WorldWideScience

Sample records for hemodialysis saline solutions

  1. Determination of triazines in hemodialysis saline solutions by adsorptive stripping voltammetry after extraction in acetonitrile

    Directory of Open Access Journals (Sweden)

    Nascimento Paulo Cícero do

    2003-01-01

    Full Text Available A method for the voltammetric determination of 2-methylthio-4,6-dialkylamino-1,3,5-triazine (triazines herbicides in hemodialysis (HD saline solutions was developed. The herbicides were detected in the saline solutions at the hanging mercury drop electrode (HMDE with high sensitivities only after extraction of the analytes in acetonitrile (ACN. The salting out effect originated by the saline environment existing in the solutions enabled the extractions. The volume ratio between the saline and ACN phases was investigated in order to find the best sensitivity to detect the triazines. The speciation amongst them (ametryn, desmetryn, prometryn and terbutryn was not possible. Recoveries between 88 and 107% were calculated in spiked samples, and detection limits of 0.03 mumol L-1 were calculated for the triazines in the saline samples using this methodology.

  2. Analytical Solution of Multicompartment Solute Kinetics for Hemodialysis

    Directory of Open Access Journals (Sweden)

    Przemysław Korohoda

    2013-01-01

    Full Text Available Objective. To provide an exact solution for variable-volume multicompartment kinetic models with linear volume change, and to apply this solution to a 4-compartment diffusion-adjusted regional blood flow model for both urea and creatinine kinetics in hemodialysis. Methods. A matrix-based approach applicable to linear models encompassing any number of compartments is presented. The procedure requires the inversion of a square matrix and the computation of its eigenvalues λ, assuming they are all distinct. This novel approach bypasses the evaluation of the definite integral to solve the inhomogeneous ordinary differential equation. Results. For urea two out of four eigenvalues describing the changes of concentrations in time are about 105 times larger than the other eigenvalues indicating that the 4-compartment model essentially reduces to the 2-compartment regional blood flow model. In case of creatinine, however, the distribution of eigenvalues is more balanced (a factor of 102 between the largest and the smallest eigenvalue indicating that all four compartments contribute to creatinine kinetics in hemodialysis. Interpretation. Apart from providing an exact analytic solution for practical applications such as the identification of relevant model and treatment parameters, the matrix-based approach reveals characteristic details on model symmetry and complexity for different solutes.

  3. COMPARATIVE EFFICACY OF HYPERTONIC SALINE AND NORMAL SALINE SOLUTIONS IN EXPERIMENTALLY INDUCED ENDOTOXIC SHOCK IN DOGS

    Directory of Open Access Journals (Sweden)

    M. A. ZAFAR, G. MUHAMMAD, M. H. HUSSAIN, T. AHMAD, A. YOUSAF AND I. SARFARAZ

    2009-07-01

    Full Text Available This study was contemplated to determine the comparative beneficial effects of hypertonic saline solution and sterile saline solution in induced endotoxic shock in dogs. For this purpose, 12 healthy Mongrel dogs were randomly divided into two equal groups (A and B. All the animals were induced endotoxaemia by slow intravenous administration of Escherichia coli endotoxins 0111:B4. Group A was treated with normal saline solution @ 90 ml/kg BW, while group B was given hypertonic saline solution @ 4 ml/kg BW, followed by normal saline solution @ 10 ml/kg BW. Different parameters were observed for evaluation of these fluids including clinical and haematological parameters, serum electrolytes, mean arterial pressure, and blood gases at different time intervals up to 24 hours post treatments. After infusion of respective fluids, all parameters returned to baseline values in both the groups but group B showed better results than group A except bicarbonates, which better recovered in group A. Thus, it was concluded that a small-volume of hypertonic saline solution could be effectively used in reversing the endotoxaemia. Moreover, it provides a rapid and inexpensive resuscitation from endotoxic shock.

  4. Rapid Resuscitation with Small Volume Hypertonic Saline Solution ...

    African Journals Online (AJOL)

    Rapid Resuscitation with Small Volume Hypertonic Saline Solution for Patients in Traumatic Haemorrhagic Shock. ... The data were entered into a computer data base and analysed. Results: Forty five patients were enrolled and resuscitated with 250 mls 7.5% HSS. Among the studied patients, 88.9% recovered from shock ...

  5. Protein-bound solute removal during extended multipass versus standard hemodialysis

    DEFF Research Database (Denmark)

    Eloot, Sunny; Van Biesen, Wim; Axelsen, Mette

    2015-01-01

    and middle molecules compared to standard hemodialysis (SHD). Since protein-bound solutes (PBS) exert important pathophysiological effects, we investigated whether MPHD results in improved removal of PBS as well. METHODS: A cross-over study (Clinical Trial NCT01267760) was performed in nine stable HD......), hippuric acid (HA), indole acetic acid (IAA), indoxyl sulfate (IS), and p-cresylsulfate (PCS). Dialyser extraction ratio, reduction ratio, and solute removal were calculated for these solutes. RESULTS: Already at 60 min after dialysis start, the extraction ratio in the hemodialyser was a factor 1.4-4 lower...

  6. Solute kinetics with short-daily home hemodialysis using slow dialysate flow rate.

    Science.gov (United States)

    Kohn, Orly F; Coe, Fredric L; Ing, Todd S

    2010-01-01

    "NxStage System One()" is increasingly used for daily home hemodialysis. The ultrapure dialysate volumes are typically between 15 L and 30 L per dialysis, substantially smaller than the volumes used in conventional dialysis. In this study, the impact of the use of low dialysate volumes on the removal rates of solutes of different molecular weights and volumes of distribution was evaluated. Serum measurements before and after dialysis and total dialysate collection were performed over 30 times in 5 functionally anephric patients undergoing short-daily home hemodialysis (6 d/wk) over the course of 8 to 16 months. Measured solutes included beta(2) microglobulin (beta(2)M), phosphorus, urea nitrogen, and potassium. The average spent dialysate volume (dialysate plus ultrafiltrate) was 25.4+/-4.7 L and the dialysis duration was 175+/-15 min. beta(2) microglobulin clearance of the polyethersulfone dialyzer averaged 53+/-14 mL/min. Total beta(2)M recovered in the dialysate was 106+/-42 mg per treatment (n=38). Predialysis serum beta(2)M levels remained stable over the observation period. Phosphorus removal averaged 694+/-343 mg per treatment with a mean predialysis serum phosphorus of 5.2+/-1.8 mg/dL (n=34). Standard Kt/V averaged 2.5+/-0.3 per week and correlated with the dialysate-based weekly Kt/V. Weekly beta(2)M, phosphorus, and urea nitrogen removal in patients dialyzing 6 d/wk with these relatively low dialysate volumes compared favorably with values published for thrice weekly conventional and with short-daily hemodialysis performed with machines using much higher dialysate flow rates. Results of the present study were achieved, however, with an average of 17.5 hours of dialysis per week.

  7. Stability of biodegradable waterborne polyurethane films in buffered saline solutions.

    Science.gov (United States)

    Lin, Ying Yi; Hung, Kun-Che; Hsu, Shan-Hui

    2015-09-21

    The stability of polyurethane (PU) is of critical importance for applications such as in coating industry or as biomaterials. To eliminate the environmental concerns on the synthesis of PU which involves the use of organic solvents, the aqueous-based or waterborne PU (WBPU) has been developed. WBPU, however, may be unstable in an electrolyte-rich environment. In this study, the authors reported the stability of biodegradable WBPU in the buffered saline solutions evaluated by atomic force microscopy (AFM). Various biodegradable WBPU films were prepared by spin coating on coverslip glass, with a thickness of ∼300 nm. The surface AFM images of poly(ε-caprolactone) (PCL) diol-based WBPU revealed nanoglobular structure. The same feature was observed when 20% molar of the PCL diol soft segment was replaced by polyethylene butylenes adipate diol. After hydration in buffered saline solutions for 24 h, the surface domains generally increased in sizes and became irregular in shape. On the other hand, when the soft segment was replaced by 20% poly(l-lactide) diol, a meshlike surface structure was demonstrated by AFM. When the latter WBPU was hydrated, the surface domains appeared to be disconnected. Results from the attenuated total reflectance infrared spectroscopy and x-ray photoelectron spectroscopy indicated that the surface chemistry of WBPU films was altered after hydration. These changes were probably associated with the neutralization of carboxylate by ions in the saline solutions, resulting in the rearrangements of soft and hard segments and causing instability of the WBPU.

  8. [Effect of compound hypertonic saline solution on septic rats].

    Science.gov (United States)

    Dong, Fang; Xu, Liang; Xu, Gang; Wang, Huabing; Lu, Huizhi; Cai, Liping

    2015-01-01

    To study the effect of compound hypertonic saline solution ( HSD ) on sepsis. 133 male Wistar rats were divided into four groups, sham operation group ( n = 15 ), cecal ligation and puncture ( CLP ) group ( n = 45 ), CLP plus normal saline ( NS ) group ( n = 45 ), and CLP plus HSD group ( n = 28 ). A rat model of sepsis was reproduced by CLP, and the rats in sham operation group received celiotomy without ligation and puncture. All rats in four groups received subcutaneous injection of 30 mL/kg 0.9% sodium chloride after laparotomy. The rats in CLP plus NS group and CLP plus HSD group received infusion of 5 mL/kg 0.9% sodium chloride or 7.5% sodium chloride/6% dextran post CLP via jugular vein for 3 hours, with the infusion rate of 0.4 mL×kg(-1)×min(-1). The survival rate of each group was observed 9 hours and 18 hours after laparotomy. Mean arterial pressure ( MAP ) at 0, 9, 18 hours were monitored. Blood specimens were collected from all rats 0, 9 and 18 hours after laparotomy, respectively, for measurement of the plasma levels of tumor necrosis factor-α ( TNF-α), interleukin-1β ( IL-1β ), and procalcitonin ( PCT ). The rats were all sacrificed, and their lung tissues were harvested for the neutrophil count in bronchoalveolar lavage fluid ( BALF ), myeloperoxidase ( MPO ) activity in lung tissue, wet/dry weight ratio ( W/D ) of lung, and pathological changes in lung tissue. There was no death in the sham operation group. The survival rates at 9 hours and 18 hours were 62.2% and 31.1% in the CLP group, 57.8% and 35.6% in the CLP plus NS group, 85.7% and 64.3% in the CLP plus HSD group, and they were all significantly higher compared with those of the CLP group and the CLP plus NS group ( Pmicroscope, no pathobiological changes were found in sham operation group. The lung tissues in the CLP group and the CLP plus NS group showed congestion, edema, infiltrating inflammatory changes, while the inflammatory changes in the lung tissue in the CLP plus HSD group

  9. Theoretical Application of Irreversible (Nonequilibrium) Thermodynamic Principles to Enhance Solute Fluxes across Nanofabricated Hemodialysis Membranes

    Science.gov (United States)

    Hedayat, Assem; Elmoselhi, Hamdi; Shoker, Ahmed

    2012-01-01

    Objective. Nanotechnology has the potential to improve hemodialysis membrane technology. Thus, a major objective is to understand how to enhance toxic solute fluxes across these membranes. The aim of this concept building study is to review the application of irreversible thermodynamic (IT) to solute fluxes. Methods. We expanded the application of the Nernst-Planck equation to include the Kedem-Katchalsky equation, pH, membrane thickness, pore size, and electric potential as variables. Results. (1) Reducing the membrane's thickness from 25 μm to 25 nm increased the flux of creatinine, β2-microglobulin, and tumor necrosis factor-α (TNF-α) by a thousand times but prevented completely albumin flux, (2) applying an electric potential of 50–400 mV across the membrane enhanced the flux of the respective molecules by 71.167 × 10−3, 38.7905 × 10−8, and 0.595 × 10−13 mol/s, and (3) changing the pH from 7.35 to 7.42 altered the fluxes minimally. Conclusions. The results supported an argument to investigate the application of IT to study forces of fluxes across membranes. Reducing the membrane's thickness—together with the application of an electrical potential—qualities achievable by nanotechnology, can enhance the removal of uremic toxins by many folds. However, changing the pH at a specific membrane thickness does not affect the flux significantly. PMID:23209903

  10. Variations in peak nasal inspiratory flow among healthy students after using saline solutions.

    Science.gov (United States)

    Olbrich Neto, Jaime; Olbrich, Sandra Regina Leite Rosa; Mori, Natália Leite Rosa; Oliveira, Ana Elisa de; Corrente, José Eduardo

    2016-01-01

    Nasal hygiene with saline solutions has been shown to relieve congestion, reduce the thickening of the mucus and keep nasal cavity clean and moist. Evaluating whether saline solutions improve nasal inspiratory flow among healthy children. Students between 8 and 11 years of age underwent 6 procedures with saline solutions at different concentrations. The peak nasal inspiratory flow was measured before and 30 min after each procedure. Statistical analysis was performed by means of t test, analysis of variance, and Tukey's test, considering p<0.05. We evaluated 124 children at all stages. There were differences on the way a same concentration was used. There was no difference between 0.9% saline solution and 3% saline solution by using a syringe. The 3% saline solution had higher averages of peak nasal inspiratory flow, but it was not significantly higher than the 0.9% saline solution. It is important to offer various options to patients. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  11. Theoretical Application of Irreversible (Nonequilibrium Thermodynamic Principles to Enhance Solute Fluxes across Nanofabricated Hemodialysis Membranes

    Directory of Open Access Journals (Sweden)

    Assem Hedayat

    2012-01-01

    Full Text Available Objective. Nanotechnology has the potential to improve hemodialysis membrane technology. Thus, a major objective is to understand how to enhance toxic solute fluxes across these membranes. The aim of this concept building study is to review the application of irreversible thermodynamic (IT to solute fluxes. Methods. We expanded the application of the Nernst-Planck equation to include the Kedem-Katchalsky equation, pH, membrane thickness, pore size, and electric potential as variables. Results. (1 Reducing the membrane’s thickness from 25 μm to 25 nm increased the flux of creatinine, β2-microglobulin, and tumor necrosis factor-α (TNF-α by a thousand times but prevented completely albumin flux, (2 applying an electric potential of 50–400 mV across the membrane enhanced the flux of the respective molecules by 71.167 × 10-3, 38.7905 × 10-8, and 0.595 × 10-13 mol/s, and (3 changing the pH from 7.35 to 7.42 altered the fluxes minimally. Conclusions. The results supported an argument to investigate the application of IT to study forces of fluxes across membranes. Reducing the membrane’s thickness—together with the application of an electrical potential—qualities achievable by nanotechnology, can enhance the removal of uremic toxins by many folds. However, changing the pH at a specific membrane thickness does not affect the flux significantly.

  12. Effects of salinity on growth and organic solutes accumulation of ...

    African Journals Online (AJOL)

    2013-03-27

    Mar 27, 2013 ... accumulation on the leaves and stem, and free amino acids in the roots, leaves and stems. Plants showed a ... with soil salinity, which has increased due to excessive fertilization ... The salts effects in plants has been studied, and its must be of ... To adapt and survive in these adverse conditions, the plants ...

  13. Thermodynamic modeling of iodine and selenium retention in solutions with high salinity

    International Nuclear Information System (INIS)

    Hagemann, Sven; Moog, Helge C.; Herbert, Horst-Juergen; Erich, Agathe

    2012-04-01

    The report on iodine and selenium retention in saline solutions includes the following chapters: (1) Introduction and scope of the work. (2) Actual status of knowledge. (3) Experimental and numerical models. (4) Thermodynamic properties of selenite and hydrogen selenite in solutions of oceanic salts. (5) Thermodynamic properties of selenate in solutions of oceanic salts. (6) Thermodynamic properties of iodide in solutions of oceanic salts. (7) Experimental studies on the retention of iodine and selenium in selected sorbents. (8) Summary and conclusions.

  14. Influence of Soil Solution Salinity on Molybdenum Adsorption by Soils

    Science.gov (United States)

    Molybdenum (Mo) adsorption on five arid-zone soils from California was investigated as a function of equilibrium solution Mo concentration (0-30 mg L-1), solution pH (4-8), and electrical conductivity (EC = 0.3 or 8 dS m-1). Molybdenum adsorption decreased with increasing pH. An adsorption maximum...

  15. Investigation of water and saline solution drops evaporation on a solid substrate

    Directory of Open Access Journals (Sweden)

    Orlova Evgenija G.

    2014-01-01

    Full Text Available Experimental investigation water and saline solution drops evaporation on a solid substrate made of anodized aluminum is presented in the paper. Parameters characterizing drop profile have been obtained (contact angle, contact diameter, height. The specific evaporation rate has been calculated from obtained values. It was found that water and saline solution drops with concentration up to 9.1% evaporate in the pinning mode. However, with increasing the salt concentration in the solution up to 16.7% spreading mode was observed. Two stages of drop evaporation depending on change of the evaporation rate have been separated.

  16. Effect of Saline Solution on the Electrical Response of Single Wall Carbon Nanotubes-Epoxy Nanocomposites

    Directory of Open Access Journals (Sweden)

    Hammad Younes

    2017-01-01

    Full Text Available The effects of saline solution on the electrical resistance of single wall carbon nanotubes-epoxy nanocomposites have been investigated experimentally. Ultrasonic assisted fabricated 1.0% and 0.5 W/W% SWCNTs epoxy nanocomposites are integrated into a Kelvin structure by smear cast the nanocomposites on a glass wafer. Four metal pads are deposited on the nanocomposites using the beam evaporator and wires are tethered using soldering. The effect of saline solution on the electrical resistance of the nanocomposites is studied by adding drop of saline solution to the surface of the fabricated nanocomposites and measuring electrical resistance. Moreover, the nanocomposites are soaked completely into 3 wt.% saline solution and real-time measurement of the electrical resistance is conducted. It is found that a drop of saline solution on the surface of the nanocomposites film increases the resistance by 50%. Furthermore, the real-time measurement reveals a 40% increase in the resistance of the nanocomposites film. More importantly, the nanocomposites are successfully reset by soaking in DI water for four hours. This study may open the door for using SWCNTs epoxy nanocomposites as scale sensors in oil and gas industry.

  17. Basics of base in hemodialysis solution: Dialysate buffer production, delivery and decontamination

    Directory of Open Access Journals (Sweden)

    N Desai

    2015-01-01

    Full Text Available Hemodialysis requires the use of high volumes of freshly prepared, clean dialysate to foster the removal of low molecular weight metabolites (i.e., urea and to correct the electrolyte and acid-base imbalance of chronic renal failure. Dialysate is produced by mixing clean, AAMI grade water with both an acid and base concentrate. This purpose of this report is to describe production, mixing and delivery of the buffer component of dialysate, and to also to address the cost, safety and feasibility of producing online bicarbonate. As endotoxin contaminated dialysate has been associated with the release of key mediators in acute and chronic inflammatory diseases associated with long-term hemodialysis therapy, aspects of disinfecting a bicarbonate delivery loop are also addressed.

  18. Analytical steady-state solutions for water-limited cropping systems using saline irrigation water

    Science.gov (United States)

    Skaggs, T. H.; Anderson, R. G.; Corwin, D. L.; Suarez, D. L.

    2014-12-01

    Due to the diminishing availability of good quality water for irrigation, it is increasingly important that irrigation and salinity management tools be able to target submaximal crop yields and support the use of marginal quality waters. In this work, we present a steady-state irrigated systems modeling framework that accounts for reduced plant water uptake due to root zone salinity. Two explicit, closed-form analytical solutions for the root zone solute concentration profile are obtained, corresponding to two alternative functional forms of the uptake reduction function. The solutions express a general relationship between irrigation water salinity, irrigation rate, crop salt tolerance, crop transpiration, and (using standard approximations) crop yield. Example applications are illustrated, including the calculation of irrigation requirements for obtaining targeted submaximal yields, and the generation of crop-water production functions for varying irrigation waters, irrigation rates, and crops. Model predictions are shown to be mostly consistent with existing models and available experimental data. Yet the new solutions possess advantages over available alternatives, including: (i) the solutions were derived from a complete physical-mathematical description of the system, rather than based on an ad hoc formulation; (ii) the analytical solutions are explicit and can be evaluated without iterative techniques; (iii) the solutions permit consideration of two common functional forms of salinity induced reductions in crop water uptake, rather than being tied to one particular representation; and (iv) the utilized modeling framework is compatible with leading transient-state numerical models.

  19. Use of azeotropic distillation for isotopic analysis of deuterium in soil water and saturate saline solution

    International Nuclear Information System (INIS)

    Santos, Antonio Vieira dos.

    1995-05-01

    The azeotropic distillation technique was adapted to extract soil water and saturate saline solution, which is similar to the sea water for the Isotopic Determination of Deuterium (D). A soil test was used to determine the precision and the nature of the methodology to extract soil water for stable isotopic analysis, using the azeotropic distillation and comparing with traditional methodology of heating under vacuum. This methodology has been very useful for several kinds of soil or saturate saline solution. The apparatus does not have a memory effect, and the chemical reagents do not affect the isotopic composition of soil water. (author). 43 refs., 10 figs., 12 tabs

  20. Gas exchange and organic solutes in forage sorghum genotypes grown under different salinity levels

    Directory of Open Access Journals (Sweden)

    Daniela S. Coelho

    Full Text Available ABSTRACT Adaptation of plants to saline environments depends on the activation of mechanisms that minimize the effects of excess ions on vital processes, such as photosynthesis. The objective of this study was to evaluate the leaf gas exchange, chlorophyll, and organic solute in ten genotypes of forage sorghum irrigated with solutions of different salinity levels. The experiment was conducted in a randomized block design, in a 10 x 6 factorial arrangement, with three replications, using ten genotypes - F305, BRS-655, BRS-610, Volumax, 1.015.045, 1.016.005, 1.016.009, 1.016.013, 1.016.015 and 1.016.031 - and six saline solutions, with electrical conductivity (ECw of 0, 2.5, 5.0, 7.5, 10 and 12.5 dS m-1. The photosynthetic activity in forage sorghum plants reduces with increasing salinity, and this response was found in the ten genotypes evaluated. The chlorophyll and protein contents were not affected by salinity, whereas carbohydrates and amino acid contents increased with increasing ECw. Soluble sugars are essential for osmoregulation of forage sorghum due to its high content in leaves.

  1. Finding a solution: Heparinised saline versus normal saline in the maintenance of invasive arterial lines in intensive care.

    Science.gov (United States)

    Everson, Matthew; Webber, Lucy; Penfold, Chris; Shah, Sanjoy; Freshwater-Turner, Dan

    2016-11-01

    We assessed the impact of heparinised saline versus 0.9% normal saline on arterial line patency. Maintaining the patency of arterial lines is essential for obtaining accurate physiological measurements, enabling blood sampling and minimising line replacement. Use of heparinised saline is associated with risks such as thrombocytopenia, haemorrhage and mis-selection. Historical studies draw variable conclusions but suggest that normal saline is at least as effective at maintaining line patency, although recent evidence has questioned this. We conducted a prospective analysis of the use of heparinised saline versus normal saline on unselected patients in the intensive care of our hospital. Data concerning duration of 471 lines insertion and reason for removal was collected. We found a higher risk of blockage for lines flushed with normal saline compared with heparinised saline (RR = 2.15, 95% CI 1.392-3.32, p  ≤ 0.001). Of the 56 lines which blocked initially (19 heparinised saline and 37 normal saline lines), 16 were replaced with new lines; 5 heparinised saline lines and 11 normal saline lines were reinserted; 5 of these lines subsequently blocked again, 3 of which were flushed with normal saline. Our study demonstrates a clinically important reduction in arterial line longevity due to blockages when flushed with normal saline compared to heparinised saline. We have determined that these excess blockages have a significant clinical impact with further lines being inserted after blockage, resulting in increased risks to patients, wasted time and cost of resources. Our findings suggest that the current UK guidance favouring normal saline flushes should be reviewed.

  2. Salinization of the soil solution decreases the further accumulation of salt in the root zone of the halophyte Atriplex nummularia Lindl. growing above shallow saline groundwater.

    Science.gov (United States)

    Alharby, Hesham F; Colmer, Timothy D; Barrett-Lennard, Edward G

    2018-01-01

    Water use by plants in landscapes with shallow saline groundwater may lead to the accumulation of salt in the root zone. We examined the accumulation of Na + and Cl - around the roots of the halophyte Atriplex nummularia Lindl. and the impacts of this increasing salinity for stomatal conductance, water use and growth. Plants were grown in columns filled with a sand-clay mixture and connected at the bottom to reservoirs containing 20, 200 or 400 mM NaCl. At 21 d, Na + and Cl - concentrations in the soil solution were affected by the salinity of the groundwater, height above the water table and the root fresh mass density at various soil depths (P soil solution therefore had a feedback effect on further salinization within the root zone. © 2017 John Wiley & Sons Ltd.

  3. Multislice CT of the liver. Effects of contrast material pushed with saline solution on hepatic enhancement

    International Nuclear Information System (INIS)

    Sekiguchi, Ryuzo; Hayashi, Takayuki; Tsukamoto, Tatsuaki; Kuroki, Yoshinori; Nasu, Katsuhiro; Murakami, Koji; Nawano, Shigeru

    2004-01-01

    The purpose of this study was to evaluate the usefulness of a method of power injection of contrast material pushed with saline solution for hepatic multislice CT using a dual-head power injector. One hundred twenty-one patients who underwent multislice CT to detect liver metastases were divided into two groups, depending on the protocol of contrast material administration: 100 mL of non-ionic contrast material (370 mgI/mL) or 100 mL of the same contrast material pushed with 30 mL of saline solution. Both contrast material and saline solution were administered at a rate of 2.5 mL/sec using a dual-head power injector. Attenuation values for the two protocols were obtained from the liver, portal vein, and descending aorta. Hepatic enhancement above 50 Hounsfield unit (HU), which is needed for the diagnosis of liver metastases, was achieved in 76.5% of patients given 100 mL of contrast material and 92.5% of those given 100 mL of contrast material pushed with a 30 mL saline solution. In contingency-table analysis, the CT attenuation value of liver categorized as less than 50 HU or more than 50 HU, showed a good relation between the categorized group and the protocol (p=0.0437). In patients with a body weight of 50 kg or more, 100 mL of contrast material pushed with saline solution provided significantly better CT attenuation values in the liver (p=0.0113), portal vein (p=0.0094), and descending aorta (p=0.0394) than those provided by the injection of 100 mL of contrast material alone. When contrast material pushed with saline solution was used, CT attenuation values in the liver were significantly increased, especially in patients with a body weight of 50 kg or more. This technique will provide a decrease in the volume of contrast material administered and a potential decrease in the side effects of contrast material. (author)

  4. Plant extracts, metaldehyde and saline solutions on the population control of Bradybaena similaris

    Directory of Open Access Journals (Sweden)

    Junir Antonio Lutinski

    2016-08-01

    Full Text Available ABSTRACT: This study aimed to test the efficiency of plant extracts, metaldehyde and saline solutions, as alternatives to the population control of the snail Bradybaena similaris , and to investigate the effect of the plant extracts in reducing the damage of the snail on Brassica oleracea . The experiments were performed at the Entomology Laboratory of the Universidade Comunitária da Região de Chapecó (Unochapecó, using a random experimental design with nine treatments in triplicate. Five adult individuals of B. similaris were subjected to each trial, totaling 135 snails. The following treatments were tested: cinnamon ( Melia azedarach , timbó ( Ateleia glazioveana , rosemary ( Rosmarinus officinalis , mate herb ( Ilex paraguariensis , two concentrations of metaldehyde (3% and 5%, two concentrations of salt solution (5% and 10 %, and a control treatment (distilled water. To evaluate the survival of B. similaris it was checked the treatments every 24 hours, over four consecutive days. The results revealed that the two concentrations of metaldehyde were fully efficient, that the saline solution (10% had and intermediate efficiency, and that all other treatments were not effective. The treatment with the M. azedarach extract induced a higher consumption of B. oleracea , while the saline solution at 10% and the extracts of R. officinalis and I. paraguariensis inhibited leaf consumption.

  5. Efficacy of mesotherapy using drugs versus normal saline solution in chronic spinal pain: a retrospective study.

    Science.gov (United States)

    Ferrara, Paola E; Ronconi, Gianpaolo; Viscito, Rossella; Pascuzzo, Romina; Rosulescu, Eugenia; Ljoka, Concetta; Maggi, Loredana; Ferriero, Giorgio; Foti, Calogero

    2017-06-01

    Mesotherapy, or intradermal therapy, is a therapeutic approach that is gaining popularity, but there is still a significant lack of information on its mechanisms of action or the pharmacokinetics of the therapeutic regimens. This retrospective study on 220 records compared the short-term and long-term effects of mesotherapy using a mixture of drugs versus normal saline solution in the treatment of patients with chronic spinal pain (CSP). At the end of treatment, outcome measures showed a significant improvement (PMesotherapy was effective in patients affected by CSP, with high patient satisfaction reported irrespective of the agent used. Considering the risks and costs of drugs, normal saline solution appears to be the best agent in cost-benefit terms for treating localized pain by mesotherapy in CSP.

  6. Spatial and temporal variation of repetitive plasma discharges in saline solutions

    International Nuclear Information System (INIS)

    Stalder, K R; Nersisyan, G; Graham, W G

    2006-01-01

    Repetitive plasma discharges developed in saline solutions have been investigated using fast, intensified charge coupled detector imaging techniques. The images show that synchronously pulsed multielectrode configurations tend to develop intense, transient plasma regions somewhat randomly in both space and time on short (10 μs) time scales, even though they appear to be stationary on longer (tens of milliseconds) time scales. Evidence for the production of both strongly ionized and weakly ionized plasmas is also presented

  7. Heparin and albumin as part of the priming solution limits exposure to anticoagulation during hemodialysis: in vitro studies.

    Science.gov (United States)

    Kyrk, Tobias; Bechara, Alex; Skagerlind, Malin; Stegmayr, Bernd

    2014-10-01

    Hemodialysis patients who are subject to increased risk of hemorrhage may need specific dialysis regimes to avoid bleeding. The aim of this study was to determine in vitro which of various anticoagulation options were most beneficial. 60 in vitro hemodialyses (HD) were performed in parallel using blood from healthy donors. The dialysis circuits were rinsed with either 1 L of 0.9% NaCl alone (n = 6), or with 1 L saline and the addition of either 5 mL 20% albumin (Alb, n = 6), 5,000 U of heparin (Hep, n = 6), Hep and Alb in combination (HA, n = 30), 20,000 U of Hep and Alb (4H-A, n = 6), and finally Hep and 20 mL 20% albumin (H-4A, n = 6). The blood was recirculated for a maximum of 192 min. Clotting was graded. A 192 min dialysis was completed with all series of HA, 4H-A, and H-4A, all with a slight grade of clotting. In contrast to the above settings (p = 0.002, Fisher's test), a total clotting of the dialysis circuit occurred for all series using the NaCl rinsing alone (median time to stop: 21, range:18-27 min, p = 0.026 compared to the HA setting) and for the Alb rinsing (median 26, range: 19-35 min, p = 0.028). Priming using HA, Hep, 4H-A, and H-4A reduced clotting and allowed 192 min of HD. Clinical studies need to confirm these data in vivo.

  8. Colloid transport in porous media: impact of hyper-saline solutions.

    Science.gov (United States)

    Magal, Einat; Weisbrod, Noam; Yechieli, Yoseph; Walker, Sharon L; Yakirevich, Alexander

    2011-05-01

    The transport of colloids suspended in natural saline solutions with a wide range of ionic strengths, up to that of Dead Sea brines (10(0.9) M) was explored. Migration of microspheres through saturated sand columns of different sizes was studied in laboratory experiments and simulated with mathematical models. Colloid transport was found to be related to the solution salinity as expected. The relative concentration of colloids at the columns outlet decreased (after 2-3 pore volumes) as the solution ionic strength increased until a critical value was reached (ionic strength > 10(-1.8) M) and then remained constant above this level of salinity. The colloids were found to be mobile even in the extremely saline brines of the Dead Sea. At such high ionic strength no energetic barrier to colloid attachment was presumed to exist and colloid deposition was expected to be a favorable process. However, even at these salinity levels, colloid attachment was not complete and the transport of ∼ 30% of the colloids through the 30-cm long columns was detected. To further explore the deposition of colloids on sand surfaces in Dead Sea brines, transport was studied using 7-cm long columns through which hundreds of pore volumes were introduced. The resulting breakthrough curves exhibited a bimodal shape whereby the relative concentration (C/C(0)) of colloids at the outlet rose to a value of 0.8, and it remained relatively constant (for the ∼ 18 pore volumes during which the colloid suspension was flushed through the column) and then the relative concentration increased to a value of one. The bimodal nature of the breakthrough suggests different rates of colloid attachment. Colloid transport processes were successfully modeled using the limited entrapment model, which assumes that the colloid attachment rate is dependent on the concentration of the attached colloids. Application of this model provided confirmation of the colloid aggregation and their accelerated attachment during

  9. Irrigation solutions in open fractures of the lower extremities: evaluation of isotonic saline and distilled water.

    Science.gov (United States)

    Olufemi, Olukemi Temiloluwa; Adeyeye, Adeolu Ikechukwu

    2017-01-01

    Open fractures are widely considered as orthopaedic emergencies requiring immediate intervention. The initial management of these injuries usually affects the ultimate outcome because open fractures may be associated with significant morbidity. Wound irrigation forms one of the pivotal principles in the treatment of open fractures. The choice of irrigation fluid has since been a source of debate. This study aimed to evaluate and compare the effects of isotonic saline and distilled water as irrigation solutions in the management of open fractures of the lower extremities. Wound infection and wound healing rates using both solutions were evaluated. This was a prospective hospital-based study of 109 patients who presented to the Accident and Emergency department with open lower limb fractures. Approval was sought and obtained from the Ethics Committee of the Hospital. Patients were randomized into either the isotonic saline (NS) or the distilled water (DW) group using a simple ballot technique. Twelve patients were lost to follow-up, while 97 patients were available until conclusion of the study. There were 50 patients in the isotonic saline group and 47 patients in the distilled water group. Forty-one (42.3%) of the patients were in the young and economically productive strata of the population. There was a male preponderance with a 1.7:1 male-to-female ratio. The wound infection rate was 34% in the distilled water group and 44% in the isotonic saline group (p = 0.315). The mean time ± SD to wound healing was 2.7 ± 1.5 weeks in the distilled water group and 3.1 ± 1.8 weeks in the isotonic saline group (p = 0.389). It was concluded from this study that the use of distilled water compares favourably with isotonic saline as an irrigation solution in open fractures of the lower extremities. © The Authors, published by EDP Sciences, 2017.

  10. Irrigation solutions in open fractures of the lower extremities: evaluation of isotonic saline and distilled water

    Directory of Open Access Journals (Sweden)

    Olufemi Olukemi Temiloluwa

    2017-01-01

    Full Text Available Introduction: Open fractures are widely considered as orthopaedic emergencies requiring immediate intervention. The initial management of these injuries usually affects the ultimate outcome because open fractures may be associated with significant morbidity. Wound irrigation forms one of the pivotal principles in the treatment of open fractures. The choice of irrigation fluid has since been a source of debate. This study aimed to evaluate and compare the effects of isotonic saline and distilled water as irrigation solutions in the management of open fractures of the lower extremities. Wound infection and wound healing rates using both solutions were evaluated. Methods: This was a prospective hospital-based study of 109 patients who presented to the Accident and Emergency department with open lower limb fractures. Approval was sought and obtained from the Ethics Committee of the Hospital. Patients were randomized into either the isotonic saline (NS or the distilled water (DW group using a simple ballot technique. Twelve patients were lost to follow-up, while 97 patients were available until conclusion of the study. There were 50 patients in the isotonic saline group and 47 patients in the distilled water group. Results: Forty-one (42.3% of the patients were in the young and economically productive strata of the population. There was a male preponderance with a 1.7:1 male-to-female ratio. The wound infection rate was 34% in the distilled water group and 44% in the isotonic saline group (p = 0.315. The mean time ± SD to wound healing was 2.7 ± 1.5 weeks in the distilled water group and 3.1 ± 1.8 weeks in the isotonic saline group (p = 0.389. Conclusions: It was concluded from this study that the use of distilled water compares favourably with isotonic saline as an irrigation solution in open fractures of the lower extremities.

  11. Metastable beta Ti-Nb-Mo alloys with improved corrosion resistance in saline solution

    International Nuclear Information System (INIS)

    Chelariu, R.; Bolat, G.; Izquierdo, J.; Mareci, D.; Gordin, D.M.; Gloriant, T.; Souto, R.M.

    2014-01-01

    Graphical abstract: - Highlights: • Microstructural and electrochemical characterization of metastable beta Ti-Nb-Mo alloys for biomedical implantation. • Corrosion resistance was established in 0.9 wt% NaCl saline solution at 25 °C using conventional and microelectrochemical techniques. • The materials spontaneously form passivating oxide films on their surface. • Surface films are stable for polarizations more positive than those encountered in the human body. • The addition of niobium to Ti12Mo enhances the capacitive characteristics of the passivating oxide layers. - Abstract: The present study explores the microstructural characteristics and electrochemical responses of four metastable beta Ti-Nb-Mo alloys for biomedical implantation. They were synthesized by the cold crucible levitation melting technique, and compositions were selected to keep the molybdenum equivalency close to 12 wt% Mo eq . For the sake of comparison, Ti12Mo was also investigated. Microstructural characterization reveals that all the alloys are β (body-centred cubic structure), and the surface is composed by β equiaxial grains with dimensions in the range of tens to hundreds μm. The corrosion resistance (potentiodynamic polarization and electrochemical impedance spectroscopy) of the alloys was determined in 0.9 wt% NaCl saline solution at 25 °C. The materials spontaneously form a passivating oxide film on their surface, and they are stable for polarizations up to +1.0 V SCE . No evidence of localized breakdown of the oxide layers is found for polarizations more positive than those encountered in the human body. The passive layers show dielectric characteristics, and the wide frequency ranges displaying capacitive characteristics occur for both higher niobium contents in the alloy and longer exposures to the saline solution. The insulating characteristics of the oxide-covered surfaces were investigated by scanning electrochemical microscopy operated in the feedback mode

  12. Improving tolerance of sunflower and safflower during growth stages to salinity through foliar spray of nutrient solutions

    International Nuclear Information System (INIS)

    Jabeen, N.; Ahmad, R.

    2012-01-01

    The effect of salinity and foliar application of nutrient solutions on sunflower and safflower in vegetative and reproductive phases of the growth were investigated in Bio saline Research Field, University of Karachi, Pakistan. The seeds were sown in pots under non saline condition and saline water irrigation was started at three leaf stage after germination. Different concentration of saline water were made by dissolving 3g and 6g sea salt per litre of tap water, equivalent to an EC of 4.8 and 8.6 dS/m respectively. Nutrient solution (KNO/sub 3 /, H/sub 3/ BO/sub 3/, Fe-EDTA or its mixture) was sprayed thrice, i.e., 45, 75 and 95 days after planting. KNO/sub 3/ was given at the rate 250 ppm and other H/sub 3/ BO/sub 3/ and Fe-EDTA was given at the rate 5 ppm. Salinity caused a significant reduction in nutrient uptake, height, biomass and yield of both sunflower and safflower. Foliar application of macro and micro nutrients (i.e. KNO/sub 3/, H/sub 3/BO/sub 3/, Fe-EDTA and mixture of KNO/sub 3/ + H/sub 3/BO/sub 3/ + Fe-EDTA) partially minimized the salt induced deficiency and showed significant increase in height, fresh and dry biomass, number and weight of seeds, and amount of oil per sunflower and safflower plant irrespective to their growth under non saline or saline conditions. Among the nutrient solutions, mixture of KNO/sub 3/+ H/sub 3/BO/sub 3/ + Fe-EDTA seemed to be the most effective followed by H/sub 3/ BO/sub 3/ and Fe-EDTA. These results suggested that foliar application of nutrients could be used to improve plant tolerance to salinity by alleviating the adverse effects of salinity on growth and reproductive yield. (author)

  13. Investigating effects of hypertonic saline solutions on lipid monolayers at the air-water interface

    KAUST Repository

    Nava Ocampo, Maria F.

    2017-05-01

    More than 70,000 people worldwide suffer from cystic fibrosis, a genetic disease characterized by chronic accumulation of mucus in patients’ lungs provoking bacterial infections, and leading to respiratory failure. An employed age-old treatment to prevent the symptoms of the disease is inhalation of hypertonic saline solution, NaCl at concentrations higher than in the human body (~150 mM). This procedure clears the mucus in the lungs, bringing relief to the patient. However, the biophysical mechanisms underlying this process are not entirely clear. We undertook a new experimental approach to understand the effects of sprayed saline solutions on model lung surfactants towards understanding the mechanisms of the treatment. The surface of lungs contains mainly 1,2-Dipalmitol-sn-glycero-3-phosphocoline (DPPC). As previously assumed by others, we considered that monolayer of DPPC at the air-water interface serves as model system for the lungs surface; we employed a Langmuir-Blodgett (LB) trough and PM-IRRAS to measure surface-specific infrared spectra of the surfactant monolayers and effects on the interfacial tensions. We investigated spraying hyper-saline solutions onto surfactant monolayers at the airwater interface in two parts: (i) validation of our methodology and techniques with stearic acid and (ii) experiments with DPPC monolayers at the air-water interface. Remarkably, when micro-droplets of NaCl were sprayed to the monolayer of stearic acid, we observed enhanced organization of the surfactant, interpreted from the intensities of the CH2 peaks in the surface-specific IR spectra. However, our results with DPPC monolayers didn’t show an effect with the salt added as aerosol, possibly indicating that the experimental methodology proposed is not adequate for the phenomena studied. In parallel, we mimicked respiratory mucous by preparing salt solutions containing 1% (wt%) agar and measured effects on their viscosities. Interestingly, we found that NaCl was much

  14. Investigation of processing effects on the corrosion resistance of Ti20Mo alloy in saline solutions

    International Nuclear Information System (INIS)

    Bolat, G.; Izquierdo, J.; Gloriant, T.; Chelariu, R.; Mareci, D.; Souto, R.M.

    2015-01-01

    Graphical abstract: - Highlights: • Alloy fabrication method affects both surface finish and corrosion resistance. • More porous surface finish and higher wettability produced by powder sintering. • Passive layer formed on sintered alloy breaks down in saline solution. • Increase in surface porosity facilitated electron transfer through the oxide film. • More corrosion resistant alloy produced by cold crucible levitation melting. - Abstract: The electrochemical properties of Ti20Mo alloys prepared using different fabrication procedures, namely cold crucible levitation melting (CCLM) and powder sintering, were investigated using linear potentiodynamic polarization and EIS measurements. The surface condition was established using AFM, with the observation of a more porous surface finish in the case of powder sintering. A major effect of surface conditioning on the corrosion resistance of Ti20Mo alloys was observed, where the compact finish exhibits a superior corrosion resistance in chloride-containing saline solutions. Less insulating surfaces towards electron exchange resulted for the more porous finish as revealed by scanning electrochemical microscopy (SECM)

  15. Using UCST ionic liquid as a draw solute in forward osmosis to treat high-salinity water

    KAUST Repository

    Zhong, Yujiang; Feng, Xiaoshuang; Chen, Wei; Wang, Xinbo; Huang, Kuo-Wei; Gnanou, Yves; Lai, Zhiping

    2015-01-01

    (trifluoromethylsulfonyl)imide ([Hbet][Tf2N]) was obtained by heating and maintaining the temperature above 56°C. This solution successfully drew water from high-salinity water up to 3.0 M through FO. When the IL solution cooled to room temperature, it spontaneously separated into a

  16. The time-dependent development of electric double-layers in saline solutions

    International Nuclear Information System (INIS)

    Morrow, R; McKenzie, D R; Bilek, M M M

    2006-01-01

    We have studied the time-dependent development of electric double-layers (ionic sheaths) in saline solutions by simultaneously solving the sodium and chlorine ion continuity equations coupled with Poisson's equation in one dimension. The study of the effects of time-varying electric fields in solution is relevant to the possible health effect of radio-frequency electric fields on cells in the human body and to assessing the potential of using external electric fields to orient proteins for attachment to surfaces for biosensing applications. Our calculations, for applied voltages of 10-175 mV between the electrode and the solution, predict time scales of ∼0.1-110 μs for the formation of double-layers in solutions of concentration between 0.001 and 1.0 M. We develop an empirical equation that can predict the double-layer formation time to within 10% over this wide parameter range. The method has been validated by comparing the solutions obtained, once the program has run to a steady state, with the standard non-linear Poisson-Boltzmann equations. Excellent agreement is found with the Gouy-Chapman solution of the non-linear Poisson-Boltzmann equation. Thus the method is not restricted in accuracy and applicability as is the case for the linear Poisson-Boltzmann equation. The method can also provide solutions for cases where there are orders of magnitude changes in the ion densities; this has not been the case for previous studies where small perturbation analysis has been employed. The method developed here can readily be extended to two and three dimensions using time-splitting methods

  17. Thermodynamic data for iron (II) in high-saline solutions at temperatures up to 90 C

    Energy Technology Data Exchange (ETDEWEB)

    Munoz, Andres G.; Scharge, Tina; Moog, Helge C.

