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Book Description
Les recommandations actuelles concernant la création des accès vasculaires pour l'hémodialyse tendent à favoriser les fistules artério-veineuses (FAV) distales. Pourtant si au long court les FAV distales présentent peu de complications leurs maturation est cependant moins bonne que pour des FAV plus proximales. Le but de ce travail est d'évaluer les complications à court et moyen terme des FAV réalisées par notre équipe, et plus particulièrement les échecs de maturation, car ce sont les premiers obstacles à une dialyse précoce après la constitution de la FAV. L'objectif principal de cette étude est d'évaluer la prévalence et les facteurs de risque d'échec de maturation afin de diminuer le nombre de réinterventions réalisées avant utilisation d'un accès. Il s'agit d'une étude observationnelle, rétrospective, monocentrique incluant tous les patients ayant une création d'un abord vasculaire pour hémodialyse de janvier 2007 à décembre 2009. 131 patients ont été inclus. Le taux d'échec de maturation a été de 27,5%. La fistule radio-céphalique (FRC) et la taille de la veine sur la cartographie ont été retrouvé comme facteurs de risque significatif d'échec de maturation (p=0,0026 et p=0,004). Le diabète et Partériopathie oblitérante des membres inférieurs ont été retrouvés comme ayant une tendance à la significativité. Les perméabilités de la FRC ne sont pas significativement différentes de celles des autres accès vasculaire. La réalisation d'une fistule radio-céphalique ne doit pas être systématique chez les patients artéritiques ou diabétiques mais aussi chez les patients âgés ou devant entré en dialyse rapidement. Des accès alternatifs tel que les fistules avec l'artère brachiale ou les lignes sur l'avant-bras peuvent être proposé chez les patients à haut risque d'échec de maturation.
Book Description
Les recommandations actuelles concernant la création des accès vasculaires pour l'hémodialyse tendent à favoriser les fistules artério-veineuses (FAV) distales. Pourtant si au long court les FAV distales présentent peu de complications leurs maturation est cependant moins bonne que pour des FAV plus proximales. Le but de ce travail est d'évaluer les complications à court et moyen terme des FAV réalisées par notre équipe, et plus particulièrement les échecs de maturation, car ce sont les premiers obstacles à une dialyse précoce après la constitution de la FAV. L'objectif principal de cette étude est d'évaluer la prévalence et les facteurs de risque d'échec de maturation afin de diminuer le nombre de réinterventions réalisées avant utilisation d'un accès. Il s'agit d'une étude observationnelle, rétrospective, monocentrique incluant tous les patients ayant une création d'un abord vasculaire pour hémodialyse de janvier 2007 à décembre 2009. 131 patients ont été inclus. Le taux d'échec de maturation a été de 27,5%. La fistule radio-céphalique (FRC) et la taille de la veine sur la cartographie ont été retrouvé comme facteurs de risque significatif d'échec de maturation (p=0,0026 et p=0,004). Le diabète et Partériopathie oblitérante des membres inférieurs ont été retrouvés comme ayant une tendance à la significativité. Les perméabilités de la FRC ne sont pas significativement différentes de celles des autres accès vasculaire. La réalisation d'une fistule radio-céphalique ne doit pas être systématique chez les patients artéritiques ou diabétiques mais aussi chez les patients âgés ou devant entré en dialyse rapidement. Des accès alternatifs tel que les fistules avec l'artère brachiale ou les lignes sur l'avant-bras peuvent être proposé chez les patients à haut risque d'échec de maturation.
Author: G. Krick Publisher: Karger Medical and Scientific Publishers ISBN: 3805599072 Category : Medical Languages : en Pages : 202
Book Description
On-line HDF represents a major technical development in the delivery of hemodialysis therapy: It combines the properties of increased diffusion available in current high-flux membranes with convective removal of between 6 and 30 liters per treatment and requires the use of ultrapure water and online filtration of replacement fluid. On-line HDF has been successfully introduced in Europe and Asia and is routinely prescribed for dialysis patients in these regions.The book at hand summarizes the history and achievements of on-line HDF in four parts: A report of the technological development in both machine and fiber/dialyzer is followed by a description of the challenges encountered in the evolution of on-line HDF, collecting the accounts of clinical key opinion leaders who had been involved in its early application. The third part presents a comprehensive review of the clinical results achieved with on-line HDF from its inception to the present times, in which it represents the clinical golden standard. The fourth and final part is dedicated to on-line HDF as a ‘vision’ for the future.
Author: Claudio Ronco Publisher: Karger Medical and Scientific Publishers ISBN: 3805582889 Category : Medical Languages : en Pages : 249
Book Description
A concise handbook on clinical and technical possibilities The application of hemodiafiltration has been restricted until recently, when a broader clinical application has been made possible due to evidence from large studies and clinical investigations. This book provides an updated review of the evolution, advances and recent results achieved by hemodiafiltration in the clinical arena. The first part is devoted to historical notes and an outline of the evolution of different forms of hemodiafiltration, made possible by technological developments in the fields of membranes, machines and fluids. The next section describes the theoretical rationale for hemodiafiltration, providing a detailed analysis of the involved mass separation processes, the hydraulic properties of the dialyzers, fluid mechanics and crossfiltration in hollow fiber hemodialyzers. An outline of different hemodiafiltration techniques, also reporting peculiar transport mechanisms and related technology, is given next, and a section on the clinical effects of hemodiafiltration concludes this book. Including different technologies, the publication offers a complete overview of the technical and clinical possibilities provided by hemodiafiltration in its widest concept, ranging from the molecular basis to the most practical application. It will be a valuable tool for the implementation of hemodiafiltration in daily practice aimed at beginners and experts, scientists and physicians, students and senior faculty members alike.
