Vascular Access Surveillance: Current Concepts

Vascular access (VA) remains a major contributing factor to the morbidity and mortality of hemodialysis (HD) patients. More than 30% of the hospitalizations of long term hemodialysis patients in the United States are related to VA and approximately $1 billion is spent annually to manage VA complications. 

A well-functioning VA is a matter of critical importance for the quality of life of these patients and it is strongly associated with adequate dialysis and prolonged technique and patient survival. However, it still remains the Achille's heel of HD.The development of stenosis is the major factor that leads to VA dysfunction and can eventually lead to thrombosis. It is therefore reasonable to devise strategies for early detection of lesions within a VA system before serious complications arise.  Read more>>>>>>>>>>>

Exercise as a Protective Cardiovascular Factor in ESRD Patients

Cardiovascular (CV) Diseases, Chronic Kidney Disease (CKD) and Diabetes are among the main causes of death all over the world. Between 1990 and 2010, the total number of deaths due to CV diseases increased by 25%, while the deaths caused by CKD anddiabetes doubled. 

CKD patients are at high risk of CV diseases, their leading cause of mortality. CKD, this serious and prevalent pathology may be caused by Hypertension (HTA) and diabetes, but at the same time, may lead to secondary HTA, diabetes and/or metabolic syndrome. Although the prevalence of those traditional CV risk factors is elevated (HTA, diabetes, low HDL…) in ESRD (End-Stage Renal Disease) patients, other “nontraditional” CV risk factors have been identified such as: increased Oxidative stress (OS), inflammation, prothrombotic factors, cachexia and malnutrition.  Read more>>>>>>>>>>

Nephrolithiasis Associated Rare Renal Tumors Masquerading Non-Functional Kidney

Nephrolithiasis is a common entity encountered in general population. Nephrolithiasis refers to formation and impaction of stones in renal pelvis and calyces. Long standing stones cause irritation, chronic inflammation and may cause ‘metaplasia’ oflining epithelium. 

The metaplasia is commonly of squamous and glandular epithelium. Metaplastic epithelium may further undergo dysplasia and result in squamous cell carcinoma and adenocarcinoma respectively, both of which are very rare tumors of kidney. Tumors of the renal pelvis are uncommon, with relative frequency of transitional cell carcinoma (90%), squamous cell carcinoma (10%) and adenocarcinoma (1%. Hereby, we report two cases of primary squamous cell carcinoma of renal parenchyma and adenocarcinoma of renal pelvis.   Read more>>>>>>>>>>>>>

Bushfires, not to be Taken Light Heartedly

Ambulance paramedics were called to a 71 year-old woman complaining of severe central chest pressure soon after witnessing a fire burning at the periphery of her property. 

On arrival she appeared anxious and stated that although she had been concerned by the local fires, it wasn’t until she witnessed first-hand a nearby bush fire that she started experiencing the pain. The Early Warning Network issued an Emergency Warning: “There is a fast moving, out of control bushfire travelling in a southerly direction . “Leaving now is the safest option, before conditions become too dangerous. Emergency Services may not be able to help if you decide to stay”. Read more>>>>>>>>>>>>>>

Treatment of Severe Aortic Stenosis

Severe valvular aortic stenosis (AS) is an aortic valve area of less than 1.0 cm2. Anginapectoris, syncope or near syncope, and congestive heart failure (CHF) are the 3 classic manifestations of severe AS. 

 

Patients with symptomatic severe valvular AS have a poor prognosis. Ross and Braunwald found that the average survival rate was 3 years after the onset of angina pectoris in patients with severe AS. Ross and Braunwald reported that the average survival rate after the onset of syncope in patients with severe AS was 3 years. Ross and Braunwald showed that the average survival rate after the onset of CHF in patients with severe AS was 1.5 to 2 years.  Read more>>>>>>>>>>>>>http://www.esciencecentral.org/journals/treatment-of-severe-aortic-stenosis-2329-9517.1000e101.php?aid=10906