    2013-12-15

    For natural aqueous systems in general and for the near field of underground nuclear waste repositories in particular thermodynamic properties of iron species and solid phases are of predominant importance. Regardless of the question of the host rock, nuclear waste containment in Germany will be based on massive steel canisters. The total mass of iron present in a repository can be, dependent on the applied variant, sum up to more than 100 000 tons. The overall geochemical milieu including pH and EH will be dominated by the overall abundance of metallic, ferrous, and ferric iron, their aqueous speciation and solid iron-phases. This milieu is imposed on all other equilibria of interest, including those which determine radionuclide solubility. In addition to this, iron bearing corrosion phases due to their shear mass may exhibit a significant sink for radionuclides in terms of incorporation or sorption. As to the evolution of EH it is important to note that application of the Nernst equation requires knowing the electrochemical activities of the involved reactants. Iron is present in aqueous solutions in two oxidation states: +II (ferrous iron) and +III (ferric iron). Ferric iron exhibits a much more complex speciation behavior than ferrous iron, where from a conceptual point of view many species may be neglected. Ferric iron, on the contrary, is subject to considerable complex formation with chloride, sulfate, and - most importantly - with hydroxide. For this reason, experimental and theoretical treatment of ''iron'' at GRS in high saline solutions proceeded along two strings, one for each oxidation state, with the ultimate goal to deliver a thermodynamic model for ''iron'' in high saline solutions.

  18. Home hemodialysis

    DEFF Research Database (Denmark)

    Agar, John W; Perkins, Anthony; Heaf, James G

    2015-01-01

    We describe the infrastructure that is necessary for hemodialysis in the home focusing on physical requirements, the organization of plumbing and water, and the key features that should guide the selection of machines that are suitable for home use.......We describe the infrastructure that is necessary for hemodialysis in the home focusing on physical requirements, the organization of plumbing and water, and the key features that should guide the selection of machines that are suitable for home use....

  19. A new water permeability measurement method for unsaturated tight materials using saline solutions

    International Nuclear Information System (INIS)

    Malinsky, Laurent; Talandier, Jean

    2012-01-01

    Document available in extended abstract form only. Relative water permeability of material in a radioactive waste disposal is a key parameter to simulate and predict saturation state evolution. In this paper we present a new measurement method and the results obtained for Callovo-Oxfordian (Cox) clay-stone, host rock of the underground Andra laboratory at Bure (Meuse/Haute-Marne). Relative water permeability of such a low permeability rock as Cox clay-stone has been measured up to now by an indirect method. It consists in submitting a rock sample to successive relative humidity steps imposed by saline solutions. The transient mass variation during each step and the mass at hydric equilibrium are interpreted generally by using an inverse analysis method. The water relative permeability function of water saturation is derived from water diffusion coefficient evolution and water retention curve. The proposed new method consists in directly measuring the water flux across a flat cylindrical submitted to a relative humidity gradient. Two special cells have been developed. The tightness of the lateral sample surface is insured by crushing a polyurethane ring surrounding the sample set in an aluminium device placed over a Plexiglas vessel filled with a saline solution. One of the cells is designed to allow humidity measurement in the cell. These cells can also be used to measure the relative humidity produced by a saline solution or by an unsaturated material. During a permeability measurement, the cell with the sample to be tested is continuously weighted in a Plexiglas box in which a saline solution imposes a different relative humidity at the upper sample face. The experimental set-up is shown on Figure 1. The mean permeability of the sample is proportional to the rate of mass variation when steady state is reached. The result of one test is shown on Figure 2(a). Twenty four permeability measurements have been performed on four argillite samples of 15 mm in height and

  20. Acid–base and hemodynamic status of patients with intraoperative hemorrhage using two solution types: Crystalloid Ringer lactate and 1.3% sodium bicarbonate in half-normal saline solution

    Directory of Open Access Journals (Sweden)

    Sayed Jalal Hashemi

    2016-01-01

    Conclusion: 1.3% sodium bicarbonate in half-normal saline solution can lead to a proper correction of hemodynamic instability. By maintaining hemodynamic status, osmolarity and electrolytes as well as better balance of acid–base, 1.3% sodium bicarbonate solution in half-normal saline solution can be more effective than Ringer lactate solution during intraoperative bleeding.

  1. Corrosion of tinplate T54S and T61 in humid atmosphere and saline solution

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, X.; Sandenbergh, R.F. [Dept. of Materials Science and Metallurgical Engineering, Univ. of Pretoria (South Africa)

    2001-09-01

    The initial corrosion mechanism and corrosion behaviors of tinplate T54S and T61 were investigated by chemical stripping layer by layer, humid atmosphere exposure, SEM and potentiodynamic method in saline solutions with the addition of a small amount of components simulating foods and tomato sauce. The results show that T54S initially corroded in the form of pitting at the bottom of grease marks on the surface while T61 displayed the initial corrosion along the steel base on the interface of the tin coating and steel, and both were driven by galvanic corrosion between tin coating as a cathode and base steel as an anode. In the solution of 3.5% NaCl, the free corrosion potential from the outer layer to steel base shifted to negative with an addition of 100 ppm HNO{sub 3} but the potential order reversed as HNO{sub 2} replaced HNO{sub 3} at equivalent content. With an addition of 100 ppm NaHS, a high cathodic peak for either the middle or the inner layers was ascribed to the involvement of the reduction of extra hydrogen, i.e. HS{sup -}. T54S displayed a wider anodic passive zone and lower passive current density than T61, which resulted from the effect of the alloy layer. (orig.)

  2. Hypertonic saline solution and high-dose furosemide infusion in cardiorenal syndrome: our experience

    Directory of Open Access Journals (Sweden)

    Francesco Ventrella

    2013-03-01

    Full Text Available Introduction Heart failure is frequently complicated by renal failure, and this association is a negative prognostic factor. These patients sometimes present oligo-/anuria and resistance to high-dose furosemide, a condition referred to as the cardiorenal syndrome (CRS. Acute or chronic reductions in left ventricular function result in decreased blood flow, with reduction of renal perfusion and activation of several neurohormonal systems, which cause resistance to diuretic therapy. This condition often requires ultrafiltration, which is an effective, but invasive and expensive procedure. Infusions of hypertonic saline solution (HSS and high-dose furosemide can be an effective alternative. Materials and methods From November 2009 through May 2010, our team treated 20 patients with CRS and resistance to iv boluses of high-dose furosemide. These patients were treated with small-volume (150-250 mL infusions of HSS (NaCl 1.57 – 4.5%, depending on serum Na values and high-dose furosemide twice a day. The aim of this treatment is to modify renal hemodynamics and the water-saline balance in the kidney by counteracting the extracellular fluid accumulation and eliminating symptoms of congestion. Results In 18 patients (90%, urine output was restored and renal function improved during the first hours of treatment. Clinical improvement was evident from the first day of therapy, and there were no adverse events. Two patients (10% did not respond to the treatment: one (who had been in critical condition since admission died; the other required regular sessions of ultrafiltration. Conclusions HSS combined with high-dose furosemide is a safe, effective, low-cost approach to the treatment of CRS that is resistant to diuretic therapy.

  3. Sodium bicarbonate versus isotonic saline solution to prevent contrast-induced nephropathy : a systematic review and meta-analysis.

    Science.gov (United States)

    Zapata-Chica, Carlos Andres; Bello Marquez, Diana; Serna-Higuita, Lina Maria; Nieto-Ríos, John Fredy; Casas-Arroyave, Fabian David; Donado-Gómez, Jorge Hernando

    2015-09-30

    Contrast-induced nephropathy is one of the main causes of acute kidney injury and increased hospital-acquired morbidity and mortality. The use of sodium bicarbonate for nephroprotection has emerged as a preventative strategy; however, its efficacy is controversial compared to other strategies, such as hydration using 0.9% saline solution. To compare the effectiveness of sodium bicarbonate vs. hydration using 0.9% saline solution to prevent contrast-induced acute kidney injury. A systematic review of studies registered in the COCHRANE, PUBMED, MEDLINE, LILACS, SCIELO and EMBASE databases was conducted. Randomized controlled studies that evaluated the use of 0.9% saline solution vs. sodium bicarbonate to prevent contrast-induced nephropathy were included. A total of 22 studies (5,686 patients) were included. Sodium bicarbonate did not decrease the risk of contrast-induced nephropathy (RD= 0.00; 95% CI= -0.02 to 0.03; p= 0.83; I(2)= 0%). No significant differences were found in the demand for renal replacement therapy (RD= 0.00; 95% CI= -0.01 to 0-01; I(2)= 0%; p= 0.99) or in mortality (RD= -0.00; 95% CI= -0.001 to 0.001; I(2)= 0%; p= 0.51). Sodium bicarbonate administration is not superior to the use of 0.9% saline solution for preventing contrast-induced nephropathy in patients with risk factors, nor is it better at reducing mortality or the need for renal replacement therapy.

  4. Modeling the effects of different irrigation water salinity on soil water movement, uptake and multicomponent solute transport

    Science.gov (United States)

    Lekakis, E. H.; Antonopoulos, V. Z.

    2015-11-01

    Simulation models can be important tools for analyzing and managing irrigation, soil salinization or crop production problems. In this study a mathematical model that describes the water movement and mass transport of individual ions (Ca2+, Mg2+ and Na+) and overall soil salinity by means of the soil solution electrical conductivity, is used. The mass transport equations of Ca2+, Mg2+ and Na+ have been incorporated as part of the integrated model WANISIM and the soil salinity was computed as the sum of individual ions. The model was calibrated and validated against field data, collected during a three year experiment in plots of maize, irrigated with three different irrigation water qualities, at Thessaloniki area in Northern Greece. The model was also used to evaluate salinization and sodification hazards by the use of irrigation water with increasing electrical conductivity of 0.8, 3.2 and 6.4 dS m-1, while maintaining a ratio of Ca2+:Mg2+:Na+ equal to 3:3:2. The qualitative and quantitative procedures for results evaluation showed that there was good agreement between the simulated and measured values of the water content, overall salinity and the concentration of individual soluble cations, at two soil layers (0-35 and 35-75 cm). Nutrient uptake was also taken into account. Locally available irrigation water (ECiw = 0.8 dS m-1) did not cause soil salinization or sodification. On the other hand, irrigation water with ECiw equal to 3.2 and 6.4 dS m-1 caused severe soil salinization, but not sodification. The rainfall water during the winter seasons was not sufficient to leach salts below the soil profile of 110 cm. The modified version of model WANISIM is able to predict the effects of irrigation with saline waters on soil and plant growth and it is suitable for irrigation management in areas with scarce and low quality water resources.

  5. Proteolysis of Sardine (Sardina pilchardus and Anchovy (Stolephorus commersonii by Commercial Enzymes in Saline Solutions

    Directory of Open Access Journals (Sweden)

    Chau Minh Le

    2015-01-01

    Full Text Available Fish sauce production is a very long process and there is a great interest in shortening it. Among the different strategies to speed up this process, the addition of external proteases could be a solution. This study focuses on the eff ect of two commercial enzymes (Protamex and Protex 51FP on the proteolysis of two fish species traditionally converted into fish sauce: sardine and anchovy, by comparison with classical autolysis. Hydrolysis reactions were conducted with fresh fish at a temperature of 30 °C and under different saline conditions (from 0 to 30 % NaCl. Hydrolysis degree and liquefaction of the raw material were used to follow the process. As expected, the proteolysis decreased with increasing amount of salt. Regarding the fi sh species, higher rate of liquefaction and higher hydrolysis degree were obtained with anchovy. Between the two proteases, Protex 51FP gave better results with both fi sh types. This study demonstrates that the addition of commercial proteases could be helpful for the liquefaction of fi sh and cleavage of peptide bonds that occur during fi sh sauce production and thus speed up the production process.

  6. Three-Stream, Bicarbonate-Based Hemodialysis Solution Delivery System Revisited: With an Emphasis on Some Aspects of Acid-Base Principles.

    Science.gov (United States)

    Lew, Susie Q; Kohn, Orly F; Cheng, Yuk-Lun; Kjellstrand, Carl M; Ing, Todd S

    2017-06-01

    Hemodialysis patients can acquire buffer base (i.e., bicarbonate and buffer base equivalents of certain organic anions) from the acid and base concentrates of a three-stream, dual-concentrate, bicarbonate-based, dialysis solution delivery machine. The differences between dialysis fluid concentrate systems containing acetic acid versus sodium diacetate in the amount of potential buffering power were reviewed. Any organic anion such as acetate, citrate, or lactate (unless when combined with hydrogen) delivered to the body has the potential of being converted to bicarbonate. The prescribing physician aware of the role that organic anions in the concentrates can play in providing buffering power to the final dialysis fluid, will have a better knowledge of the amount of bicarbonate and bicarbonate precursors delivered to the patient. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  7. Using UCST ionic liquid as a draw solute in forward osmosis to treat high-salinity water

    KAUST Repository

    Zhong, Yujiang

    2015-12-09

    The concept of using a thermo-responsive ionic liquid (IL) with an upper critical solution temperature (UCST) as a draw solute in forward osmosis (FO) was successfully demonstrated here experimentally. A 3.2 M solution of protonated betaine bis(trifluoromethylsulfonyl)imide ([Hbet][Tf2N]) was obtained by heating and maintaining the temperature above 56°C. This solution successfully drew water from high-salinity water up to 3.0 M through FO. When the IL solution cooled to room temperature, it spontaneously separated into a water-rich phase and an IL-rich phase: the water-rich phase was the produced water that contained a low IL concentration, and the IL-rich phase could be used directly as the draw solution in the next cycle of the FO process. The thermal stability, thermal-responsive solubility and UV-vis absorption spectra of the IL were also studied in detail.

  8. Particles and solutes migration in porous medium : radionuclides and clayey particles simultaneous transport under the effect of a salinity gradient

    International Nuclear Information System (INIS)

    Faure, M.H.

    1994-01-01

    This work deals with the radiation protection of high-level and long-life radioactive waste storages. The colloids presence in ground waters can accelerate the radionuclides migration in natural geological deposits. The aim of this thesis is then to control particularly the particles motion in porous medium in order to anticipate quantitatively their migration. Liquid chromatography columns are filled with a clayey sand and fed with a decreasing concentration sodium chloride solution in order to study the particles outlet under a salinity gradient. When the porous medium undergoes a decrease of salinity it deteriorates. The adsorption of the cations : sodium 22, calcium 45, cesium 137 and neptunium 237 is then studied by the ions exchange method. The radionuclide solution is injected before the decrease of the feed solution salinity. The decrease of the sodium chloride concentration leads to the decrease of the radionuclides concentration because the adsorption competition between the sodium ion and the injected cation is lower. The particles transport, without fouling of the porous medium, is carried out in particular physical and chemical conditions which are described. (O.L.). 71 refs., 105 figs., 26 tabs

  9. Comparison of Outcomes for Normal Saline and an Antiseptic Solution for Negative-Pressure Wound Therapy with Instillation.

    Science.gov (United States)

    Kim, Paul J; Attinger, Christopher E; Oliver, Noah; Garwood, Caitlin; Evans, Karen K; Steinberg, John S; Lavery, Larry A

    2015-11-01

    Negative-pressure wound therapy with instillation is an adjunctive treatment that uses periodic instillation of a solution and negative pressure for a wide diversity of wounds. A variety of solutions have been reported, with topical antiseptics as the most frequently chosen option. The objective of this study was to compare the outcomes of normal saline versus an antiseptic solution for negative-pressure wound therapy with instillation for the adjunctive treatment of infected wounds. This was a prospective, randomized, effectiveness study comparing 0.9% normal saline versus 0.1% polyhexanide plus 0.1% betaine for the adjunctive treatment of infected wounds that required hospital admission and operative débridement. One hundred twenty-three patients were eligible, with 100 patients randomized for the intention-to-treat analysis and 83 patients for the per-protocol analysis. The surrogate outcomes measured were number of operative visits, length of hospital stay, time to final surgical procedure, proportion of closed or covered wounds, and proportion of wounds that remained closed or covered at the 30-day follow-up. There were no statistically significant differences in the demographic profiles in the two cohorts except for a larger proportion of male patients (p = 0.004). There was no statistically significant difference in the surrogate outcomes with the exception of the time to final surgical procedure favoring normal saline (p = 0.038). The authors' results suggest that 0.9% normal saline may be as effective as an antiseptic (0.1% polyhexanide plus 0.1% betaine) for negative-pressure wound therapy with instillation for the adjunctive inpatient management of infected wounds. Therapeutic, II.

  10. Determination of phthalate esters in physiological saline solution by monolithic silica spin column extraction method

    Directory of Open Access Journals (Sweden)

    Lu Lu

    2011-05-01

    Full Text Available Monolithic silica spin column extraction (MonoSpin-SPE was developed as a simple, sensitive, and eco-friendly pretreatment method which combined with ultra-fast liquid chromatography-mass spectrometry (UFLC-MS to determine the levels of six phthalate esters, dimethyl-(DMP, diethyl-(DEP, dipropyl- [DPrP], butyl-benzyl-(BBP, dicyclohexyl(DcHP, and di- n-octyl-(DOP phthalate in physiological saline samples. Under optimized experimental conditions, the method was linear in the following ranges: 0.2- 50 μ/L for DMP, DEP, DPrP, DcHP and DOP; 5 – 100 μ/L for BBP. The correlation coefficients (R2 were in the range of O. 9951 – O. 9995 for all the analytes and the limits of detection (LODs and limits of quantification (LOQs were in the ranges of 0.02 – 0.9 μ/L and 0.08 – 2.7 μ/L, respectively. The pretreatment process showed good reproducibility with inter-day and intra-day relative standard deviations (RSDs below 8.5% and 11.2%, respectively. This method was used to determine the levels of six phthalate esters in physiological saline samples and the recoveries ranged from 71.2% to 107. 3%. DMP and DEP were found in actual physical saline samples (brand A and brand B. Keywords: Monolithic silica spin column, Phthalate esters, Physiological saline samples, Ultra fast liquid chromatographymass spectrometry (UFLC-MS

  11. Energy Recovery from Solutions with Different Salinities Based on Swelling and Shrinking of Hydrogels

    KAUST Repository

    Zhu, Xiuping

    2014-06-17

    Several technologies, including pressure-retarded osmosis (PRO), reverse electrodialysis (RED), and capacitive mixing (CapMix), are being developed to recover energy from salinity gradients. Here, we present a new approach to capture salinity gradient energy based on the expansion and contraction properties of poly(acrylic acid) hydrogels. These materials swell in fresh water and shrink in salt water, and thus the expansion can be used to capture energy through mechanical processes. In tests with 0.36 g of hydrogel particles 300 to 600 μm in diameter, 124 mJ of energy was recovered in 1 h (salinity ratio of 100, external load of 210 g, water flow rate of 1 mL/min). Although these energy recovery rates were relatively lower than those typically obtained using PRO, RED, or CapMix, the costs of hydrogels are much lower than those of membranes used in PRO and RED. In addition, fouling might be more easily controlled as the particles can be easily removed from the reactor for cleaning. Further development of the technology and testing of a wider range of conditions should lead to improved energy recoveries and performance. © 2014 American Chemical Society.

  12. Energy Recovery from Solutions with Different Salinities Based on Swelling and Shrinking of Hydrogels

    KAUST Repository

    Zhu, Xiuping; Yang, Wulin; Hatzell, Marta C.; Logan, Bruce E.

    2014-01-01

    Several technologies, including pressure-retarded osmosis (PRO), reverse electrodialysis (RED), and capacitive mixing (CapMix), are being developed to recover energy from salinity gradients. Here, we present a new approach to capture salinity gradient energy based on the expansion and contraction properties of poly(acrylic acid) hydrogels. These materials swell in fresh water and shrink in salt water, and thus the expansion can be used to capture energy through mechanical processes. In tests with 0.36 g of hydrogel particles 300 to 600 μm in diameter, 124 mJ of energy was recovered in 1 h (salinity ratio of 100, external load of 210 g, water flow rate of 1 mL/min). Although these energy recovery rates were relatively lower than those typically obtained using PRO, RED, or CapMix, the costs of hydrogels are much lower than those of membranes used in PRO and RED. In addition, fouling might be more easily controlled as the particles can be easily removed from the reactor for cleaning. Further development of the technology and testing of a wider range of conditions should lead to improved energy recoveries and performance. © 2014 American Chemical Society.

  13. Intravenous hypertonic saline solution (7.5%) and oral electrolytes to treat of calves with noninfectious diarrhea and metabolic acidosis.

    Science.gov (United States)

    Leal, M L R; Fialho, S S; Cyrillo, F C; Bertagnon, H G; Ortolani, E L; Benesi, F J

    2012-01-01

    The aim of this study was to compare the efficacy of treating osmotic diarrhea and dehydration in calves with hypertonic saline solution (HSS) IV, isotonic electrolyte solution (IES) PO, and a combination of these 2 solutions (HSS + IES). Eighteen male calves 8-30 days of age were used to evaluate the efficacy of 3 methods of fluid therapy after induction of osmotic diarrhea and dehydration. The diarrhea and dehydration were induced by administration of saccharose, spironolactone, and hydrochlorothiazide for 48 hours. The animals were randomly divided into 3 experimental groups: Group 1: 7.2% hypertonic saline solution-HSS (5 mL/kg IV); Group 2: oral isotonic electrolyte solution IES (60 mL/kg PO); or Group 3: HSS+IES. Clinical signs and laboratory finding observed 48 hours post-induction (Time 0) included diarrhea, dehydration, lethargy, and metabolic acidosis. Calves treated with HSS + IES experienced decreases in hematocrit, total protein concentration, albumin concentration, urea nitrogen concentration, and plasma volume as well as increases in blood pH, blood bicarbonate concentration, and central venous pressure between 1 and 3 hours post-treatment. These findings also were observed in animals treated with IES, however, at a slower rate than in the HSS + IES-treated animals. Animals treated with HSS continued to display signs of dehydration, lethargy, and metabolic acidosis 24 hours post-treatment. Treatment with a combination of HSS and IES produced rapid and sustainable correction of hypovolemia and metabolic acidosis in calves with noninfections diarrhea and dehydration. Copyright © 2012 by the American College of Veterinary Internal Medicine.

  14. Performance of Potassium Bicarbonate and Calcium Chloride Draw Solutions for Desalination of Saline Water Using Forward Osmosis

    Directory of Open Access Journals (Sweden)

    M. Nematzadeh

    2015-01-01

    Full Text Available Forward osmosis (FO has recently drawn attention as a promising membrane based method for seawater and brackish water desalination. In this study, we focus on the use of calciun chloride (CaCl2 and potassium bicarbonate (KHCO3 as inorganic salt draw solution candidates due to their appropriate performance in water flux and reverse salt diffusion as well as reasonable cost. The experiments were carried at 25 °C and cross-flow rate of 3 L min−1.  At the same osmotic pressure, the water flux of CaCl2 draw solution tested against deionized feed water, showed 20% higher permeation than KHCO3, which it was attributed to the lower internal concentration polarization (ICP. The reverse diffusion of CaCl2 was found higher than KHCO3 solution which it would be related to the smaller ionic size and the higher permeation of this salt through the membrane. The water flux for both draw solutions against 0.33 M NaCl feed solution was about 2.8 times lower than deionized feed water because of ICP. Higher concentrations of draw solution is required for increasing the water permeation from saline water feed towards the draw side.

  15. Proteomic Investigations into Hemodialysis Therapy

    Directory of Open Access Journals (Sweden)

    Mario Bonomini

    2015-12-01

    Full Text Available The retention of a number of solutes that may cause adverse biochemical/biological effects, called uremic toxins, characterizes uremic syndrome. Uremia therapy is based on renal replacement therapy, hemodialysis being the most commonly used modality. The membrane contained in the hemodialyzer represents the ultimate determinant of the success and quality of hemodialysis therapy. Membrane’s performance can be evaluated in terms of removal efficiency for unwanted solutes and excess fluid, and minimization of negative interactions between the membrane material and blood components that define the membrane’s bio(incompatibility. Given the high concentration of plasma proteins and the complexity of structural functional relationships of this class of molecules, the performance of a membrane is highly influenced by its interaction with the plasma protein repertoire. Proteomic investigations have been increasingly applied to describe the protein uremic milieu, to compare the blood purification efficiency of different dialyzer membranes or different extracorporeal techniques, and to evaluate the adsorption of plasma proteins onto hemodialysis membranes. In this article, we aim to highlight investigations in the hemodialysis setting making use of recent developments in proteomic technologies. Examples are presented of why proteomics may be helpful to nephrology and may possibly affect future directions in renal research.

  16. Proteomic Investigations into Hemodialysis Therapy

    Science.gov (United States)

    Bonomini, Mario; Sirolli, Vittorio; Pieroni, Luisa; Felaco, Paolo; Amoroso, Luigi; Urbani, Andrea

    2015-01-01

    The retention of a number of solutes that may cause adverse biochemical/biological effects, called uremic toxins, characterizes uremic syndrome. Uremia therapy is based on renal replacement therapy, hemodialysis being the most commonly used modality. The membrane contained in the hemodialyzer represents the ultimate determinant of the success and quality of hemodialysis therapy. Membrane’s performance can be evaluated in terms of removal efficiency for unwanted solutes and excess fluid, and minimization of negative interactions between the membrane material and blood components that define the membrane’s bio(in)compatibility. Given the high concentration of plasma proteins and the complexity of structural functional relationships of this class of molecules, the performance of a membrane is highly influenced by its interaction with the plasma protein repertoire. Proteomic investigations have been increasingly applied to describe the protein uremic milieu, to compare the blood purification efficiency of different dialyzer membranes or different extracorporeal techniques, and to evaluate the adsorption of plasma proteins onto hemodialysis membranes. In this article, we aim to highlight investigations in the hemodialysis setting making use of recent developments in proteomic technologies. Examples are presented of why proteomics may be helpful to nephrology and may possibly affect future directions in renal research. PMID:26690416

  17. Hemodialysis-related headache.

    Science.gov (United States)

    Sav, Murat Yusuf; Sav, Tansu; Senocak, Elif; Sav, Nadide Melike

    2014-10-01

    Headache is one of the most frequently encountered neurological symptoms during hemodialysis. According to International Classification of Headache criteria dialysis-related headache was defined as the headache occurring during hemodialysis with no specific characteristic. It resolves spontaneously within 72 hours after the hemodialysis session ends. There are few studies in the literature investigating the clinical features of dialysis headache. The pathophysiology of hemodialysis-related headache is not known, but various triggering factors have been identified, including changes in blood pressure, serum sodium and magnesium levels during hemodialysis sessions, caffeine deprivation and stress. The aim of this article is to evaluate and analyze features of headache in patients undergoing hemodialysis. © 2014 International Society for Hemodialysis.

  18. Hypertonic saline solution reduces the oxidative stress responses in traumatic brain injury patients

    Directory of Open Access Journals (Sweden)

    Mojtaba Mojtahedzadeh

    2014-01-01

    Full Text Available Background: Oxidative stress processes play an important role in the pathogenesis of secondary brain injury after traumatic brain injury (TBI. Hypertonic saline (HTS has advantages as being preferred osmotic agent, but few studies investigated oxidant and antioxidant effects of HTS in TBI. This study was designed to compare two different regimens of HTS 5% with mannitol on TBI-induced oxidative stress. Materials and Methods: Thirty-three adult patients with TBI were recruited and have randomly received one of the three protocols: 125 cc of HTS 5% every 6 h as bolus, 500 cc of HTS 5%as infusion for 24 h or 1 g/kg mannitol of 20% as a bolus, repeated with a dose of 0.25-0.5 g/kg every 6 h based on patient′s response for 3 days. Serum total antioxidant power (TAP, reactive oxygen species (ROS and nitric oxide (NO were measured at baseline and daily for 3 days. Results: Initial serum ROS and NO levels in patients were higher than control(6.86± [3.2] vs. 1.57± [0.5] picoM, P = 0.001, 14.6± [1.6] vs. 7.8± [3.9] mM, P = 0.001, respectively. Levels of ROS have decreased for all patients, but reduction was significantly after HTS infusion and mannitol (3. 08 [±3.1] to 1.07 [±1.6], P = 0.001, 5.6 [±3.4] to 2.5 [±1.8], P = 0.003 respectively. During study, NO levels significantly decreased in HTS infusion but significantly increased in mannitol. TAP Levels had decreased in all patients during study especially in mannitol (P = 0.004. Conclusion: Hypertonic saline 5% has significant effects on the oxidant responses compared to mannitol following TBI that makes HTS as a perfect therapeutic intervention for reducing unfavorable outcomes in TBI patients.

  19. Plasmas in saline solutions sustained using rectified ac voltages: polarity and frequency effects on the discharge behaviour

    International Nuclear Information System (INIS)

    Chang Hungwen; Hsu Chengche

    2012-01-01

    In this work, three major problems, namely severe electrode damage, poor plasma stability and excess power consumption, arising in ac-driven plasmas in saline solutions are solved using a rectified power source. Diagnostic studies on the effects of power source polarity and frequency on the plasma behaviour are performed. Examination of I-V characteristics and temporally resolved light emission shows that the polarity significantly influences the current amplitude when the plasma exists, while the frequency alters the bubble dynamics, which in turn affects the plasma ignition voltage. When the plasma is driven by a rectified ac power source, the electrode erosion is reduced substantially. With a low frequency, moderate applied voltage and positively rectified ac power source (e.g. 100 Hz and 350 V), a stable plasma is ignited in nearly every power cycle. (paper)

  20. Corrosion Of Stainless Steel With A Laser Bar Code In A Saline Solution

    OpenAIRE

    Domingues S.R.; Proenca M.B.; Ierardi M.C.F.; Freire C.M.A.

    1996-01-01

    The corrosion of stainless steel AISI 304 L plates marked by laser beam fusion is studied. The electrochemical experiments are carried out in 3.5% NaCl water solution. Electrochemical curves are obtained by potentiodynamic method. Sample surfaces are also examined by scanning electron microscopy. The changes of corrosion resistance after laser treatment are insignificant.

  1. The Effect of Potassium Concentration in Nutrient Solution on Lycopene, Vitamin C and Qualitative Characteristics of Cherry Tomato in Saline Conditions

    Directory of Open Access Journals (Sweden)

    E. Shabani Sangtarashani

    2013-06-01

    Full Text Available Potassium (K has a special place in improving the quality of agricultural products. To evaluate the effect of K concentration in nutrient solution on lycopene content, vitamin C and qualitative characteristics of cherry tomato in NaCl salinity conditions, an experiment was carried out as a completely randomized design with five treatments and three replications at university of Tabriz, Tabriz, Iran, in 2010. Treatments consisted of four concentrations of K (0.2, 2, 7 and 14 mM in nutrient solution with 60 mM NaCl concentration. A nutrient solution treatment without salinity was considered as control. The experiment was conducted in greenhouse, in a hydroponic system. The results indicated that increasing of K concentration increased lycopene content in fruit. Lycopene content in control treatment showed significant difference (P<0.01 in comparison with salinity treatments. With increasing the K concentration (except at 14 mM concentration, vitamin C content was increased, but indicated no statistically significant difference. Vitamin C content in saline conditions was more than control treatment, but showed no significant difference. Adding potassium concentration in nutrient solution improved yield and enhanced quality parameters such as percentage of dry matter, soluble solids and electrical conductivity of fruit extract. Since in saline conditions, the qualitative characteristics of tomato at 7 mM concentration were in the best situation, therefore using this concentration is recommended.

  2. Short-term dissolution experiments on various cement formulations in standard Canadian shield saline solution in the presence of clay

    International Nuclear Information System (INIS)

    Heimann, R.B.; Stanchell, M.A.T.

    1986-12-01

    A commercially available sulphate-resisting portland cement (SRPC) and three cement formulations derived from it by adding 10 and 20 vol% silica fume or 35 vol% fly-ash have been leached in Standard Canadian Shield Saline Solution (SCSSS) with added calcium-montmorillonite or sodium-montmorillonite at 150 degrees C for 14 days. The leach solutions have been analyzed by atomic absorption spectroscopy for silicon, magensium, iron and potassium, and by inductively coupled plasma spectrometry for aluminum and phosphorous. The surfaces of the leached samples have been investigated by scanning electron microscopy in conjunction with energy-dispersive X-ray spectroscopy, and by X-ray powder diffraction methods. Cumulative pore size distrubtion curves have been recorded for as-cured and leached cement samples. It has been shown that the presence of clay accelerates the rate of dissolution of the various cements, and that the pH of the leaching solutions plays a dominant role in the elemental release kinetics

  3. Particle and solute migration in porous media. Modeling of simultaneous transport of clay particles and radionuclides in a salinity gradient

    International Nuclear Information System (INIS)

    Faure, M.H.

    1994-03-01

    Understanding the mechanisms which control the transient transport of particles and radionuclides in natural and artificial porous media is a key problem for the assessment of safety of radioactive waste disposals. An experimental study has been performed to characterize the clayey particle mobility in porous media: a laboratory- made column, packed with an unconsolidated sand bentonite (5% weight) sample, is flushed with a salt solution. An original method of salinity gradient allowed us to show and to quantify some typical behaviours of this system: threshold effects in the peptization of particles, creation of preferential pathways, formation of immobile water zones induce solute-transfer limitation. The mathematical modelling accounts for a phenomenological law, where the distribution of particles between the stagnant water zone and the porous medium is a function of sodium chloride concentration. This distribution function is associated with a radionuclide adsorption model, and is included in a convective dispersive transport model with stagnant water zones. It allowed us to simulate the particle and solute transport when the salt environment is modified. The complete model has been validated with experiments involving cesium, calcium and neptunium in a sodium chloride gradient. (author). refs., figs., tabs

  4. Interactions between globular proteins and F-actin in isotonic saline solution.

    Science.gov (United States)

    Lakatos, S; Minton, A P

    1991-10-05

    Solutions of each of three different globular proteins (cytochrome c, chromophorically labeled serum albumin, and chromophorically labeled aldolase), mixed with another unlabeled globular protein or with fibrous actin, were prepared in pH 8.0 Tris-HCl buffer containing 0.15 M NaCl. Each solution was centrifuged at low speed, at 5 degrees C, until unassociated globular protein in solution achieved sedimentation equilibrium. Individual absorbance gradients of both macrosolutes in the mixtures subsequent to centrifugation were obtained via optical scans of the centrifuge tubes at two wavelengths. The gradients of each macrosolute in mixtures of two globular proteins revealed no association of globular proteins under the conditions of these experiments, but perturbation of the gradients of serum albumin, aldolase, and cytochrome c in the presence of F-actin indicated association of all three globular proteins with F-actin. Perturbation of actin gradients in the presence of serum albumin and aldolase suggested partial depolymerization of the F-actin by the globular protein. Analysis of the data with a simple phenomenological model relating free globular protein, bound globular protein, and total actin concentration provided estimates of the respective equilibrium constants for association of serum albumin and aldolase with F-actin, under the conditions of these experiments, of the order of 0.1 microM-1.

  5. Evaluating the effect of administrating hypertonic and isotonic saline solutions on clinical improvement, serum electrolyte concentrations and renal function of calves affected by diarrhea

    Directory of Open Access Journals (Sweden)

    A Hasanpour

    2009-11-01

    This study was conducted on 40 calves under the age of one mouth with 30 calves affected by diarrhea allocated to 3 treatment groups of 10 calves each and the control group consisting of 10 calves. The control group received neither treatment nor any injections. In the first treatment group, only antibiotics were administered without any fluid therapy. In the second treatment group, apart from antibiotic therapy of diarrhea, hypertonic saline solution (7.5% was administered at a dose of 5 ml/kg as slow intravenous infusion alongside oral ORS solution whereas in the third treatment group isotonic saline solution (0.9% was given intravenously according to the formula (Body weight × %Dehydration alongside oral ORS solution. In all groups, clinical examination and blood sampling was undertaken at times 0, 1, 2, 8 and 24 hours following treatment. At time 0, the diarrhea had resulted in clinical and laboratory signs such as a fever, the dehydration, tachycardia, oligopnea, increased packed sell volume, hypernatremia, hyperchloremia, hyperkalemia, hyperphosphatemia, hypercalcemia, increased serum creatinine and BUN values. Following treatment, fever subsided and the dehydration was corrected and this correction occurred faster in calves which had received hypertonic saline solution. Correction of sodium, potassium, chloride, phosphorus and calsium imbalance occurred faster in patients which were treated by hypertonic solution. Fluid therapy with saline solutions prevented the increase in serum creatinine and BUN values. In conclusion, the administration of hypertonic saline solutions leads to much faster and more reliable clinical improvement and electrolyte imbalance correction in calves affected by diarrhea.

  6. Behavior of gellan in aqueous-salt solutions and oilfield saline water

    Directory of Open Access Journals (Sweden)

    Zhanar Nurakhmetova

    2015-09-01

    Full Text Available The influence of storage time and temperature on the behavior of low acyl gellan (LAG was studied by viscometry and 1H NMR spectroscopy without salt addition. The viscometric results revealed that the effectiveness of salts to enhance gelation of gellan changes in the following order: BaСl2>CaCl2»MgCl2>KCl>NaCl. The sol-gel and liquid-solid phase transitions of gellan solutions were observed upon addition of oilfield water containing 73 g L-1 of alkaline and alkaline earth metal ions. The effectiveness of salts to induce the separation of liquid and solid phases changes in the sequence: NaCl>KCl>MgCl2»CaCl2»BaСl2. The hydrodynamic behavior of 0.5 wt.% gellan solution injected into the sand pack model with high (20 Darcy and lower (2 Darcy permeability is useful to model the oil reservoirs in the process of enhanced oil recovery.

  7. Hydrothermal carbonization of glucose in saline solution: sequestration of nutrients on carbonaceous materials

    Directory of Open Access Journals (Sweden)

    Jessica Nover

    2016-02-01

    Full Text Available In this study, feasibility of selected nutrient sequestration during hydrothermal carbonization (HTC was tested for three different HTC temperatures (180, 230, and 300 °C. To study the nutrient sequestration in solid from liquid solution, sugar and salt solutions were chosen as HTC feedstock. Glucose was used as carbohydrate source and various salts e.g., ammonium hydrophosphate, potassium chloride, potassium sulfate, and anhydrous ferric chloride were used as source of nitrogen and phosphorus, potassium, and iron, respectively. Solid hydrochar was extensively characterized by means of elemental, ICP-OES, SEM-EDX, surface area, pore volume and size, and ATR-FTIR to determine nutrients’ sequestration as well as hydrochar quality variation with HTC temperatures. The spherical mesoporous hydrochars produced during HTC have low surface area in the range of 1.0–3.5 m2 g−1. Hydrochar yield was increased about 10% with the increase of temperature from 180 °C to 300 °C. Nutrient sequestration was also increased with HTC temperature. In fact, around 71, 31, and 23 wt% nitrogen, iron, and phosphorus were sequestered at 300 °C, respectively. Potassium sequestration was very low throughout the HTC and maximum 5.2% was observed in solid during HTC.

  8. Analytical Solution for Interface Flow to a Sink With an Upconed Saline Water Lens: Strack's Regimes Revisited

    Science.gov (United States)

    Kacimov, A. R.; Obnosov, Y. V.

    2018-01-01

    A study is made of a steady, two-dimensional groundwater flow with a horizontal well (drain), which pumps out freshwater from an aquifer sandwiched between a horizontal bedrock and ponded soil surface, and containing a lens-shaped static volume of a heavier saline water (DNAPL-dense nonaqueous phase liquid) as a free surface. For flow toward a line sink, an explicit analytical solution is obtained by a conformal mapping of the hexagon in the complex potential plane onto a reference plane and the Keldysh-Sedov integral representation of a mixed boundary-value problem for a complex physical coordinate. The interface is found as a function of the pumping rate, the well locus, the ratio of liquid densities, and the hydraulic heads at the soil surface and in the well. The shape with two inflexion points and fronts varies from a small-thickness bedrock-spread pancake to a critical curvilinear triangle, which cusps toward the sink. The problem is mathematically solvable in a relatively narrow band of geometric and hydraulic parameters. A similar analytic solution for a static heavy bubble confined by a closed-curve interface (no contact with the bedrock) is outlined as an illustration of the method to solve a mixed boundary-value problem.

  9. Corrosion behaviour of 8090 alloy in saline solution with moderate aggressiveness

    International Nuclear Information System (INIS)

    Conde, A.; Damborenea, J.J.

    1998-01-01

    Corrosion studies of Al-Li alloys are not so extensive and concentrate almost exclusively on atmospheric exposure tests and accelerated laboratory tests due to the fact they provide a reasonable approximation to the real behaviour of the alloy in service conditions. This paper attempts to establish a correlation between the evolution of the impedance diagrams and the process of the attack undergone by a commercial 8090 T8171 alloy, with the aim of establishing the kinetics of the corrosion process. After 100 h of immersion, samples showed only a slight intergranular attack. As a results of the low aggressiveness of the solution no major deviations from the ideal behaviour described by the Randles circuit are expected in the impedance plots. After 50 hours of testing, the impedance diagram evolves towards two semicircles which seem to be related with the charge transfer and ionic migration through the oxide layer and the adsorption of electrolyte anions. (Author) 7 refs

  10. Interaction Mechanisms between Air Bubble and Molybdenite Surface: Impact of Solution Salinity and Polymer Adsorption.

