surgery and orthopaedic surgery adult patients. Ambulatory, paediatric and memory disorder patients were excluded. 378 patients completed the questionnaire (Good Nursing Care Scale for Patients (GNCS-P)).MethodsPerceived quality of care was examined by the GNCS-P questionnaire. Patient-related factors were obtained from electronic patient records and questionnaire. A telephone interview related to postdischarge complications was conducted 30 days after discharge.Main outcome measuresPatient evaluation of quality of care at discharge, its association with patient-related factors and patient-reported postdischarge complications.ResultsThe overall quality was evaluated high or very high by the patients. The lowest overall quality of care rate was assessed by surgical patients living alone (p=0.0088) and patients who evaluated their state of health moderate or poor (p=0.0047). Surgical patients reporting postoperative complications after discharge evaluated lower overall quality of care (p=0.0105) than patients with no complications.ConclusionPatient demographic factors do not seem to influence the perceptions of the quality of care. Instead, subjective state of health and living conditions (living alone) may have an influence on the patient experience of quality of care. The perceived quality of care in healthcare staff technical and communication skills may have an association with reported postoperative complications.

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