Author: Walter H. Hörl Publisher: Springer Science & Business Media ISBN: 1402022751 Category : Medical Languages : en Pages : 1640
Book Description
The leading Textbook on the subject. A completely rewritten and up-to-date fifth edition, based upon the highly respected fourth edition, edited by C. Jacobs, C.M. Kjellstrand, K.M. Koch and J.F. Winchester. This new edition is truly global in scope and features the contributions of the top experts from around the world.
Author: R. Gokal Publisher: Springer Science & Business Media ISBN: 9401108145 Category : Medical Languages : en Pages : 1185
Book Description
In 1986 the first edition of Continuous Ambulatory Peritoneal Dialysis, edited by R. Gokal, was published. In 1989 the third edition of Peritoneal Dialysis, edited by K.D. Nolph, was published. Both books were widely recognized for their comprehensive discussion of this particular field. Rather than edit new editions of each of these books separately, two of the most prominent figures in this field have decided to combine their knowledge and enthusiasm in this single book: The Textbook of Peritoneal Dialysis. The book is unique in its detailed discussion of a complete range of topics, including new advances in our understanding of the physiology of peritoneal dialysis, peritoneal dialysis kinetics, clinical results and a chapter dealing with the concepts of intraperitoneal chemotherapy. These examples of the dynamic nature of the field further illustrate the importance of this textbook, and make it required reading for everybody working within the field of peritoneal dialysis.
Author: Mauro Pittiruti Publisher: Edra ISBN: 882144399X Category : Medical Languages : en Pages : 316
Book Description
Venous access devices are necessary for any patient requiring repeated blood sampling, parenteral nutrition, chemotherapy, antibiotic therapy or other IV treatments to be delivered in the hospital setting or at home. In the last decade, ultrasound-guided PICCs and Midline catheters – inserted by adequately trained physicians or nurses - have suddenly and widely spread in the field of venous access devices all over the world. The introduction and diffusion of PICCs in Italy has been historically linked to the GAVeCeLT association (the Italian Group of Long Term Venous Access Devices) and particularly to the authors’ scientific and didactic activity. This volume examines the clinical indications for these devices and illustrates the details of their insertion and management in several clinical settings. Furthermore, all the specifications regarding the materials to use and all the aspects related to device removal and replacement, as well as the different strategies for complications prevention, are thoroughly discussed.
Author: Konstantin Nikolaou Publisher: Springer ISBN: 3319425862 Category : Medical Languages : en Pages : 1116
Book Description
The fourth edition of this well-received book offers a comprehensive update on recent developments and trends in the clinical and scientific applications of multislice computed tomography. Following an initial section on the most significant current technical aspects and issues, detailed information is provided on a comprehensive range of diagnostic applications. Imaging of the head and neck, the cardiovascular system, the abdomen, and the lungs is covered in depth, describing the application of multislice CT in a variety of tumors and other pathologies. Emerging fields such as pediatric imaging and CT-guided interventions are fully addressed, and emergency CT is also covered. Radiation exposure, dual-energy imaging, contrast enhancement, image postprocessing, CT perfusion imaging, and CT angiography all receive close attention. The new edition has been comprehensively revised and complemented by contributions from highly experienced and well-known authors who offer diverse perspectives, highlighting the possibilities offered by the most modern multidetector CT systems. This book will be particularly useful for general users of CT systems who wish to upgrade and enhance not only their machines but also their knowledge.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309148057 Category : Medical Languages : en Pages : 506
Book Description
Reducing the intake of sodium is an important public health goal for Americans. Since the 1970s, an array of public health interventions and national dietary guidelines has sought to reduce sodium intake. However, the U.S. population still consumes more sodium than is recommended, placing individuals at risk for diseases related to elevated blood pressure. Strategies to Reduce Sodium Intake in the United States evaluates and makes recommendations about strategies that could be implemented to reduce dietary sodium intake to levels recommended by the Dietary Guidelines for Americans. The book reviews past and ongoing efforts to reduce the sodium content of the food supply and to motivate consumers to change behavior. Based on past lessons learned, the book makes recommendations for future initiatives. It is an excellent resource for federal and state public health officials, the processed food and food service industries, health care professionals, consumer advocacy groups, and academic researchers.
Author: Jay T. Bishoff Publisher: ISBN: Category : Medical Languages : en Pages : 290
Book Description
This atlas delivers the most current laparoscopic approaches for diagnosing and treating kidney, adrenal, ureter, and lymph node diseases. It thoroughly reviews instrumentation and basic techniques, including stapling and suturing options, retraction, electrocautery, coagulation/hemostasis, and more. Step-by-step instructions, accompanied by nearly 400 superb original line drawings*all from the surgeon's perspective*clearly illustrate and explain the critical steps for every operation.
Author: Mathieu Roussin
Author: Mathieu Roussin
Author: G. Krick
Author: Claudio Ronco
Author: Anita E. Molzahn
Author: Walter H. Hörl
Author: R. Gokal
Author: Mauro Pittiruti
Author: Konstantin Nikolaou
Author: Institute of Medicine
Author: Jay T. Bishoff