    Science.gov (United States)

    Xie, Lei; Wang, Jingyi; Yuan, Duowei; Shi, Chen; Cui, Xin; Zhang, Hao; Liu, Qi; Liu, Qingxia; Zeng, Hongbo

    2017-03-07

    The surface characteristics of molybdenite (MoS 2 ) such as wettability and surface interactions have attracted much research interest in a wide range of engineering applications, such as froth flotation. In this work, a bubble probe atomic force microscope (AFM) technique was employed to directly measure the interaction forces between an air bubble and molybdenite mineral surface before/after polymer (i.e., guar gum) adsorption treatment. The AFM imaging showed that the polymer coverage on the surface of molybdenite could achieve ∼5.6, ∼44.5, and ∼100% after conditioning in 1, 5, and 10 ppm polymer solution, respectively, which coincided with the polymer coverage results based on contact angle measurements. The electrolyte concentration and surface treatment by polymer adsorption were found to significantly affect bubble-mineral interaction and attachment. The experimental force results on bubble-molybdenite (without polymer treatment) agreed well with the calculations using a theoretical model based on the Reynolds lubrication theory and augmented Young-Laplace equation including the effect of disjoining pressure. The overall surface repulsion was enhanced when the NaCl concentration decreased from 100 to 1 mM, which inhibited the bubble-molybdenite attachment. After conditioning the molybdenite surface in 1 ppm polymer solution, it was more difficult for air bubbles to attach to the molybdenite surface due to the weakened hydrophobic interaction with a shorter decay length. Increasing the polymer concentration to 5 ppm effectively inhibited bubble attachment on mineral surface, which was mainly due to the much reduced hydrophobic interaction as well as the additional steric repulsion between the extended polymer chains and bubble surface. The results provide quantitative information on the interaction mechanism between air bubbles and molybdenite mineral surfaces on the nanoscale, with useful implications for the development of effective polymer

  11. Combined radiofrequency ablation and acetic acid-hypertonic saline solution instillation: an in vivo study of rabbit liver

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong-Min; Han, Joon-Koo; Kim, Se-Hyung; Choi, Byung-Ihn [Seoul National University, Seoul (Korea, Republic of); Kim, Young-Kon; Kim, Sang-Won [Chonbuk National University, Chonju (Korea, Republic of)

    2004-03-15

    We wanted to determine whether combined radiofrequency ablation (RFA) and acetic acid-hypertonic saline solution (AHS) instillation can increase the extent of thermally mediated coagulation in in vivo rabbit liver tissue. We also wished to determine the optimal concentration of the solution in order to maximize its effect on extent of the RFA-induced coagulation. Forty thermal ablation zones were produced in 40 rabbits by using a 17-gauge internally cooled electrode with a 1-cm active tip under ultrasound guidance. The rabbits were assigned to one of four groups: group A: RFA alone (n=10); group B: RFA with 50% AHS instillation (n=10); group C: RFA with 25% AHS instillation (n=10); group D: RFA with 15% AHS instillation (n=10). A range of acetic acid concentrations diluted in 36% NaCl to a total volume of 2 mL were instilled into the liver before RFA. The RF energy (30W) was applied for three minutes. After RFA, in each group, the maximum diameters to the thermal ablation zones in the gross specimens were compared. Technical success and the complication that arose were evaluated by CT and on the basis of autopsy findings. All procedures are technically successful. There were six procedure-related complications (6/40; 15%); two localized perihepatic hematomas and four chemical peritonitis. The incidence of chemical peritonitis was highest for group B with the 50% AHS solution instillation (30%). With instillation of 15% AHS solution, a marked decrease of tissue impedance (24.5 {+-} 15.6 {omega}) and an increase of current (250 mA) occurred as compared to RFA alone. With instillation of the solutions before RFA (group B, C and D). this produced a greater mean diameter of coagulation necrosis than the diameters for rabbits not instilled with the solution (group A) ({rho}<0.05). However, there was no significant difference between group B, C, and D. Combined AHS instillation and RFA can increase the dimension of coagulation necrosis in the liver with a single

  12. Influence of saline solution on hydration behavior of β-dicalcium silicate in comparison with biphasic calcium phosphate/hydroxyapatite bio-ceramics

    Energy Technology Data Exchange (ETDEWEB)

    Radwan, M.M., E-mail: mmahmoudradwan@yahoo.com [Ceramics Dept, National Research Centre, Cairo (Egypt); Abd El-Hamid, H.K. [Ceramics Dept, National Research Centre, Cairo (Egypt); Mohamed, A.F. [The Holding Company for Production of Vaccines, Sera and Drugs (EGYVAC) (Egypt)

    2015-12-01

    The influence of using saline solution as mixing and curing liquid on some characteristics of β-dicalcium silicate (β-C{sub 2}S) and biphasic compound tri-calcium phosphate/hydroxyapatite (TCP/HAp) bio-ceramics was investigated. β-C{sub 2}S (27–30 nm) was prepared by solid state reaction at 1450 °C, while biphasic compound TCP/HAp (7–15 nm) was synthesized from an aqueous solution of Ca(NO{sub 3}){sub 2}·4H{sub 2}O and (NH{sub 4}){sub 2}HPO{sub 4}·12H{sub 2}O by chemical precipitation method. Setting times, compressive strength, pH values, X-ray diffraction analysis, infrared spectroscopy, scanning electron microscopy (SEM) were investigated. The evaluation of cytotoxicity of both calcium silicate and biphasic compounds to human gingival fibroblasts was carried out. The use of saline solution as mixing and immersing liquid shortened the setting time for the two bio-cements. TCP/HAp did not show any mechanical strength but β-C{sub 2}S showed good strength values. Both synthesized compounds showed a moderate cytotoxicity and both materials were effective in a no significant way. - Highlights: • The dissolution and hydration of β-C{sub 2}S and TCP/HAp in distilled water and saline solution were studied. • TCP/HAp did not show mechanical strength, while β-C{sub 2}S showed good mechanical strength. • The use of saline solution did enhances the dissolution & hydration rate. • An increase in pH values was detected when using saline solution. • Both materials showed a moderate cytotoxicity in no significant way.

  13. Effects of Hypertonic Saline Solution on Clinical Parameters, Serum Electrolytes and Plasma Volume in the Treatment of Haemorrhagic Septicaemia in Buffaloes

    Directory of Open Access Journals (Sweden)

    M. Arif Zafar*, G. Muhammad, Zafar Iqbal1 and M. Riaz2

    2010-04-01

    Full Text Available This study was conducted to determine the efficacy of hypertonic saline solution (HSS along with antibiotic (ceftiofur HCl and non-steroidal anti-inflammatory drug (ketoprofen in the treatment of haemorrhagic septicaemia in buffaloes. For this purpose, 50 buffaloes suffering from haemorrhagic septicaemia were randomly divided in two equal groups A and B. Group A served as control and was treated with ceftiofur HCl (IM and ketoprofen (IV @ 6 and 2 mg/Kg BW, respectively, for five days. Buffaloes of group B were administered with rapid intravenous infusion of hypertonic saline solution (7.5% NaCl @ 4 ml/Kg BW once in combination with ceftiofur HCl and ketoprofen. Animals were monitored for 24 hours after initiation of treatment. Clinical parameters, serum electrolytes, plasma volume and survival index were recorded at different intervals after treatment. Survival rate (80% in group B was significantly higher (P<0.05 than 48% in group A. The heart rate and respiration rate recovered more effectively in the buffaloes administered with treatment protocol B. Plasma volume was 98% which was almost normal within 24 hours after the infusion of hypertonic saline solution to the animals of group B. It was concluded from the study that hypertonic saline solution as an adjunct to antibiotic and a non-steroidal anti-inflammatory drug more efficiently improved respiration and heart rates and effectively restored plasma volume in resuscitating the buffaloes from haemorrhagic septicaemia than the conventional treatment.

  14. Transient photoresponse of nitrogen-doped ultrananocrystalline diamond electrodes in saline solution

    Energy Technology Data Exchange (ETDEWEB)

    Ahnood, Arman, E-mail: arman.ahnood@unimelb.edu.au; Ganesan, Kumaravelu; Stacey, Alastair; Prawer, Steven [School of Physics, University of Melbourne, Melbourne, Victoria 3010 (Australia); Simonov, Alexandr N.; Spiccia, Leone [School of Chemistry and the ARC Centre of Excellence for Electromaterials Science, Monash University, Melbourne, Victoria 3800 (Australia); Laird, Jamie S. [CSIRO, Minerals Resources Flagship, School of Physics, University of Melbourne, Melbourne, Victoria 3010 (Australia); Maturana, Matias I. [National Vision Research Institute, Australian College of Optometry, Carlton, Victoria 3053 (Australia); NeuroEngineering Laboratory, Department of Electrical and Electronic Engineering, University of Melbourne, Parkville, Victoria 3010 (Australia); Ibbotson, Michael R. [National Vision Research Institute, Australian College of Optometry, Carlton, Victoria 3053 (Australia); ARC Centre of Excellence for Integrative Brain Function, Department of Optometry and Vision Sciences, University of Melbourne, Parkville, Victoria 3010 (Australia)

    2016-03-07

    Beyond conventional electrically-driven neuronal stimulation methods, there is a growing interest in optically-driven approaches. In recent years, nitrogen-doped ultrananocrystalline diamond (N-UNCD) has emerged as a strong material candidate for use in electrically-driven stimulation electrodes. This work investigates the electrochemical activity of N-UNCD in response to pulsed illumination, to assess its potential for use as an optically-driven stimulation electrode. Whilst N-UNCD in the as-grown state exhibits a weak photoresponse, the oxygen plasma treated film exhibits two orders of magnitude enhancement in its sub-bandgap open circuit photovoltage response. The enhancement is attributed to the formation of a dense network of oxygen-terminated diamond nanocrystals at the N-UNCD surface. Electrically connected to the N-UNCD bulk via sub-surface graphitic grain boundaries, these diamond nanocrystals introduce a semiconducting barrier between the sub-surface graphitic semimetal and the electrolyte solution, leading to a photovoltage under irradiation with wavelengths of λ = 450 nm and shorter. Within the safe optical exposure limit of 2 mW mm{sup −2}, charge injection capacity of 0.01 mC cm{sup −2} is achieved using a 15 × 15 μm electrode, meeting the requirements for extracellular and intercellular stimulation. The nanoscale nature of processes presented here along with the diamond's biocompatibility and biostability open an avenue for the use of oxygen treated N-UNCD as optically driven stimulating electrodes.

  15. Transient photoresponse of nitrogen-doped ultrananocrystalline diamond electrodes in saline solution

    International Nuclear Information System (INIS)

    Ahnood, Arman; Ganesan, Kumaravelu; Stacey, Alastair; Prawer, Steven; Simonov, Alexandr N.; Spiccia, Leone; Laird, Jamie S.; Maturana, Matias I.; Ibbotson, Michael R.

    2016-01-01

    Beyond conventional electrically-driven neuronal stimulation methods, there is a growing interest in optically-driven approaches. In recent years, nitrogen-doped ultrananocrystalline diamond (N-UNCD) has emerged as a strong material candidate for use in electrically-driven stimulation electrodes. This work investigates the electrochemical activity of N-UNCD in response to pulsed illumination, to assess its potential for use as an optically-driven stimulation electrode. Whilst N-UNCD in the as-grown state exhibits a weak photoresponse, the oxygen plasma treated film exhibits two orders of magnitude enhancement in its sub-bandgap open circuit photovoltage response. The enhancement is attributed to the formation of a dense network of oxygen-terminated diamond nanocrystals at the N-UNCD surface. Electrically connected to the N-UNCD bulk via sub-surface graphitic grain boundaries, these diamond nanocrystals introduce a semiconducting barrier between the sub-surface graphitic semimetal and the electrolyte solution, leading to a photovoltage under irradiation with wavelengths of λ = 450 nm and shorter. Within the safe optical exposure limit of 2 mW mm"−"2, charge injection capacity of 0.01 mC cm"−"2 is achieved using a 15 × 15 μm electrode, meeting the requirements for extracellular and intercellular stimulation. The nanoscale nature of processes presented here along with the diamond's biocompatibility and biostability open an avenue for the use of oxygen treated N-UNCD as optically driven stimulating electrodes.

  16. Exploring Poly(ethylene glycol-Polyzwitterion Diblock Copolymers as Biocompatible Smart Macrosurfactants Featuring UCST-Phase Behavior in Normal Saline Solution

    Directory of Open Access Journals (Sweden)

    Noverra M. Nizardo

    2018-03-01

    Full Text Available Nonionic-zwitterionic diblock copolymers are designed to feature a coil-to-globule collapse transition with an upper critical solution temperature (UCST in aqueous media, including physiological saline solution. The block copolymers that combine presumably highly biocompatible blocks are synthesized by chain extension of a poly(ethylene glycol (PEG macroinitiator via atom transfer radical polymerization (ATRP of sulfobetaine and sulfabetaine methacrylates. Their thermoresponsive behavior is studied by variable temperature turbidimetry and 1H NMR spectroscopy. While the polymers with polysulfobetaine blocks exhibit phase transitions in the physiologically interesting window of 30–50 °C only in pure aqueous solution, the polymers bearing polysulfabetaine blocks enabled phase transitions only in physiological saline solution. By copolymerizing a pair of structurally closely related sulfo- and sulfabetaine monomers, thermoresponsive behavior can be implemented in aqueous solutions of both low and high salinity. Surprisingly, the presence of the PEG blocks can affect the UCST-transitions of the polyzwitterions notably. In specific cases, this results in “schizophrenic” thermoresponsive behavior displaying simultaneously an UCST and an LCST (lower critical solution temperature transition. Exploratory experiments on the UCST-transition triggered the encapsulation and release of various solvatochromic fluorescent dyes as model “cargos” failed, apparently due to the poor affinity even of charged organic compounds to the collapsed state of the polyzwitterions.

  17. Acid-base and hemodynamic status of patients with intraoperative hemorrhage using two solution types: Crystalloid Ringer lactate and 1.3% sodium bicarbonate in half-normal saline solution.

    Science.gov (United States)

    Hashemi, Sayed Jalal; Heidari, Sayed Morteza; Yaraghi, Ahmad; Seirafi, Reza

    2016-01-01

    Intraoperative hemorrhage is one of the problems during surgery and, if it happens in a high volume without an immediate action to control, it can be fatal. Nowadays, various injectable solutions are used. The aim of this study was to compare the acid-base and hemodynamic status of the patient using two solutions, Ringer lactate and 1.3% sodium bicarbonate, in half saline solution. This clinical trial was performed at the Al-Zahra Hospital in 2013 on 66 patients who were randomly selected and put in two studied groups at the onset of hemorrhage. For the first group, crystalloid Ringer lactate solution and for the second group, 1.3% sodium bicarbonate in half-normal saline solution was used. Electrocardiogram, heart rate, O2 saturation non-invasive blood pressure and end-tidal CO2 were monitored. The arterial blood gas, blood electrolytes, glucose and blood urea nitrogen were measured before serum and blood injection. After the infusion of solutions and before blood transfusions, another sample was sent for measurement of blood parameters. Data were analyzed using SPSS software. The mean arterial pressure was significantly higher in the second group than in the first group at some times after the infusion of solutions. pHh levels, base excess, bicarbonate, sodium, strong ion differences and osmolarity were significantly greater and potassium and chloride were significantly lower in the second group than in the first group after the infusion of solutions. 1.3% sodium bicarbonate in half-normal saline solution can lead to a proper correction of hemodynamic instability. By maintaining hemodynamic status, osmolarity and electrolytes as well as better balance of acid-base, 1.3% sodium bicarbonate solution in half-normal saline solution can be more effective than Ringer lactate solution during intraoperative bleeding.

  18. Diagnostic studies of ac-driven plasmas in saline solutions: the effect of frequency on the plasma behavior

    International Nuclear Information System (INIS)

    Chang, Hung-wen; Hsu, Cheng-che

    2011-01-01

    The effect of frequency on the characteristics of plasmas in saline solution driven by 50-1000 Hz ac power is studied. Two distinct modes, namely bubble and jetting modes, are identified. The bubble mode occurs under low frequencies. In this mode, a millimeter-sized bubble is tightly attached to the electrode tip and oscillates with the applied voltage. With an increase in frequency, it shows the jetting mode, in which bubbles, hundreds of micometers in diameter, are continuously formed and jetted away from the electrode surface. Such a significant change in the bubble behavior influences the power input at a given applied voltage and significantly affects the plasma behavior. In spite of the fact that no significant difference is seen in the optical emission spectra, the broadening of the H β peak shows that the bubble mode has a lower electron density than that of the jetting mode. The temporally resolved optical emission intensities show light emission in the negative half of the power period regardless of the modes. This shows clearly that the driving frequency significantly influences the bubble dynamics, which in turn alters the plasma behavior.

  19. Reverse osmosis, the solution for producing steam from highly saline water; Osmosis inversa, la solucion para la produccion de vapor con aguas de alta salinidad

    Energy Technology Data Exchange (ETDEWEB)

    Pujadas, A.

    2003-07-01

    Based on an exhaustive description of a particular example, the costs of installing an implementing various water treatment solutions for feeding a steam boiler are examined. When the characteristics of the water available indicate that it has a high saline content, i is possible to demonstrate the enormous technical, economic and environmental advantages of reducing its saline level by a system of reverse osmosis compared to the classical ion exchange resins. A list is given of the features to be taken into account in defining the equipment involved in treating the water for feeding steam boilers. (Author)

  20. Groundwater flow and solute transport at the Mourquong saline-water disposal basin, Murray Basin, southeastern Australia

    Science.gov (United States)

    Simmons, Craig; Narayan, Kumar; Woods, Juliette; Herczeg, Andrew

    2002-03-01

    Saline groundwater and drainage effluent from irrigation are commonly stored in some 200 natural and artificial saline-water disposal basins throughout the Murray-Darling Basin of Australia. Their impact on underlying aquifers and the River Murray, one of Australia's major water supplies, is of serious concern. In one such scheme, saline groundwater is pumped into Lake Mourquong, a natural groundwater discharge complex. The disposal basin is hydrodynamically restricted by low-permeability lacustrine clays, but there are vulnerable areas in the southeast where the clay is apparently missing. The extent of vertical and lateral leakage of basin brines and the processes controlling their migration are examined using (1) analyses of chloride and stable isotopes of water (2H/1H and 18O/16O) to infer mixing between regional groundwater and lake water, and (2) the variable-density groundwater flow and solute-transport code SUTRA. Hydrochemical results indicate that evaporated disposal water has moved at least 100 m in an easterly direction and that there is negligible movement of brines in a southerly direction towards the River Murray. The model is used to consider various management scenarios. Salt-load movement to the River Murray was highest in a "worst-case" scenario with irrigation employed between the basin and the River Murray. Present-day operating conditions lead to little, if any, direct movement of brine from the basin into the river. Résumé. Les eaux souterraines salées et les effluents de drainage de l'irrigation sont stockés dans environ 200 bassins naturels ou artificiels destinés à retenir les eaux salines dans tout le bassin de Murray-Darling, en Australie. Leur impact sur les aquifères sous-jacents et sur la rivière Murray, l'une des principales ressources en eau d'Australie, constitue un problème grave. Dans une telle situation, les eaux souterraines salines sont pompées dans le lac Mourquong, complexe dans lequel les nappes se d

  1. Hemodialysis and water quality.

    Science.gov (United States)

    Coulliette, Angela D; Arduino, Matthew J

    2013-01-01

    Over 383,900 individuals in the U.S. undergo maintenance hemodialysis that exposes them to water, primarily in the form of dialysate. The quality of water and associated dialysis solutions have been implicated in adverse patient outcomes and is therefore critical. The Association for the Advancement of Medical Instrumentation has published both standards and recommended practices that address both water and the dialyzing solutions. Some of these recommendations have been adopted into Federal Regulations by the Centers for Medicare and Medicaid Services as part of the Conditions for Coverage, which includes limits on specific contaminants within water used for dialysis, dialysate, and substitution fluids. Chemical, bacterial, and endotoxin contaminants are health threats to dialysis patients, as shown by the continued episodic nature of outbreaks since the 1960s causing at least 592 cases and 16 deaths in the U.S. The importance of the dialysis water distribution system, current standards and recommendations, acceptable monitoring methods, a review of chemical, bacterial, and endotoxin outbreaks, and infection control programs are discussed. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  2. Salinization and Saline Environments

    Science.gov (United States)

    Vengosh, A.

    2003-12-01

    One of the most conspicuous phenomena of water-quality degradation, particularly in arid and semi-arid zones, is salinization of water and soil resources. Salinization is a long-term phenomenon, and during the last century many aquifers and river basins have become unsuitable for human consumption owing to high levels of salinity. Future exploitation of thousands of wells in the Middle East and in many other water-scarce regions in the world depends, to a large extent, on the degree and rate of salinization. Moreover, every year a large fraction of agricultural land is salinized and becomes unusable.Salinization is a global environmental phenomenon that affects many different aspects of our life (Williams, 2001a, b): changing the chemical composition of natural water resources (lakes, rivers, and groundwater), degrading the quality of water supply to the domestic and agriculture sectors, contribution to loss of biodiversity, taxonomic replacement by halotolerant species ( Williams, 2001a, b), loss of fertile soil, collapse of agricultural and fishery industries, changing of local climatic conditions, and creating severe health problems (e.g., the Aral Basin). The damage due to salinity in the Colorado River Basin alone, for example, ranges between 500 and 750 million per year and could exceed 1 billion per year if the salinity in the Imperial Dam increases from 700 mg L-1 to 900 mg L-1 (Bureau of Reclamation, 2003, USA). In Australia, accelerating soil salinization has become a massive environmental and economic disaster. Western Australia is "losing an area equal to one football oval an hour" due to spreading salinity ( Murphy, 1999). The annual cost for dryland salinity in Australia is estimated as AU700 million for lost land and AU$130 million for lost production ( Williams et al., 2002). In short, the salinization process has become pervasive.Salinity in water is usually defined by the chloride content (mg L-1) or total dissolved solids content (TDS, mg L-1or g

  3. Usefulness of underwater endoscopic submucosal dissection in saline solution with a monopolar knife for colorectal tumors (with videos).

    Science.gov (United States)

    Nagata, Mitsuru

    2018-05-01

    Generally, colorectal endoscopic submucosal dissection (ESD) is performed with a monopolar knife with CO 2 supply from an endoscope. There are few case reports about underwater ESD (UESD) in saline solution with a bipolar knife. The usefulness and safety of UESD in saline solution with a monopolar knife are unclear. The present study aimed to investigate the usefulness and safety of UESD in saline solution with a monopolar knife for colorectal tumors. This retrospective, observational study on UESD for colorectal tumors included 26 colorectal tumors from 24 patients treated with UESD at our department between October 2015 and February 2017. The characteristics of patients, factors associated with ESD difficulty, treatment results, and variations in blood test data before and after UESD were analyzed. En bloc resection was successful in all lesions without any serious adverse events. The median major diameter of the resected specimens was 30 mm (interquartile range [IQR], 28-35) and of the tumor 22.5 mm (IQR, 17.8-25.3). The median procedure time was 60 minutes (IQR, 45-111) and median speed of dissection 10.4 mm 2 /min (IQR, 6.4-12.2). No cases of perforation occurred. Post-ESD bleeding occurred in only 1 case, and endoscopic hemostasis was achieved. There was no case of electrolyte imbalance requiring treatment after UESD. UESD in saline solution with a monopolar knife for colorectal tumors is useful and safe. UESD has potential advantages that should be further assessed. Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  4. Experimental alteration of R7T7 nuclear model glass in solutions with different salinities (90/sup 0/C, 1 bar): implications for the selection of geological repositories

    Energy Technology Data Exchange (ETDEWEB)

    Godon, N.; Thomassin, J.H.; Touray, J.C.; Vernaz, E.

    1988-01-01

    In order to simulate the leaching of nuclear wastes in repositories percolated by solutions of variable salinity, leaching tests of R7T7 glass in solutions with different NaCl contents have been performed at 90/sup 0/C and 1 bar using a static procedure. A comparison of the efficiency of the different leachants indicated that the alteration was maximum in pure water and in 23.7 g (NaCl) kg/sup -1/ solution. In deionized water, uranium- and rare-earth elements simulating the actinides were found quite immobile: they have not been detected in solution but are present in the alteration layer. On the other hand, in the 23.7 g (NaCl) kg/sup -1/ solution, high amounts of uranium, cerium and neodymium have been detected in solution and did not accumulate in the solid phases. In the highest salinity brines, the bulk reactivity of the glass decreased. In all leachants, the alteration layer was structured in two parts: hydrated glass and flakes. The flakes were mainly nickel-and zinc-bearing aluminosilicate phases. When crystallized, the flakes were identified as berthierine.

  5. Development of techniques and models for the determination of redox potentials of saline solutions; Entwicklung von Methoden und Modellen zur Bestimmung des Redoxpotentials salinarer Loesungen

    Energy Technology Data Exchange (ETDEWEB)

    Hagemann, Sven; Bischofer, Barbara; Scharge, Tina; Schoenwiese, Dagmar

    2014-03-15

    The mobility of radionuclides and heavy metals in aqueous systems depends significantly on their oxidation state. Under saline conditions the measurement of pH values and redox potential are distorted/falsified by solution-specific and hardly assessable ion diffusion effects at the reference electrode. The secure prognosis of redox properties is an essential prerequisite for the calculation of the expected heavy metal and radionuclide concentrations in case of a hypothetical solution ingress in an underground disposal facility. The evaluation of the existing data base shows that there are large uncertainties even for the solubility of widespread oxides and oxy-hydroxides like goethite or hematite. The redox properties of natural systems are determined by the solubility of metastable ferrous intermediate products like ferrihydrite, ''green rust'' or jarosite. The work is aimed to establish a consistent data base with information on these phases and ferrous solute species.

  6. Development of techniques and models for the determination of redox potentials of saline solutions; Entwicklung von Methoden und Modellen zur Bestimmung des Redoxpotentials salinarer Loesungen

    Energy Technology Data Exchange (ETDEWEB)

    Hagemann, Sven; Bischofer, Barbara; Scharge, Tina; Schoenwiese, Dagmar

    2014-03-15

    The mobility of radionuclides and heavy metals in aqueous systems depends significantly on their oxidation state. Under saline conditions the measurement of pH values and redox potential are distorted/falsified by solution-specific and hardly assessable ion diffusion effects at the reference electrode. The secure prognosis of redox properties is an essential prerequisite for the calculation of the expected heavy metal and radionuclide concentrations in case of a hypothetical solution ingress in an underground disposal facility. The evaluation of the existing data base shows that there are large uncertainties even for the solubility of widespread oxides and oxy-hydroxides like goethite or hematite. The redox properties of natural systems are determined by the solubility of metastable ferrous intermediate products like ferrihydrite, ''green rust'' or jarosite. The work is aimed to establish a consistent data base with information on these phases and ferrous solute species.

  7. Diffusive Silicon Nanopore Membranes for Hemodialysis Applications.

    Directory of Open Access Journals (Sweden)

    Steven Kim

    Full Text Available Hemodialysis using hollow-fiber membranes provides life-sustaining treatment for nearly 2 million patients worldwide with end stage renal disease (ESRD. However, patients on hemodialysis have worse long-term outcomes compared to kidney transplant or other chronic illnesses. Additionally, the underlying membrane technology of polymer hollow-fiber membranes has not fundamentally changed in over four decades. Therefore, we have proposed a fundamentally different approach using microelectromechanical systems (MEMS fabrication techniques to create thin-flat sheets of silicon-based membranes for implantable or portable hemodialysis applications. The silicon nanopore membranes (SNM have biomimetic slit-pore geometry and uniform pores size distribution that allow for exceptional permeability and selectivity. A quantitative diffusion model identified structural limits to diffusive solute transport and motivated a new microfabrication technique to create SNM with enhanced diffusive transport. We performed in vitro testing and extracorporeal testing in pigs on prototype membranes with an effective surface area of 2.52 cm2 and 2.02 cm2, respectively. The diffusive clearance was a two-fold improvement in with the new microfabrication technique and was consistent with our mathematical model. These results establish the feasibility of using SNM for hemodialysis applications with additional scale-up.

  8. Diffusive Silicon Nanopore Membranes for Hemodialysis Applications

    Science.gov (United States)

    Kim, Steven; Feinberg, Benjamin; Kant, Rishi; Chui, Benjamin; Goldman, Ken; Park, Jaehyun; Moses, Willieford; Blaha, Charles; Iqbal, Zohora; Chow, Clarence; Wright, Nathan; Fissell, William H.; Zydney, Andrew; Roy, Shuvo

    2016-01-01

    Hemodialysis using hollow-fiber membranes provides life-sustaining treatment for nearly 2 million patients worldwide with end stage renal disease (ESRD). However, patients on hemodialysis have worse long-term outcomes compared to kidney transplant or other chronic illnesses. Additionally, the underlying membrane technology of polymer hollow-fiber membranes has not fundamentally changed in over four decades. Therefore, we have proposed a fundamentally different approach using microelectromechanical systems (MEMS) fabrication techniques to create thin-flat sheets of silicon-based membranes for implantable or portable hemodialysis applications. The silicon nanopore membranes (SNM) have biomimetic slit-pore geometry and uniform pores size distribution that allow for exceptional permeability and selectivity. A quantitative diffusion model identified structural limits to diffusive solute transport and motivated a new microfabrication technique to create SNM with enhanced diffusive transport. We performed in vitro testing and extracorporeal testing in pigs on prototype membranes with an effective surface area of 2.52 cm2 and 2.02 cm2, respectively. The diffusive clearance was a two-fold improvement in with the new microfabrication technique and was consistent with our mathematical model. These results establish the feasibility of using SNM for hemodialysis applications with additional scale-up. PMID:27438878

  9. High-spatial-resolution isotropic three-dimensional fast-recovery fast spin-echo magnetic resonance dacryocystography combined with topical administration of sterile saline solution

    International Nuclear Information System (INIS)

    Jing, Zhang; Lang, Chen; Qiu-Xia, Wang; Rong, Liu; Xin, Luo; Wen-Zhen, Zhu; Li-Ming, Xia; Jian-Pin, Qi; He, Wang

    2013-01-01

    Objective: This study aims to investigate the clinical performance of three-dimensional (3D) fast-recovery fast spin-echo (FRFSE) magnetic resonance dacryocystography (MRD) with topical administration of sterile saline solution for the assessment of the lacrimal drainage system (LDS). Methods: A total of 13 healthy volunteers underwent both 3D-FRFSE MRD and two-dimensional (2D)-impulse recovery (IR)-single-shot fast spin-echo (SSFSE) MRD after topical administration of sterile saline solution, and 31 patients affected by primary LDS outflow impairment or postsurgical recurrent epiphora underwent 3D-FRFSE MRD and conventional T1- and T2-weighted sequences. All patients underwent lacrimal endoscopy or surgery, which served as a standard of reference for confirming the MRD findings. Results: 3D-FRFSE MRD detected more visualized superior and inferior canaliculi and nasolacrimal duct than 2D-IR-SSFSE MRD. Compared with 2D-IR-SSFSE MRD, 3D-FRFSE MRD showed more visualized segments per LDS, although the difference was not statistically significant. Significant improvements in the inferior canaliculus and nasolacrimal duct visibility grades were achieved using 3D-FRFSE MRD. 3D-FRFSE MRD had 100% sensitivity and 63.6% specificity for detecting LDS obstruction. In 51 out of the 62 LDSs that were assessed, a 90% agreement was noted between the findings of 3D-FRFSE MRD and lacrimal endoscopy in detecting the obstruction level. Conclusion: 3D-FRFSE MRD combined with topical administration of sterile saline solution is a simple and noninvasive method of obtaining detailed morphological and functional information on the LDS. Overall, 3D-FRFSE MRD could be used as a reliable diagnostic method in many patients with epiphora prior to surgery

  10. Frequent hemodialysis in children.

    Science.gov (United States)

    Warady, Bradley A; Fischbach, Michel; Geary, Denis; Goldstein, Stuart L

    2007-07-01

    Frequent hemodialysis is currently conducted in a limited number of pediatric dialysis centers. However, the preliminary experience with children who have undergone procedures such as "daily" intensive hemodiafiltration and nocturnal hemodialysis has been positive, with the allowance for unrestricted diets and fluid intake, the lack of need for phosphate binders, excellent metabolic and blood pressure control, and, in the case of hemodiafiltration, excellent growth. The provision of frequent daily hemodialysis with the NxStage System has also recently been introduced to pediatrics. An overview about what is currently understood regarding the technical and clinical application of these approaches to therapy for children with end-stage renal disease form the basis for this article and highlight the impact of the procedures to date and the need for additional experience and collaborative data collection.

  11. Analysis of the variation of the activity of a "9"9"mTc sample after dilution with saline solution

    International Nuclear Information System (INIS)

    Kuahara, L.T.; Correa, E.L.; Potiens, M.P.A.

    2016-01-01

    The activity meter is essential equipment in nuclear medicine services.To ensure its good operation and know the factors which may influence its readings is vital for the activity administered to the patient be correct. Many factors may influence the activity meter accuracy, such as the type of container, geometry, and radioactive material volume. The aim of this study was to analyze the measurements variations in 0.5 ml and 1.0 ml of "9"9"mTc pure and diluted in 2.5 ml of saline solution, in containers used in nuclear medicine. Variations of up to 4 % in measured values were found. (author)

  12. Resposta de cultivares de alface à salinidade da solução nutritiva com rejeito salino em hidroponia Response of lettuce cultivars to nutrient solution salinity with saline rejects in hydropony

    Directory of Open Access Journals (Sweden)

    Nildo da S Dias

    2011-10-01

    Full Text Available No processo de dessalinização se gera, além da água potável, um rejeito altamente salino e de poder poluente elevado, o qual pode ser utilizado na produção agrícola rentável dependendo da adoção de práticas culturais adequadas e da tolerância das plantas às condições salinas. Nos últimos anos a tendência tem sido a substituição da agricultura convencional por sistemas hidropônicos de cultivos, considerados um dos mais eficientes no uso de água. O objetivo desta pesquisa foi analisar a resposta de duas cultivares de alface sob sistema hidropônico de cultivo (Lactuca sativa L., cvs. Verônica e Babá de verão em diferentes níveis de salinidade da solução nutritiva preparadas com água de abastecimento, água de rejeito coletada no dessalinizador e da sua diluição com água de abastecimento a 75, 50 e 25%, resultando em condutividades elétricas da solução nutritiva (CEs de 1,1; 2,4; 3,6; 4,7 e 5,7 dS m-1 após as diluições e adição de fertilizantes. Ocorreu variação genotípica sob as variáveis de crescimento e produção da alface, exceto para o número de folhas, sendo a cultivar Babá de verão a que produziu maior rendimento, independentemente do nível de salinidade e, portanto, a cultivar mais tolerante à salinidade da água com rejeito salino.In desalination process, besides the potable water, highly salty and polluted water (brine is generated, which can be used for producing profitable crops depending on the adequate cultural practices as well as on the plant ability of reacting to saline conditions. The trend in recent years has been towards conversion of conventional agriculture to soilless agriculture which is considered to be a more efficient use of water system. The aim of this research was to examine the response of two lettuce cultivars (Lactuca sativa L. cvs. Veronica, Babá de verão under hydroponic system to different levels of salinity of the nutrient solutions prepared with tap water

  13. Study and application of new chelating resin to recovery uranium from in-situ leach solution with high content saline chloride ion

    International Nuclear Information System (INIS)

    Zhang Jianguo; Qiu Yueshuang; Feng Yu; Deng Huidong; Zhao Chaoya

    2014-01-01

    Research on the adsorption and elution property of D814 chelating resin was carried out aiming at the difficult separation of uranium from high content saline chloride ion in situ leach liquor and the adsorption mechanism is also discussed. Influence factors such as contact time, pH value, Ca"2"+, Mg"2"+ and Cl"- concentration etc. to the resin adsorption were studied. Experimental results show that adsorption rate is lowly which need 6h to arrive at the adsorption equilibrium. The resin adsorption uranium pH in the solution is from l.33 to 9. When total salinity is over 20 g/L, calcium ion, and magnesium ion is about 3 g/L, there are no big influence on resin adsorption capacity. The resin has good chloride ion resistance. When chloride ion is over 60 g/L, it is no influence on resin adsorption uranium. Column experiment results indicate that ratio of saturation volume to break-through point volume is l.82, resin saturation uranium capacity is 40.5 mg. U/_g_(_∓_)_R. When elution volume bed number is 23, the eluted solution uranium concentration is below 80 mg/L. The elution rate of the uranium is 96.2%. (authors)

  14. Reposição de volume na sepse com solução salina hipertônica Sepsis volume reposition with hypertonic saline solution

    Directory of Open Access Journals (Sweden)

    Gilberto Friedman

    2008-09-01

    Full Text Available Esta revisão discute os efeitos hemodinâmicos e imunomoduladores da solução hipertônica em choque experimental e em pacientes com sepse. Comentamos sobre os mecanismos de ação da solução hipertônica, recorrendo a dados sobre choque hemorrágico e séptico. Atuações específicas da solução salina hipertônica aplicáveis a sepse grave e choque séptico são enfatizadas. Os dados disponíveis corroboram os benefícios em potencial da infusão de solução salina hipertônica em vários aspetos da fisiopatologia da sepse, inclusive hipoperfusão dos tecidos, consumo reduzido de oxigênio, disfunção endotelial, depressão miocárdica e presença de um amplo elenco de citocinas próinflamatórias e várias espécies de oxidantes. Uma terapia que, ao mesmo tempo, bloqueie os componentes prejudiciais da sepse terá um impacto no seu tratamento. Estudos prospectivos adequadamente desenhados poderão no futuro comprovar o papel benéfico da solução salina hipertônica.The present review discusses the hemodynamic and immune-modulatory effects of hypertonic saline in experimental shock and in patients with sepsis. We comment on the mechanisms of action of hypertonic saline, calling upon data in hemorrhagic and septic shock. Specific actions of hypertonic saline applicable to severe sepsis and septic shock are highlighted. Data available support potential benefits of hypertonic saline infusion in various aspects of the pathophysiology of sepsis, including tissue hypoperfusion, decreased oxygen consumption, endothelial dysfunction, cardiac depression, and the presence of a broad array of pro-inflammatory cytokines and various oxidant species. A therapy that simultaneously blocks the damaging components of sepsis will have an impact on the management of sepsis. Proper designed prospective studies may prove a beneficial role for hypertonic saline solution in the future.

  15. Intra-articular injection of hyaluronic acid is not superior to saline solution injection for ankle arthritis: a randomized, double-blind, placebo-controlled study.

    Science.gov (United States)

    DeGroot, Henry; Uzunishvili, Sofia; Weir, Robert; Al-omari, Ali; Gomes, Bruna

    2012-01-04

    Intra-articular injections of hyaluronic acid are potentially useful to treat ankle osteoarthritis, yet their effectiveness has not been proven. Both single and multiple-dose treatments for ankle arthritis with use of various hyaluronic acid products have been recommended, but few high-quality studies have been published. The aim of this study was to compare the effectiveness of a single intra-articular injection of hyaluronic acid with a single intra-articular injection of normal saline solution (placebo) for osteoarthritis of the ankle. Sixty-four patients with ankle osteoarthritis who met all study criteria were randomly assigned to a single intra-articular injection of 2.5 mL of low-molecular-weight, non-cross-linked hyaluronic acid or a single intra-articular injection of 2.5 mL of normal saline solution. The primary outcome measure was the change from baseline in the American Orthopaedic Foot & Ankle Society (AOFAS) clinical rating score at the six-week and twelve-week follow-up examination. Secondary outcome measures included the Ankle Osteoarthritis Scale score and patient-reported pain with use of a visual analog pain scale. Of the sixty-four patients randomized and treated, eight patients withdrew, leaving fifty-six patients who completed the entire study. There was one mild adverse event (1.6%) among the sixty-four patients. At six weeks and twelve weeks, the mean AOFAS scores in the hyaluronic acid group had improved from baseline by 4.9 and 4.9 points, respectively, whereas the mean AOFAS scores in the placebo group initially worsened by 0.4 point at six weeks and then improved by 5.4 points at twelve weeks. While the change at twelve weeks from baseline was substantial for both groups, the between-group differences were not significant. We found that a single intra-articular injection of low-molecular-weight, non-cross-linked hyaluronic acid is not demonstrably superior to a single intra-articular injection of saline solution for the treatment of

  16. Depression in hemodialysis patients

    International Nuclear Information System (INIS)

    Anees, M.; Barki, H.; Masood, M.

    2008-01-01

    To measure the frequency of depression and its risk factors in patients under going hemodialysis. It is a cross-sectional prospective study conducted at Hemodialysis unit of Shalamar Hospital and Shaikh Zayed Hospital, Lahore from 1/sup st/ January 2006 to 30/sup th/ April 2006. All patients getting regular hemodialysis for more than three months were included. Beck's Depression Inventory- II (BDI-II; adapted in Urdu) was administered on all the patients who were able to read or understand it. Blood sample were drawn at the same time for routine hematological, biochemical parameters and viral markers (Anti HCV and HbsAg). Diagnosis was made as per Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV) for correlation of psychological variables with clinical, hematological and biochemical parameters. Eighty nine patients were enrolled which included fifty two (58.4%) were male and seventy seven (86.5%) were married. Major causes of renal failure were diabetes, hypertension and chronic glomerulonephrotis. Duration of dialysis was from 03 to 49 months with mean of 19.64 +- 11.7 months. Severity of depression was categorized in to mild, moderate and severe on the basis of BDI score. Majority of the patients fifty (56.1%) were moderately to severely depressed and there was no gender difference in the prevalence of depression. Majority of patients undergoing hemodialysis were depressed. Major risk factors for depression were marital status, illiteracy, number of children, socioeconomic factors, gender, hypertension and hypoalbuminemia. Patients with anemia, hyponatremia and hyperkalemia had suicidal tendency. Patients with hepatitis C and disturbed liver function have strong correlation with psychological parameters. (author)

  17. Hemodialysis Catheters: How to Keep Yours Working Well

    Science.gov (United States)

    ... for specific treatment recommendations. Print Email Read related articles Home Hemodialysis Nocturnal Hemodialysis What Is Dry Weight Nutrition and Hemodialysis The Buttonhole Technique The National Kidney ...

  18. Size control and supporting of palladium nanoparticles made by laser ablation in saline solution as a facile route to heterogeneous catalysts

    International Nuclear Information System (INIS)

    Marzun, Galina; Nakamura, Junji; Zhang, Xiaorui; Barcikowski, Stephan; Wagener, Philipp

    2015-01-01

    Graphical abstract: - Highlights: • We studied laser-generated, size-controlled palladium nanoparticles in saline solution. • Palladium nanoparticles were electrostatically stabilized by anions. • Photo- and electrocatalyst are prepared by supporting Pd nanoparticles to TiO 2 and graphene. • Particle size does not change during supporting process, while 18 wt% load has been achieved. • Palladium nanoparticles and graphene undergo a redox-reaction during adsorption. - Abstract: In the literature many investigations on colloidal stability and size control of gold nanoparticles are shown but less for ligand-free palladium nanoparticles, which can be promising materials in various applications. Palladium nanoparticles are perspective materials for a manifold of energy application like photo- and electrocatalysis or hydrogen storage. For this purpose, size-controlled nanoparticles with clean surfaces and facile immobilization on catalyst supports are wanted. Laser ablation in saline solution yields ligand-free, charged colloidal palladium nanoparticles that are supported by titania and graphene nanosheets as model systems for photo- and electrocatalysis, respectively. By adjusting the ionic strength during laser ablation in liquid, it is possible to control stability and particle size without compromising subsequent nanoparticle adsorption of supporting materials. A quantitative deposition of nearly 100% yield with up to 18 wt% nanoparticle load was achieved. The average size of the laser-generated nanoparticles remains the same after immobilization on a support material, in contrast to other preparation methods of catalysts. The characterization by X-ray photoelectron spectroscopy reveals a redox reaction between the immobilized nanoparticles and the graphene support

  19. Nosocomial infective endocarditis in Hemodialysis

    International Nuclear Information System (INIS)

    Bhat, A.W.; Solangi, S.; Murtada, O.

    2002-01-01

    There is an increased risk of infective endocarditis catheterization usedfor Hemodialysis. We report a case of a young man who had endocarditissecondary to the use of a permanent jugular catheter for hemodialysis. Bloodcultures were repeatedly negative, but vegetations were seen on the tricuspidvalve on echocardiography. A high index of suspicion is recommended for thisserious complication. (author)

  20. Diagnosis, Treatment, and Prevention of Hemodialysis Emergencies.

    Science.gov (United States)

    Saha, Manish; Allon, Michael

    2017-02-07

    Given the high comorbidity in patients on hemodialysis and the complexity of the dialysis treatment, it is remarkable how rarely a life-threatening complication occurs during dialysis. The low rate of dialysis emergencies can be attributed to numerous safety features in modern dialysis machines; meticulous treatment and testing of the dialysate solution to prevent exposure to trace elements, toxins, and pathogens; adherence to detailed treatment protocols; and extensive training of dialysis staff to handle medical emergencies. Most hemodialysis emergencies can be attributed to human error. A smaller number are due to rare idiosyncratic reactions. In this review, we highlight major emergencies that may occur during hemodialysis treatments, describe their pathogenesis, offer measures to minimize them, and provide specific interventions to prevent catastrophic consequences on the rare occasions when such emergencies arise. These emergencies include dialysis disequilibrium syndrome, venous air embolism, hemolysis, venous needle dislodgement, vascular access hemorrhage, major allergic reactions to the dialyzer or treatment medications, and disruption or contamination of the dialysis water system. Finally, we describe root cause analysis after a dialysis emergency has occurred to prevent a future recurrence. Copyright © 2017 by the American Society of Nephrology.

  1. The role of adequate reference materials in density measurements in hemodialysis

    Science.gov (United States)

    Furtado, A.; Moutinho, J.; Moura, S.; Oliveira, F.; Filipe, E.

    2015-02-01

    In hemodialysis, oscillation-type density meters are used to measure the density of the acid component of the dialysate solutions used in the treatment of kidney patients. An incorrect density determination of this solution used in hemodialysis treatments can cause several and adverse events to patients. Therefore, despite the Fresenius Medical Care (FME) tight control of the density meters calibration results, this study shows the benefits of mimic the matrix usually measured to produce suitable reference materials for the density meter calibrations.

  2. The role of adequate reference materials in density measurements in hemodialysis

    International Nuclear Information System (INIS)

    Furtado, A; Moura, S; Filipe, E; Moutinho, J; Oliveira, F

    2015-01-01

    In hemodialysis, oscillation-type density meters are used to measure the density of the acid component of the dialysate solutions used in the treatment of kidney patients. An incorrect density determination of this solution used in hemodialysis treatments can cause several and adverse events to patients. Therefore, despite the Fresenius Medical Care (FME) tight control of the density meters calibration results, this study shows the benefits of mimic the matrix usually measured to produce suitable reference materials for the density meter calibrations

  3. The future of hemodialysis membranes.

    Science.gov (United States)

    Humes, H D; Fissell, W H; Tiranathanagul, K

    2006-04-01

    Hemodialytic treatment of patients with either acute or chronic renal failure has had a dramatic impact on the mortality rates of these patients. Unfortunately, this membrane-based therapy is still incomplete renal replacement, as the mortality and morbidity of these patients remain unacceptably high. Much progress must be made to improve the biocompatibility of hemodialysis membranes as well as their hydraulic and permselective properties to remove small solutes and 'middle molecules' in compact cartridges. The next directions of development will leverage materials and mechanical engineering technology, including microfluidics and nanofabrication, to further improve the clearance functions of the kidney to replicate glomerular permselectivity while retaining high rates of hydraulic permeability. The extension of membrane technology to biohybrid devices utilizing progenitor/stem cells will be another substantive advance for renal replacement therapy. The ability to not only replace solute and water clearance but also active reabsorptive transport and metabolic activity will add additional benefit to the therapy of patients suffering from renal failure. This area of translational research is rich in creative opportunities to improve the unmet medical needs of patients with either chronic or acute renal failure.

  4. Anterior ischemic optic neuropathy in patients undergoing hemodialysis

    NARCIS (Netherlands)

    DoorenbosBot, ACC; Geerlings, W; Houtman, IA

    Four patients are discussed who underwent hemodialysis and developed anterior ischemic optic neuropathy (AION). Three patients had been treated by hemodialysis for several years. One patient developed bilateral optic neuropathy after the first hemodialysis session, So far, only four hemodialysis

  5. Immune-Inflammatory and Metabolic Effects of High Dose Furosemide plus Hypertonic Saline Solution (HSS Treatment in Cirrhotic Subjects with Refractory Ascites.

    Directory of Open Access Journals (Sweden)

    Antonino Tuttolomondo

    Full Text Available Patients with chronic liver diseases are usually thin as a result of hypermetabolism and malnutrition expressed by reduced levels of leptin and impairment of other adyponectins such as visfatin.We evaluated the metabolic and inflammatory effects of intravenous high-dose furosemide plus hypertonic saline solutions (HSS compared with repeated paracentesis and a standard oral diuretic schedule, in patients with cirrhosis and refractory ascites.59 consecutive cirrhotic patients with refractory ascites unresponsive to outpatient treatment. Enrolled subjects were randomized to treatment with intravenous infusion of furosemide (125-250mg⁄bid plus small volumes of HSS from the first day after admission until 3 days before discharge (Group A, n:38, or repeated paracentesis from the first day after admission until 3 days before discharge (Group B, n: 21. Plasma levels of ANP, BNP, Leptin, visfatin, IL-1β, TNF-a, IL-6 were measured before and after the two type of treatment.Subjects in group A were observed to have a significant reduction of serum levels of TNF-α, IL-1β, IL-6, ANP, BNP, and visfatin, thus regarding primary efficacy endpoints, in Group A vs. Group B we observed higher Δ-TNF-α, Δ-IL-1β, Δ-IL-6, Δ-ANP, Δ-BNP, Δ-visfatin, Δ-Leptin at discharge.Our findings underline the possible inflammatory and metabolic effect of saline overload correction in treatment of cirrhosis complications such as refractory ascites, suggesting a possible role of inflammatory and metabolic-nutritional variables as severity markers in these patients.

  6. Headache associated with hemodialysis

    Directory of Open Access Journals (Sweden)

    Nikić Petar M.

    2008-01-01

    Full Text Available INTRODUCTION Hemodialysis (HD is one of the most accessible methods for the treatment of the growing number of patients suffering from terminal-stage renal insufficiency. Although headache is the most frequently encountered neurological symptom during HD, there are few studies reporting its prevalence and clinical features. OBJECTIVE The objective of this study was to examine the frequency, demographic and clinical features of headache during HD, and to compare these parameters among patients with and without headache. METHOD The study involved 126 patients (48 female and 78 male with chronic renal failure on regular HD for at least six months, at the Dialysis Unit of Nephrology Department, Kruševac. All patients were inquired about their possible problems with headache using the standardized questionnaire designed according to the diagnostic criteria of the International Headache Classification of Headache Disorders, second edition, published in 2004 (ICHD-II. Subsequently, the patients were clinically evaluated and patients with headaches were further sub classified by a neurologist with special interest in headache disorders. Patients with headache were compared to the patients without headache regarding age, sex, duration of HD, causes of end-stage renal disease, arterial diastolic and systolic blood pressure, and serum values of the most important blood parameters such as sodium, potassium, urea and creatinine. In the group of patients with headache we analyzed the characteristics of specific headache type according to ICHD-II classification. We also analyzed the most important clinical features of hemodialysis headache (HDH. RESULTS In the group of 126 evaluated patients, 41 (32.5% patients had headaches. There were no statistically significant differences between the patients with headaches and those without headaches regarding sex, age, BMI, duration of HD, causes of end-stage renal disease, arterial blood pressure, red blood cell count

  7. Anisotropic effective permittivity of an ultrathin gold coating on optical fiber in air, water and saline solutions.

    Science.gov (United States)

    Zhou, Wenjun; Mandia, David J; Barry, Seán T; Albert, Jacques

    2014-12-29

    The optical properties of an ultrathin discontinuous gold film in different dielectric surroundings are investigated experimentally by measuring the polarization-dependent wavelength shifts and amplitudes of the cladding mode resonances of a tilted fiber Bragg grating. The gold film was prepared by electron-beam evaporation and had an average thickness of 5.5 nm ( ± 1 nm). Scanning electron imaging was used to determine that the film is actually formed of individual particles with average lateral dimensions of 28 nm ( ± 8 nm). The complex refractive indices of the equivalent uniform film in air at a wavelength of 1570 nm were calculated from the measurements to be 4.84-i0.74 and 3.97-i0.85 for TM and TE polarizations respectively (compared to the value for bulk gold: 0.54-i10.9). Additionally, changes in the birefringence and dichroism of the films were measured as a function of the surrounding medium, in air, water and a saturated NaCl (salt) solution. These results show that the film has stronger dielectric behavior for TM light than for TE, a trend that increases with increasing surrounding index. Finally, the experimental results are compared to predictions from two widely used effective medium approximations, the generalized Maxwell-Garnett and Bruggeman theories for gold particles in a surrounding matrix. It is found that both of these methods fail to predict the observed behavior for the film considered.

  8. Intermediate and long-term radiological consequences of an uncontrolled access of saline solution into the Asse mine - 59163

    International Nuclear Information System (INIS)

    Ustohalova, Veronika; Kueppers, Christian

    2012-01-01

    analytical solution of one- or two-dimensional dispersion-convention transport equation. The tool 'Migration' allows to quickly estimate the possible ranges of radioactive contamination in the ground water table over time whereas several parameters can be varied. The radiological exposure in the tool 'Exposure' can be calculated according to Gernrman approach AVV [3] or BglB [4]. The calculation model was tested on specific examples and the agreement with the reality was proven. There have been several approaches published on the subject of groundwater flow or radionuclide transfer in Asse mine but no one introduced more exactly radionuclide migration with coupled migration of decay chains and combined it in addition with the computation of radionuclide transfer in the biosphere. (authors)

  9. Bacteremic infection in hemodialysis.

    Science.gov (United States)

    Nsouli, K A; Lazarus, M; Schoenbaum, S C; Gottlieb, M N; Lowrie, E G; Shocair, M

    1979-11-01

    This is a retrospective study of 133 episodes of bacteremic infection in 112 hemodialysis patients. The frequency of bacteremic infection was 9.5% in patients with chronic renal failure and 10.9% in patients with acute renal failure. In patients with acute renal failure, pneumonia and intra-abdominal abscess were the most frequent sources of septicemia. Sepsis was usually due to Gram-negative organisms and mortality was high. In patients with chronic renal failure, infection of the shunt or fistula was the most common cause, was frequently due to Staphylococcus organism, and had a more favorable survival rate. Gram-negative septicemia from a nonaccess source in patients with chronic renal failure was associated with a higher mortality. Bacterial endocarditis and septic pulmonary emboli occurred in 3.6% of septic episodes and 0.35% of patients at risk and had very low mortality. A low threshold for obtaining blood cultures and early antibiotic treatment are believed to be important in the treatment of bacteremic infections in patients undergoing long-term hemodialysis.

  10. Rosuvastatin in diabetic hemodialysis patients

    DEFF Research Database (Denmark)

    Holdaas, Hallvard; Holme, Ingar; Schmieder, Roland E

    2011-01-01

    A randomized, placebo-controlled trial in diabetic patients receiving hemodialysis showed no effect of atorvastatin on a composite cardiovascular endpoint, but analysis of the component cardiac endpoints suggested that atorvastatin may significantly reduce risk. Because the AURORA (A Study...

  11. A Comparison Study of Growth Factor Expression following Treatment with Transcutaneous Electrical Nerve Stimulation, Saline Solution, Povidone-Iodine, and Lavender Oil in Wounds Healing

    Directory of Open Access Journals (Sweden)

    Adalet Koca Kutlu

    2013-01-01

    Full Text Available This study compared the effects of transcutaneous electrical nerve stimulation (TENS, saline solution (SS, povidone-iodine (PI, and lavender oil (Lavandula angustifolia through expression of growth factors in a rat model of wound healing. Six experimental groups were established, each containing 8 rats: a healthy group with no incision wounds, an incision-control group, an incision and TENS group, an incision and SS group, an incision and PI group, and an incision and lavender oil group. Experiments continued for 5 days, after which the skin in the excision area was removed. Tissue concentrations of epidermal growth factor (EGF and platelet-derived growth factor (PDGF-A were measured using enzyme-linked immunosorbent assay (ELISA. Tissue expressions of EGF, PDGF-A, and fibroblast growth factor (FGF-2 were determined using immunohistochemistry. Wound closure progressed more rapidly in the TENS and lavender oil groups than in the control and other study groups. In particular, PDGF-A expressions in the dermis and EGF expression in the epidermis were significantly intense in the TENS group (P<0.05. In addition, ELISA levels of growth factors such as PDGF-A and EGF were significantly higher in TENS group compared to the control group (P<0.05. These immunohistochemical and ELISA results suggest that TENS may improve wound healing through increasing growth factors in the dermis and epidermis more than other topical applications.

  12. Influence of alkaline (PH 8.3-12.0) and saline solutions on chemical, mineralogical and physical properties of two different bentonites - batch experiments at 25 deg. C

    International Nuclear Information System (INIS)

    Heikola, Tiina; Vuorinen, Ulla; Kumpulainen, Sirpa; Kiviranta, Leena; Korkeakoski, Petri

    2012-01-01

    Document available in extended abstract form only. Construction of a spent fuel repository deep in the bedrock will need supporting structures using cement materials. A part of them can be removed before closure but still it is estimated that about 1000 tonnes will remain in the host rock. Degradation of cementitious materials produces leachates of high pH. If such an alkaline plume reaches the bentonite buffer, it may induce mineralogical and chemical changes in bentonite over long term, and further affect the safety functions of the buffer. Laboratory experiments were done with the objective to gain data of possible alterations in mineralogical, chemical and physical properties of bentonites contacted with high-pH saline solutions. Two untreated, high grade, Na- and Ca-bentonites, were used in batch experiments, which were carried out in an anaerobic glove-box at 25±1 deg. C for 554 days. Each bentonite sample (20 g) was leached with approximately 3.8 L of leaching solution, which equals 190 mL/g of bentonite. The bentonites were leached with three types of simulated cement waters (pH 9.7, 11.3 and 12.0) and one saline groundwater simulate (pH 8.3) as a reference. The leaching solutions were 0.3 M, and contained NaCl and CaCl 2 , and trace amounts of SiO 2 , K, Br, Mg and SO 4 . Dissolved oxygen and carbon dioxide were removed from leaching solutions before mixing of bentonite in PC bottles. The samples were placed on a platform shaker in order to allow better contact between bentonite and the leaching solution. The evolution of pH in the samples was followed by measuring the pH-value of each sample in the solution phase approximately twice a week and the solution was renewed when values of two to three consecutive measurements did not change. On average, the leaching solution was renewed once a month. For each renewal of the leaching solution the phases were separated, the reacted solution withdrawn, and the chemical composition analysed. Before analysis the

  13. Hemodialysis: stressors and coping strategies.

    Science.gov (United States)

    Ahmad, Muayyad M; Al Nazly, Eman K

    2015-01-01

    End-stage renal disease (ESRD) is an irreversible and life-threatening condition. In Jordan, the number of ESRD patients treated with hemodialysis is on the rise. Identifying stressors and coping strategies used by patients with ESRD may help nurses and health care providers to gain a clearer understanding of the condition of these patients and thus institute effective care planning. The purpose of this study was to identify stressors perceived by Jordanian patients on hemodialysis, and the coping strategies used by them. A convenience sample of 131 Jordanian men and women was recruited from outpatients' dialysis units in four hospitals. Stressors perceived by participants on hemodialysis and the coping strategies were measured using Hemodialysis Stressor Scale, and Ways of Coping Scale-Revised. Findings showed that patients on hemodialysis psychosocial stressors scores mean was higher than the physiological stressors mean. Positive reappraisal coping strategy had the highest mean among the coping strategies and the lowest mean was accepting responsibility. Attention should be focused towards the psychosocial stressors of patients on hemodialysis and also helping patients utilize the coping strategies that help to alleviate the stressors. The most used coping strategy was positive reappraisal strategy which includes faith and prayer.

  14. AFM and SFG studies of pHEMA-based hydrogel contact lens surfaces in saline solution: adhesion, friction, and the presence of non-crosslinked polymer chains at the surface.

    Science.gov (United States)

    Kim, Seong Han; Opdahl, Aric; Marmo, Chris; Somorjai, Gabor A

    2002-04-01

    The surfaces of two types of soft contact lenses neutral and ionic hydrogels--were characterized by atomic force microscopy (AFM) and sum-frequency-generation (SFG) vibrational spectroscopy. AFM measurements in saline solution showed that the presence of ionic functional groups at the surface lowered the friction and adhesion to a hydrophobic polystyrene tip. This was attributed to the specific interactions of water and the molecular orientation of hydrogel chains at the surface. Friction and adhesion behavior also revealed the presence of domains of non-crosslinked polymer chains at the lens surface. SFG showed that the lens surface became partially dehydrated upon exposure to air. On this partially dehydrated lens surface, the non-crosslinked domains exhibited low friction and adhesion in AFM. Fully hydrated in saline solution, the non-crosslinked domains extended more than tens of nanometers into solution and were mobile.

  15. Chemical behaviour of trivalent and pentavalent americium in saline NaCl-solutions. Studies of transferability of laboratory data to natural conditions. Interim report. Reported period: 1.2.1993-31.12.1993

    International Nuclear Information System (INIS)

    Runde, W.; Kim, J.I.

    1994-09-01

    In order to clarify the chemical behaviour of Americium in saline aqueous systems relevant for final storage this study deals with the chemical reactions of trivalent and pentavalent Americium in NaCl-solutions under the influence of radiolysis from its own alpha radiation. The focus of the study was on investigating the geologically relevant reactions, such as hydrolysis or carbonate- and chloride complexing in solid-liquid equilibriums. Comprehensive measurements on solubility and spectroscopic studies in NaCl-solutions were carried out in a CO 2 -free atmosphere and 10 -2 atm CO 2 partial pressure. Identification and characterisation of the AM (III) and AM(V) solid phases were supplemented by structural research with the chemically analogue EU (III) and Np(V) compounds. The alpha-radiation induced radiolysis in saline NaCl solutions and the redox behaviour of Americium which was influenced thereby were spectroscopically quantified. (orig.) [de

  16. Potential application of metabolic engineering to tune the production of compatible solutes for enhancing tolerance of crop plants to salinity/drought (abstract)

    International Nuclear Information System (INIS)

    Sharmila, P.; Saradhi, P.P.

    2005-01-01

    Essential need to develop genotypes of crop plants that can substantially withstand salinity and drought with little yield losses is being increasingly felt, as the cultivable agricultural lands is increasingly being exposed to these stresses. In-spite of gains in productivity, conventional plant breeding methods have their limitations either due to limited gene pool or due to species barrier for gene transfer. Modern molecular tools have paved ways for identification of genes imparting abiotic stress tolerance in unrelated species/organisms and to transfer the selected genes into desirable crop plant species by conquering the incompatibility barriers. In fact, now genetic engineering has been widely realized to be in important tool for developing abiotic stress tolerant crop plants. Abiotic stress tolerance is a complex phenomenon involving simultaneous expression of a number of genes coupled with an interaction of varying weather variables and crop phonology. However, in order to tackle the issue, successful attempts have been made in identifying genes enhancing abiotic stress tolerance. The genes for biosynthesis of various compatible solutes (viz., mtlD for mannitol: P5CS or P5CSF129A for proline; coda/cox or belA/beIB for glycinebetaine' lpsl for trehalose; PINOI for inositol) have been demonstrated to enhance abiotic stress tolerance of plants. We have isolated the codA gene (Accession number AY589052) for choline oxidase from an Indian strain of Arthrobacter sp. from IMTECH (Chandigarh) and the mtlD genes from local strains of E. coli (accession number A Y523630) and halobacterium sp. (Accession number A Y52363 1). We have enhanced the tolerance of Brassica juncea to salt, drought and low temperature stresses by introducing the codA gene from Arthrobacter globiformis using Agrobacterium tumefaciens mediated transformation. Presenting our research team is busy developing genotypes of chickpea black gram, peanut and sorghum besides mustard with enhanced

  17. Music for Hemodialysis patients

    DEFF Research Database (Denmark)

    Gross, B; Ketema Wassie, F; Agnholt, Hanne

    Music for hemodialysis patients Background Patients starting a new regimen of dialysis often experience anxiety and other psychological disturbances. They struggle with the unknown situation, feelings of uncertainty and on top of that, a high level of sophisticated technological equipment. Music...... is known from literature to influence and dampen anxiety and tension and has been used for millennia in the treatment of illness. Here we report a study on the influence of music on patients undergoing dialysis and whether music has a potential for lowering discomfort in patients during first-time dialysis.......   Purpose To investigate whether music can reduce feelings of anxiety, tension and restlessness in patients new to dialysis treatment and make them more relaxed during the treatment.   Method Twenty patients aged 42-84 were selected for participation in the study, which took place over two separate dialysis...

  18. Finite elements-based 2D theoretical analysis of the effect of IEX membrane thickness and salt solution residence time on the ion transport within a salinity gradient power reverse electrodialysis half cell pair

    OpenAIRE

    Etienne, Brauns

    2013-01-01

    Reverse electrodialysis electrical power generation is based on the transport of salt ions through ion conductive membranes. The ion flux, equivalent to an electric current, results from a salinity gradient, induced by two salt solutions at significantly different concentrations. Such equivalent electric current in combination with the corresponding electrochemical potential difference across the membrane, equivalent to an electric potential, results in a battery equivalency. While having a c...

  19. Variable pulmonary manifestations in hemodialysis patients

    International Nuclear Information System (INIS)

    Kim, Yoo Kyung; Shim, Sung Shine; Shin, Jung Hee; Choi, Gyu Bock; Lee, Kyung Soo; Yi, Chin A; Oh, Yu Whan

    2003-01-01

    A wide variety of pulmonary disorders related to hemodialysis or pre-existing renal disease occurs in hemodialysis patients. The disorders may be classified as 1) pulmonary abnormalities associated with chronic renal failures; 2) pulmonary complications arising during hemodialysis; 3) pulmonary infection; or 4) pulmonary-renal syndrome. An awareness of the various possible pulmonary disorders arising in hemodialysis patients may be helpful for the proper and timely management of such patients. We describe and illustrate various radiographic and CT findings of variable pulmonary disorders in hemodialysis patients

  20. Air contamination during hemodialysis should be minimized.

    Science.gov (United States)

    Stegmayr, Bernd

    2017-04-01

    During preparation of the hemodialysis (HD) extracorporeal circuit (ECC) a priming solution is used to remove air from the tubes and dialyzer. Ultra sound techniques have verified micro embolic signals (MES) in the ECC that may derive from clots or gas embolies. In vitro studies could clarify that embolies of air develop within the ECC and also pass the safety systems such as air traps and enter the venous line that goes into the patient. Clinical studies have confirmed the presence of MES within the ECC that pass into the return-venous-line during conventional HD without inducing an alarm. In addition, studies confirmed that such MES were present within the AV fistula and subclavian vein, but also detected within the carotid artery. Autopsy studies revealed the presence of gas embolies surrounded by clots within the lung but also brain and myocardial tissue. This review will focus on how the MES develop and measures of how the exposure can be limited. © 2016 International Society for Hemodialysis.

  1. Transhepatic venous catheters for hemodialysis

    Directory of Open Access Journals (Sweden)

    Mohamed El Gharib

    2014-06-01

    Conclusion: Based on our findings, transhepatic hemodialysis catheters have proven to achieve good long-term functionality. A high level of maintenance is required to preserve patency, although this approach provides remarkably durable access for patients who have otherwise exhausted access options.

  2. Changes in Plasma Copeptin Levels during Hemodialysis : Are the Physiological Stimuli Active in Hemodialysis Patients?

    NARCIS (Netherlands)

    Ettema, Esmee M.; Kuipers, Johanna; Assa, Solmaz; Bakker, Stephan J. L.; Groen, Henk; Westerhuis, Ralf; Gaillard, Carlo A. J. M.; Gansevoort, Ron T.; Franssen, Casper F. M.

    2015-01-01

    Objectives Plasma levels of copeptin, a surrogate marker for the vasoconstrictor hormone arginine vasopressin (AVP), are increased in hemodialysis patients. Presently, it is unknown what drives copeptin levels in hemodialysis patients. We investigated whether the established physiological stimuli

  3. Effect of peritoneal cavity lavage with 0.9% and 3.0% saline solution in the lung and spleen of gerbils with induced peritonitis.

    Science.gov (United States)

    Nunes, Vinícius Rodrigues Taranto; Barbuto, Rafael Calvão; Vidigal, Paula Vieira Teixeira; Pena, Guilherme Nogueira; Rocha, Silvia Lunardi; de Siqueira, Lucas Tourinho; Caliari, Marcelo Vidigal; de Araujo, Ivana Duval

    2014-04-01

    Peritoneal cavity lavage is used widely in the treatment of peritonitis. Nonetheless, some studies question its rationale and prove it to be deleterious to the mesothelium. The present study aims to determine whether 0.9% and 3.0% saline lavage of the peritoneal cavity have an effect on the early systemic inflammatory response, namely, in the lung injury and splenic cellularity of gerbils with induced peritonitis. Thirty-four male gerbils were divided into four groups: Control (n=9), submitted to laparotomy at time zero, re-laparotomy after 2 h, and sacrificed after a total of 6 h from start; untreated (n=8), submitted to peritonitis induction through cecal ligation and puncture (CLP) at time zero, re-laparotomy intended for drying of abdominal cavity and resection of the ischemic cecum after 2 h, and sacrifice after a total of 6 h from start; saline (n=8), submitted to peritonitis induction through CLP at time zero, re-laparotomy intended for warm 0.9% saline lavage of the abdominal cavity and resection of the ischemic cecum after 2 h, and sacrificed after a total of 6 h from start; and hypertonic (n=9), submitted to peritonitis induction through CLP at time zero, re-laparotomy intended for warm hypertonic saline (3.0%) lavage of the abdominal cavity and resection of the ischemic cecum after 2 h, and sacrificed after a total of 6 h from start. After sacrifice, we collected the left lung and the spleen for morphometric analysis. In the both the saline and hypertonic groups, there was significant decrease in the mean nuclei count in the lungs, compared with the untreated group (p0.05). The present study demonstrated that the peritoneal lavage with large volumes of warm 0.9% and 3.0% saline has a beneficial effect on the early systemic inflammatory response in infected animals, modulating and reducing the lung injury but having no effect on splenic cell count.

  4. Increased Cerebral Water Content in Hemodialysis Patients

    OpenAIRE

    Reetz, Kathrin; Abbas, Zaheer; Eitner, Frank; Gross, Theresa; Schulz, Jörg Bernhard; Floege, Jürgen; Shah, N. J.; Costa, Ana Sofia; Gras, Vincent; Tiffin-Richards, Frances; Mirzazade, Shahram; Holschbach, Bernhard; Frank, Rolf Dario; Vassiliadou, Athina; Krüger, Thilo

    2015-01-01

    Little information is available on the impact of hemodialysis on cerebral water homeostasis and its distribution in chronic kidney disease. We used a neuropsychological test battery, structural magnetic resonance imaging (MRI) and a novel technique for quantitative measurement of localized water content using 3T MRI to investigate ten hemodialysis patients (HD) on a dialysis-free day and after hemodialysis (2.4±2.2 hours), and a matched healthy control group with the same time interval. Neuro...

  5. The Making of Salty Soy Sauce From Koro Benguk (Mucuna Pruriens (Study of Saline Concentration of Salt Solution and Duration of Moromi's Fermentation

    Directory of Open Access Journals (Sweden)

    Arie Febrianto Mulyadi

    2016-02-01

    Full Text Available The objectives of this study were to determine the saline concentration and moromi’s fermentation duration of Koro Benguk salty soy sauce at best organolepticly and determine consumers’ preferences towards Koro Benguk salty soy sauce from the best treatment results. The study was conducted using a randomized design method using two factors: the saline concentration (17%; 20%; and 23% and duration of moromi’s fermentation (2; 3; and 4 weeks. The best treatment results based on the Friedman test was on the saline concentration of 17% and moromi’s fermentation duration was 4 weeks, with the NP value of 1,000; had a preference color level of 5:40 (liked; aroma of 4.30 (rather liked; flavor of 4.55 (rather liked; and viscosity of 5.05 (liked. The obtained protein was 7.14%; and dissolved solids of 27obrix. Consumers’ preferences towards the best treatment showed that product of Koro Benguk salty soy sauce was acceptable to consumers.

  6. High concentrations of Na+ and Cl- ions in soil solution have simultaneous detrimental effects on growth of faba bean under salinity stress.

    Science.gov (United States)

    Tavakkoli, Ehsan; Rengasamy, Pichu; McDonald, Glenn K

    2010-10-01

    Despite the fact that most plants accumulate both sodium (Na(+)) and chloride (Cl(-)) ions to high concentration in their shoot tissues when grown in saline soils, most research on salt tolerance in annual plants has focused on the toxic effects of Na(+) accumulation. There have also been some recent concerns about the ability of hydroponic systems to predict the responses of plants to salinity in soil. To address these two issues, an experiment was conducted to compare the responses to Na(+) and to Cl(-) separately in comparison with the response to NaCl in a soil-based system using two varieties of faba bean (Vicia faba), that differed in salinity tolerance. The variety Nura is a salt-sensitive variety that accumulates Na(+) and Cl(-) to high concentrations while the line 1487/7 is salt tolerant which accumulates lower concentrations of Na(+) and Cl(-). Soils were prepared which were treated with Na(+) or Cl(-) by using a combination of different Na(+) salts and Cl(-) salts, respectively, or with NaCl. While this method produced Na(+)-dominant and Cl(-)-dominant soils, it unavoidably led to changes in the availability of other anions and cations, but tissue analysis of the plants did not indicate any nutritional deficiencies or toxicities other than those targeted by the salt treatments. The growth, water use, ionic composition, photosynthesis, and chlorophyll fluorescence were measured. Both high Na(+) and high Cl(-) reduced growth of faba bean but plants were more sensitive to Cl(-) than to Na(+). The reductions in growth and photosynthesis were greater under NaCl stress and the effect was mainly additive. An important difference to previous hydroponic studies was that increasing the concentrations of NaCl in the soil increased the concentration of Cl(-) more than the concentration of Na(+). The data showed that salinity caused by high concentrations of NaCl can reduce growth by the accumulation of high concentrations of both Na(+) and Cl(-) simultaneously, but

  7. Urea biosensor for hemodialysis monitoring

    Science.gov (United States)

    Glass, Robert S.

    1999-01-01

    An electrochemical sensor capable of detecting and quantifying urea in fluids resulting from hemodialysis procedures. The sensor is based upon measurement of the pH change produced in an aqueous environment by the products of the enzyme-catalyzed hydrolysis of urea. The sensor may be fabricated using methods amenable to mass fabrication, resulting in low-cost sensors and thus providing the potential for disposable use. In a typical application, the sensor could be used in treatment centers, in conjunction with an appropriate electronics/computer system, in order to determine the hemodialysis endpoint. The sensor can also be utilized to allow at-home testing to determine if dialysis was necessary. Such a home monitor is similar, in principle, to devices used for blood glucose testing by diabetics, and would require a blood droplet sample by using a finger prick.

  8. Optimizing lithium dosing in hemodialysis

    DEFF Research Database (Denmark)

    Bjarnason, N H; Munkner, R; Kampmann, J P

    2006-01-01

    We studied a 62-year-old female hemodialysis patient during initiation and maintenance of lithium carbonate therapy. Three different methods were applied to estimate the regimen: a scenario based on volume of distribution (V(d)), a scenario based on glomerular filtration rate (GFR), and a scenario...... estimates. Furthermore, the maintenance dose estimated from the central compartment (V1) led to plasma concentrations within the therapeutic range. Thus, a regimen where 12.2 mmol lithium was given after each hemodialysis session resulted in stable between-dialysis plasma lithium concentrations...... in this patient with no residual kidney function. We did not observe adverse effects related to this regimen, which was monitored from 18 days to 8 months of therapy, and the patient experienced relief from her severe depressive disorder. In conclusion, dialysis patients may be treated with lithium administrated...

  9. Selection of an approach for the density determination of high-saline solutions. Report on working package 2. Development of the international status of science and technology concerning methods and tools for operational and long-term safety cases; Auswahl eines Ansatzes zur Bestimmung der Dichte in hochsalinaren Loesungen. Bericht zum Arbeitspaket 2. Weiterentwicklung des internationalen Stands von Wissenschaft und Technik zu Methoden und Werkzeugen fuer Betriebs- und Langzeitsicherheitsnachweise

    Energy Technology Data Exchange (ETDEWEB)

    Mayer, Kim-Marisa; Moog, Helge C.; Seher, Holger

    2016-09-15

    The report describes the approaches for density determination of low- and high saline solutions using the chemical composition. As an example for a simplified calculation method the procedure implemented in the TOUGH2 code is discussed. The GRS approach and the saline solutions relevant for a final repository are specified. The results of different calculation approaches are compae4d with experimental results.

  10. Exsanguination of a home hemodialysis patient as a result of misconnected blood-lines during the wash back procedure: A case report

    Directory of Open Access Journals (Sweden)

    Allcock Kerryanne

    2012-05-01

    Full Text Available Abstract Background Home hemodialysis is common in New Zealand and associated with lower cost, improved survival and better patient experience. We present the case of a fully trained home hemodialysis patient who exsanguinated at home as a result of an incorrect wash back procedure. Case presentation The case involves a 67 year old male with a history of well controlled hypertension and impaired glucose tolerance. He commenced on peritoneal dialysis in 2006 following the development of end stage kidney failure secondary to focal segmental glomerulosclerosis. He transferred to hemodialysis due to peritoneal membrane failure in 2010, and successfully trained for home hemodialysis over a 20 week period. Following one month of uncomplicated dialysis at home, he was found deceased on his machine at home in the midst of dialysis. His death occurred during the wash back procedure performed using the “open circuit” method, and resulted from misconnection of the saline bag to the venous end of the extracorporeal blood circuit instead of the arterial end. This led to approximately 2.3L of his blood being pumped into the saline bag resulting in hypovolaemic shock and death from exsanguination. Conclusions Despite successful training, critical procedural errors can still be made by patients on home hemodialysis. In this case, the error involved misconnection of the saline bag for wash back. This case should prompt providers of home hemodialysis to review their training protocols and manuals. Manufacturers of dialysis machinery should be encouraged to design machines specifically for home hemodialysis, and consider distinguishing the arterial and venous ends of the extracorporeal blood circuit with colour coding or incompatible connectivity, to prevent occurrences such as these in the future.

  11. Increased Intracranial Pressure during Hemodialysis in a Patient with Anoxic Brain Injury

    Directory of Open Access Journals (Sweden)

    Anton Lund

    2017-01-01

    Full Text Available Dialysis disequilibrium syndrome (DDS is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk. We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy. A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest. Computed tomography (CT revealed an inferior vena cava aneurysm and multiple pulmonary emboli as the likely cause. An intracranial pressure (ICP monitor was inserted, and, on day 3, continuous renal replacement therapy (CRRT was initiated due to acute kidney injury, during which the patient developed severe intracranial hypertension. CT of the brain showed diffuse cerebral edema. CRRT was discontinued, sedation was increased, and hypertonic saline was administered, upon which ICP normalized. Due to persistent hyperkalemia and overhydration, ultrafiltration and intermittent hemodialysis were performed separately on day 4 with a small dialyzer, low blood and dialysate flow, and high dialysate sodium content. During subsequent treatments, isolated ultrafiltration was well tolerated, whereas hemodialysis was associated with increased ICP necessitating frequent pauses or early cessation of dialysis. In patients at risk of DDS, hemodialysis should be performed with utmost care and continuous monitoring of ICP should be considered.

  12. Increased Intracranial Pressure during Hemodialysis in a Patient with Anoxic Brain Injury.

    Science.gov (United States)

    Lund, Anton; Damholt, Mette B; Strange, Ditte G; Kelsen, Jesper; Møller-Sørensen, Hasse; Møller, Kirsten

    2017-01-01

    Dialysis disequilibrium syndrome (DDS) is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk. We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy. A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest. Computed tomography (CT) revealed an inferior vena cava aneurysm and multiple pulmonary emboli as the likely cause. An intracranial pressure (ICP) monitor was inserted, and, on day 3, continuous renal replacement therapy (CRRT) was initiated due to acute kidney injury, during which the patient developed severe intracranial hypertension. CT of the brain showed diffuse cerebral edema. CRRT was discontinued, sedation was increased, and hypertonic saline was administered, upon which ICP normalized. Due to persistent hyperkalemia and overhydration, ultrafiltration and intermittent hemodialysis were performed separately on day 4 with a small dialyzer, low blood and dialysate flow, and high dialysate sodium content. During subsequent treatments, isolated ultrafiltration was well tolerated, whereas hemodialysis was associated with increased ICP necessitating frequent pauses or early cessation of dialysis. In patients at risk of DDS, hemodialysis should be performed with utmost care and continuous monitoring of ICP should be considered.

  13. Particles and solutes migration in porous medium : radionuclides and clayey particles simultaneous transport under the effect of a salinity gradient; Migration de particules et de solutes en milieu poreux : modelisation du transport simultane de particules argileuses et de radionucleides sous l`effet d`un gradient de salinite

    Energy Technology Data Exchange (ETDEWEB)

    Faure, M H

    1994-03-29

    This work deals with the radiation protection of high-level and long-life radioactive waste storages. The colloids presence in ground waters can accelerate the radionuclides migration in natural geological deposits. The aim of this thesis is then to control particularly the particles motion in porous medium in order to anticipate quantitatively their migration. Liquid chromatography columns are filled with a clayey sand and fed with a decreasing concentration sodium chloride solution in order to study the particles outlet under a salinity gradient. When the porous medium undergoes a decrease of salinity it deteriorates. The adsorption of the cations : sodium 22, calcium 45, cesium 137 and neptunium 237 is then studied by the ions exchange method. The radionuclide solution is injected before the decrease of the feed solution salinity. The decrease of the sodium chloride concentration leads to the decrease of the radionuclides concentration because the adsorption competition between the sodium ion and the injected cation is lower. The particles transport, without fouling of the porous medium, is carried out in particular physical and chemical conditions which are described. (O.L.). 71 refs., 105 figs., 26 tabs.

  14. Investigations in Marine Chemistry: Salinity II.

    Science.gov (United States)

    Schlenker, Richard M.

    Presented is a science activity in which the student investigates methods of calibration of a simple conductivity meter via a hands-on inquiry technique. Conductivity is mathematically compared to salinity using a point slope formula and graphical techniques. Sample solutions of unknown salinity are provided so that the students can sharpen their…

  15. Incremental short daily home hemodialysis: a case series

    OpenAIRE

    Toth-Manikowski, Stephanie M.; Mullangi, Surekha; Hwang, Seungyoung; Shafi, Tariq

    2017-01-01

    Background Patients starting dialysis often have substantial residual kidney function. Incremental hemodialysis provides a hemodialysis prescription that supplements patients? residual kidney function while maintaining total (residual + dialysis) urea clearance (standard Kt/Vurea) targets. We describe our experience with incremental hemodialysis in patients using NxStage System One for home hemodialysis. Case presentation From 2011 to 2015, we initiated 5 incident hemodialysis patients on an ...

  16. Effects of hemodialysis on serum fetuin-A levels

    Directory of Open Access Journals (Sweden)

    Roman Safranek

    2012-06-01

    Full Text Available Fetuin-A is a calcification inhibitor, negative acute phase response marker and cardiovascular mortality predictor in hemodialysis patients. Low levels of fetuin-A are associated with malnutrition, inflammation, decreased bone mass density, low-turnover bone and use of high calcium concentration dialysate. Hemodialysis procedure (HD has been shown to decrease fetuin-A levels by 20%, probably due to HD-induced inflammation or acute changes in calcium metabolism. The aim of our study was to investigate effects of HD on serum fetuin-A levels. Forty clinically and hemodynamically stable hemodialysis patients (21 females, 68 (38-85 years underwent routine bicarbonate hemodialysis or hemodiafiltration with polysulfone dialyzer. On consecutive HD dialysis solution with different calcium concentration with/without citric acid was used to assess influence of calcium shifts and parathyroid activity on fetuin-A changes during HD. All other parameters of HD were kept constant. Serum fetuin-A, calcium, phosphorus, iPTH, CRP and other biochemical parameters were measured before and after each HD. Our data show that predialysis serum fetuin-A levels have positive correlation with iPTH levels (p<0.05 and tendency to decrease with higher CRP levels. There was no change in fetuin-A levels during HD: 206 (167.1; 231.9 ug/ml before and 208.9 (170.3; 246.3 ug/ml after HD; respectively. When corrected for haemoconcentration, decrease in fetuin-A was only 2.8% (p<0.05. There was also no difference between effect of hemodialysis and hemodia-filtration procedure. The use of different calcium dialysate concentrations had distinct effect on iPTH levels during and after HD, however, we observed no associated changes in fetuin-A levels. The use of dialysate solution with citric acid had no effect on fetuin-A levels. In conclusion, standard bicarbonate HD with polysulfone dialyser and ultrapure dialysate induces only minor changes in fetuin-A and no changes in hsCRP levels

  17. OPCAB in patients on hemodialysis.

    Science.gov (United States)

    Milani, Rodrigo; Brofman, Paulo Roberto Slud; Souza, José Augusto Moutinho de; Barboza, Laura; Guimarães, Maximiliano Ricardo; Barbosa, Alexandre; Varela, Alexandre Manoel; Ravagnelli, Marcel Rogers; Silva, Francisco Maia da

    2007-01-01

    To analyze the hospital outcomes of patients, with chronic renal insufficiency in the hemodialysis, submitted to OPCAB. Fifty-one patients with chronic renal insufficiency were submitted to OPCAB. Hemodialysis was performed on the day before and the day after the operation. Myocardial revascularization was performed using LIMA's suture and suction stabilization. Fifty-one patients, with an average of 61.28+/-11.09 years, were analyzed. Thirty patients (58.8%) were female. The predominant functional class was IV in 21 (41.1%) of the patients. The left ventricle ejection fraction was dire in 21 (41.1%) patients. The mean EUROSCORE of this series was 7.65+/-3.83 and the mean number of distal anastomosis was 3.1+/-0.78 per patient. The average time of mechanical ventilation was 3.78+/-4.35 hours and the mean ICU stay was 41.9+/-13.8 hours, while the average hospitalization was 6.5+/-1.31 days. In respect to complications, nine (17.6%) of the patients developed atrial fibrilation, and one (1.9%) patient presented with a case of ischemic stroke but had a good recovery during hospitalization. There were no deaths in this series. Chronic renal patients submitted to hemodialysis were always a high risk population for myocardial revascularization. In this series, the absence of extracorporeal circulation appeared to be safe and efficient in this special subgroup of patients. The operations were performed with low indices of complications, absence of deaths and relatively low stays in the ICU and in hospital.

  18. Effects of frequent hemodialysis on perceived caregiver burden in the Frequent Hemodialysis Network trials.

    Science.gov (United States)

    Suri, Rita S; Larive, Brett; Hall, Yoshio; Kimmel, Paul L; Kliger, Alan S; Levin, Nathan; Tamura, Manjula Kurella; Chertow, Glenn M

    2014-05-01

    Patients receiving hemodialysis often perceive their caregivers are overburdened. We hypothesize that increasing hemodialysis frequency would result in higher patient perceptions of burden on their unpaid caregivers. In two separate trials, 245 patients were randomized to receive in-center daily hemodialysis (6 days/week) or conventional hemodialysis (3 days/week) while 87 patients were randomized to receive home nocturnal hemodialysis (6 nights/week) or home conventional hemodialysis for 12 months. Changes in overall mean scores over time in the 10-question Cousineau perceived burden scale were compared. In total, 173 of 245 (70%) and 80 of 87 (92%) randomized patients in the Daily and Nocturnal Trials, respectively, reported having an unpaid caregiver at baseline or during follow-up. Relative to in-center conventional dialysis, the 12-month change in mean perceived burden score with in-center daily hemodialysis was -2.1 (95% confidence interval, -9.4 to +5.3; P=0.58). Relative to home conventional dialysis, the 12-month change in mean perceived burden score with home nocturnal dialysis was +6.1 (95% confidence interval, -0.8 to +13.1; P=0.08). After multiple imputation for missing data in the Nocturnal Trial, the relative difference between home nocturnal and home conventional hemodialysis was +9.4 (95% confidence interval, +0.55 to +18.3; P=0.04). In the Nocturnal Trial, changes in perceived burden were inversely correlated with adherence to dialysis treatments (Pearson r=-0.35; P=0.02). Relative to conventional hemodialysis, in-center daily hemodialysis did not result in higher perceptions of caregiver burden. There was a trend to higher perceived caregiver burden among patients randomized to home nocturnal hemodialysis. These findings may have implications for the adoption of and adherence to frequent nocturnal hemodialysis.

  19. Short daily hemodialysis is associated with lower plasma FGF23 levels when compared with conventional hemodialysis.

    Science.gov (United States)

    Zaritsky, Joshua; Rastogi, Anjay; Fischmann, George; Yan, Jieshi; Kleinman, Kenneth; Chow, Georgina; Gales, Barbara; Salusky, Isidro B; Wesseling-Perry, Katherine

    2014-02-01

    The utilization of short-term daily hemodialysis has increased over the last few years, but little is known on its effects on the control of serum phosphate and fibroblast growth factor 23 (FGF23) levels. We therefore performed a cross-sectional study to compare FGF23 levels as well as other biochemical variables between 24 patients undergoing short daily hemodialysis using the NxStage System® and 54 patients treated with conventional in-center hemodialysis. FGF23 levels were measured using the second-generation Immutopics® C-terminal assay. Short daily hemodialysis patients were younger than patients on conventional hemodialysis but there were no differences between groups in the duration of end-stage renal disease nor in the number of patients with residual renal function. A greater number of short daily hemodialysis patients received vitamin D sterol therapy than did conventional in-center hemodialysis patients while there were no differences in the use of different phosphate binders and calcimimetic therapy between groups. Overall serum calcium, phosphorus and intact parathyroid hormone levels were similar between groups. While serum phosphorus levels correlated with FGF23 concentrations in each group separately [r=0.522 (P<0.01) and r=0.42 (P<0.01) in short daily and conventional in-center hemodialysis, respectively], FGF23 levels were lower [823 RU/mL (263, 2169)] in the patients receiving short daily hemodialysis than in patients treated with conventional hemodialysis [2521 RU/mL (909, 5556)] (P<0.01 between groups). These findings demonstrate that FGF23 levels are significantly lower in short daily hemodialysis patients and suggest that FGF23 levels may be a more sensitive biomarker of cumulative phosphate burden than single or multiple serum phosphorus determinations in patients treated with hemodialysis.

  20. Destructive spondyloarthropathy in hemodialysis patients

    International Nuclear Information System (INIS)

    Orzincolo, C.; Ghedini, M.; Cardona, P.; Bedani, P.L.; Scutellari, P. N.

    1991-01-01

    Destructive spondyloarthropathy (DSA) has been observed in patients undergoing long-term hemodialysis. The pathophysiology of this condition is still unknown, but there is evidence that amyloid depositions play an important role in its development. Despite several reports, the radiological evolution of these lesions is poorly known. The authors report the results of the radiographic follow-up (12-18 months) of 9 cases (7 female and 2 male patients; age 63±6 years) hemodilized for over 60 months (mean: 126±33). In 7 cases. radiographic patterns of destructive arthropathy were seen in peripheral joints as well. X-ray pictures demonstrated: 1) increased erosion of vertebral end plates (in all cases); 2) increased narrowing of invertebral spaces (in 5 cases); 3) increased collapse of vertebral bodies (in 5 cases); 4) increased malalignment of the involved segments (in 4 cases). In 3 autopsied cases β 2 -microglobulin amyloid depositions were found in disc and ligamentous paravertebral tissue. These results confirm that: 1) DSA is progressive in longterm hemodialysis patients; 2) radiographic evolution is often very quick; 3) the cervical spine is the most frequently involved location and the one where lesions are quickest to develop; 4) severe malalignament of the involved spine may be present, with subsequent neurological complications

  1. The nature of rusts and corrosion characteristics of low alloy and plain carbon steels in three kinds of concrete pore solution with salinity and different pH

    International Nuclear Information System (INIS)

    Singh, J.K.; Singh, D.D.N.

    2012-01-01

    Highlights: ► LAS rebars corrode 2–3 times slower than PCS in concrete pore solution and mortars. ► Raman and XRD studies show that goethite and maghemite phases of rusts formed on LAS. ► On PCS unstable phases of lepidocrocite and akaganite are formed. ► EIS confirms more stable rust on LAS than on PCS. ► A model is proposed to explain formation of passive film on surface of steels. - Abstract: Correlation of corrosion characteristics and nature of rusts on low alloy (LA) and plain carbon (PC) steels exposed in simulated concrete pore solution of different pH is studied. Rusts formed under wet/dry conditions are examined by Raman spectroscopy and X-ray diffraction. LA rust is more adherent compared to PC as confirmed by measurement of weight in gain and electrochemical studies. EIS results show improvement in protective properties of steels with passage of time. Both steels are found prone to pitting attack in chloride contaminated pore solution. Rebars embedded in concrete exhibit same trend as recorded in solution exposure tests.

  2. Dissecting aortic aneurysm in maintenance hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Ounissi M

    2009-01-01

    Full Text Available The dissecting aortic aneurysm (DAA is a rare pathology that may result in fatal outcome. We report follow up of three cases of DAA patients undergoing maintenance hemo-dialysis who were managed conservatively.

  3. Serum trypsin inhibitory capacity in hemodialysis patients

    International Nuclear Information System (INIS)

    Hashemi, Mohammad; Mehrabifar, Hamid; Homayooni, Fatemeh; Naderi, Mohammad; Montazerifar, Farzaneh; Ghavami, Saeid

    2009-01-01

    It has been established that overproduction of reactive oxygen species (ROS) occurs during hemodialysis causing oxidation of proteins. Alpha-1-antitrypsin is the major circulating anti-protease which contains methionine in the active site. The aim of the present study was to measure the level of serum trypsin inhibitory capacity (sTIC) in hemodialysis patients. This case-control study was performed in 52 hemodialysis patients and 49 healthy controls. sTIC was measured by enzymatic assay. The sTIC was significantly (P< 0.001) lower in hemodialysis patients (1.87 + - 0.67 micron mol/min/mL) than healthy controls (2.83 + - 0.44 micron mol/min/L). Reduction of sTIC may be due to the oxidation of methionine residue in the reactive site of alpha-1 antitrypsin. (author)

  4. Reengineering hemodialysis for the home environment.

    Science.gov (United States)

    Treu, Denny

    2010-01-01

    Denny Treu of NxStage Medical, Inc., who has led the development of six dialysis systems with various companies, reports here on a home hemodialysis system that his company successfully designed specifically for home use.

  5. Leachability of 226Ra and 210Pb from botton sediments by river waters from the Pocos de Caldas region and by saline solutions

    International Nuclear Information System (INIS)

    Oliveira, A.E. de; Franca, E.P.

    1983-01-01

    River bottom sediment samples collected in eight points of Rio das Antas and Rio Verde basins were contamined with 226 Ra or 210 Pb in the laboratory, and leached by distilled and river water or solutions of inorganic salts which should be presented in the final tailing pond effluent (Na 2 SO 4 , MgSO 4 , CaSO 4 , BaCl 2 and NaF). (E.G.) [pt

  6. An advanced analytical solution for pressure build-up during CO2 injection into infinite saline aquifers: The role of compressibility

    Science.gov (United States)

    Wu, Haiqing; Bai, Bing; Li, Xiaochun

    2018-02-01

    Existing analytical or approximate solutions that are appropriate for describing the migration mechanics of CO2 and the evolution of fluid pressure in reservoirs do not consider the high compressibility of CO2, which reduces their calculation accuracy and application value. Therefore, this work first derives a new governing equation that represents the movement of complex fluids in reservoirs, based on the equation of continuity and the generalized Darcy's law. A more rigorous definition of the coefficient of compressibility of fluid is then presented, and a power function model (PFM) that characterizes the relationship between the physical properties of CO2 and the pressure is derived. Meanwhile, to avoid the difficulty of determining the saturation of fluids, a method that directly assumes the average relative permeability of each fluid phase in different fluid domains is proposed, based on the theory of gradual change. An advanced analytical solution is obtained that includes both the partial miscibility and the compressibility of CO2 and brine in evaluating the evolution of fluid pressure by integrating within different regions. Finally, two typical sample analyses are used to verify the reliability, improved nature and universality of this new analytical solution. Based on the physical characteristics and the results calculated for the examples, this work elaborates the concept and basis of partitioning for use in further work.

  7. Effect of hemodialysis on leflunomide plasma concentrations.

    Science.gov (United States)

    Beaman, Jasmine M; Hackett, L Peter; Luxton, Grant; Illett, Kenneth F

    2002-01-01

    To report on the influence of hemodialysis on the disposition of leflunomide in a woman with end-stage renal disease. A 65-year-old white woman with a history of diabetes, end-stage renal disease, rheumatoid arthritis, vasculitis, and leg ulcers was admitted to the hospital with a flare in the symptoms of joint pain and vasculitis. Prior to admission, she had been treated for rheumatoid arthritis with methotrexate 7.5 mg once a week. Due to adverse effects from methotrexate and continuing painful joints, leflunomide was considered as a therapeutic alternative. A loading dose of 100 mg was followed two days later by a daily dose of 10 mg. The active metabolite of leflunomide (A771726) was measured before and after hemodialysis and between hemodialysis sessions over a period of 80 days. Pre- and post-hemodialysis concentrations were compared for 17 sessions during this time. Based on the initial measured concentrations, the leflunomide dose was increased to 20 mg/d for several weeks before being reduced to 15 mg due to elevated liver enzymes. Although renal pathways are responsible in part for excretion of A771726, the concentrations achieved in this patient at doses of 10-20 mg/d were at the low end of the range reported in the literature. It was shown that pre- and post-hemodialysis concentrations of A771726 did not differ significantly. Thus, the low concentrations of A771726 were not a result of the hemodialysis. Steady-state concentrations of A771726 in plasma were not affected by hemodialysis or renal impairment. Reduction of the dose of leflunomide in patients with chronic renal failure undergoing hemodialysis does not appear to be required.

  8. Dialyzability of gadodiamide in hemodialysis patients

    International Nuclear Information System (INIS)

    Saitoh, Tomoya; Tanaka, Yoshiaki; Kuno, Tsutomu; Nagura, Yuji; Hayasaka, Kazumasa

    2006-01-01

    The aim of this study was to evaluate the contrast enhancement, pharmacokinetics, dialyzability, and safety of gadodiamide in patients on hemodialysis. Thirteen hemodialysis patients with abdominal disease were examined after receiving intravenous gadodiamide (0.1 mmol/kg body weight) by magnetic resonance imaging (MRI) and were dialyzed at 1, 3, 5, and 8 days. Blood samples were obtained immediately before, during, and at the end of the first hemodialysis session and immediately before and at the end of the next three sessions. The complete blood count, blood biochemistry, β 2 -microglobulin, and gadolinium were measured. Dialysis of urea, creatinine, and gadolinium during the first hemodialysis session was assessed. Precontrast and postcontrast MRI and Gd-enhanced MR angiography (MRA) images were reviewed and visually evaluated by two radiologists; their evaluation was based on consensus. Gadodiamide did not cause any changes in renal function. An average of 73.8%, 92.4%, and 98.9% of the gadodiamide dose was eliminated by the end of the first, second, and third hemodialysis sessions, respectively. The average half-time of gadodiamide was 1.93 h (SD 0.55). The mean clearance of gadodiamide during hemodialysis was 63.5 ml/min (SD 21.9). There were no side effects related to the injection of gadodiamide. In all cases, diagnosable MRI and MRA images were obtained after gadodiamide injection in the hemodialysis patients. In hemodialysis patients, gadodiamide achieves diagnosable images. It is dialyzable and can be used safely without measures to increase excretion. (author)

  9. Dissolution and carbonation of a serpentinite: Inferences from acid attack and high P-T experiments performed in aqueous solutions at variable salinity

    International Nuclear Information System (INIS)

    Orlando, Andrea; Borrini, Daniele; Marini, Luigi

    2011-01-01

    Highlights: → In order to perform geological sequestration of CO 2 , serpentinite should be dissolved by acids or by aqueous solutions. → At atmospheric pressure serpentinite is efficaciously dissolved at 70 deg. C using acid attacks. → At higher P-T conditions, significant carbonation occurs at 30 MPa and 300 deg. C using CO 2 saturated aqueous solutions. - Abstract: Dissolution experiments on a serpentinite were performed at 70 deg. C, 0.1 MPa, in H 2 SO 4 solution, in open and closed systems, in order to evaluate the overall dissolution rate of mineral components over different times (4, 9 and 24 h). In addition, the serpentinite powder was reacted with a NaCl-bearing aqueous solution and supercritical CO 2 for 24 h at higher pressures (9-30 MPa) and temperatures (250-300 deg. C) either in a stirred reactor or in an externally-heated pressure vessel to assess both the dissolution rate of serpentinite minerals and the progress of the carbonation reaction. Results show that, at 0.1 MPa, MgO extraction from serpentinite ranges from 82% to 98% and dissolution rate varies from 8.5 x 10 -10 mole m -2 s -1 to 4.2 x 10 -9 mole m -2 s -1 . Attempts to obtain carbonates from the Mg-rich solutions by increasing their pH failed since Mg- and NH 4 - bearing sulfates promptly precipitated. On the other hand, at higher pressures, significant crystallization (5.0-10.4 wt%) of Ca- and Fe-bearing magnesite was accomplished at 30 MPa and 300 deg. C using 100 g L -1 NaCl aqueous solutions. The corresponding amount of CO 2 sequestered by crystallization of carbonates is 9.4-15.9 mole%. Dissolution rate (from 6.3 x 10 -11 mole m -2 s -1 to 1.3 x 10 -10 mole m -2 s -1 ) is lower than that obtained at 0.1 MPa and 70 deg. C but it is related to pH values much higher (3.3-4.4) than that (-0.65) calculated for the H 2 SO 4 solution. Through a thorough review of previous experimental investigations on the dissolution kinetics of serpentine minerals the authors propose adopting: (i

  10. Dissolution and carbonation of a serpentinite: Inferences from acid attack and high P-T experiments performed in aqueous solutions at variable salinity

    Energy Technology Data Exchange (ETDEWEB)

    Orlando, Andrea, E-mail: orlando@igg.cnr.it [C.N.R., Istituto di Geoscienze e Georisorse, U.O.S. di Firenze, Via G. La Pira, 4, I-50121 Firenze (Italy); Borrini, Daniele [Dipartimento di Scienze della Terra, Universita degli Studi di Firenze, Via G. La Pira, 4, I-50121 Firenze (Italy); Marini, Luigi [Consultant in Applied Geochemistry, Via A. Fratti 253, I-55049 Viareggio (Italy)

    2011-08-15

    Highlights: > In order to perform geological sequestration of CO{sub 2}, serpentinite should be dissolved by acids or by aqueous solutions. > At atmospheric pressure serpentinite is efficaciously dissolved at 70 deg. C using acid attacks. > At higher P-T conditions, significant carbonation occurs at 30 MPa and 300 deg. C using CO{sub 2} saturated aqueous solutions. - Abstract: Dissolution experiments on a serpentinite were performed at 70 deg. C, 0.1 MPa, in H{sub 2}SO{sub 4} solution, in open and closed systems, in order to evaluate the overall dissolution rate of mineral components over different times (4, 9 and 24 h). In addition, the serpentinite powder was reacted with a NaCl-bearing aqueous solution and supercritical CO{sub 2} for 24 h at higher pressures (9-30 MPa) and temperatures (250-300 deg. C) either in a stirred reactor or in an externally-heated pressure vessel to assess both the dissolution rate of serpentinite minerals and the progress of the carbonation reaction. Results show that, at 0.1 MPa, MgO extraction from serpentinite ranges from 82% to 98% and dissolution rate varies from 8.5 x 10{sup -10} mole m{sup -2} s{sup -1} to 4.2 x 10{sup -9} mole m{sup -2} s{sup -1}. Attempts to obtain carbonates from the Mg-rich solutions by increasing their pH failed since Mg- and NH{sub 4}- bearing sulfates promptly precipitated. On the other hand, at higher pressures, significant crystallization (5.0-10.4 wt%) of Ca- and Fe-bearing magnesite was accomplished at 30 MPa and 300 deg. C using 100 g L{sup -1} NaCl aqueous solutions. The corresponding amount of CO{sub 2} sequestered by crystallization of carbonates is 9.4-15.9 mole%. Dissolution rate (from 6.3 x 10{sup -11} mole m{sup -2} s{sup -1} to 1.3 x 10{sup -10} mole m{sup -2} s{sup -1}) is lower than that obtained at 0.1 MPa and 70 deg. C but it is related to pH values much higher (3.3-4.4) than that (-0.65) calculated for the H{sub 2}SO{sub 4} solution. Through a thorough review of previous experimental

  11. Incremental short daily home hemodialysis: a case series.

    Science.gov (United States)

    Toth-Manikowski, Stephanie M; Mullangi, Surekha; Hwang, Seungyoung; Shafi, Tariq

    2017-07-05

    Patients starting dialysis often have substantial residual kidney function. Incremental hemodialysis provides a hemodialysis prescription that supplements patients' residual kidney function while maintaining total (residual + dialysis) urea clearance (standard Kt/Vurea) targets. We describe our experience with incremental hemodialysis in patients using NxStage System One for home hemodialysis. From 2011 to 2015, we initiated 5 incident hemodialysis patients on an incremental home hemodialysis regimen. The biochemical parameters of all patients remained stable on the incremental hemodialysis regimen and they consistently achieved standard Kt/Vurea targets. Of the two patients with follow-up >6 months, residual kidney function was preserved for ≥2 years. Importantly, the patients were able to transition to home hemodialysis without automatically requiring 5 sessions per week at the outset and gradually increased the number of treatments and/or dialysate volume as the residual kidney function declined. An incremental home hemodialysis regimen can be safely prescribed and may improve acceptability of home hemodialysis. Reducing hemodialysis frequency by even one treatment per week can reduce the number of fistula or graft cannulations or catheter connections by >100 per year, an important consideration for patient well-being, access longevity, and access-related infections. The incremental hemodialysis approach, supported by national guidelines, can be considered for all home hemodialysis patients with residual kidney function.

  12. Removal of uremic retention products by hemodialysis is coupled with indiscriminate loss of vital metabolites.

    Science.gov (United States)

    Zhang, Zhi-Hao; Mao, Jia-Rong; Chen, Hua; Su, Wei; Zhang, Yuan; Zhang, Li; Chen, Dan-Qian; Zhao, Ying-Yong; Vaziri, Nosratola D

    2017-12-01

    Although dialysis ameliorates uremia and fluid and electrolytes disorders, annual mortality rate remains high in dialysis population reflecting its shortcoming in replacing renal function. Unlike the normal kidney, dialysis causes dramatic shifts in volume and composition of body fluids and indiscriminate removal of vital solutes. Present study was undertaken to determine the impact of hemodialysis on plasma metabolites in end-stage renal disease (ESRD) patients. 80 hemodialysis patients and 80 age/gender-matched healthy controls were enrolled in the study. Using ultra performance liquid chromatography-high-definition mass spectrometry, we measured plasma metabolites before, during, and after hemodialysis procedure and in blood entering and leaving the dialysis filter. Principal component analysis revealed significant difference in concentration of 214 metabolites between healthy control and ESRD patients' pre-dialysis plasma (126 increased and 88 reduced in ESRD group). Comparison of post-dialysis with pre-dialysis data revealed significant changes in the 362 metabolites. Among ESI + metabolites 195 decreased and 55 increased and among ESI - metabolites 82 decreased and 30 increased following hemodialysis. Single blood passage through the dialyzer caused significant changes in 323 metabolites. Comparison of ESRD patients' post-hemodialysis with healthy subjects' data revealed marked differences in metabolic profiles. We identified 55 of the 362 differential metabolites including well known uremic toxins, waste products and vital biological compounds. In addition to uremic toxins and waste products hemodialysis removes large number of identified and as-yet un-identified metabolites. Depletion of vital biological compounds by dialysis may contribute to the high morbidity and annual mortality rate in this population. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  13. Physico-Chemical Study of the Separation of Calcium Isotopes by Chemical Exchange Between Amalgam and Salt Solutions; Etude physico-chimique de la separation des isotopes du calcium par echange chimique entre amalgame et solution saline

    Energy Technology Data Exchange (ETDEWEB)

    Duie, P; Dirian, G [Commissariat a l' Energie Atomique. Centre d' Etudes Nucleaires de Saclay, 91 - Gif-sur-Yvette (France)

    1962-07-01

    In a preliminary study of the isotopic exchange between Ca amalgam and aqueous or organic solutions of Ca salts, the main parameters governing the feasibility of a separation process based on these systems such as separation factor, exchange kinetics, rate of decomposition of the amalgam were investigated. The separation factor between {sup 40}Ca and {sup 46}Ca was found to be of the order of 1.02. The rate of the exchange reaction is rather low for aqueous solutions, extremely low for organic solutions. The amalgam seems not to be attacked by dimethyl-formamide solutions; but it is rapidly decomposed by aqueous solutions of Ca halides. This decomposition is slow in the case of aqueous solutions of calcium formate and still slower for Ca(OH){sub 2}; however, except in particular conditions, the observed rate is often much higher, owing to interfering reactions between amalgam and water vapor contained in H{sub 2} bubbles. (authors) [French] On a fait une etude preliminaire, pour des systemes amalgame de calcium - solution aqueuse ou organique de sels de calcium, des principaux parametres pouvant intervenir dans l'application d'un procede d'echange a l'enrichissement isotopique du calcium: facteur de separation, cinetique de l'echange, cinetique de la decomposition de l'amalgame. Les facteurs de separation {sup 40}Ca-{sup 46}Ca sont de l'ordre de 1,02. L'echange est assez lent pour les solutions aqueuses, extremement lent pour les solutions organiques. La decomposition de l'amalgame est pratiquement inexistante avec les solutions dans le dimethyl- formamide, appreciable pour les solutions alcooliques, rapide pour les solutions aqueuses d'halogenures; elle est normalement lente pour les solutions aqueuses de formiate et surtout de chaux, mais la decomposition est en general acceleree par une reaction parasite entre l'amalgame et l'eau a l'etat vapeur, reaction que l'on n'evite dans des conditions tres particulieres. (auteurs)

  14. Hemodialysis, plea of availability versus adequecy gezira experience

    African Journals Online (AJOL)

    Methods: Pre and post hemodialysis blood sample were obtained from the study ... duration of hemodialysis session, increase blood flow rate and dialysate flow rate. ... renal replacement therapy (peritoneal dialysis and renal transplantations).

  15. Influence of Frequent Nocturnal Home Hemodialysis on Food Preference

    NARCIS (Netherlands)

    Ipema, Karin; Franssen, Casper; van der Schans, Cees; Smit, Lianne; Noordman, Sabine; Haisma, Hinke

    Objective: Dialysis patients frequently report a change of taste that is reversible after renal transplantation, suggesting that uremic toxins may negatively influence taste. Currently, frequent nocturnal home hemodialysis (NHHD) is the most effective method of hemodialysis, and is associated with

  16. The PHREEQC modeling of CO{sub 2} transport in highly saline solutions of a final radioactive waste repository; PHREEQC. Modellierung des Transportes von CO{sub 2} in hochsalinaren Loesungen eines Endlagers

    Energy Technology Data Exchange (ETDEWEB)

    Weyand, Torben [Bonn Univ. (Germany); Gesellschaft fuer Reaktorsicherheit mbH (GRS), Koeln (Germany); Bracke, Guido [Gesellschaft fuer Reaktorsicherheit mbH (GRS), Koeln (Germany); Reichert, Barbara [Bonn Univ. (Germany)

    2014-03-15

    The safe confinement of radioactive materials in the containment providing zone of the host rock (CPRZ) over a period of one million years is required for a final repository for highly radioactive heat-generating waste (BMU 2010). In order to assess the safe containment of radionuclides in the CPRZ a sound understanding of the ongoing processes in a repository is necessary. These processes include the transport and chemical interactions of the radionuclide {sup 14}C in the gas phase and in highly saline solutions in a final repository for radioactive waste. The geochemical code PHREEQC /PAR 13/ was used to study the chemical interactions of CO{sub 2} and {sup 14}C as {sup 14}CO{sub 2} during transport in the gas phase and highly saline solutions. The model and scenario was based on the concept for a repository in Gorleben /BOL 11/. A gas generation of CO{sub 2} containing {sup 14}C was assumed since the disposed containers with the radioactive waste corrode /LAR 13/. The advective transport is triggered by gas generation. The physical dissolution of CO{sub 2}, chemical equilibria with aquatic carbon-containing species (e. g. HCO{sub 3}{sup -}(aq), CO{sub 3}{sup 2-}(aq)) and solid phases (e. g. magnesite, MgCO{sub 3}) coupled with transport were modelled. Due to the addition of dissolved MgCl{sub 2} in the crushed salt backfill of the main drift the aquatic species MgCO{sub 3}(aq) and the mineral MgCO{sub 3}(s) is formed. The influence of CO{sub 2} partial pressure and the chemical interactions in the presence of dissolved Fe{sup 2+}, Ca{sup 2+}, Mg{sup 2+} and K{sup +} were studied. Due to the physical solution, the CO{sub 2} partial pressure has a major influence on the transport of {sup 14}C. In the presence of calcium CaCO{sub 3}(aq), the minerals calcite (CaCO{sub 3}(s)) and dolomite (MgCa(CO{sub 3}){sub 2}(s)) were formed in the highly saline solutions. No siderite (FeCO{sub 3}) in the presence of Fe{sup 2+} was formed. The transport of {sup 14}C was delayed

  17. Solubility Model for Ferrous Iron Hydroxide, Hibbingite, Siderite, and Chukanovite in High Saline Solutions of Sodium Chloride, Sodium Sulfate, and Sodium Carbonate

    International Nuclear Information System (INIS)

    Kim, Sungtae; Marrs, Cassandra; Nemer, Martin; Jang, Jay Je-Hun

    2017-01-01

    Here, a solubility model is presented for ferrous iron hydroxide (Fe(OH) 2 (s)), hibbingite (Fe 2 Cl(OH) 3 (s)), siderite (FeCO 3 (s)), and chukanovite (Fe 2 CO 3 (OH) 2 (s)). The Pitzer activity coefficient equation was utilized in developing the model to account for the excess free energies of aqueous species in the background solutions of high ionic strength. Solubility limiting minerals were analyzed before and after experiments using X-ray diffraction. Formation of Fe(OH) 2 (s) was observed in the experiments that were initiated with Fe 2 Cl(OH) 3 (s) in Na 2 SO 4 solution. Coexistence of siderite and chukanovite was observed in the experiments in Na 2 CO 3 + NaCl solutions. Two equilibrium constants that had been reported by us for the dissolution of Fe(OH) 2 (s) and Fe 2 Cl(OH) 3 (s) (Nemer et al.) were rederived in this paper, using newer thermodynamic data selected from the literature to maintain internal consistency of the series of our data analyses in preparation, including this paper. Three additional equilibrium constants for the following reactions were determined in this paper: dissolution of siderite and chukanovite and dissociation of the aqueous species Fe(CO 3 ) 2 –2 . Five Pitzer interaction parameters were derived in this paper: β (0) , β (1) , and C φ parameters for the species pair Fe +2 /SO 4 –2 ; β (0) and β (1) parameters for the species pair Na+/Fe(CO3)2–2. Our model predicts that, among the four inorganic ferrous iron minerals, siderite is the stable mineral in two WIPP-related brines (WIPP: Waste Isolation Pilot Plant), i.e., GWB and ERDA6 (Brush and Domski), and the electrochemical equilibrium between elemental iron and siderite provides a low oxygen fugacity (10 –91.2 atm) that can keep the actinides at their lowest oxidation states. (Nemer et al., Brush and Domski; references numbered 1 and 2 in the main text).

  18. 21 CFR 876.5665 - Water purification system for hemodialysis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Water purification system for hemodialysis. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5665 Water purification system for hemodialysis. (a) Identification. A water purification system for hemodialysis is a...

  19. Hemodialysis

    Science.gov (United States)

    ... need to eat a special diet? Yes. Generally speaking, patients on dialysis are advised to increase their ... on our websites is information developed solely from internal experts on the subject matter, including medical advisory ...

  20. Removal of toxic chromium from aqueous solution, wastewater and saline water by marine red alga Pterocladia capillacea and its activated carbon

    Directory of Open Access Journals (Sweden)

    Ahmed El Nemr

    2015-01-01

    Full Text Available Pterocladia capillacea, a red marine macroalgae, was tested for its ability to remove toxic hexavalent chromium from aqueous solution. A new activated carbon obtained from P. capillacea via acid dehydration was also investigated as an adsorbent for toxic chromium. The experiments were conducted to study the effect of important parameters such as pH, chromium concentration and adsorbent weight. Batch equilibrium tests at different pH conditions showed that at pH 1.0, a maximum chromium uptake was observed for both inactivated dried red alga P. capillacea and its activated carbon. The maximum sorption capacities for dried red alga and its activated carbon were about 12 and 66 mgg−1, respectively, as calculated by Langmuir model. The ability of inactivated red alga P. capillacea and developed activated carbon to remove chromium from synthetic sea water, natural sea water and wastewater was investigated as well. Different isotherm models were used to analyze the experimental data and the models parameters were evaluated. This study showed that the activated carbon developed from red alga P. capillacea is a promising activated carbon for removal of toxic chromium.

  1. Development of a thermodynamic model for zinc, lead and cadmium in saline solutions; Entwicklung eines thermodynamischen Modells fuer Zink, Blei und Cadmium in salinaren Loesungen

    Energy Technology Data Exchange (ETDEWEB)

    Hagemann, Sven

    2012-07-15

    Waters on aboveground and underground landfills often contain high concentrations of pollutants like zinc, lead and cadmium. Interactions between wastes and aqueous solutions could lead to a mobilisation of these elements. If their maximum solubilities are to be predicted by geochemical modelling a thermodynamic data base is needed. Due to the lack of experimental data such a data base could not be developed yet. In order to fill the gaps isopiestic as well as solubility measurements were made at 25 C. Furthermore the complex formation of zinc and cadmium was investigated and quantified by means of Raman spectrometry and evolving factor analysis. It could be proven that only complexes with two and four chlorine atoms achieve significant concentrations. On basis of these results and a critical evaluation of literature data a consistent thermodynamic data base for was developed for the calculation of activity coefficients and solubilities in the system Na, K, Mg, Ca, Zn, Cd, Cl, SO{sub 4}-H{sub 2}O at 298,15 K.

  2. Carbon steel corrosion under anaerobic-aerobic cycling conditions in near-neutral pH saline solutions - Part 1: Long term corrosion behaviour

    International Nuclear Information System (INIS)

    Sherar, B.W.A.; Keech, P.G.; Shoesmith, D.W.

    2011-01-01

    Highlights: → Anaerobic-aerobic cycling on pipeline steel forms two distinct surface morphologies. → Seventy-five percentage of the surface was covered by a black, compact layer ∼4.5 μm thick. → A tubercle, ∼3 to 4 mm in cross section, covered the remaining 25% of surface. → The tubercle cross section showed a single large pit ∼275 μm deep. - Abstract: The influence of anaerobic-aerobic cycling on pipeline steel corrosion was investigated in near-neutral carbonate/sulphate/chloride solution (pH 9) over 238 days. The corrosion rate increased and decreased as exposure conditions were switched between redox conditions. Two distinct corrosion morphologies were observed. The majority of the surface corroded uniformly to produce a black magnetite/maghemite layer approximately 4.5 μm thick. The remaining surface was covered with an orange tubercle, approximately 3-4 mm in cross section. Analysis of the tubercle cross section revealed a single large pit approximately 275 μm deep. Repeated anaerobic-aerobic cycling localized the corrosion process within this tubercle-covered pit.

  3. The effect of aerobic corrosion on anaerobically-formed sulfide layers on carbon steel in dilute near-neutral pH saline solutions

    International Nuclear Information System (INIS)

    Sherar, B.W.A.; Keech, P.G.; Shoesmith, D.W.

    2013-01-01

    Highlights: •The corrosion rate is low when steel is exposed to anaerobic conditions (pH = 8.9). •An anaerobic corrosion with sulfide to aerobic switch increases the corrosion rate. •Aerobic conditions leads to corrosion and oxide deposition beneath FeS. •Continual air exposure leads to the blistering of the original FeS film. -- Abstract: The aerobic corrosion of pipeline steel was investigated in an aqueous sulfide solution by monitoring the corrosion potential and periodically measuring the polarization resistance. The properties and composition of the corrosion product deposits formed were determined using scanning electron microscopy, energy dispersive X-ray analysis, and Raman spectroscopy. The establishment of aerobic conditions leads to corrosion and (oxyhydr)oxide deposition beneath the anaerobically-formed mackinawite film originally present on the steel surface. This leads to blistering and spalling of the sulfide film. Chemical conversion of the mackinawite to Fe(III) (oxyhydr)oxides also occurs but is a relatively slow reaction

  4. Severe Valproic Acid Intoxication Responding to Hemodialysis

    Directory of Open Access Journals (Sweden)

    Ali Ertuğ Arslanköylü

    2017-08-01

    Full Text Available Valproic acid is a commonly used antiepileptic drug which causes intoxication easily due to its narrow therapeutic window. Here, we present a child with valproic acid poisoning who responded to hemodialysis. A 14-year-old male patient with epilepsy and mental motor retardation was admitted to the pediatric intensive care unit due to valproic acid intoxication. Plasma valproic acid level was 710 µg/mL. The patient’s vital signs were stable and a decrease was observed in the valproic acid and ammonia levels with supportive treatment at the beginning. On the third day of the admission, hemodynamic and mental status of the patient deteriorated, plasma ammonia and lactate levels elevated, thus, we decided to perform hemodialysis. After hemodialysis, the patient’s hemodynamic status and mental function improved in conjunction with the reduction in valproic acid, ammonia and lactate levels. Thus he was transferred to the pediatric ward. Hemodialysis may be considered an effective treatment choice for severe valproic acid intoxication. Here, it was shown that hemodialysis may also be effective in patients with deteriorated general status under supportive treatment in the late phase of valproic acid intoxication.

  5. The cost of hemodialysis in a large hemodialysis center

    Directory of Open Access Journals (Sweden)

    Khalid Al Saran

    2012-01-01

    Full Text Available To assess the cost of hemodialysis (HD delivered at our center according to the treatment protocols based on the current Kidney Disease Outcome Quality Initiative (K/DOQI guidelines, we analyzed our cost data during the period from 1st of January 2007 to 30th of June 2010. The methods were used to determine both direct costs (related to dialysis treatment such as dialysis disposables, dialysis related drugs, medical personnel, out-patient medications, laboratory and other ancillary services and overhead costs (building, maintenance and engineering costs, housekeeping, and administrative personnel. During the study period, an average of 2,500 HD sessions per month were performed for 200 patients. The mean total cost per HD session was calculated as 297 US dollars (USD [1,114 Saudi Riyals (SR], and the mean total cost of dialysis per patient per year was 46,332 USD (173,784 SR. Direct costs contributed to 81.15% of the total cost from which the personnel cost represented 41.11% and dialysis disposables represented 13.64%, while medications (outpatient and intravenous dialysis related medications including albumin, erythropoiesis stimulating agents, iron and vitamin D3 accounted for 12.47% of the total cost. Our total cost level is well below the average cost in the industrialized countries.

  6. The distribution of soluble radionuclide-relevant trace elements between salt minerals and saline solutions; Die Verteilung loeslicher Radionuklid-relevanter Spurenelemente zwischen Salzmineralen und salinaren Loesungen

    Energy Technology Data Exchange (ETDEWEB)

    Voss, Ina

    2015-07-16

    The research platform ENTRIA (Disposal options for radioactive residues Interdisciplinary analyses and development of evaluation principles) includes the sub-project ''Final disposal in deep geological formations without any arrangements for retrieval''. This approach considers rock salt (beside clay and granite) as host rock formation for disposal of heat-producing long-live waste. Most rock salt formations contain Mg-rich brines derived from highly evolved sea water evaporation processes now included in the rock salt mass. If such brines get access to metal-canister corrosion will allow release of soluble nuclides to the brine. In this scenario, it cannot be excluded that contaminated brines leave the deep seated disposal area and move along geological or technical migration pathways towards the rock salt/cap rock contact. The temperature of the brine will drop from near 80 C to 25 or 30 C. The deceasing temperature of the brine causes precipitation of magnesian chloride and sulfate phase in equilibrium with the brine. In order to understand the salt precipitation and the retention mechanism of dissolved trace elements experiments have been set up which allow formation of sylvite, carnallite, kainite, and hydrous Mg-sulphates under controlled conditions. The retention capacity of crystallizing salt minerals based occurring in magnesian brine solutions at decreasing temperature within a salt dome is best measured as the distribution coefficient D. This concept assumes incorporation of trace elements into the lattice of salt minerals. The distribution coefficients of the trace elements, Rb, Cs, Co, Ni, Zn, Li and B between sylvite, carnallite, kainite, and MgSO{sub 4} phases have been determined at experimental temperatures of 25, 35, 55 and 83 C. The results clearly indicate the following range of distribution coefficients (D): Sylvite D > 1 Rb and Br, D < 1 Co, Ni, Zn, Li and B, Carnallite D > 1 Rb and Cs, D < 1 Co, Ni, Zn, Li and B, Kainite D

  7. Hemodialysis Treatment Time: As Important as it Seems?

    Science.gov (United States)

    Daugirdas, John T

    2017-03-01

    Hemodialysis treatment time and Kt/V can both be considered to be primary measures of hemodialysis adequacy, because when either goes to zero, mortality is certain in patients without residual kidney function. Treatment time is important, but it needs to be adjusted based on surface-area-normalized Kt/V, residual kidney function, and expected ultrafiltration rate. Rescaling dose of dialysis measured as Kt/V to body surface area prevents ultrashort dialysis in small patients, women, and children with minimal residual kidney function. Most if not all of the observational studies of associations between outcome and dialysis session length are probably confounded by dose targeting bias. Once adequate Kt/V (taking into account body surface area) has been provided, adequate dialysis time probably is most relevant in terms of limiting the need for a high fluid removal rate. The latter may adversely impact survival by causing recurrent ischemia to cardiovascular and other tissues. There is little high-quality evidence at this time to support a minimum 4-hour treatment time for all patients, regardless of body size, solute removal, or residual kidney function. On the other hand, there is little evidence that prolonging weekly treatment time up to 24 hours per week is harmful. The final decision regarding treatment time is best individualized, based on patient acceptability and experience, residual kidney function, body surface-area-normalized Kt/V, and expected ultrafiltration rate. © 2017 Wiley Periodicals, Inc.

  8. [Vascular access guidelines for hemodialysis].

    Science.gov (United States)

    Rodríguez Hernández, J A; González Parra, E; Julián Gutiérrez, J M; Segarra Medrano, A; Almirante, B; Martínez, M T; Arrieta, J; Fernández Rivera, C; Galera, A; Gallego Beuter, J; Górriz, J L; Herrero, J A; López Menchero, R; Ochando, A; Pérez Bañasco, V; Polo, J R; Pueyo, J; Ruiz, Camps I; Segura Iglesias, R

    2005-01-01

    Quality of vascular access (VA) has a remarkable influence in hemodialysis patients outcomes. Dysfunction of VA represents a capital cause of morbi-mortality of these patients as well an increase in economical. Spanish Society of Neprhology, aware of the problem, has decided to carry out a revision of the issue with the aim of providing help in comprehensión and treatment related with VA problems, and achieving an homogenization of practices in three mayor aspects: to increase arteriovenous fistula utilization as first vascular access, to increment vascular access monitoring practice and rationalise central catheters use. We present a consensus document elaborated by a multidisciplinar group composed by nephrologists, vascular surgeons, interventional radiologysts, infectious diseases specialists and nephrological nurses. Along six chapters that cover patient education, creation of VA, care, monitoring, complications and central catheters, we present the state of the art and propose guidelines for the best practice, according different evidence based degrees, with the intention to provide help at the professionals in order to make aproppiate decissions. Several quality standars are also included.

  9. Modalities of hemodialysis: Quality improvement

    Directory of Open Access Journals (Sweden)

    Ayman Karkar

    2012-01-01

    Full Text Available Hemodialysis (HD treatment had, over many years, improved the survival rate of patients with end-stage renal disease. However, standard or conventional HD prescription is far from being optimal in replacing the function of normal kidneys. Its unphysiologic clearance pattern and inability to remove all types and sizes of uremic toxins results in inter- and intra-dialysis complications and an unacceptably high rate of cardiovascular morbidity and mortality. Efficiency of HD can be improved by increasing blood and dialysate flow rates, dialyzer size and surface area and duration and frequency of dialysis sessions. Home HD, where short daily or long slow nocturnal HD sessions can conveniently be performed, provides an excellent option for quality of life improvement and reduction in morbidity and mortality. Recent innovations in the specifications of HD machines and improvement in dialysis membranes characteristics and water treatment technology paved the way for achieving quality HD. These advancements have resulted in efficient implementation of adsorption, diffusion and/or convection principles using adsorption HD, hemofiltration, hemodiafiltration (HDF and online HDF modalities in order to achieve optimum HD. Implementation of these innovations resulted in better quality care achievements in clinical practice and reduction in morbidity and mortality rates among HD patients.

  10. Hemodialysis in the Poisoned Patient

    Directory of Open Access Journals (Sweden)

    Megan Boysen-Osborn

    2017-09-01

    Full Text Available Audience: This classic team based learning (cTBL didactic is aimed for emergency medicine residents and fourth year medical students entering emergency medicine. Introduction: Over one million visits per year to United States (US emergency departments (ED are related to poisonings.1 Extracorporeal treatment (ECTR, specifically hemodialysis (HD, is one potential method to enhance elimination of certain drugs and their toxic metabolites.2-12 While HD may be life-saving in certain poisonings, it may have no effect on others and it carries associated risks and costs. It is essential that emergency physicians know the indications for HD in the poisoned patient. This cTBL reviews many poisonings which may be managed by HD. Objectives: By the end of this cTBL, the learner will: 1 recognize laboratory abnormalities related to toxic alcohol ingestion; 2 calculate an anion gap and osmolal gap; 3 know the characteristics of drugs that are good candidates for HD; 4 discuss the management of patients with toxic alcohol ingestions; 5 discuss the management of patients with salicylate overdose; 6 know the indications for HD in patients with overdoses of antiepileptic drugs; 7 discuss the management of patients with lithium toxicity. Method: This didactic session is a cTBL (classic team based learning.

  11. Bicytopenia, especially thrombocytopenia in hemodialysis and non-hemodialysis patients treated with linezolid therapy.

    Science.gov (United States)

    Kato, Hideo; Hamada, Yukihiro; Hagihara, Mao; Hirai, Jun; Yamagishi, Yuka; Matsuura, Katsuhiko; Mikamo, Hiroshige

    2015-10-01

    One of the major adverse events associated with linezolid treatment is pancytopenia. However, there are few reports about the tolerability of linezolid among patients undergoing hemodialysis. This study retrospectively investigated the frequency of bicytopenia (thrombocytopenia and erythropenia) secondary to linezolid treatment in patients undergoing and not-undergoing hemodialysis. In total, 181 patients treated with linezolid from January 2010 to July 2012 at Aichi Medical University Hospital were divided into three groups; patients undergoing hemodialysis (HD group), those with creatinine clearance (CLCR) of linezolid therapy were compared among three groups. Thrombocytopenia (linezolid therapy. In particular, the PLT nadir in HD group occurred earlier than that in non-HD groups (HD, 11.5 days [4-31 days]; CLCR linezolid treatment in patients undergoing hemodialysis. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  12. PRESCRIPTION AND ADEQUACY OF HEMODIALYSIS

    Directory of Open Access Journals (Sweden)

    I Gde Raka Widiana

    2013-10-01

    Full Text Available Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 Physiologically, uremic syndrome is a pollutional phenomenone of body fluid caused by uremic substance retention due to failing kidney. Hemodialysis (HD is a substitution therapy to replace native kidney to filter out the toxic substances. The clearance capacity can be measured using urea kinetic modeling, where urea is used as a marker. Prescription of HD will produced prescribed KT/V, namely the amount of HD doses given. On the other hand delivered KT/V is real clearance effect occurred in the body. Each component of dialysis machine can be adjusted to produce adequate delivered KT/V. This KT/V has also to be adjusted with weekly frequency of HD and residual function of the native kidney. Value of KT/V in each HD session according the consensus has to be attained in order the patient live a better life longer /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  13. Technical aspects of home hemodialysis

    Directory of Open Access Journals (Sweden)

    Alhomayeed B

    2009-01-01

    Full Text Available Home hemodialysis (HHD has proved to be a useful form of renal replacement therapy. The economic advantage of HHD is well established and interest in it is renewed. Once it has been decided to establish a HHD program, a well developed strategic plan is required. This should address financial and logistical issues and establish policies that will address responsi-bilities of both patients and HD centers. The recruitment of patients is facilitated by ensuring that all incident patients have early access to an education program describing all forms of renal replacement therapy that the regional renal program provides. Patients and members of the pre-dialysis education program should understand the selection process criteria in advance. Once the assessment is completed and the patient agrees to the proceedings, a plan of action should be esta-blished for enrolling the patient into the program and initiating training. Patients′ education pro-gram should take into consideration principles of adult learning. When choosing dialysis equip-ment for home use, the needs and preferences of the patients should be respected. As a rule of thumb, the equipment should be simple to use, yet still provide adequate and reliable therapy. De-ciding where to set up and position the HHD equipment is important. Installation of HHD ma-chine at home requires a continuous supply of accessories. Before establishing a HHD program, commitment of the dialysis center to provide and maintain the infrastructure of the program is mandatory. The estimated patients suitable for HHD are less than 15% of all prospective dialysis patients. Generally, those who are have greatly improved quality of life and by using modalities such as nocturnal and daily dialysis can have improved physical well-being with considerable potential cost savings.

  14. Technical aspects of home hemodialysis.

    Science.gov (United States)

    Alhomayeed, B; Lindsay, R M

    2009-03-01

    Home hemodialysis (HHD) has proved to be a useful form of renal replacement therapy. The economic advantage of HHD is well established and interest in it is renewed. Once it has been decided to establish a HHD program, a well developed strategic plan is required. This should address financial and logistical issues and establish policies that will address responsi-bilities of both patients and HD centers. The recruitment of patients is facilitated by ensuring that all incident patients have early access to an education program describing all forms of renal replacement therapy that the regional renal program provides. Patients and members of the pre-dialysis education program should understand the selection process criteria in advance. Once the assessment is completed and the patient agrees to the proceedings, a plan of action should be esta-blished for enrolling the patient into the program and initiating training. Patients' education pro-gram should take into consideration principles of adult learning. When choosing dialysis equip-ment for home use, the needs and preferences of the patients should be respected. As a rule of thumb, the equipment should be simple to use, yet still provide adequate and reliable therapy. De-ciding where to set up and position the HHD equipment is important. Installation of HHD ma-chine at home requires a continuous supply of accessories. Before establishing a HHD program, commitment of the dialysis center to provide and maintain the infrastructure of the program is mandatory. The estimated patients suitable for HHD are less than 15% of all prospective dialysis patients. Generally, those who are have greatly improved quality of life and by using modalities such as nocturnal and daily dialysis can have improved physical well-being with considerable potential cost savings.

  15. Hypersensitivity reactions in patients receiving hemodialysis.

    Science.gov (United States)

    Butani, Lavjay; Calogiuri, Gianfranco

    2017-06-01

    To describe hypersensitivity reactions in patients receiving maintenance hemodialysis. PubMed search of articles published during the past 30 years with an emphasis on publications in the past decade. Case reports and review articles describing hypersensitivity reactions in the context of hemodialysis. Pharmacologic agents are the most common identifiable cause of hypersensitivity reactions in patients receiving hemodialysis. These include iron, erythropoietin, and heparin, which can cause anaphylactic or pseudoallergic reactions, and topical antibiotics and anesthetics, which lead to delayed-type hypersensitivity reactions. Many hypersensitivity reactions are triggered by complement activation and increased bradykinin resulting from contact system activation, especially in the context of angiotensin-converting enzyme inhibitor use. Several alternative pharmacologic preparations and dialyzer membranes are available, such that once an etiology for the reaction is established, recurrences can be prevented without affecting the quality of care provided to patients. Although hypersensitivity reactions are uncommon in patients receiving hemodialysis, they can be life-threatening. Moreover, considering the large prevalence of the end-stage renal disease population, the implications of such reactions are enormous. Most reactions are pseudoallergic and not mediated by immunoglobulin E. The multiplicity of potential exposures and the complexity of the environment to which patients on dialysis are exposed make it challenging to identify the precise cause of these reactions. Great diligence is needed to investigate hypersensitivity reactions to avoid recurrence in this high-risk population. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  16. Sterilization of heparinized cuprophan hemodialysis membranes

    NARCIS (Netherlands)

    ten Hoopen, Hermina W.M.; Hinrichs, W.L.J.; Hinrichs, W.L.J.; Engbers, G.H.M.; Feijen, Jan

    1996-01-01

    The effects of sterilization of dry heparinized Cuprophan hemodialysis membranes by means of ethylene oxide (EtO) exposure, gamma irradiation, or steam on the anticoagulant activity and chemical characteristics of immobilized heparin and the permeability of the membrane were investigated.

  17. Intravenous iron supplementation in children on hemodialysis.

    NARCIS (Netherlands)

    Leijn, E.; Monnens, L.A.H.; Cornelissen, E.A.M.

    2004-01-01

    BACKGROUND: Children with end-stage renal disease (ESRD) on hemodialysis (HD) are often absolute or functional iron deficient. There is little experience in treating these children with intravenous (i.v.) iron-sucrose. In this prospective study, different i.v. iron-sucrose doses were tested in

  18. Subjective sleep efficiency of hemodialysis patients

    NARCIS (Netherlands)

    Koch, B.C.P.; Nagtegaal, J.E.; Hagen, E.C.; van Dorp, W.Th.; Boringa, J.B.S.; Kerkhof, G.A.; ter Wee, P.M.

    2008-01-01

    Background: Sleep disturbances have a major influence on quality of life. A commonly used measure of sleep disturbances is sleep efficiency. The purpose of this study was to investigate the prevalence of decreased subjective sleep efficiency in hemodialysis patients. An additional goal was to

  19. Clinical variables, lifestyle and coping in hemodialysis.

    Science.gov (United States)

    Comelis Bertolin, Daniela

    2016-10-01

    To verify the relationship between coping strategies of people with chronic kidney disease undergoing hemodialysis and their clinical variables and lifestyle habits. It was developed a cross-sectional study that used the Coping Strategies Inventory of Folkman and Lazarus and a semi-structured questionnaire for collecting clinical variables and lifestyles of patients undergoing hemodialysis in the Urology and Nephrology Institute of São Jose do Rio Preto-SP (Brazil). Participants were 107 adults undergoing hemodialysis, with an average age of 51 years; 62.4% were men. The main causes of chronic kidney disease were chronic glomerulonephritis, diabetes mellitus, undetermined cause and hypertension. The most reported coping strategies were focused on emotion. There were greater coping scores among people who had diabetes, those who had leisure and those who referred religion. People who exercised and those who had undergone renal transplantation had more positive coping. Clinical variables of people undergoing hemodialysis can be sources of stress, and lifestyle habits are associated with coping strategies to mitigate the effects of stress. Copyright© by the Universidad de Antioquia.

  20. On pressure: volume relations in hemodialysis

    NARCIS (Netherlands)

    E.H.Y. Ie (Eric)

    2005-01-01

    textabstractChapter 1 is a brief introduction to several aspects of cardiovascular pressure-volume relations in dialysis patients. The aims of the thesis are presented. In Chapter 2, an overview is presented of circulatory physiology in hemodialysis (HD) patients. Volume withdrawal by

  1. Use of hemodialysis in meprobamate overdosage.

    Science.gov (United States)

    Lobo, P I; Spyker, D; Surratt, P; Westervelt, F B

    1977-02-01

    A case of meprobamate overdosage successfully treated with hemodialysis is described. The patient was admitted 4 hours after an overdosage of meprobamate (30-40 g) deeply unconscious, hypotensive, in respiratory failure and with a serum meprobamate level of 50 mg/100 ml. Hemodialysis was instituted using a Gambro parallel flow dialyzer and a portable re-circulating dialyzate delivery system (Redy, CCi Life Systems). Meprobamate removal with hemodialysis was 672+/-167 mg/hr with a corresponding clearance of 61.97+/-9.9 ml/min. Drug removal with forced diuresis was 177+/-23.4 mg/hr. Metabolic degradation of the drug was approximately 482 mg/hr with a plasma disappearance rate of 5.2%/hr. No drug could be detected in the dialyzate fluid after its passage through the Redy re-circulating dialyzate system. Because of the rapidity of metabolic degradation of meprobamate, we feel that hemodialysis should be reserved for severe clinical intoxication and either compromised normal excretory routes or progressive clinical deterioration.

  2. Parameter Identification for Salinity in a Quasilinear Thermodynamic System of Sea Ice

    OpenAIRE

    Wei Lv; Xiaojiao Li; Enmin Feng

    2014-01-01

    This study is intended to provide a parameter identification method to determine salinity of sea ice by temperature and salinity observations. A quasilinear thermodynamic system of sea ice with unknown salinity is described and its property is proved. Then, a parameter identification model is established and the existence of its optimal solution is discussed. The salinity profile is calculated by the temperature and salinity data, which were measured at Nella Fjord around Zhongshan Station, A...

  3. Hemodialysis without Systemic Anticoagulation: A Prospective Randomized Trial to Evaluate 3 Strategies in Patients at Risk of Bleeding

    Science.gov (United States)

    Guéry, Bruno; Alberti, Corinne; Servais, Aude; Harrami, Elarbi; Bererhi, Lynda; Zins, Brigitte; Touam, Malik; Joly, Dominique

    2014-01-01

    Objective In this clinical trial, we aimed to compare three means of performing chronic hemodialysis in patients with contra-indication to systemic heparinization. Methods This open-label monocentric randomized « n-of-one » trial, conducted in a single tertiary care center, recruited chronic hemodialysis patients with a contra-indication to systemic heparinization for at least 3 consecutive sessions. All patients underwent hemodialysis with an AN69ST dialyzer, and were administered three alternative dialysis procedures in a random sequence: intermittent saline flushes, constant saline infusion, or pre-dialysis heparin coating of the membrane. The primary outcome was the need to interrupt the dialysis session because of clotting events due to either (i) a complete coagulation of the circuit; (ii) a partial coagulation of the circuit; (iii) a>50% rise over baseline in the venous pressure. Results At the end of the inclusion period (May, 2007 to December, 2008), the number of patients to include (n = 75) was not reached: only 46 patients were included and underwent randomization. The study was terminated, and statistical analysis took into account 224 hemodialysis sessions performed in 44 patients with analyzable data. Heparin adsorption was associated with a significant reduction of the need to interrupt the dialysis session because of clotting events: odds ratio 0.3 (CI 95% 0.2 to 0.6; p3 h dialysis sessions and for having complete blood restitution. There were no significant effects of the dialysis procedure on weight loss, online ionic dialysance, and adverse events. Conclusion Heparin-coated AN69ST dialysis membrane is a safe and effective method to avoid or delay per-dialytic clotting events in patients with contra-indication to systemic anticoagulation. However, results are not generalizable safely to patients with active bleeding, since weak heparinemia, not assessed in this study, may occur. Trial Registration ClinicalTrials.gov NCT00473109. PMID

  4. Particle and solute migration in porous media. Modeling of simultaneous transport of clay particles and radionuclides in a salinity gradient; Migration de particules et de solutes en milieu poreux. Modelisation du transport simultane de particules argileuses et de radionucleides sous l`effet d`un gradient de salinite

    Energy Technology Data Exchange (ETDEWEB)

    Faure, M H

    1994-03-01

    Understanding the mechanisms which control the transient transport of particles and radionuclides in natural and artificial porous media is a key problem for the assessment of safety of radioactive waste disposals. An experimental study has been performed to characterize the clayey particle mobility in porous media: a laboratory- made column, packed with an unconsolidated sand bentonite (5% weight) sample, is flushed with a salt solution. An original method of salinity gradient allowed us to show and to quantify some typical behaviours of this system: threshold effects in the peptization of particles, creation of preferential pathways, formation of immobile water zones induce solute-transfer limitation. The mathematical modelling accounts for a phenomenological law, where the distribution of particles between the stagnant water zone and the porous medium is a function of sodium chloride concentration. This distribution function is associated with a radionuclide adsorption model, and is included in a convective dispersive transport model with stagnant water zones. It allowed us to simulate the particle and solute transport when the salt environment is modified. The complete model has been validated with experiments involving cesium, calcium and neptunium in a sodium chloride gradient. (author). refs., figs., tabs.

  5. Erectile Dysfunction in Males on Hemodialysis

    International Nuclear Information System (INIS)

    Haider, E.; Iftikhar, R.; Ghazanfar, A.; Afzal, M.; Mir, A. W.; Mansoor, K.; Taj, R.; Samiullah, R.

    2013-01-01

    Objective: The determine the frequency of erectile dysfunction in males on hemodialysis. Study Design: Descriptive study. Place and duration: Hemodialysis unit, Combined Military Hospital Kharian from October 2011 to April 2012. Patients and Methods: A total of 150 married male patients of end stage renal disease (ESRD) on hemodialysis were included in the study. Patients with cognitive and/or communication deficits and on hemodialysis for less than 06 months were excluded from the study. Erectile dysfunction (ED) was assessed using International Index of Erectile Function-5 (IIEF-5). Frequency of erectile dysfunction (ED) was analyzed using Statistical Package for Social Sciences (SPSS) version 17. Results: Mean age of the patients were 52.89 = 8.25 years. Mean duration of hemodialysis was 34 +- 9.62 months. The underlying etiology of end stage renal disease were diabetic nephropathy 69(46%), hypertensive nephropathy 51(34%), obstructive nephropathy 18(12%), glomerulonephritis 9(6%), autosomal polycystic kidney disease 3(2%). Mean IIEF-5 score was 13.29 +- 6.38. The frequency of erectile dysfunction was 74%. The majority of the patients, 73(48.7%) had moderate erectile dysfunction, while 24 (16%) had severe and 14 (9.3%) had mild erectile dysfunction. Out of total 150 patients enrolled, 39 (26%) patients had no erectile dysfunction. Conclusion: ED is a highly prevalent problem in men with ESRD. Physicians are urged to recognize the high prevalence of erection problems in men with ESRD and proactively question all patients regarding their sexual function. This will not only improve the recognition of this condition among these patients but also improve the quality of life after adequate treatment. (author)

  6. Tratamiento del prolapso rectal en la infancia con infiltración de solución salina al 16,5 % Treatment of the prolapse of the rectum in childhood with 16,5 % saline solution infiltration

    Directory of Open Access Journals (Sweden)

    Carlos Ramírez Pérez

    2011-09-01

    el grupo experimental (6,2 %, un caso más. La recurrencia se comportó de forma inversa, predominó en un 6,2 % en el grupo control. Para disminuir el número de complicaciones se estipuló el uso profiláctico de antimicrobianos, el día del procedimiento y 2 días más. Conclusiones: quedó demostrado que el tratamiento de elección del prolapso rectal en la infancia es la infiltración, y que una sola sesión con 20 mL de solución salina al 16,5 % en cada paciente es un efectivo agente esclerosante.Introduction: when the conservative medical treatment fails in children with prolapse of the rectum it is necessary the perirrectal infiltration with irritant substances. In 1990s these infiltrations in our center were carried out using glycerin, but due to be scarce in the market we must to find other alternative infiltrating agent. The objective of present paper is to describe the experience with the use of 16,5 % saline solution. Methods: an experimental, prospective, longitudinal and interventional study of non-controlled clinical trial was conducted. It consists of a second part in which we used the randomization with a control group for validation. Universe included 27 patients and sample included 16 patients with prolapse of the rectum over 2003-2007, seen in service of gastroenterology of the Provincial Children Hospital of Holguín province. The variables developed were: a concentration suitable for treatment, amount of substance to be infiltrated, complications, recurrence, number of infiltrations and the cure at a year. Results are showed in percentage tables. Results: the effectiveness of the 16,5 % saline solution was of 100 %, all patients cured and any had relapse, thus there were not necessary two or more treatment sessions. There was a comment on a child that, after failure of breast milk infiltration like a first option and also of the cerclage, finally, resolved with this method. Complications were relatively few (18,9 %: an abscess, a cellulitis

  7. Stochastic modeling of soil salinity

    Science.gov (United States)

    Suweis, S.; Porporato, A. M.; Daly, E.; van der Zee, S.; Maritan, A.; Rinaldo, A.

    2010-12-01

    A minimalist stochastic model of primary soil salinity is proposed, in which the rate of soil salinization is determined by the balance between dry and wet salt deposition and the intermittent leaching events caused by rainfall events. The equations for the probability density functions of salt mass and concentration are found by reducing the coupled soil moisture and salt mass balance equations to a single stochastic differential equation (generalized Langevin equation) driven by multiplicative Poisson noise. Generalized Langevin equations with multiplicative white Poisson noise pose the usual Ito (I) or Stratonovich (S) prescription dilemma. Different interpretations lead to different results and then choosing between the I and S prescriptions is crucial to describe correctly the dynamics of the model systems. We show how this choice can be determined by physical information about the timescales involved in the process. We also show that when the multiplicative noise is at most linear in the random variable one prescription can be made equivalent to the other by a suitable transformation in the jump probability distribution. We then apply these results to the generalized Langevin equation that drives the salt mass dynamics. The stationary analytical solutions for the probability density functions of salt mass and concentration provide insight on the interplay of the main soil, plant and climate parameters responsible for long term soil salinization. In particular, they show the existence of two distinct regimes, one where the mean salt mass remains nearly constant (or decreases) with increasing rainfall frequency, and another where mean salt content increases markedly with increasing rainfall frequency. As a result, relatively small reductions of rainfall in drier climates may entail dramatic shifts in longterm soil salinization trends, with significant consequences, e.g. for climate change impacts on rain fed agriculture.

  8. BLANCHIMENT ACCÉLÉRÉ DES ŒUFS NON FÉCONDÉS DE TRUITE ARC-EN-CIEL (ONCORHYNCHUS MYKISS SOUS L’EFFET DE SOLUTIONS SALINES EN VUE DE LEUR TRI MÉCANIQUE

    Directory of Open Access Journals (Sweden)

    MILLA S.

    2007-01-01

    Full Text Available Le blanchiment des œufs non fécondés dans les pontes de salmonidés en incubation artificielle permet leur élimination par tri mécanique. Le déclenchement de ce phénomène normalement plus ou moins tardif durant l’incubation a pu être accéléré grâce à une brève exposition des œufs à une solution de sel de mer. Les modalités et les effets de cette exposition sur les taux de mortalité et de malformations des embryons ont été testés sur des pontes de truite arc-en-ciel à divers stades de développement (140, 190 et 240 degrés*jours. Le passage durant 1 à 20 min dans une solution saline de 30 à 120 g/l a permis d’augmenter significativement le taux de blanchiment des œufs non fécondés sans affecter celui des œufs fécondés. Toutefois, par un effet mécanique, la manipulation nécessaire au traitement a entraîné une augmentation significative de la mortalité embryonnaire pour une manipulation à 140 degrés*jours et du taux de malformations larvaires pour une manipulation à 190 degrés*jours. A 240 degrés*jours, la manipulation n’a pas affecté le développement embryonnaire mais a entraîné un retard de l’éclosion de quelques heures. Cette étude offre de nouvelles perspectives pour améliorer le tri mécanique des œufs fécondés et non fécondés au cours de l’incubation chez la truite arc-en-ciel.

  9. Thyroid hormone concentrations in dialysate during hemodialysis in children

    International Nuclear Information System (INIS)

    Waters, W.; Bulla, M.; Buschsieweke, U.; Kutzim, H.; Koeln Univ.

    1981-01-01

    Thyroxine (T4) concentration in dialysate in the course of hemodialysis was determined in 15 children. Concentrations were measured by a modified radioimmunoassay. During hemodialysis there was a slight increase in T4 concentration. At the end of hemodialysis T4 concentration was about 50% higher than soon after the onset of hemodialysis. The loss of T4 into dialysate during hemodialysis was 19.2 μg; the loss of T3 was less than 75 ng. The amount of the daily loss of thyroid hormones into dialysate was found to be in the range of normal urinary excretion. The lowering of serum thyroid hormone concentrations in children on hemodialysis cannot be explained by the loss of these hormones into dialysate. (orig.) [de

  10. Analytical and Finite Element Modeling of Nanomembranes for Miniaturized, Continuous Hemodialysis

    Directory of Open Access Journals (Sweden)

    Tucker Burgin

    2015-12-01

    Full Text Available Hemodialysis involves large, periodic treatment doses using large-area membranes. If the permeability of dialysis membranes could be increased, it would reduce the necessary dialyzer size and could enable a wearable device that administers a continuous, low dose treatment of chronic kidney disease. This paper explores the application of ultrathin silicon membranes to this purpose, by way of analytical and finite element models of diffusive and convective transport of plasma solutes during hemodialysis, which we show to be predictive of experimental results. A proof-of-concept miniature nanomembrane dialyzer design is then proposed and analytically predicted to clear uremic toxins at near-ideal levels, as measured by several markers of dialysis adequacy. This work suggests the feasibility of miniature nanomembrane-based dialyzers that achieve therapeutic levels of uremic toxin clearance for patients with kidney failure.

  11. Changes in Plasma Copeptin Levels during Hemodialysis: Are the Physiological Stimuli Active in Hemodialysis Patients?

    Directory of Open Access Journals (Sweden)

    Esmée M Ettema

    Full Text Available Plasma levels of copeptin, a surrogate marker for the vasoconstrictor hormone arginine vasopressin (AVP, are increased in hemodialysis patients. Presently, it is unknown what drives copeptin levels in hemodialysis patients. We investigated whether the established physiological stimuli for copeptin release, i.e. plasma osmolality, blood volume and mean arterial pressure (MAP, are operational in hemodialysis patients.One hundred and eight prevalent, stable hemodialysis patients on a thrice-weekly dialysis schedule were studied during hemodialysis with constant ultrafiltration rate and dialysate conductivity in this observational study. Plasma levels of copeptin, sodium, MAP, and blood volume were measured before, during and after hemodialysis. Multivariate analysis was used to determine the association between copeptin (dependent variable and the physiological stimuli plasma sodium, MAP, excess weight as well as NT-pro-BNP immediately prior to dialysis and between copeptin and changes of plasma sodium, MAP and blood volume with correction for age, sex and diabetes during dialysis treatment.Patients were 63 ± 15.6 years old and 65% were male. Median dialysis vintage was 1.6 years (IQR 0.7-4.0. Twenty-three percent of the patients had diabetes and 82% had hypertension. Median predialysis copeptin levels were 141.5 pmol/L (IQR 91.0-244.8 pmol/L. Neither predialysis plasma sodium levels, nor NT-proBNP levels, nor MAP were associated with predialysis copeptin levels. During hemodialysis, copeptin levels rose significantly (p<0.01 to 163.0 pmol/L (96.0-296.0 pmol/L. Decreases in blood volume and MAP were associated with increases in copeptin levels during dialysis, whereas there was no significant association between the change in plasma sodium levels and the change in copeptin levels.Plasma copeptin levels are elevated predialysis and increase further during hemodialysis. Volume stimuli, i.e. decreases in MAP and blood volume, rather than osmotic

  12. Symbiotic nitrogen fixation in legumes: Perspectives for saline agriculture

    NARCIS (Netherlands)

    Bruning, B.; Rozema, J.

    2013-01-01

    Saline agriculture provides a solution for at least two environmental and social problems. It allows us to return to agricultural production areas that have been lost as a consequence of salinization and it can save valuable fresh water by using brackish or salt water to irrigate arable lands. Sea

  13. Dextrose saline compared with normal saline rehydration of hyperemesis gravidarum: a randomized controlled trial.

    Science.gov (United States)

    Tan, Peng Chiong; Norazilah, Mat Jin; Omar, Siti Zawiah

    2013-02-01

    To compare 5% dextrose-0.9% saline against 0.9% saline solution in the intravenous rehydration of hyperemesis gravidarum. Women at their first hospitalization for hyperemesis gravidarum were enrolled on admission to the ward and randomly assigned to receive either 5% dextrose-0.9% saline or 0.9% saline by intravenous infusion at a rate 125 mL/h over 24 hours in a double-blind trial. All participants also received thiamine and an antiemetic intravenously. Oral intake was allowed as tolerated. Primary outcomes were resolution of ketonuria and well-being (by 10-point visual numerical rating scale) at 24 hours. Nausea visual numerical rating scale scores were obtained every 8 hours for 24 hours. Persistent ketonuria rates after the 24-hour study period were 10 of 101 (9.9%) compared with 11 of 101 (10.9%) (P>.99; relative risk 0.9, 95% confidence interval 0.4-2.2) and median (interquartile range) well-being scores at 24 hours were 9 (8-10) compared with 9 (8-9.5) (P=.73) in the 5% dextrose-0.9% saline and 0.9% saline arms, respectively. Repeated measures analysis of variance of the nausea visual numerical rating scale score as assessed every 8 hours during the 24-hour study period showed a significant difference in favor of the 5% dextrose-0.9% saline arm (P=.046) with the superiority apparent at 8 and 16 hours, but the advantage had dissipated by 24 hours. Secondary outcomes of vomiting, resolution of hyponatremia, hypochloremia and hypokalemia, length of hospitalization, duration of intravenous antiemetic, and rehydration were not different. Intravenous rehydration with 5% dextrose-0.9% saline or 0.9% saline solution in women hospitalized for hyperemesis gravidarum produced similar outcomes. ISRCTN Register, www.controlled-trials.com/isrctn, ISRCTN65014409. I.

  14. Intensive Home Hemodialysis: An Eye at the Past Looking for the Hemodialysis of the Future.

    Science.gov (United States)

    Naso, Agostino; Scaparrotta, Giuseppe; Naso, Elena; Calò, Lorenzo A

    2015-09-01

    Multiple observational studies along with a limited number of randomized clinical trials suggest that intensive hemodialysis (IHD) not only improves outcomes for uremic patients undergoing chronic dialysis but does so with a more favorable cost/benefit ratio compared with conventional hemodialysis. As a result of this, there has been a rapid increase in the interest in home hemodialysis (HHD) as HHD represents the easiest means of implementing IHD. While HHD has generated increased interest given its association with better outcomes/reduced hospitalizations, there are very few randomized controlled trials comparing HHD with other hemodialysis methods. Reported HHD-associated increased survival benefits compared with in-center hemodialysis are from uncontrolled studies, which raise patient selection bias as underlying the differences found. Thus, while HHD draws increasing attention, studies that pay careful attention to the psychosocial, demographic, and clinical factors associated with patients selected to undergo HHD will be needed to ultimately demonstrate its benefits, clarify the clinical applications, and determine the limits of IHD use in dialysis patients. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  15. Saline as the Sole Contrast Agent for Successful MRI-guided Epidural Injections

    International Nuclear Information System (INIS)

    Deli, Martin; Fritz, Jan; Mateiescu, Serban; Busch, Martin; Carrino, John A.; Becker, Jan; Garmer, Marietta; Grönemeyer, Dietrich

    2013-01-01

    Purpose. To assess the performance of sterile saline solution as the sole contrast agent for percutaneous magnetic resonance imaging (MRI)-guided epidural injections at 1.5 T. Methods. A retrospective analysis of two different techniques of MRI-guided epidural injections was performed with either gadolinium-enhanced saline solution or sterile saline solution for documentation of the epidural location of the needle tip. T1-weighted spoiled gradient echo (FLASH) images or T2-weighted single-shot turbo spin echo (HASTE) images visualized the test injectants. Methods were compared by technical success rate, image quality, table time, and rate of complications. Results. 105 MRI-guided epidural injections (12 of 105 with gadolinium-enhanced saline solution and 93 of 105 with sterile saline solution) were performed successfully and without complications. Visualization of sterile saline solution and gadolinium-enhanced saline solution was sufficient, good, or excellent in all 105 interventions. For either test injectant, quantitative image analysis demonstrated comparable high contrast-to-noise ratios of test injectants to adjacent body substances with reliable statistical significance levels (p < 0.001). The mean table time was 22 ± 9 min in the gadolinium-enhanced saline solution group and 22 ± 8 min in the saline solution group (p = 0.75). Conclusion. Sterile saline is suitable as the sole contrast agent for successful and safe percutaneous MRI-guided epidural drug delivery at 1.5 T.

  16. Quadriplegia after parathyroidectomy in a hemodialysis patient.

    Science.gov (United States)

    Wang, Yu-Chieh; Huang, Shih-Yu; Lin, Ho-Tien; Hu, Jenkin-S; Chan, Kwok-Hon; Tsou, Mei-Yung

    2011-03-01

    We present a case of post-operative iatrogenic quadriplegia, which occurred after subtotal parathyroidectomy. This patient was on long-term hemodialysis for 7 years. The need of prolonged neck extension for this procedure was probably the main risk factor for the spinal cord injury. Systemic hypotension which contributed to the injury in this case, should be anticipated and promptly treated to prevent further damage. Spinal deformities associated with end-stage renal disease may make such patients more susceptible. Since appropriate precautions against potential neurologic damage can be undertaken, we suggest that evaluating carefully for the pre-existing spinal stenosis before a procedure requiring prominent and prolonged hyper-extension of the neck, especially in long-term hemodialysis patients is of paramount importance. Copyright © 2011. Published by Elsevier B.V.

  17. Increased cerebral water content in hemodialysis patients.

    Directory of Open Access Journals (Sweden)

    Kathrin Reetz

    Full Text Available Little information is available on the impact of hemodialysis on cerebral water homeostasis and its distribution in chronic kidney disease. We used a neuropsychological test battery, structural magnetic resonance imaging (MRI and a novel technique for quantitative measurement of localized water content using 3T MRI to investigate ten hemodialysis patients (HD on a dialysis-free day and after hemodialysis (2.4±2.2 hours, and a matched healthy control group with the same time interval. Neuropsychological testing revealed mainly attentional and executive cognitive dysfunction in HD. Voxel-based-morphometry showed only marginal alterations in the right inferior medial temporal lobe white matter in HD compared to controls. Marked increases in global brain water content were found in the white matter, specifically in parietal areas, in HD patients compared to controls. Although the global water content in the gray matter did not differ between the two groups, regional increases of brain water content in particular in parieto-temporal gray matter areas were observed in HD patients. No relevant brain hydration changes were revealed before and after hemodialysis. Whereas longer duration of dialysis vintage was associated with increased water content in parieto-temporal-occipital regions, lower intradialytic weight changes were negatively correlated with brain water content in these areas in HD patients. Worse cognitive performance on an attention task correlated with increased hydration in frontal white matter. In conclusion, long-term HD is associated with altered brain tissue water homeostasis mainly in parietal white matter regions, whereas the attentional domain in the cognitive dysfunction profile in HD could be linked to increased frontal white matter water content.

  18. Increased cerebral water content in hemodialysis patients.

    Science.gov (United States)

    Reetz, Kathrin; Abbas, Zaheer; Costa, Ana Sofia; Gras, Vincent; Tiffin-Richards, Frances; Mirzazade, Shahram; Holschbach, Bernhard; Frank, Rolf Dario; Vassiliadou, Athina; Krüger, Thilo; Eitner, Frank; Gross, Theresa; Schulz, Jörg Bernhard; Floege, Jürgen; Shah, Nadim Jon

    2015-01-01

    Little information is available on the impact of hemodialysis on cerebral water homeostasis and its distribution in chronic kidney disease. We used a neuropsychological test battery, structural magnetic resonance imaging (MRI) and a novel technique for quantitative measurement of localized water content using 3T MRI to investigate ten hemodialysis patients (HD) on a dialysis-free day and after hemodialysis (2.4±2.2 hours), and a matched healthy control group with the same time interval. Neuropsychological testing revealed mainly attentional and executive cognitive dysfunction in HD. Voxel-based-morphometry showed only marginal alterations in the right inferior medial temporal lobe white matter in HD compared to controls. Marked increases in global brain water content were found in the white matter, specifically in parietal areas, in HD patients compared to controls. Although the global water content in the gray matter did not differ between the two groups, regional increases of brain water content in particular in parieto-temporal gray matter areas were observed in HD patients. No relevant brain hydration changes were revealed before and after hemodialysis. Whereas longer duration of dialysis vintage was associated with increased water content in parieto-temporal-occipital regions, lower intradialytic weight changes were negatively correlated with brain water content in these areas in HD patients. Worse cognitive performance on an attention task correlated with increased hydration in frontal white matter. In conclusion, long-term HD is associated with altered brain tissue water homeostasis mainly in parietal white matter regions, whereas the attentional domain in the cognitive dysfunction profile in HD could be linked to increased frontal white matter water content.

  19. Sterilization of heparinized cuprophan hemodialysis membranes

    OpenAIRE

    ten Hoopen, Hermina W.M.; Hinrichs, W.L.J.; Hinrichs, W.L.J.; Engbers, G.H.M.; Feijen, Jan

    1996-01-01

    The effects of sterilization of dry heparinized Cuprophan hemodialysis membranes by means of ethylene oxide (EtO) exposure, gamma irradiation, or steam on the anticoagulant activity and chemical characteristics of immobilized heparin and the permeability of the membrane were investigated. Sterilization did not result in a release of heparin or heparin fragments from heparinized Cuprophan. Sterilization of heparinized Cuprophan by means of EtO exposure and gamma irradiation induced a slight, i...

  20. Managing hyperparathyroidism in hemodialysis: role of etelcalcetide

    Directory of Open Access Journals (Sweden)

    Eidman KE

    2018-02-01

    Full Text Available Keith E Eidman,1 James B Wetmore1,2 1Division of Nephrology, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN, 2Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, MN, USA Abstract: Secondary hyperparathyroidism (SHPT is common in patients receiving maintenance hemodialysis and is associated with adverse outcomes. Currently, SHPT is managed by reducing circulating levels of phosphate with oral binders and parathyroid hormone (PTH with vitamin D analogs and/or the calcimimetic cinacalcet. Etelcalcetide, a novel calcimimetic administered intravenously (IV at the end of a hemodialysis treatment session, effectively reduces PTH in clinical trials when given thrice weekly. Additional clinical effects include reductions in circulating levels of phosphate and FGF-23 and an improved profile of markers of bone turnover. However, despite being administered IV, etelcalcetide appears to be associated with rates of nausea and vomiting comparable to those of cinacalcet. Additionally, etelcalcetide, relative to placebo, causes hypocalcemia and prolonged electrocardiographic QT intervals, effects that must be considered when contemplating its use. Etelcalcetide likely has a role in treating hemodialysis patients with uncontrolled SHPT or with hypercalcemia or hyperphosphatemia receiving activated vitamin D compounds. However, its use should be at least partially constrained by consideration of the risk of hypocalcemia and resultant prolonged QT intervals in vulnerable patients. Because of its effectiveness as a PTH-reducing agent administered in the dialysis unit, etelcalcetide represents a potentially promising new therapeutic approach to the often vexing problem of SHPT in hemodialysis patients. However, whether its use is associated with changes in surrogate clinical end points, such as effects on rates of parathyroidectomy, fracture, vascular calcification, or mortality or on quality of life

  1. International variations and trends in home hemodialysis.

    Science.gov (United States)

    Agar, John W M

    2009-05-01

    Home hemodialysis, once a valid, viable dialysis choice, faded as facility-based care was preferentially funded and supported through the 1970s and 1980s. It was simply more comfortable for providers, physicians, and nurses to capture dialysis patients through clinic schedules and clinical protocols. Home patients were unpredictable, out of sight and out of control, trouble, and best avoided. This was so except in Australia and New Zealand where funding and support remained strong for what was seen there as an effective, outcome-rich, and cost-effective modality. The renaissance of home hemodialysis began in Canada when home-based nocturnal dialysis emerged in the 1990s. Home patients soon appreciated the self-determination and re-employment opportunities that overnight dialysis delivered. This article explores the origins, the near demise, the foundations of renewal, and the now-expanding potential of home and nocturnal hemodialysis in regions as diverse as North America, Australia and New Zealand, South East Asia, the United Kingdom, and Finland. Home dialysis fed by cost containment, outcome success, patient acceptance, and new smart equipment has emerged as a bright new modality option. Trainee nephrologists would be wise to take more notice as this near ghost of the past forges an exciting future.

  2. Hospitalization in daily home hemodialysis and matched thrice-weekly in-center hemodialysis patients.

    Science.gov (United States)

    Weinhandl, Eric D; Nieman, Kimberly M; Gilbertson, David T; Collins, Allan J

    2015-01-01

    Cardiovascular disease is a common cause of hospitalization in dialysis patients. Daily hemodialysis improves some parameters of cardiovascular function, but whether it associates with lower hospitalization risk is unclear. Observational cohort study using US Renal Data System data. Medicare-enrolled daily (5 or 6 sessions weekly) home hemodialysis (HHD) patients initiating NxStage System One use from January 1, 2006, through December 31, 2009, and contemporary thrice-weekly in-center hemodialysis patients, matched 5 to 1. Daily HHD or thrice-weekly in-center hemodialysis. All-cause and cause-specific hospital admissions, hospital readmissions, and hospital days assessed from Medicare Part A claims. For 3,480 daily HHD and 17,400 thrice-weekly in-center hemodialysis patients in intention-to-treat analysis, the HR of all-cause admission for daily HHD versus in-center hemodialysis was 1.01 (95%CI, 0.98-1.03). Cause-specific admission HRs were 0.89 (95%CI, 0.86-0.93) for cardiovascular disease, 1.18 (95%CI, 1.13-1.23) for infection, 1.01 (95%CI, 0.93-1.09) for vascular access dysfunction, and 1.02 (95%CI, 0.99-1.06) for other morbidity. Regarding cardiovascular disease, first admission and readmission HRs for daily HHD versus in-center hemodialysis were 0.91 and 0.87, respectively. Regarding infection, first admission and readmission HRs were 1.35 and 1.03, respectively. Protective associations of daily HHD with heart failure and hypertensive disease were most pronounced, as were adverse associations of daily HHD with bacteremia/sepsis, cardiac infection, osteomyelitis, and vascular access infection. Results may be confounded by unmeasured factors, including vascular access type; information about dialysis frequency, duration, and dose was lacking; causes of admission may be misclassified; results may not apply to patients without Medicare coverage. All-cause hospitalization risk was similar in daily HHD and thrice-weekly in-center hemodialysis patients. However

  3. Protein-Bound Uremic Toxin Profiling as a Tool to Optimize Hemodialysis.

    Directory of Open Access Journals (Sweden)

    Sunny Eloot

    Full Text Available We studied various hemodialysis strategies for the removal of protein-bound solutes, which are associated with cardiovascular damage.This study included 10 patients on standard (3 x 4 h/week high-flux hemodialysis. Blood was collected at the dialyzer inlet and outlet at several time points during a midweek session. Total and free concentration of several protein-bound solutes was determined as well as urea concentration. Per solute, a two-compartment kinetic model was fitted to the measured concentrations, estimating plasmatic volume (V1, total distribution volume (V tot and intercompartment clearance (K21. This calibrated model was then used to calculate which hemodialysis strategy offers optimal removal. Our own in vivo data, with the strategy variables entered into the mathematical simulations, was then validated against independent data from two other clinical studies.Dialyzer clearance K, V1 and V tot correlated inversely with percentage of protein binding. All Ks were different from each other. Of all protein-bound solutes, K21 was 2.7-5.3 times lower than that of urea. Longer and/or more frequent dialysis that processed the same amount of blood per week as standard 3 x 4 h dialysis at 300 mL/min blood flow showed no difference in removal of strongly bound solutes. However, longer and/or more frequent dialysis strategies that processed more blood per week than standard dialysis were markedly more adequate. These conclusions were successfully validated.When blood and dialysate flow per unit of time and type of hemodialyzer are kept the same, increasing the amount of processed blood per week by increasing frequency and/or duration of the sessions distinctly increases removal.

  4. Protein-Bound Uremic Toxin Profiling as a Tool to Optimize Hemodialysis.

    Science.gov (United States)

    Eloot, Sunny; Schneditz, Daniel; Cornelis, Tom; Van Biesen, Wim; Glorieux, Griet; Dhondt, Annemie; Kooman, Jeroen; Vanholder, Raymond

    2016-01-01

    We studied various hemodialysis strategies for the removal of protein-bound solutes, which are associated with cardiovascular damage. This study included 10 patients on standard (3 x 4 h/week) high-flux hemodialysis. Blood was collected at the dialyzer inlet and outlet at several time points during a midweek session. Total and free concentration of several protein-bound solutes was determined as well as urea concentration. Per solute, a two-compartment kinetic model was fitted to the measured concentrations, estimating plasmatic volume (V1), total distribution volume (V tot) and intercompartment clearance (K21). This calibrated model was then used to calculate which hemodialysis strategy offers optimal removal. Our own in vivo data, with the strategy variables entered into the mathematical simulations, was then validated against independent data from two other clinical studies. Dialyzer clearance K, V1 and V tot correlated inversely with percentage of protein binding. All Ks were different from each other. Of all protein-bound solutes, K21 was 2.7-5.3 times lower than that of urea. Longer and/or more frequent dialysis that processed the same amount of blood per week as standard 3 x 4 h dialysis at 300 mL/min blood flow showed no difference in removal of strongly bound solutes. However, longer and/or more frequent dialysis strategies that processed more blood per week than standard dialysis were markedly more adequate. These conclusions were successfully validated. When blood and dialysate flow per unit of time and type of hemodialyzer are kept the same, increasing the amount of processed blood per week by increasing frequency and/or duration of the sessions distinctly increases removal.

  5. Comparison of Hemoglobin Levels Before and After Hemodialysis and Their Effects on Erythropoietin Dosing and Cost

    OpenAIRE

    Sagheb; Fallahzadeh; Moaref; Fallahzadeh; Dormanesh

    2016-01-01

    Background Hemoglobin levels measured after hemodialysis, as compared to hemoglobin levels measured before hemodialysis, are suggested to be a more accurate reflection of the hemoglobin levels between hemodialysis sessions, and to be a better reference point for adjusting erythropoietin dosing. Objectives The aim of this study was to compare the hemoglobin levels before and after hemodialysis, to calculate the required erythropoie...

  6. Comparative results of gastric submucosal injection with hydroxypropyl methylcellulose, carboxymethylcellulose and normal saline solution in a porcine model Resultados comparativos de injeção submucosa gástrica com hidroximetil celulose, carboximetilcelulose e soro fisiológico em modelo suíno

    Directory of Open Access Journals (Sweden)

    Luciano Lenz

    2010-06-01

    Full Text Available CONTEXT: Endoscopic mucosal resection is an established modality for excision of sessile lesions in the gastrointestinal tract. Submucosal fluid injection creates a cushion and may prevent thermal injury and perforation. OBJECTIVES: This blind study investigated the performance of three different solutions to create submucosal fluid cushions in porcine stomach. METHODS: Three solutions were injected in the stomach of nine pigs BR1: normal saline solution, carboxymethylcellulose 0.5% and hydroxypropyl methylcellulose 0.25%. In each pig, submucosal injections with 6 mL per test-solution were performed. One drop of methylene blue was added to all injections for better visualization. The time for the bleb to disappear was recorded. RESULTS: The overall median time of visible submucosal cushion was 37 minutes (range 12-60 min for hydroxypropyl methylcellulose, 31 minutes for carboxymethylcellulose (range 10-43 min and 19 minutes for normal saline solution (range 8-37 min. There was no statistically significant difference neither between normal saline solution and carboxymethylcellulose (P = 0.146 nor carboxymethylcellulose and hydroxypropyl methylcellulose (P = 0.119 but the median duration of hydroxypropyl methylcellulose was significantly longer than normal saline solution (P = 0.039. CONCLUSIONS: The length of hydroxypropyl methylcellulose submucosal fluid cushion is longer in comparison with normal saline solution. The median time for carboxymethylcellulose was not longer than normal saline solution. Hydroxypropyl methylcellulose, in the concentration of 0.25%, may be a durable alternative for submucosal injection.CONTEXTO: A ressecção endoscópica mucosa é uma modalidade estabelecida para a excisão de lesões sésseis no trato gastrointestinal. A injeção de fluídos na submucosa cria uma coxim que pode prevenir lesão térmica e perfuração. OBJETIVO: Este estudo cego investiga o desempenho de três diferentes soluções para criar um

  7. Changes in Left Ventricular Diastolic Function During Hemodialysis Sessions

    NARCIS (Netherlands)

    Assa, Solmaz; Hummel, Yoran M.; Voors, Adriaan A.; Kuipers, Johanna; Groen, Henk; de Jong, Paul E.; Westerhuis, Ralf; Franssen, Casper F. M.

    Background: Left ventricular diastolic dysfunction is common in hemodialysis patients and is associated with worse outcome. Previous studies have shown that diastolic function worsens from pre- to post-dialysis session, but this has not been studied during hemodialysis. We studied the evolution of

  8. 21 CFR 876.5860 - High permeability hemodialysis system.

    Science.gov (United States)

    2010-04-01

    ... hemodialysis system. (a) Identification. A high permeability hemodialysis system is a device intended for use as an artificial kidney system for the treatment of patients with renal failure, fluid overload, or... system removes toxins or excess fluid from the patient's blood using the principles of convection (via a...

  9. Stabilizing effects of cool dialysate temperature on hemodynamic parameters in diabetic patients undergoing hemodialysis

    International Nuclear Information System (INIS)

    Ghasemi, A.; Shafiee, M.; Rowghani, K.

    2008-01-01

    To investigate the effect of cool dialysis on hemodynamic parameters and serum nitric oxide levels in diabetic patients, we studied 20 old (mean age 63.3+-7.5) chronic hemodialysis diabetics who were dialyzed twice, once using cool and once using standard (37 C) temperature dialysis solution. During the study, all the dialysis conditions were maintained the same except cooling the dailysate from 37C to 35C. Hemodynamic parameters including SBP, DBP and HR were measured hourly. Oral temperature was measured before and after dialysis. Serum urea and nitric oxide metabolites were determined before and after hemodialysis. Systolic, diastolic and mean arterial pressure decreased significantly during standard compared to cool dialysis. Maximum decrease of systolic, diastolic and mean arterial pressure was observed during the third hour of dialysis and magnitude of decrease was 18, 17 and 14 percent for standard temperature and 6, 1, and 4 percent for cool dialysis, respectively. Heart rate did not differ significantly between the two study groups. Compared to the pre dialysis levels of serum nitric oxide metabolites, the post dialysis levels decreased significantly with cool and standard temperature dialysate (59+-5 vs. 37+-4, and 63+-7 vs. 41+-5, umol/L respectively, P<0.01). Cool dialysis could decrease episodes of hypotension and stabilized hemodynamic parameters in diabetic patients. Probably other mechanisms than increased serum nitric oxide levels may be involved in hemodialysis hypotension in this group of patients. (author)

  10. Cost of installing and turning off hemodialysis on patients with central venous catheters

    Directory of Open Access Journals (Sweden)

    Gillene Santos Ferreira

    2014-12-01

    Full Text Available The objective was to identify the average total cost (ATC for installing and turning off hemodialysis on patients with central venous catheters. This quantitative, exploratory, and descriptive research, in the mode of a single-case study, was conducted in a public university hospital. The non-probabilistic sample corresponded to the observation of 100 installations and 100 terminations of hemodialysis on 42 patients during 23 days of collection. The ATC was calculated by multiplying the time spent by nurses by the unit cost of direct labor, and adding the cost of materials, solutions, and medications. The Brazilian currency (R$ was used for the calculations. The ATC for installation was R$ 80.10 and for shutting off was R$ 13.04, totaling R$ 93.14 per hemodialysis session. The results obtained will facilitate a better planning of the allocation of human, material, and financial resources enabling the increase of managerial strategies aimed at economic efficiency. doi: 10.5216/ree.v16i4.23044.

  11. Manejo da fertirrigação e controle da salinidade do solo sob ambiente protegido, utilizando-se extratores de solução do solo Fertigation management and soil salinity control in a protected ambient using soil solution extractors

    Directory of Open Access Journals (Sweden)

    Nildo da S. Dias

    2005-12-01

    solution. The initial soil salinity value was obtained by applying saline solutions of fertilizer salts using an artificial soil salinization curve previously obtained in laboratory. Results showed that the solution extractors allow determination of the ionic concentration in soil solution with satisfactory accuracy. The soil salinity increased in time and higher salinity levels were observed near the soil surface and below the drippers. The differences in water consumption caused by soil salinity were more evident with fertigation management control, adjusting to a quadratic model.

  12. A modified HPLC method improves the simultaneous determination of plasma kynurenine and tryptophan concentrations in patients following maintenance hemodialysis

    Science.gov (United States)

    XIAO, CHENGGEN; CHEN, YUANHAN; LIANG, XINLING; XIE, ZHEN; ZHANG, MIN; LI, RUIZHAO; LI, ZHILIAN; FU, XIA; YU, XIYONG; SHI, WEI

    2014-01-01

    The ratio between plasma kynurenine (Kyn) and tryptophan (Trp) serves as a marker of indoleamine 2,3-dioxygenase, a critical immunomodulatory molecule. Simultaneous detection of the two markers may be performed using high-pressure liquid chromatography (HPLC). However, for uremic patients, the conventional detection method may be affected by a range of accumulated toxins. The current study aimed to establish a method for the simultaneous measurement of Kyn and Trp in patients following maintenance hemodialysis via HPLC-ultraviolet detection. The procedure involved the use of a SinoChrom ODS-BP C18 column (4.6×150 mm; inner diameter, 4.5 μm) and a mobile phase of 15 mmol/l sodium acetate acetic acid solution (containing 5% acetonitrile, pH 4.8). The modified method was verified using plasma samples from 10 healthy controls and 91 maintenance hemodialysis patients. The results demonstrated that the modified method was successful in simultaneously detecting the concentrations of Trp and Kyn in the healthy controls and maintenance hemodialysis patients. The method is simple, fast, accurate and suitable for clinical and research purposes in maintenance hemodialysis patients. PMID:24669249

  13. The effect of salinity on the growth, morphology and physiology of ...

    African Journals Online (AJOL)

    The salinity of water and soil decreases the growth and yield of agricultural products. Salinity affects many physiological and morphological processes of plant by influencing soil solution osmotic potential and ion absorption and accumulation of minerals. To evaluate the effect of salinity on some physiological and ...

  14. Designing a model to minimize inequities in hemodialysis facilities distribution

    Directory of Open Access Journals (Sweden)

    Teresa M. Salgado

    2011-11-01

    Full Text Available Portugal has an uneven, city-centered bias in the distribution of hemodialysis centers found to contribute to health care inequities. A model has been developed with the aim of minimizing access inequity through the identification of the best possible localization of new hemodialysis facilities. The model was designed under the assumption that individuals from different geographic areas, ceteris paribus, present the same likelihood of requiring hemodialysis in the future. Distances to reach the closest hemodialysis facility were calculated for every municipality lacking one. Regions were scored by aggregating weights of the “individual burden”, defined as the burden for an individual living in a region lacking a hemodialysis center to reach one as often as needed, and the “population burden”, defined as the burden for the total population living in such a region. The model revealed that the average travelling distance for inhabitants in municipalities without a hemodialysis center is 32 km and that 145,551 inhabitants (1.5% live more than 60 min away from a hemodialysis center, while 1,393,770 (13.8% live 30-60 min away. Multivariate analysis showed that the current localization of hemodialysis facilities is associated with major urban areas. The model developed recommends 12 locations for establishing hemodialysis centers that would result in drastically reduced travel for 34 other municipalities, leaving only six (34,800 people with over 60 min of travel. The application of this model should facilitate the planning of future hemodialysis services as it takes into consideration the potential impact of travel time for individuals in need of dialysis, as well as the logistic arrangements required to transport all patients with end-stage renal disease. The model is applicable in any country and health care planners can opt to weigh these two elements differently in the model according to their priorities.

  15. Saline groundwater in crystalline bedrock

    International Nuclear Information System (INIS)

    Lampen, P.

    1992-11-01

    The State-of-art report describes research made on deep saline groundwaters and brines found in crystalline bedrock, mainly in site studies for nuclear waste disposal. The occurrence, definitions and classifications of saline groundwaters are reviewed with a special emphasis on the different theories concerning the origins of saline groundwaters. Studies of the saline groundwaters in Finland and Sweden have been reviewed more thoroughly. Also the mixing of different bodies of groundwaters, observations of the contact of saline groundwaters and permafrost, and the geochemical modelling of saline groundwaters as well as the future trends of research have been discussed. (orig.)

  16. Effect of High-Cutoff Hemodialysis vs Conventional Hemodialysis on Hemodialysis Independence Among Patients With Myeloma Cast Nephropathy: A Randomized Clinical Trial.

    Science.gov (United States)

    Bridoux, Frank; Carron, Pierre-Louis; Pegourie, Brigitte; Alamartine, Eric; Augeul-Meunier, Karine; Karras, Alexandre; Joly, Bertrand; Peraldi, Marie-Noëlle; Arnulf, Bertrand; Vigneau, Cécile; Lamy, Thierry; Wynckel, Alain; Kolb, Brigitte; Royer, Bruno; Rabot, Nolwenn; Benboubker, Lotfi; Combe, Christian; Jaccard, Arnaud; Moulin, Bruno; Knebelmann, Bertrand; Chevret, Sylvie; Fermand, Jean-Paul

    2017-12-05

    Cast nephropathy is the main cause of acute kidney injury in multiple myeloma and persistent reduction in kidney function strongly affects prognosis. Strategies to rapidly remove nephrotoxic serum-free light chains combined with novel antimyeloma agents have not been evaluated prospectively. To compare the hemodialysis independence rate among patients newly diagnosed with myeloma cast nephropathy treated with hemodialysis using a high-cutoff dialyzer (with very large membrane pores and high permeability to immunoglobulin light chains) or a conventional high-flux dialyzer (with small pores and lower permeability). Randomized clinical trial involving 98 patients with biopsy-proven myeloma cast nephropathy requiring hemodialysis treated at 48 French centers between July 2011 and June 2016; the final date of follow-up was June 29, 2016. Intensive hemodialysis (eight 5-hour sessions over 10 days) with either a high-cutoff dialyzer (46 patients) or a conventional high-flux dialyzer (48 patients). All patients received the same chemotherapy regimen of bortezomib and dexamethasone. Primary end point was hemodialysis independence at 3 months; secondary end points: hemodialysis independence rates at 6 and 12 months, hemodialysis- and chemotherapy-related adverse events, and death. Among 98 randomized patients, 94 (96%) (median age, 68.8 years [interquartile range, 61.2-75.3 years]; 45% women) were included in the modified intent-to-treat analysis. The hemodialysis independence rate at 3 months was 41.3% (n = 19) in the high-cutoff hemodialysis group vs 33.3% (n = 16) in the conventional hemodialysis group (between-group difference, 8.0% [95% CI, -12.0% to 27.9%], P = .42); at 6 months, the rate was 56.5% (n = 26) vs 35.4% (n = 17), respectively (between-group difference, 21.1% [95% CI, 0.9% to 41.3%], P = .04); and at 12 months, the rate was 60.9% (n = 28) vs 37.5% (n = 18) (between-group difference, 23.4% [95% CI, 3.2% to 43.5%], P = .02

  17. Surface characterization of hemodialysis membranes based on streaming potential measurements.

    Science.gov (United States)

    Werner, C; Jacobasch, H J; Reichelt, G

    1995-01-01

    Hemodialysis membranes made from cellulose (CUPROPHAN, HEMOPHAN) and sulfonated polyethersulfone (SPES) were characterized using the streaming potential technique to determine the zeta potential at their interfaces against well-defined aqueous solutions of varied pH and potassium chloride concentrations. Streaming potential measurements enable distinction between different membrane materials. In addition to parameters of the electrochemical double layer at membrane interfaces, thermodynamic characteristics of adsorption of different solved species were evaluated. For that aim a description of double layer formation as suggested by Börner and Jacobasch (in: Electrokinetic Phenomena, p. 231. Institut für Technologie der Polymere, Dresden (1989)) was applied which is based on the generally accepted model of the electrochemical double layer according to Stern (Z. Elektrochemie 30, 508 (1924)) and Grahame (Chem. Rev. 41, 441 (1947)). The membranes investigated show different surface acidic/basic and polar/nonpolar behavior. Furthermore, alterations of membrane interfaces through adsorption processes of components of biologically relevant solutions were shown to be detectable by streaming potential measurements.

  18. Influence of salinity and water content on soil microorganisms

    Directory of Open Access Journals (Sweden)

    Nan Yan

    2015-12-01

    Full Text Available Salinization is one of the most serious land degradation problems facing world. Salinity results in poor plant growth and low soil microbial activity due to osmotic stress and toxic ions. Soil microorganisms play a pivotal role in soils through mineralization of organic matter into plant available nutrients. Therefore it is important to maintain high microbial activity in soils. Salinity tolerant soil microbes counteract osmotic stress by synthesizing osmolytes which allows them to maintain their cell turgor and metabolism. Osmotic potential is a function of the salt concentration in the soil solution and therefore affected by both salinity (measured as electrical conductivity at a certain water content and soil water content. Soil salinity and water content vary in time and space. Understanding the effect of changes in salinity and water content on soil microorganisms is important for crop production, sustainable land use and rehabilitation of saline soils. In this review, the effects of soil salinity and water content on microbes are discussed to guide future research into management of saline soils.

  19. Home hemodialysis: beliefs, attitudes, and practice patterns.

    Science.gov (United States)

    Jayanti, Anuradha; Morris, Julie; Stenvinkel, Peter; Mitra, Sandip

    2014-10-01

    There is increasing interest of the worldwide kidney community in home hemodialysis (HHD). This is due to emerging evidence of its superiority over conventional hemodialysis (HD), largely attributed to improved outcomes on intensive schedule HD, best deployed in patient's own homes. Despite published work in this area, universal uptake remains limited and reasons are poorly understood. All those who provide HD care were invited to participate in a survey on HHD, initiated to understand the beliefs, attitudes, and practice patterns of providers offering this therapy. The survey was developed and posted on the Nephrology Dialysis Transplantation-Educational (NDT-E) website. Two hundred and seventy-two responses were deemed suitable for complete analysis. It is apparent from the survey that there is great variability in the prevalence of HHD. Physicians have a great deal of interest in this modality, with majority viewing home as being the ideal location for the offer of intensive HD schedules (55%). A significant number (21%) feel intensive HD may be offered even outside the home setting. Those who offer this therapy do not see a financial disadvantage in it. Many units identify lack of appropriately trained personnel (35%) and funding for home adaptation (50.4%) as key barriers to widespread adoption of this therapy. Despite the interest and belief in this therapy among practitioners, HHD therapy is still not within reach of a majority of patients. Modifiable organizational, physician, and patient factors exist, which could potentially redefine the landscape of HHD provision. Well-designed systematic research of national and local barriers is needed to design interventions to help centers facilitate change. © 2014 International Society for Hemodialysis.

  20. Biofeedback systems and adaptive control hemodialysis treatment

    Directory of Open Access Journals (Sweden)

    Azar Ahmad

    2008-01-01

    Full Text Available On-line monitoring devices to control functions such as volume, body temperature, and ultrafiltration, were considered more toys than real tools for routine clinical application. However, bio-feedback blood volume controlled hemodialysis (HD is now possible in routine dialysis, allowing the delivery of a more physiologically acceptable treatment. This system has proved to reduce the incidence of intra-HD hypotension episodes significantly. Ionic dialysance and the patient′s plasma conductivity can be calculated easily from on-line measurements at two different steps of dialysate conductivity. A bio-feedback system has been devised to calculate the patient′s plasma conductivity and modulate the conductivity of the dialysate continuously in order to achieve a desired end-dialysis patient plasma conductivity corresponding to a desired end-dialysis plasma sodium concentration. Another bio-feedback system can control the body tempe-rature by measuring it at the arterial and venous lines of the extra-corporeal circuit, and then modulating the dialysate temperature in order to stabilize the patients′ temperature at constant values that result in improved intra-HD cardiovascular stability. The module can also be used to quantify vascular access recirculation. Finally, the simultaneous computer control of ultrafiltration has proven the most effective means for automatic blood pressure stabilization during hemo-dialysis treatment. The application of fuzzy logic in the blood-pressure-guided biofeedback con-trol of ultrafiltration during hemodialysis is able to minimize HD-induced hypotension. In con-clusion, online monitoring and adaptive control of the patient during the dialysis session using the bio-feedback systems is expected to render the process of renal replacement therapy more physiological and less eventful.

  1. High sensitivity pyrogen testing in water and dialysis solutions.

    Science.gov (United States)

    Daneshian, Mardas; Wendel, Albrecht; Hartung, Thomas; von Aulock, Sonja

    2008-07-20

    The dialysis patient is confronted with hundreds of litres of dialysis solution per week, which pass the natural protective barriers of the body and are brought into contact with the tissue directly in the case of peritoneal dialysis or indirectly in the case of renal dialysis (hemodialysis). The components can be tested for living specimens or dead pyrogenic (fever-inducing) contaminations. The former is usually detected by cultivation and the latter by the endotoxin-specific Limulus Amoebocyte Lysate Assay (LAL). However, the LAL assay does not reflect the response of the human immune system to the wide variety of possible pyrogenic contaminations in dialysis fluids. Furthermore, the test is limited in its sensitivity to detect extremely low concentrations of pyrogens, which in their sum result in chronic pathologies in dialysis patients. The In vitro Pyrogen Test (IPT) employs human whole blood to detect the spectrum of pyrogens to which humans respond by measuring the release of the endogenous fever mediator interleukin-1beta. Spike recovery checks exclude interference. The test has been validated in an international study for pyrogen detection in injectable solutions. In this study we adapted the IPT to the testing of dialysis solutions. Preincubation of 50 ml spiked samples with albumin-coated microspheres enhanced the sensitivity of the assay to detect contaminations down to 0.1 pg/ml LPS or 0.001 EU/ml in water or saline and allowed pyrogen detection in dialysis concentrates or final working solutions. This method offers high sensitivity detection of human-relevant pyrogens in dialysis solutions and components.

  2. Uso da solução salina para manutenção de acessos venosos em adultos: uma revisão Uso de la solución salina para la manutención de sondas venosas en adultos: una revisión Use of saline solutions for the mantenaince of venous catheters in adults: a review

    Directory of Open Access Journals (Sweden)

    Francimar Tinoco de Oliveira

    2006-12-01

    Full Text Available Trata-se de uma revisão bibliográfica sobre a prática da salinização em cateteres venosos periféricos. O estudo objetivou analisar os artigos científicos sobre o uso de solução salina na manutenção da permeabilidade de cateteres venosos periféricos em adultos, indexados no MedLine e LILACS no período de 1995 a 2005. A amostra consistiu de 5 artigos os quais foram analisados quanto à procedência e periódico de publicação, ao delineamento do estudo, a amostragem, e ao efeito da solução salina. Dois estudos indicam evidências da salinização, outros dois o oposto e um não é conclusivo. Há pequena produção acerca da temática exigindo-se novas pesquisas para validação do método.Es una revisión bibliográfica con el objetivo de analizar los resúmenes de salinización de catéteres venosos en el banco de dados MedLine y LILACS en el período de 1995 a 2005 y la base de datos OVID. La muestra se ha compuesto con cinco artículos que se han analizado a partir de la procedencia y periódico de publicación, el delineamiento del estudio, el tamaño de las muestras y si los resultados son conclusivos o no para evidencias de salinización. Dos estudios indican evidencias del efecto de la salinización en la permeabilidad, otro dos lo contrario y uno no es conclusivo. Se concluye que hay poca producción lo que valida nuevas encuestas.This article is a bibliography review about the use of saline solution in peripheral venous catheters. The study aimed at analyzing scientific articles about the use of saline solution for the maintenance of peripheral venous catheters patency in adults, indexed at the MedLine and LILACS databases in the periods between 1995 and 2005. The sample consisted of 5 articles analyzed in publication frequency, saline solution effects, study delineation, and nursing periodic publications. The review concluded that this thematic has a modest production and not conclusive about the efficacy of the saline

  3. Absolute Salinity, ''Density Salinity'' and the Reference-Composition Salinity Scale: present and future use in the seawater standard TEOS-10

    Science.gov (United States)

    Wright, D. G.; Pawlowicz, R.; McDougall, T. J.; Feistel, R.; Marion, G. M.

    2011-01-01

    Salinity plays a key role in the determination of the thermodynamic properties of seawater and the new TEOS-101 standard provides a consistent and effective approach to dealing with relationships between salinity and these thermodynamic properties. However, there are a number of practical issues that arise in the application of TEOS-10, both in terms of accuracy and scope, including its use in the reduction of field data and in numerical models. First, in the TEOS-10 formulation for IAPSO Standard Seawater, the Gibbs function takes the Reference Salinity as its salinity argument, denoted SR, which provides a measure of the mass fraction of dissolved material in solution based on the Reference Composition approximation for Standard Seawater. We discuss uncertainties in both the Reference Composition and the Reference-Composition Salinity Scale on which Reference Salinity is reported. The Reference Composition provides a much-needed fixed benchmark but modified reference states will inevitably be required to improve the representation of Standard Seawater for some studies. However, the Reference-Composition Salinity Scale should remain unaltered to provide a stable representation of salinity for use with the TEOS-10 Gibbs function and in climate change detection studies. Second, when composition anomalies are present in seawater, no single salinity variable can fully represent the influence of dissolved material on the thermodynamic properties of seawater. We consider three distinct representations of salinity that have been used in previous studies and discuss the connections and distinctions between them. One of these variables provides the most accurate representation of density possible as well as improvements over Reference Salinity for the determination of other thermodynamic properties. It is referred to as "Density Salinity" and is represented by the symbol SAdens; it stands out as the most appropriate representation of salinity for use in dynamical physical

  4. Absolute Salinity, "Density Salinity" and the Reference-Composition Salinity Scale: present and future use in the seawater standard TEOS-10

    Science.gov (United States)

    Wright, D. G.; Pawlowicz, R.; McDougall, T. J.; Feistel, R.; Marion, G. M.

    2010-08-01

    Salinity plays a key role in the determination of the thermodynamic properties of seawater and the new TEOS-101 standard provides a consistent and effective approach to dealing with relationships between salinity and these thermodynamic properties. However, there are a number of practical issues that arise in the application of TEOS-10, both in terms of accuracy and scope, including its use in the reduction of field data and in numerical models. First, in the TEOS-10 formulation for IAPSO Standard Seawater, the Gibbs function takes the Reference Salinity as its salinity argument, denoted SR, which provides a measure of the mass fraction of dissolved material in solution based on the Reference Composition approximation for Standard Seawater. We discuss uncertainties in both the Reference Composition and the Reference-Composition Salinity Scale on which Reference Salinity is reported. The Reference Composition provides a much-needed fixed benchmark but modified reference states will inevitably be required to improve the representation of Standard Seawater for some studies. The Reference-Composition Salinity Scale should remain unaltered to provide a stable representation of salinity for use with the TEOS-10 Gibbs function and in climate change detection studies. Second, when composition anomalies are present in seawater, no single salinity variable can fully represent the influence of dissolved material on the thermodynamic properties of seawater. We consider three distinct representations of salinity that have been used in previous studies and discuss the connections and distinctions between them. One of these variables provides the most accurate representation of density possible as well as improvements over Reference Salinity for the determination of other thermodynamic properties. It is referred to as "Density Salinity" and is represented by the symbol SAdens; it stands out as the most appropriate representation of salinity for use in dynamical physical

  5. Absolute Salinity, ''Density Salinity'' and the Reference-Composition Salinity Scale: present and future use in the seawater standard TEOS-10

    Directory of Open Access Journals (Sweden)

    D. G. Wright

    2011-01-01

    Full Text Available Salinity plays a key role in the determination of the thermodynamic properties of seawater and the new TEOS-101 standard provides a consistent and effective approach to dealing with relationships between salinity and these thermodynamic properties. However, there are a number of practical issues that arise in the application of TEOS-10, both in terms of accuracy and scope, including its use in the reduction of field data and in numerical models.

    First, in the TEOS-10 formulation for IAPSO Standard Seawater, the Gibbs function takes the Reference Salinity as its salinity argument, denoted SR, which provides a measure of the mass fraction of dissolved material in solution based on the Reference Composition approximation for Standard Seawater. We discuss uncertainties in both the Reference Composition and the Reference-Composition Salinity Scale on which Reference Salinity is reported. The Reference Composition provides a much-needed fixed benchmark but modified reference states will inevitably be required to improve the representation of Standard Seawater for some studies. However, the Reference-Composition Salinity Scale should remain unaltered to provide a stable representation of salinity for use with the TEOS-10 Gibbs function and in climate change detection studies.

    Second, when composition anomalies are present in seawater, no single salinity variable can fully represent the influence of dissolved material on the thermodynamic properties of seawater. We consider three distinct representations of salinity that have been used in previous studies and discuss the connections and distinctions between them. One of these variables provides the most accurate representation of density possible as well as improvements over Reference Salinity for the determination of other thermodynamic properties. It is referred to as "Density Salinity" and is represented by the symbol

  6. The home hemodialysis hub: physical infrastructure and integrated governance structure.

    Science.gov (United States)

    Marshall, Mark R; Young, Bessie A; Fox, Sally J; Cleland, Calli J; Walker, Robert J; Masakane, Ikuto; Herold, Aaron M

    2015-04-01

    An effective home hemodialysis program critically depends on adequate hub facilities and support functions and on transparent and accountable organizational processes. The likelihood of optimal service delivery and patient care will be enhanced by fit-for-purpose facilities and implementation of a well-considered governance structure. In this article, we describe the required accommodation and infrastructure for a home hemodialysis program and a generic organizational structure that will support both patient-facing clinical activities and business processes. © 2015 International Society for Hemodialysis.

  7. Hyperhemocysteinemia and cardiovascular risks in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Sagheb Mohammad

    2010-01-01

    Full Text Available The risk of premature and progressive occlusive vascular disease is high in chronic uremic patients, and it accounts for more than 40% of the mortality in dialysis patients. End stage renal failure (ESRF patients exhibit elevated plasma homocystein levels, about four fold as much as those in the controls, and it is now considered as a causative factor for increased risk of cardiovascular death among these patients. The aim of this study was to evaluate the relationship of total plasma homocysteine level and echocardiographic abnormalities as a surrogate of cardiac disease outcome in hemodialysis patients. 123 adult patients on maintenance hemodialysis and having echocardiography done during January till November 2006 were enrolled in this cross-sectional study. Plasma homocysteine level was directly related to the presence of aortic regur-gitation r= 0.27 P= 0.009. There were negative correlations between ejection fraction (EF, left ventricular systolic dimension (LV.S (r= - 0.71, P= 0.0001, left ventricular diastolic dimension (LV.D (r= -0.23 p= 0.01 and age (r= - 0.021 P= 0.02. In conclusion we did not find the para-doxical reverse epidemiology in our patients and plasma total homocysteine level was in direct correlation with cardiac risk factors such as left ventricular mass index and aortic regurgitation.

  8. The Fresenius Medical Care home hemodialysis system.

    Science.gov (United States)

    Schlaeper, Christian; Diaz-Buxo, Jose A

    2004-01-01

    The Fresenius Medical Care home dialysis system consists of a newly designed machine, a central monitoring system, a state-of-the-art reverse osmosis module, ultrapure water, and all the services associated with a successful implementation. The 2008K@home hemodialysis machine has the flexibility to accommodate the changing needs of the home hemodialysis patient and is well suited to deliver short daily or prolonged nocturnal dialysis using a broad range of dialysate flows and concentrates. The intuitive design, large graphic illustrations, and step-by-step tutorial make this equipment very user friendly. Patient safety is assured by the use of hydraulic systems with a long history of reliability, smart alarm algorithms, and advanced electronic monitoring. To further patient comfort with their safety at home, the 2008K@home is enabled to communicate with the newly designed iCare remote monitoring system. The Aquaboss Smart reverse osmosis (RO) system is compact, quiet, highly efficient, and offers an improved hygienic design. The RO module reduces water consumption by monitoring the water flow of the dialysis system and adjusting water production accordingly. The Diasafe Plus filter provides ultrapure water, known for its long-term benefits. This comprehensive approach includes planning, installation, technical and clinical support, and customer service.

  9. [Hemodialysis in patients with chronic renal insufficiency].

    Science.gov (United States)

    Canaud, Bernard; Leray-Moragués, Hélène; Chenine-Koualef, Leila; Patrier, Laure

    2012-01-01

    Hemodialysis is the most advanced form of artificial renal support. It ensures the survival of almost 2 million patients wordwide. Considerable progress has been made in recent years thanks to a better understanding of uremia, optimization of treatment modalities and more personalized treatment schedules. Increase of uremic toxins removal, improvement of hemodynamic tolerance of the sessions, reduction of proinflammatory reactions due to the bioincompatibility system are major advances that may explain the reduction of morbidity and mortality in dialysis patients. New technologies (nanotechnology, biotechnology, microelectronics) are now expected to introduce further progresses by miniaturizing devices and providing them with an "artificial intelligence" capable of interacting with the patient. The main obstacle remains ageing of uremic patients, increasing prevalence of comorbidities and shortage of social resources that are not conducive to innovation. By promoting a more physiological, longer and more effective hemodialysis performed at home with help of teledialysis monitoring that would probably be an interesting option to evaluate on a medico-economical point of view.

  10. Restless legs syndrome in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Shahram Rafie

    2016-01-01

    Full Text Available Restless legs syndrome (RLS is a neurological disorder characterized by uncomfortable sensation of paresthesia in legs that subsequently causes involuntary and continuous movement of the lower limbs, especially at rest. Its prevalence in hemodialysis is more than that in the general population. Different risk factors have been suggested for RLS. We studied the prevalence and risk factors of RLS in 137 hemodialysis patients followed up at our center. The patients completed at least three months on dialysis and fulfilled four criteria for the diagnosis of RLS. We compared the patients with and without RLS, and the odds ratios (ORs were estimated by the logistic regression models. The prevalence of RLS was 36.5% in the study patients. Among the variables, diabetes was the only predicting factor for the development of RLS. The diabetic patients may be afflicted with RLS 2.25 times more than the non-diabetics. Women developed severe RLS 5.23 times more than men. Neurodegeneration, decrease in dopamine level, higher total oxidant status, and neuropathy in diabetic patients may explain the RLS symptoms.

  11. Noninvasive continuous monitoring of digital pulse waves during hemodialysis

    DEFF Research Database (Denmark)

    Burkert, Antje; Scholze, Alexandra; Tepel, Martin

    2009-01-01

    Intermittent hemodynamic instability during hemodialysis treatment is a frequent complication in patients with end-stage renal failure. A noninvasive method for continuous hemodynamic monitoring is needed. We used noninvasive digital photoplethysmography and an algorithm for continuous, investiga...

  12. Sublethal microcystin exposure and biochemical outcomes among hemodialysis patients

    Science.gov (United States)

    Cyanobacteria are commonly-occurring contaminants of surface waters worldwide. Microcystins, potent hepatotoxins, are among the best characterized cyanotoxins. During November, 2001, a group of 44 hemodialysis patients were exposed to microcystins via contaminated dialysate. Seru...

  13. Inpatient Dialysis Unit Project Development: Redesigning Acute Hemodialysis Care.

    Science.gov (United States)

    Day, Jennifer

    2017-01-01

    Executive leaders of an acute care hospital performed a market and financial analysis, and created a business plan to establish an inpatient hemodialysis unit operated by the hospital to provide safe, high-quality, evidence-based care to the population of individuals experiencing end stage renal disease (ESRD) within the community. The business plan included a SWOT (Strengths - Weaknesses - Opportunities - Threats) analysis to assess advantages of the hospital providing inpatient hemodialysis services versus outsourcing the services with a contracted agency. The results of the project were a newly constructed tandem hemodialysis room and an operational plan with clearly defined key performance indicators, process improvement initiatives, and financial goals. This article provides an overview of essential components of a business plan to guide the establishment of an inpatient hemodialysis unit. Copyright© by the American Nephrology Nurses Association.

  14. [Effects of midodrine on symptomatic hypotension during hemodialysis].

    Science.gov (United States)

    Cotera, Alejandro; Alvo, Miriam; Sanhueza, María Eugenia; Elgueta, Leticia; Gormaz, Juan Pablo; Ibáñez, Carlos; Cuadra, Cristián

    2002-09-01

    Hypotension occurs in 20% of hemodialysis procedures. To study the effects of midodrine on hypotension during hemodialysis. Ten patients on chronic hemodialysis and with a history of hypotension during the procedure, were studied. They received midodrine 10 mg per os or placebo during 5 dialytic procedures each, in a double blind cross over design. Blood pressure levels prior to dialysis were similar during the midodrine or placebo administration periods. During dialysis, systolic blood pressure fell 19.3 +/- 28 mmHg with midodrine and 23.4 +/- 28 mmHg with placebo. Diastolic blood pressure fell 7.3 +/- 11.5 mmHg with midodrine and 11.1 +/- 12 mmHg with placebo. The reduction in median arterial pressure was also less pronounced with midodrine. Midodrine lessens the fall in arterial pressure during hemodialysis, in patients with symptomatic hypotension.

  15. Hepatitis C virus infection in hemodialysis patients in Maracaibo, Venezuela

    Directory of Open Access Journals (Sweden)

    Francisca Monsalve-Castillo

    2012-02-01

    Full Text Available Over a two year period, the incidence of hepatitis C virus (HCV infection was evaluated in 29 hemodialysis patients, aged between 15 and 75 years (mean ± SD: 45 ± 39.5 years, from the University Hospital Hemodyalisis Unit, Maracaibo, Zulia State, Venezuela. Anti-HCV antibodies were determined using a fourth generation ELISA (Innotest HCV Ab IV kit and positive blood samples were tested using a recombinant assay kit (Inno-LIA HCV Ab III, both kits from Innogenetics N.V., Belgium. The findings indicate a lack of HCV seroconversion in the hemodialysis patients over the study period, confirmed by the recombinant assay. Risk factors for HCV infection were 0.3270 (95% confidence interval: 0.01323-8.080 in patients undergoing hemodialysis. The findings suggest a lack of significant sources for HCV infection due to the preventive measures to avoid its transmission in the hemodialysis unit.

  16. Middle East respiratory syndrome clinical practice guideline for hemodialysis facilities

    Directory of Open Access Journals (Sweden)

    Hayne Cho Park

    2017-06-01

    Full Text Available The Korean Society of Nephrology participated in the task force team consisting of government authorities and civilian experts to prevent and control the spread of Middle East respiratory syndrome (MERS in 2015. The Korean Society of Nephrology MERS Task Force Team took an immediate action and drafted ‘the clinical recommendation for hemodialysis facilities’ to follow when the first and the only confirmed case was reported in the hemodialysis unit. Owing to the dedicated support from medical doctors, dialysis nurses, and related medical companies, we could prevent further transmission of MERS infection successfully in hemodialysis units. This special report describes the experience of infection control during MERS outbreak in 2015 and summarizes the contents of ‘the clinical practice guideline for hemodialysis facilities dealing with MERS patients’ built upon our previous experience.

  17. Influence of combination hemodialysis/hemoperfusion against score of depression in regular hemodialysis patients

    Science.gov (United States)

    Permatasari, T. D.; Thamrin, A.; Hanum, H.

    2018-03-01

    Patients with chronic kidney disease, have a higher risk for psychological distress such as anxiety, depression and cognitive decline. Combination of Hemodialysis (HD)/hemoperfusion (HP) regularly able to eliminate uremic toxin with mild-to-large molecular weight better. HD/HP can remove metabolites, toxin, and pathogenic factors and regulate the water, electrolyte and acid-base balance to improve the quality of patient’s sleep and appetite also reduces itching of the skin, which in turn improve the quality and life expectancy. This research was a cross sectional research with a pre-experimental design conducted from July to September 2015 with 17 regular hemodialysis patients as samples. Inclusion criteria were regular hemodialysis patients and willingly participated in the research. The assessmentwas conducted using BDI to assess depression. To obtained the results, data were analyzed using T-Test and showed that that the average BDI score before the combination of HD/HP 18.59±9 to 8.18±2.83 after the combination (p<0.001). In conclusion, combination HD/HP can lower depression scores in patients with regular HD.

  18. Referral pattern of hemodialysis patients to nephrologists

    International Nuclear Information System (INIS)

    Anees, M.; Mumtaz, A.; Nazir, M.; Ibrahim, M.; Kausar, T.

    2007-01-01

    To determine the referral pattern of dialysis patients to nephrologists and the effects of late referral on clinical, hematological and biochemical parameters in patients presenting for the first-time to dialysis center. This study was conducted on all patients of end stage renal diseases presenting for the first-time for undergoing hemodialysis at our center. Patients with acute renal failure were excluded from the study. At presentation, a history was taken from all the patients regarding seeking of nephrology services and referral pattern. Early and late referral was defined as the time of first referral or admission to a nephrologists greater or less than six months respectively before initiation of hemodialysis. All the patients were examined and their blood sample was drawn at the same time for routine hematological, biochemical parameters (urea, creatinine, serum potassium, calcium, phosphate and albumin) and viral markers (Anti HCV and HbsAg). In this study, 248 patients were enrolled, amongst them, 131 (52.8%) were male and 117 (47.2%) were female. Major causes of renal failure were diabetes mellitus, chronic glomerulonephritis and hypertension. Most of the patients were euvolemic and hypertensive. Sixty percent of patients were having very high urea (>200 mg/dl) and creatinine (>8.0 mg/dl). Most of the patients, 226 (91.1%), were anemic (Hemoglobin <11gm/dl) and 224 (90%) were hypoalbuminemic (serum albumin < 4gm/dl) on first presentation. Majority of patients were hyperkalemic, 139 (56.0%), hypocalcemic, 168 (67.7%) and serum phosphate level was high in only 117 (47%) patients. All the patients presented in emergency room to nephrologists at very late stage (100% late referral), when disease was very much advanced. All of them did not have permanent vascular access for hemodialysis on first presentation to dialysis center. Reasons for late referral were non-availability of nephrologists and nephrology services, non-renal doctors biased, unawareness and

  19. Blastocystis sp. and other intestinal parasites in hemodialysis patients.

    Science.gov (United States)

    Kulik, Rose Anne; Falavigna, Dina Lúcia Morais; Nishi, Letícia; Araujo, Silvana Marques

    2008-08-01

    Chronic renal insufficiency disease (CRI) leads to uremia in hemodialysis patients and induces a state of immunodepression that results in higher frequencies of infections and diarrhea. Hemodialysis patients resident in the city of Campo Mourão, Paraná, Brazil were analyzed from April 2006 through September 2007 for Blastocystis sp. and other intestinal parasites and for associated diarrhea. Fecal samples from 86 hemodialysis patients and 146 healthy (reference) persons were examined by standard methods for detecting ova, larvae and cysts, which included preservation in 10% formalin and the Kinyoun method. Thirty-three hemodialysis patients (45.1%) and 36 reference individuals (25.7%) were found to be parasitized. The differences in the percentages of parasitism and polyparasitism between the reference group and the chronic renal patients was significant (p= 0.0318 and 0.0019, respectively). Blastocystis sp. (18%-20.1%), Endolimax nana (14%-16.3%), Cryptosporidium sp. (4%-4.7%) and Entamoeba coli (4%-4.7%) were the most frequent protozoa found in the hemodialysis patients. Parasitism was not significantly associated with diarrhea (p=0.9947) or with decreased white blood cell counts (p=0.7046) in these individuals. Because parasitic infections may be an important comorbidity factor in hemodialysis patients, we suggest that parasitological stool examinations, especially for Blastocystis sp. and Cryptosporidium sp., be included in routine medical follow-up examinations of these patients.

  20. Blastocystis sp. and other intestinal parasites in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Rose Anne Kulik

    Full Text Available Chronic renal insufficiency disease (CRI leads to uremia in hemodialysis patients and induces a state of immunodepression that results in higher frequencies of infections and diarrhea. Hemodialysis patients resident in the city of Campo Mourão, Paraná, Brazil were analyzed from April 2006 through September 2007 for Blastocystis sp. and other intestinal parasites and for associated diarrhea. Fecal samples from 86 hemodialysis patients and 146 healthy (reference persons were examined by standard methods for detecting ova, larvae and cysts, which included preservation in 10% formalin and the Kinyoun method. Thirty-three hemodialysis patients (45.1% and 36 reference individuals (25.7% were found to be parasitized. The differences in the percentages of parasitism and polyparasitism between the reference group and the chronic renal patients was significant (p= 0.0318 and 0.0019, respectively. Blastocystis sp. (18%-20.1%, Endolimax nana (14%-16.3%, Cryptosporidium sp. (4%-4.7% and Entamoeba coli (4%-4.7% were the most frequent protozoa found in the hemodialysis patients. Parasitism was not significantly associated with diarrhea (p=0.9947 or with decreased white blood cell counts (p=0.7046 in these individuals. Because parasitic infections may be an important comorbidity factor in hemodialysis patients, we suggest that parasitological stool examinations, especially for Blastocystis sp. and Cryptosporidium sp., be included in routine medical follow-up examinations of these patients.

  1. Sleep quality and spiritual well-being in hemodialysis patients.

    Science.gov (United States)

    Eslami, Ahmad Ali; Rabiei, Leili; Khayri, Freidoon; Rashidi Nooshabadi, Mohammad Reza; Masoudi, Reza

    2014-07-01

    Sleep disorders are considered as one of the most important problems in hemodialysis patients, making their everyday life a serious hazard. Sleep quality of hemodialysis patients and consequences of sleep disorders on other aspects of health such as spiritual well-being are important issues. This study examined the relationship between spiritual well-being and quality of sleep in hemodialysis patients in Isfahan, Iran. This study was a correlation research, carried out on 190 hemodialysis patients. Data collection Questionnaires included demographic forms, Pittsburgh sleep quality index (PSQI), and Ellison and Paloutzian spiritual well-being scale. Data were analyzed using descriptive and inferential statistics (Pearson correlation and linear regression analysis) at P spiritual health conditions. Pearson correlation test showed significant relationship between the sleep quality items of Pittsburg and spiritual well-being (P spiritual health, family, education, financial status, marital status, occupation, and use of sleep medication, the predictive power of these variables was found 0.417% and prediction of spiritual well-being was more than others (ß = 0.209). Considering bed as one of the most vital physical, mental, and emotional needs, it is very important in mental and spiritual well-being of hemodialysis patients as an influencing factor in mental relaxation and reducing disease tensions. Paying attention to sleep quality and spiritual well-being components of hemodialysis patients in formulating and promoting healthcare programs is recommended.

  2. The mothers' experiences in the pediatrics hemodialysis unit.

    Science.gov (United States)

    Mieto, Fernanda Stella Risseto; Bousso, Regina Szylit

    2014-01-01

    The need for hemodialysis exerts a deep impact on the lives of children and adolescents with end-stage kidney chronic failure and their mothers, who predominantly assume the care related to treatment. The hemodialysis requires that the mother accompanies the child during sessions at least three times a week and, since it is not a healing practice, they also experience the waiting for a kidney transplant, attributing different meanings to this experience. To understand what it means for the mothers to accompany the child in a Pediatric Hemodialysis Unit and to construct a theoretical model representing this experience. The Symbolic Interactionism was adopted as a theoretical model and the Grounded Theory as a methodological framework. Data were collected through interviews with 11 mothers. The comparative analysis of the data enabled the identification of two phenomena that compose the experience: "Seeing the child´s life being sucked by the hemodialysis machine" expresses the experiences of the mothers that generates new demands to comprehend the new health conditions of their children and "Giving new meaning to the dependence of the hemodialysis machine" that represents the strategies employed to endure the experience. The relationship of these phenomena allowed the identification of the main category: "Having the mother's life imprisoned by the hemodialysis machine", from which we propose a new theoretical model. The results of the study allow us to provide a theoretical ground for planning an assistance that meets the real needs of the mothers, identifying aspects that require intervention.

  3. Skin Perfusion Pressure Is a Prognostic Factor in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Shingo Hatakeyama

    2012-01-01

    Full Text Available Peripheral arterial disease (PAD is common in hemodialysis patients and predicts a poor prognosis. We conducted a prospective cohort study to identify risk factors for PAD including skin perfusion pressure (SPP in hemodialysis patients. The cohort included 373 hemodialysis patients among 548 patients who received hemodialysis at Oyokyo Kidney Research Institute, Hirosaki, Japan from August 2008 to December 2010. The endpoints were lower limb survival (peripheral angioplasty or amputation events and overall survival of 2 years. Our results showed that <70 mmHg SPP was a poor prognosis for the lower limb survival and overall survival. We also identified age, history of cardiovascular disease, presence of diabetes mellitus, smoking history, and SPP < 70 mmHg as independent risk factors for lower limb survival and overall survival. Then, we constructed risk criteria using the significantly independent risk factors. We can clearly stratify lower limb survival and overall survival of the hemodialysis patients into 3 groups. Although the observation period is short, we conclude that SPP value has the potential to be a risk factor that predicts both lower limb survival and the prognosis of hemodialysis patients.

  4. Isotonic saline nasal irrigation in clinical practice: a literature review

    Directory of Open Access Journals (Sweden)

    Sabrina Costa Lima

    Full Text Available Abstract Introduction: Nasal instillation of saline solution has been used as part of the treatment of patients with upper respiratory tract diseases. Despite its use for a number of years, factors such as the amount of saline solution to be used, degree of salinity, method and frequency of application have yet to be fully explained. Objective: Review the reported outcomes of saline nasal irrigation in adults with allergic rhinitis, acute or chronic sinusitis and after functional endoscopic sinus surgery (FESS, and provide evidence to assist physiotherapists in decision making in clinical practice. Methods: A search was conducted of the Pubmed and Cochrane Library databases between 2007 and 2014. A combination of the following descriptors was used as a search strategy: nasal irrigation, nasal lavage, rhinitis, sinusitis, saline, saline solution. Results: Eight clinical trials were included, analyzed according to participant diagnosis. Conclusion: The evidence found was heterogeneous, but contributed to elucidating uncertainties regarding the use of nasal lavage in the clinical practice of physical therapy, such as the protocols used.

  5. Sweet pepper production in substrate in response to salinity, nutrient solution management and training system Produção de pimentão cultivado em substrato em resposta à salinidade, manejo da solução nutritiva e sistema de condução

    Directory of Open Access Journals (Sweden)

    José S Rubio

    2011-09-01

    Full Text Available The objective of the present study was to evaluate the marketable fruit yield of sweet pepper plants (Capsicum annuum cv. Orlando in function of the management of nutrient solution with training system. Plants were grown on coconut coir dust under greenhouse conditions in the southeast of Spain. A randomized block design in split-split plot with four blocks was used to test the effect of the nutrient solution strength (full or half-strength Hoagland nutrient solution, training system (two and three stems per plant and water salinity (saline and non-saline on total and marketable yield, fruit quality, and fruit mineral concentration. Salt treatment decreased fruit yield by decreasing the fruit fresh weight but not the number of fruits per plant. Under saline and non-saline conditions, the higher yield of fruits was obtained in plants watered with half-strength Hoagland solution, and grown with three stems per plant. Blossom end rot incidence increased under saline conditions or using full-strength Hoagland solution, but decreased with the combination of half-strength Hoagland solution and three-stem training system. Salt treatment also decreased fruit quality in all the treatments due to a decrease in PO2-, SO4(2-, Fe2+;3+, Cu1+;2+ and Mn2+ concentrations, and fruit shape index. Likewise, plants exposed to salinity and watered with half-strength Hoagland solution and trained with three stems showed a reduction in juice glucose and fructose concentration. Based on these results, an increase of the marketable fruit yield could be obtained under non or moderate saline conditions with the implementation of suitable culture practices.Este experimento teve como objetivo avaliar a produção comercial de pimentão doce (Capsicum annuum cv. Orlando em função do manejo da solução nutritiva, da salinidade e do sistema de condução. As plantas de pimentão doce foram cultivadas em substrato de fibra de coco em casa de vegetação no sudeste da Espanha

  6. Organization of a Regional Hemodialysis Center

    Directory of Open Access Journals (Sweden)

    D. G. Dantsiger

    2006-01-01

    Full Text Available The paper presents a concept of formation and development of interregional, regional, and equated centers, interregional specialized units set up on the basis of therapeutic-and-prophylactic institutions on the basis of a multileveled multistage health care system. Large multidisciplinary clinical hospital One (Novokuznetsk was used as an example to consider the mechanism of integration of innovation technology of organizing a specialized medical aid. Analysis of the needs of the region’s population for dialysis care for patients with acute and chronic renal failure has revealed the barest necessity of setting up a regional hemodyalisis center under a multidisciplinary clinical hospital. The setting up of a hemodialysis center substantially has quantitatively and qualitatively improved health care delivered to patients with acute and chronic renal failure.

  7. Intradialytic Exercise is Medicine for Hemodialysis Patients.

    Science.gov (United States)

    Parker, Kristen

    2016-01-01

    When a person's kidneys fail, hemodialysis (HD) is the most common treatment modality. With a growing number of patients requiring this life-sustaining treatment, and with evidence illustrating the significant physical dysfunction of this population, encouraging exercise is essential. The use of intradialytic exercise, as a novel and efficient use of time during HD, is well established in Australia and some European nations; however, it is slower to start in North America. While a large number of small studies have demonstrated numerous benefits and safe delivery of intradialytic exercise training for patients with end-stage kidney disease, intradialytic exercise is rarely delivered as standard of care. It is of utmost importance for health care staff to overcome barriers and bring theory into practice. Included in this report are current recommendations from governing bodies, expert opinion, as well as established policies and procedures from a successful intradialytic exercise program in Canada.

  8. Estresse salino no crescimento inicial e nutrição mineral de gliricídia (Gliricidia sepium (Jacq. Kunth ex Steud em solução nutritiva(1 Growth and mineral nutrition of (Gliricidia sepium (Jacq. Kunth ex Steud seedlings in nutrient solution under saline stress

    Directory of Open Access Journals (Sweden)

    Séfora Gil Gomes de Farias

    2009-10-01

    Full Text Available A salinidade é um dos fatores que mais limitam o crescimento e desenvolvimento de plantas na região semiárida. A sobrevivência destas em ambientes salinos dependerá de processos adaptativos, que envolvem absorção, transporte e distribuição de íons nos vários órgãos da planta. Com o objetivo de avaliar o crescimento e a nutrição mineral de mudas de gliricídia cultivada em diferentes condições de salinidade, realizou-se um experimento em telado de náilon da Unidade Acadêmica de Engenharia Florestal da Universidade Federal de Campina Grande, Patos - PB. As sementes foram colocadas para germinar em vasos de Leonard, contendo solução nutritiva de Hoagland & Arnon (50 % da concentração original, com as concentrações de NaCl: 0, 100 200 e 400 mmol L-1. Os tratamentos foram distribuídos em delineamento inteiramente casualizado, com quatro repetições, com uma planta por vaso. Aos 60 dias após a emergência, as plantas foram colhidas e avaliadas quanto a altura, matéria seca e teores de N, P, K, Ca, Mg, S e Na na raiz, no caule e nas folhas. O aumento da salinidade promoveu reduções no crescimento e nos teores de macronutrientes, ocorrendo o inverso nos teores de Na, sobretudo na raiz. A gliricídia mostrou-se sensível à salinidade.Salinity is one of the most limiting factors to plant growth and development. Plant survival in saline environments depends on adaptive processes involving uptake, transport, and distribution of ions in plant organs. To evaluate growth and mineral nutrition of Gliricidia sepium seedlings under saline conditions, an experiment was carried out under nylon-mesh protection, at the Federal University of Campina Grande, in Patos - PB. Seeds were sown in pots containing Hoagland & Arnon nutrient solution with four NaCl levels (0, 100, 200 and 400 mmol L-1, with four replications (1 plant/pot in a completely randomized design. Sixty days after seedling emergence, the plant height and root, stem and

  9. Why home hemodialysis? A systematic "marketing" analysis.

    Science.gov (United States)

    Piccoli, Giorgina Barbara; Ferraresi, Martina; Consiglio, Valentina; Scognamiglio, Stefania; Deagostini, Maria Chiara; Randone, Olga; Vigotti, Federica Neve; Calderale, Pasquale Mario

    2012-01-01

    Home hemodialysis (HHD) has met with alternating fortunes. The present revival of interest is due to lower costs and more frequent/efficient treatments. HHD is underdeveloped, and a marketing approach may help in defining development strategies. The aim of this study was to systematically review the recent literature (2000-2010) according to a marketing approach, defining the potential of HHD according to the classical marketing items: market size, growth rate, profitability, trends, keys for success, needs for structures and distribution channels. A Medline search was conducted for 2000-2010. The analysis took into account the recent trends in publication as a measure of interest, size and trends, while survival and costs were analyzed as keys for success. The issues of structures and distribution channels were arbitrarily considered as equivalent to the overall hemodialysis market. Interest in HHD is growing, as shown by the increasing number of published papers (9 in 2000, 52 in 2010); yet, clinical studies accounted for less than half of the papers. In the 138 clinical studies, quality of life (33 papers) and metabolism (16 papers) were the most studied topics. Survival and cost analyses were highly heterogeneous (the broad inclusion of nocturnal or quotidian dialysis has to be mentioned). Overall, survival was equal to, or better than, that for other modalities, including transplantation and peritoneal dialysis; costs compared favorably with hospital dialysis and were equivalent to those of peritoneal dialysis. The small "market" of HHD is increasing, with potential for further growth, the keys for success being equivalence or superiority of survival at equivalent or lower costs.

  10. Beta-2 Microglobulin Levels in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Mumtaz Asim

    2010-01-01

    Full Text Available The objective of the study was to determine the level of β2-microglobulin (β2-m in hemodialysis (HD patients and the factors affecting it. This cross sectional, hospital based study was conducted between September and December 2008 at the Hemodialysis unit of Shalamar Hospital, Lahore. All patients with end-stage renal disease (ESRD who were on main-tenance HD for more than three months were included in the study. Patients with acute renal failure and on dialysis for less than three months were excluded. Demographic data were collec-ted and details of dialysis (type of dialyzers, dialysate bath, membrane used were recorded. Blood samples of the patients were drawn for hematological (hemoglobin, hematocrit, bioche-mical (urea, creatinine, uric acid, albumin and β2-m level measurement. The total number of patients studied was 50. The major causes of ESRD included diabetes mellitus and hypertension seen in 37 (74% and 10 patients (20%, respectively. The β2-m levels were significantly elevated in the study patients; 92.6 ± 17.1 mg/L with a range of 54 to 130 mg/L as compared to 2.0 ± 1.29 mg/L in the control group. The patients′ age had a statistically significant relationship with the β2-m level. The major reason for increased β2-m level was use of low-flux dialyzers. Synthetic polysulphone membrane, bicarbonate, ultra pure dialysate and duration on HD were not asso-ciated with high β2-m levels. Also, we found an inverse relationship between β2-m levels and serum albumin of the study patients. Our study suggests that the β2-m levels are significantly high in dialysis patients. Use of low-flux dialyzer seems to be the major reason for the high β2-m levels. Age and albumin have statistically significant relationship with β2-m levels.

  11. Nutritional Status in Nocturnal Hemodialysis Patients : A Systematic Review with Meta-Analysis

    NARCIS (Netherlands)

    Ipema, Karin J. R.; Struijk, Simone; van der Velden, Annet; Westerhuis, Ralf; van der Schans, Cees P.; Gaillard, Carlo A. J. M.; Krijnen, Wim P.; Franssen, Casper F. M.

    2016-01-01

    Background Hemodialysis patients experience an elevated risk of malnutrition associated with increased morbidity and mortality. Nocturnal hemodialysis (NHD) results in more effective removal of waste products and fluids. Therefore, diet and fluid restrictions are less restricted in NHD patients.

  12. Hemodialysis Induces an Acute Decline in Cerebral Blood Flow in Elderly Patients

    NARCIS (Netherlands)

    Polinder-Bos, Harmke; Vállez García, David; Kuipers, Johanna; Elting, Jan Willem J.; Aries, M.J.H.; Krijnen, Wim P.; Groen, Hendrik; Willemsen, Antoon; van Laar, Peter; Strijkert, Fijanne; Luurtsema, Geert; Slart, Riemer; Westerhuis, Ralf; Gansevoort, Ron T.; Gaillard, Carlo A.; Franssen, Casper

    The initiation of hemodialysis is associated with an accelerated decline of cognitive function and an increased incidence of cerebrovascular accidents and white matter lesions. Investigators have hypothesized that the repetitive circulatory stress of hemodialysis induces ischemic cerebral injury,

  13. Chemical interaction of fresh and saline waters with compacted bentonite

    International Nuclear Information System (INIS)

    Muurinen, A.; Lehikoinen, J.; Melamed, A.; Pitkaenen, P.

    1996-01-01

    The interaction of compacted sodium bentonite with fresh and saline ground-water simulant was studied. The parameters varied in the experiments were the compositions of the solutions and oxygen and carbon dioxide content in the surroundings. The main interests of the study were the chemical changes in the experimental solution, bentonite porewater and bentonite together with the microstructural properties of bentonite. The major processes with fresh water were the diffusion of sodium, potassium, sulphate, bicarbonate and chloride from bentonite to the solution, and the diffusion of calcium and magnesium from the solution into bentonite. The major processes in the experiments with saline water were the diffusion of the sodium, magnesium, sulphate and bicarbonate from bentonite into the solution, and the diffusion of calcium from the solution into bentonite

  14. Effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients

    OpenAIRE

    Zahra Abbas Ali Madadi; Jalil Azimian; Farzaneh Falahatpishe; Mahmoud Alipour Heidari

    2017-01-01

    Background: Pain and stress of hemodialysis are experienced by more than 50% of patients who are suffering from renal disease; hence decreasing a part of these adverse effects can be effective on individual’s long term coping with hemodialysis. The current study was done to determine the effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients. Methods: This clinical trial was conducted on 31 hemodialysis patients in 2014. The patients ...

  15. Chemical behaviour of trivalent and pentavalent americium in saline NaCl-solutions. Studies of transferability of laboratory data to natural conditions. Interim report. Reported period: 1.2.1993-31.12.1993; Chemisches Verhalten von drei- und fuenfwertigem Americium in Salinen NaCl-Loesungen. Untersuchung der Uebertragbarkeit von Labordaten auf natuerliche Verhaeltnisse. Zwischenbericht. Berichtszeitraum 1.2.1993-31.12.1993

    Energy Technology Data Exchange (ETDEWEB)

    Runde, W; Kim, J I

    1994-09-15

    In order to clarify the chemical behaviour of Americium in saline aqueous systems relevant for final storage this study deals with the chemical reactions of trivalent and pentavalent Americium in NaCl-solutions under the influence of radiolysis from its own alpha radiation. The focus of the study was on investigating the geologically relevant reactions, such as hydrolysis or carbonate- and chloride complexing in solid-liquid equilibriums. Comprehensive measurements on solubility and spectroscopic studies in NaCl-solutions were carried out in a CO{sub 2}-free atmosphere and 10{sup -2} atm CO{sub 2} partial pressure. Identification and characterisation of the AM (III) and AM(V) solid phases were supplemented by structural research with the chemically analogue EU (III) and Np(V) compounds. The alpha-radiation induced radiolysis in saline NaCl solutions and the redox behaviour of Americium which was influenced thereby were spectroscopically quantified. (orig.) [Deutsch] Zur Klaerung des chemischen Verhaltens von Americium in endlagerrelevanten salinen aquatischen Systemen befasst sich die vorliegende Arbeit mit den chemischen Reaktionen des drei- und fuenfwertigen Americiums in NaCl-Loesungen unter dem Einfluss der Radiolyse durch die eigene {alpha}-Strahlung. Der Schwerpunkt dieser Arbeit lag auf der Untersuchung der geologisch relevanten Reaktionen, wie Hydrolyse sowie Carbonat- und Chloridkomplexierung in fest-fluessig Gleichgewichtssystemen. Hierzu wurden umfassende Loeslichkeitsmessungen und spektroskopische Untersuchungen in NaCl-Loesungen, sowohl unter CO{sub 2}-freier Atmosphaere als auch unter 10{sup -2} atm CO{sub 2}-Partialdruck, durchgefuehrt. Die Identifizierung und Charakterisierung der Am(III)- und Am(V)-Festphasen wurde ergaenzt durch strukturelle Untersuchungen mit den chemisch analogen Eu(III)- und Np(V)-Verbindungen. Die von der {alpha}-Strahlung induzierte Radiolyse in salinen NaCl-Loesungen und das dadurch beeinflusste Redoxverhalten von Americium

  16. The carbon footprints of home and in-center maintenance hemodialysis in the United Kingdom.

    Science.gov (United States)

    Connor, Andrew; Lillywhite, Robert; Cooke, Matthew W

    2011-01-01

    Climate change presents a global health threat. However, the provision of healthcare, including dialysis, is associated with greenhouse gas emissions. The aim of this study was to determine the carbon footprints of the differing modalities and treatment regimes used to deliver maintenance hemodialysis (HD), in order to inform carbon reduction strategies at the level of both individual treatments and HD programs. This was a component analysis study adhering to PAS2050. Emissions factors were applied to data that were collected for building energy use, travel and procurement. Thrice weekly in-center HD has a carbon footprint of 3.8 ton CO2 Eq per patient per year. The majority of emissions arise within the medical equipment (37%), energy use (21%), and patient travel (20%) sectors. The carbon footprint of providing home HD varies with the regime. For standard machines: 4 times weekly (4 days, 4.5 hours), 4.3 ton CO2 Eq; 5 times weekly (5 days, 4 hours), 5.1 ton CO2 Eq ; short daily (6 days, 2 hours), 5.2 ton CO2 Eq; nocturnal (3 nightly, 7 hours), 3.9 ton CO2 Eq; and nocturnal (6 nightly, 7 hours), 7.2 ton CO2 Eq. For NxStage equipment: short daily (5.5 days, 3 hours), 1.8 ton CO2 Eq; 6 nightly nocturnal (2.1 ton CO2 Eq). The carbon footprint of HD is influenced more by the frequency of treatments than by their duration. The anticipated rise in the prevalence of home HD patients, dialyzing more frequently and for longer than in-center patients, will increase the emissions associated with HD programs (despite reductions in patient travel emissions). Emerging technologies, such as NxStage, might offer a solution to this problem. © 2011 The Authors. Hemodialysis International © 2011 International Society for Hemodialysis.

  17. Knowledge and Practice of Hemodialysis Amongst Dialysis Nurses.

    Science.gov (United States)

    Manandhar, Dhiraj Narayan; Chhetri, Pramod Kumar; Poudel, Prakash; Baidya, Samir Keshari; Agrawaal, Krishna Kumar

    2017-01-01

    Dialysis nurses should have a good knowledge regarding hemodialysis treatment. The status of Nepalese dialysis nurses on this aspect is unknown. This study was done to assess the knowledge and practice on different aspects of the hemodialysis treatment. We distributed validated questionnaires to the participants in a biannual conference in Kathmandu on 24th September as most of the dialysis nurses attend the event. We calculated mean and standard deviation for continuous variables and frequencies and percentage for the responses and compared counseling with different parameters. Total 94 out of 116 participants who were giving care to dialysis patients were in the study. Total 39 (42%) received formal nursing training in hemodialysis and 71 (78%) respondents always counseled patients regarding fluid intake. A total of 37 (96%) trained nurses always counseled the importance of regular dialysis. Seventy-six (81.7%) respondents did counseling on vaccination against Hepatitis B. Counseling on vaccination against influenza and pneumococcus was 47 (50%). When comparing educational status, respondents below bachelor level did more frequent counseling than level above (P=0.03). All the respondents knew the importance of hand washing and BP monitoring during hemodialysis. Ninety-one (96.7%) respondents knew how to deal with BP changes during hemodialysis. Seventy-three (77.6%) respondents were very confident on managing complications. Only 31 (33%) respondents knew how to deal with patients on continuous ambulatory peritoneal dialysis. Dialysis nurses have knowledge on basic procedures of hemodialysis but there is a space for improvement in dealing with complications to provide quality service to hemodialysis patients.

  18. Efficiency of acidemia correction on intermittent versus continuous hemodialysis in acute methanol poisoning

    Czech Academy of Sciences Publication Activity Database

    Zakharov, S.; Pelclová, D.; Navrátil, Tomáš; Běláček, J.; Latta, J.; Písař, M.; Rulíšek, J.; Lepš, J.; Zídek, P.; Kučera, C.; Boček, R.; Mazur, M.; Belik, Z.; Chalupa, J.; Talafa, V.; Kodras, K.; Nalos, D.; Sedlak, C.; Šenkyřík, M.; Šmíd, J.; Šálek, T.; Roberts, D. M.; Hovda, K. E.

    2017-01-01

    Roč. 55, č. 2 (2017), s. 123-132 ISSN 1556-3650 Institutional support: RVO:61388955 Keywords : Acidemia * continuous veno-venous hemodialysis * extended daily hemodialysis * intermittent hemodialysis * metabolic acidosis * methanol poisoning Subject RIV: CF - Physical ; Theoretical Chemistry OBOR OECD: Physical chemistry Impact factor: 3.677, year: 2016

  19. The Language of Coping: Understanding Filipino Geriatric Patients' Hemodialysis Lived Experiences

    Science.gov (United States)

    de Guzman, Allan B.; Chy, Mark Anthony S.; Concepcion, April Faye P.; Conferido, Alvin John C.; Coretico, Kristine I.

    2009-01-01

    The majority of patients with chronic kidney disease (CKD) are undergoing maintenance hemodialysis. Hemodialysis is a process of removing metabolic waste, other poisons, and excess fluids from the blood and replacing essential blood constituents through a dialysis machine. With hemodialysis causing stress not only to physical status but also to…

  20. Saline agriculture in Mediterranean environments

    Directory of Open Access Journals (Sweden)

    Albino Maggio

    2011-03-01

    Full Text Available Salinization is increasingly affecting world's agricultural land causing serious yield loss and soil degradation. Understanding how we could improve crop productivity in salinized environments is therefore critical to meet the challenging goal of feeding 9.3 billion people by 2050. Our comprehension of fundamental physiological mechanisms in plant salt stress adaptation has greatly advanced over the last decades. However, many of these mechanisms have been linked to salt tolerance in simplified experimental systems whereas they have been rarely functionally proven in real agricultural contexts. In-depth analyses of specific crop-salinity interactions could reveal important aspects of plant salt stress adaptation as well as novel physiological/agronomic targets to improve salinity tolerance. These include the developmental role of root vs. shoot systems respect to water-ion homeostasis, morphological vs. metabolic contributions to stress adaptation, developmental processes vs. seasonal soil salinity evolution, residual effects of saline irrigation in non-irrigated crops, critical parameters of salt tolerance in soil-less systems and controlled environments, response to multiple stresses. Finally, beneficial effects of salinization on qualitative parameters such as stress-induced accumulation of high nutritional value secondary metabolites should be considered, also. In this short review we attempted to highlight the multifaceted nature of salinity in Mediterranean agricultural systems by summarizing most experimental activity carried out at the Department of Agricultural Engineering and Agronomy of University of Naples Federico II in the last few years.

  1. Mortality risk in hemodialysis patients with increased arterial stiffness is reduced by attainment of classical clinical performance measures

    DEFF Research Database (Denmark)

    Scholze, Alexandra; Thies, Christina; Cheikhalfraj, Mohamed

    2009-01-01

    We determined whether attainment of classical clinical performance measures for hemodialysis care improves survival in hemodialysis patients with increased arterial stiffness.......We determined whether attainment of classical clinical performance measures for hemodialysis care improves survival in hemodialysis patients with increased arterial stiffness....

  2. INFLUENCIA DEL TIEMPO DE INMERSIÓN EN SOLUCIÓN SALINA EN EL COMPORTAMIENTO ELECTROQUÍMICO DE LA ALEACIÓN COMERCIAL DE ALUMINIO AA3003H16 | INFLUENCE OF IMMERSION TIME IN SALINE SOLUTION ON ELECTROCHEMICAL BEHAVIOR OF COMMERCIAL ALUMINUM ALLOY AA3003H16

    Directory of Open Access Journals (Sweden)

    Solange Ysbeth Paredes-Dugarte

    2015-11-01

    Full Text Available The behavior of AA3003H16 aluminum alloy was analyzed in a saline environment. The corrosion rate of the alloy at different exposure times (12 h, 1, 2, 4, 6 and 8 days in the corrosive medium was determined by electrochemical technique of Tafel extrapolation. The corrosion damage morphology was examined by optical microscopy and scanning electron microscopy with energy dispersive X-ray microanalysis. Results show that corrosion speed of alloy AA3003H16 increased with time of exposure. Such behavior was attributed not only to the change in the natural oxide film, but also to the characteristics of the intermetallic particles and the aluminum matrix. The corrosion attack nucleated preferentially at the periphery of the intermetallic particles α-Al (FeMn Si and β-Al (FeMn. The exposure time in the corrosive medium does not influence the morphology of the attack, showing small and large bites from the early hours of immersion in saline solution.

  3. The Effect of the Type of Hemodialysis Buffer on the QTc Interval in Patients on Chronic Hemodialysis

    Directory of Open Access Journals (Sweden)

    Reza Hekmat

    2009-03-01

    Full Text Available Background: Identifying the sources of variation in QTc measurementsis important for preventing arrhythmias during and afterhemodialysis. The present study was designed to determine thecorrelation between the type of hemodialysis buffer and thechanges in QTc interval in patients on chronic hemodialysis.Methods: Fifty-nine patients on chronic hemodialysis whoreferred in winter 2007 to hemodialysis centers of Ghaem andHashemi Nejad hospitals, in Mashhad, Iran, were divided intotwo groups according to their last dialysate buffer: acetate orbicarbonate. Electrocardiography, arterial blood gas parameters,serum K+, Na+, ionized calcium, and albumin levels weremeasured prior to and after hemodialysis in all patients.Results: All arterial blood gas parameters and serum electrolytesconcentrations were increased except K+ levels that weresignificantly decreased with hemodialysis. PCO2 and QTc intervalswere slightly increased in all patients, however thisincrease was not statistically significant. We found that thetype of dialysate affected the QTc interval, HCO3, base excess,base excess of extra cellular fluid, and base bufferchanges with no effect on ionized calcium, pH, PCO2, andserum albumin concentration. QTc interval was prolonged byusing bicarbonate and shortened by using acetate dialysatebuffer. We found no correlation between the variations of QTcinterval and serum electrolytes or arterial blood gas parametersin either group.Conclusion: Bicarbonate buffer use in hemodialysis prolongedQTc interval and acetate buffer shortened it. This effectis independent of serum electrolytes and pH changes duringhemodialysis. The effect of bicarbonate buffer is probablydue to more tolerability of ultra filtration, more effectiveedema reduction and augmented body electro-conductivity.

  4. Longitudinal study of leptin levels in chronic hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Averbukh Zhan

    2011-06-01

    Full Text Available Abstract Background The influence of serum leptin levels on nutritional status and survival in chronic hemodialysis patients remained to be elucidated. We conducted a prospective longitudinal study of leptin levels and nutritional parameters to determine whether changes of serum leptin levels modify nutritional status and survival in a cohort of prevalent hemodialysis patients. Methods Leptin, dietary energy and protein intake, biochemical markers of nutrition and body composition (anthropometry and bioimpedance analysis were measured at baseline and at 6, 12, 18 and 24 months following enrollment, in 101 prevalent hemodialysis patients (37% women with a mean age of 64.6 ± 11.5 years. Observation of this cohort was continued over 2 additional years. Changes in repeated measures were evaluated, with adjustment for baseline differences in demographic and clinical parameters. Results Significant reduction of leptin levels with time were observed (linear estimate: -2.5010 ± 0.57 ng/ml/2y; p Conclusions Thus leptin levels reflect fat mass depots, rather than independently contributing to uremic anorexia or modifying nutritional status and/or survival in chronic hemodialysis patients. The importance of such information is high if leptin is contemplated as a potential therapeutic target in hemodialysis patients.

  5. Total body and regional bone mineral content in hemodialysis patients

    International Nuclear Information System (INIS)

    Hagiwara, Satoshi; Aratani, Hideyui; Miki, Takami; Nishizawa, Yoshiki; Okamura, Terue; Koizumi, Yoshiko; Ochi, Hironobu; Morii, Hirotoshi

    1994-01-01

    Bone mineral content (BMC) in the total body and lumbar spine was evaluated in 126 hemodialysis patients (60 males, 66 females) by dual photon absorptiometry with the Norland DBD 2600. Measurements of: 1) total body BMC divided by lean body mass (BMC TB /LBM), 2) bone mineral density (BMD) of total body, 3) BMD of four regional sections (head, trunk, pelvis, and legs), and 4) BMD of lumbar spine, generally showed a significant decrease in the hemodialysis patients compared to the reference population. However, arm BMD did not show a significant difference between patients and control populations. The z-score of BMC TB /LBM declined significantly throughout the duration of hemodialysis, although that of the lumbar spine BMD did not. It should be noted that the degree of decrease in BMC was more prominent in the total body measurement than in the lumbar spine measurement. There was preferential osteopenia of the total body in the hemodialysis patients. Although the lumbar spine BMD showed a lower value than the control population, the lumbar spine is not the recommended region to monitor the BMD change in hemodialysis patients. (author)

  6. Epidemiology, surveillance, and prevention of bloodstream infections in hemodialysis patients.

    Science.gov (United States)

    Patel, Priti R; Kallen, Alexander J; Arduino, Matthew J

    2010-09-01

    Infections cause significant morbidity and mortality in patients undergoing hemodialysis. Bloodstream infections (BSIs) are particularly problematic, accounting for a substantial number of hospitalizations in these patients. Hospitalizations for BSI and other vascular access infections appear to have increased dramatically in hemodialysis patients since 1993. These infections frequently are related to central venous catheter (CVC) use for dialysis access. Regional initiatives that have shown successful decreases in catheter-related BSIs in hospitalized patients have generated interest in replicating this success in outpatient hemodialysis populations. Several interventions have been effective in preventing BSIs in the hemodialysis setting. Avoiding the use of CVCs in favor of access types with lower associated BSI risk is among the most important. When CVCs are used, adherence to evidence-based catheter insertion and maintenance practices can positively influence BSI rates. In addition, facility-level surveillance to detect BSIs and stimulate examination of vascular access use and care practices is essential to a comprehensive approach to prevention. This article describes the current epidemiology of BSIs in hemodialysis patients and effective prevention strategies to decrease the incidence of these devastating infections.

  7. Reversible primary hypothyroidism in Japanese patients undergoing maintenance hemodialysis.

    Science.gov (United States)

    Sanai, T; Inoue, T; Okamura, K; Sato, K; Yamamoto, K; Abe, T; Node, K; Tsuruya, K; Iida, M

    2008-02-01

    The presence or absence of hypothyroidism was assessed in 152 consecutive Japanese patients with end-stage renal disease on hemodialysis. Eight patients who had undergone treatment for thyroid disease before starting hemodialysis therapy, and 3 patients with amyloidosis due to rheumatoid arthritis were excluded. Of the remaining 141 hemodialysis patients, 14 (9.9%) (9 males and 5 females, aged 69.1 A+/- 8.8 years with a mean duration of hemodialysis of 69 A+/- 51 months) were in a hypothyroid state, defined as a thyroid-stimulating hormone (TSH) level > 5 mU/l. Antithyroid peroxidase antibodies were positive in only 1 of the 14 patients, while antithyroglobulin antibodies were negative in all of these patients. After iodide restriction, the serum TSH level decreased in all the patients from a mean of 16.49 A+/- 22.80 to 4.44 A+/- 3.35 mU/l after 1 month, 4.25 A+/- 2.24 mU/l after 2 months and 3.97 A+/- 2.22 mU/l after 3 months. The 3 months of iodide restriction were also associated with decreases in systolic blood pressure (142 A+/- 19 to 125 A+/- 16 mmHg, p patients on hemodialysis. Retention of excess iodide may be the mechanism responsible for reversible hypothyroidism rather than immunological perturbations. It is, therefore, recommended to attempt iodide restriction before starting l-thyroxine replacement therapy.

  8. Optimizing silicon application to improve salinity tolerance in wheat

    Directory of Open Access Journals (Sweden)

    A. Ali

    2009-05-01

    Full Text Available Salinity often suppresses the wheat performance. As wheat is designated as silicon (Si accumulator, hence Si application may alleviate the salinity induced damages. With the objective to combat the salinity stress in wheat by Si application (0, 50, 100, 150 and 200 mg L-1 using calcium silicate, an experiment was conducted on two contrasting wheat genotypes (salt sensitive; Auqab-2000 and salt tolerant; SARC-5 in salinized (10 dS m-1 and non-salinized (2 dS m-1 solutions. Plants were harvested 32 days after transplanting and evaluation was done on the basis of different morphological and analytical characters. Silicon supplementation into the solution culture improved wheat growth and K+/Na+ with reduced Na+ and enhanced K+ uptake. Concomitant improvement in shoot growth was observed; nonetheless the root growth remained unaffected by Si application. Better results were obtained with 150 and 200 mg L-1 of Si which were found almost equally effective. It was concluded that SARC-5 is better than Auqab-2000 against salt stress and Si inclusion into the solution medium is beneficial for wheat and can improve the crop growth both under optimal and salt stressful conditions.

  9. Modelling Transcapillary Transport of Fluid and Proteins in Hemodialysis Patients.

    Directory of Open Access Journals (Sweden)

    Mauro Pietribiasi

    Full Text Available The kinetics of protein transport to and from the vascular compartment play a major role in the determination of fluid balance and plasma refilling during hemodialysis (HD sessions. In this study we propose a whole-body mathematical model describing water and protein shifts across the capillary membrane during HD and compare its output to clinical data while evaluating the impact of choosing specific values for selected parameters.The model follows a two-compartment structure (vascular and interstitial space and is based on balance equations of protein mass and water volume in each compartment. The capillary membrane was described according to the three-pore theory. Two transport parameters, the fractional contribution of large pores (αLP and the total hydraulic conductivity (LpS of the capillary membrane, were estimated from patient data. Changes in the intensity and direction of individual fluid and solute flows through each part of the transport system were analyzed in relation to the choice of different values of small pores radius and fractional conductivity, lymphatic sensitivity to hydraulic pressure, and steady-state interstitial-to-plasma protein concentration ratio.The estimated values of LpS and αLP were respectively 10.0 ± 8.4 mL/min/mmHg (mean ± standard deviation and 0.062 ± 0.041. The model was able to predict with good accuracy the profiles of plasma volume and serum total protein concentration in most of the patients (average root-mean-square deviation < 2% of the measured value.The applied model provides a mechanistic interpretation of fluid transport processes induced by ultrafiltration during HD, using a minimum of tuned parameters and assumptions. The simulated values of individual flows through each kind of pore and lymphatic absorption rate yielded by the model may suggest answers to unsolved questions on the relative impact of these not-measurable quantities on total vascular refilling and fluid balance.

  10. Do clinical outcomes in chronic hemodialysis depend on the choice of a dialyzer?

    Science.gov (United States)

    Ward, Richard A

    2011-01-01

    Nephrologists are presented with a range of choices when selecting a dialyzer for chronic hemodialysis. Dialyzers differ in the material, structure, permeability and surface area of their membrane, and how the dialyzer is sterilized. Opinions vary regarding the impact of dialyzer characteristics on patient outcomes and which, if any, of these properties to take into account when choosing a dialyzer can be confusing. In the general dialysis population, there is no compelling evidence that the choice of a membrane material from among those materials currently in clinical use has a significant impact on morbidity or mortality (although there are rare patients who will react adversely to a given dialysis membrane). Similarly, most dialyzers are capable of adequately removing small solutes, such as urea, provided they are used with an appropriate blood flow rate and treatment time to ensure delivery of a single-pool Kt/V(urea) of at least 1.25 for men and 1.65 for women. However, in some dialysis patient subpopulations, the results of randomized clinical trials suggest that use of dialyzer containing high-flux membranes confers an outcome advantage. The extent to which this advantage is realized might also depend on how the dialyzer is used, with application in convective therapies such as hemodiafiltration being superior to diffusive therapies such as hemodialysis. This possibility is currently the subject of several large clinical trials. © 2011 Wiley Periodicals, Inc.

  11. Less impairment of hemostasis and reduced blood loss in pigs after resuscitation from hemorrhagic shock using the small-volume concept with hypertonic saline/hydroxyethyl starch as compared to administration of 4% gelatin or 6% hydroxyethyl starch solution.

    Science.gov (United States)

    Haas, Thorsten; Fries, Dietmar; Holz, Carmen; Innerhofer, Petra; Streif, Werner; Klingler, Anton; Hanke, Alexander; Velik-Salchner, Corinna

    2008-04-01

    Small-volume resuscitation using hypertonic saline/hydroxyethyl starch 200/0.62 (HS-HES) has been shown to be an effective alternative to the administration of crystalloids or colloids in trauma patients. All i.v. fluids cause dose-related dilutional coagulopathy and show intrinsic effects on the hemostatic system, but only few data refer to functional consequences after small-volume resuscitation. Using thrombelastometry (ROTEM), we studied 30 pigs (weighing 35-45 kg) after withdrawal of 60% of blood volume [1484 mL (1369-1624 mL)] and receiving 4 mL/kg HS-HES for compensation of blood loss or 4% gelatin or 6% HES 130/0.4 in a 1:1 ratio to lost blood volume. To compare the ROTEM variables (coagulation time, clot formation time, alpha angle, clot firmness, and fibrinogen polymerization) with bleeding tendency, a hepatic incision was made and blood loss was measured. Median (25th, 75th percentile) fibrinogen polymerization was significantly higher after HS-HES infusion [11 mm (10, 11), P = 0.0034] when compared with administration of 4% gelatin [4.5 mm (3.0, 5.8)] or HES 130/0.4 [3.5 mm (2.3, 4.0)]. Median blood loss after liver incision was 725 mL (900, 375) after HS-HES, 1625 mL (1275, 1950) after 4% gelatin, and 1600 mL (1500, 1800) after 6% HES 130/0.4 (P = 0.004). Hemodynamic stabilization was traceable in all groups but showed differences regarding filling pressures. Resuscitation from hemorrhagic shock with HS-HES 200/0.62 results in less impairment of clot formation when compared with compensation of blood loss by administering 6% HES 130/0.4 or 4% gelatin.

  12. Establishing Core Outcome Domains in Hemodialysis: Report of the Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) Consensus Workshop.

    Science.gov (United States)

    Tong, Allison; Manns, Braden; Hemmelgarn, Brenda; Wheeler, David C; Evangelidis, Nicole; Tugwell, Peter; Crowe, Sally; Van Biesen, Wim; Winkelmayer, Wolfgang C; O'Donoghue, Donal; Tam-Tham, Helen; Shen, Jenny I; Pinter, Jule; Larkins, Nicholas; Youssouf, Sajeda; Mandayam, Sreedhar; Ju, Angela; Craig, Jonathan C

    2017-01-01

    Evidence-informed decision making in clinical care and policy in nephrology is undermined by trials that selectively report a large number of heterogeneous outcomes, many of which are not patient centered. The Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) Initiative convened an international consensus workshop on November 7, 2015, to discuss the identification and implementation of a potential core outcome set for all trials in hemodialysis. The purpose of this article is to report qualitative analyses of the workshop discussions, describing the key aspects to consider when establishing core outcomes in trials involving patients on hemodialysis therapy. Key stakeholders including 8 patients/caregivers and 47 health professionals (nephrologists, policymakers, industry, and researchers) attended the workshop. Attendees suggested that identifying core outcomes required equitable stakeholder engagement to ensure relevance across patient populations, flexibility to consider evolving priorities over time, deconstruction of language and meaning for conceptual consistency and clarity, understanding of potential overlap and associations between outcomes, and an assessment of applicability to the range of interventions in hemodialysis. For implementation, they proposed that core outcomes must have simple, inexpensive, and validated outcome measures that could be used in clinical care (quality indicators) and trials (including pragmatic trials) and endorsement by regulatory agencies. Integrating these recommendations may foster acceptance and optimize the uptake and translation of core outcomes in hemodialysis, leading to more informative research, for better treatment and improved patient outcomes. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  13. Establishing Core Outcome Domains in Hemodialysis: Report of the Standardized Outcomes in Nephrology−Hemodialysis (SONG-HD) Consensus Workshop

    Science.gov (United States)

    Tong, Allison; Manns, Braden; Hemmelgarn, Brenda; Wheeler, David C.; Evangelidis, Nicole; Tugwell, Peter; Crowe, Sally; Van Biesen, Wim; Winkelmayer, Wolfgang C.; O’Donoghue, Donal; Tam-Tham, Helen; Shen, Jenny; Pinter, Jule; Larkins, Nicholas; Youssouf, Sajeda; Mandayam, Sreedhar; Ju, Angela; Craig, Jonathan C.

    2017-01-01

    Evidence-informed decision-making in clinical care and policy in nephrology is undermined by trials that selectively report a large number of heterogeneous outcomes, many of which are not patient-centered. The Standardized Outcomes in Nephrology−Hemodialysis (SONG-HD) Initiative convened an international consensus workshop on November 7, 2015, to discuss the identification and implementation of a potential core outcome set for all trials in hemodialysis. The purpose of this article is to report qualitative analyses of the workshop discussions, describing the key aspects to consider when establishing core outcomes in trials involving patients on hemodialysis. Key stakeholders including eight patients/caregivers and 47 health professionals (nephrologists, policy makers, industry, researchers) attended the workshop. Attendees suggested that identifying core outcomes required equitable stakeholder engagement to ensure relevance across patient populations; flexibility to consider evolving priorities over time; deconstruction of language and meaning for conceptual consistency and clarity; understanding of potential overlap and associations between outcomes; and an assessment of applicability to the range of interventions in hemodialysis. For implementation, they proposed that core outcomes must have simple, inexpensive and validated outcome measures that could be used in clinical care (quality ndicators) and trials (including pragmatic trials), and endorsement by regulatory agencies. Integrating these recommendations may foster acceptance and optimize the uptake and translation of core outcomes in hemodialysis, leading to more informative research, for better treatment, and improved patient outcomes. PMID:27497527

  14. Investigation of Lake Water Salinity by Using Four-Band Salinity Algorithm on WorldView-2 Satellite Image for a Saline Industrial Lake

    Science.gov (United States)

    Budakoǧlu, Murat; Karaman, Muhittin; Damla Uça Avcı, Z.; Kumral, Mustafa; Geredeli (Yılmaz), Serpil

    2014-05-01

    Salinity of a lake is an important characteristic since, these are potentially industrial lakes and the degree of salinity can significantly be used for determination of mineral resources and for the production management. In the literature, there are many studies of using satellite data for salinity related lake studies such as determination of salinity distribution and detection of potential freshwater sources in less salt concentrated regions. As the study area Lake Acigol, located in Denizli (Turkey) was selected. With it's saline environment, it's the major sodium sulphate production resource of Turkey. In this study, remote sensing data and data from a field study was used and correlated. Remote sensing is an efficient tool to monitor and analyze lake properties by using it complementary to field data. Worldview-2 satellite data was used in this study which consists of 8 bands. At the same time with the satellite data acquisition, a field study was conducted to collect the salinity values in 17 points of the laker with using YSI 556 Multiparametre for measurements. The values were measured as salinity amount in grams per kilogram solution and obtained as ppt unit. It was observed that the values vary from 34 ppt - 40.1 ppt and the average is 38.056 ppt. In Thalassic serie, the lake was in mixoeuhaline state in the time of issue. As a first step, ATCOR correction was performed on satellite image for atmospheric correction. There were some clouds on the lake field, hence it was decided to continue the study by using the 12 sampling points which were clear on the image. Then, for each sampling point, a spectral value was obtained by calculating the average at a 11*11 neighborhood. The relation between the spectral reflectance values and the salinity was investigated. The 4-band algorithm, which was used for determination of chlorophyll-a distribution in highly turbid coastal environment by Wei (2012) was applied. Salinity α (Λi-1 / Λj-1) * (Λk-1 / Λm-1) (i

  15. Benfotiamine reduces genomic damage in peripheral lymphocytes of hemodialysis patients.

    Science.gov (United States)

    Schupp, Nicole; Dette, Eva Maria; Schmid, Ursula; Bahner, Udo; Winkler, Michaela; Heidland, August; Stopper, Helga

    2008-09-01

    Hemodialysis patients have an elevated genomic damage in peripheral blood lymphocytes (PBLs) and an increased cancer incidence, possibly due to accumulation of uremic toxins like advanced glycation end products (AGEs). Because the vitamin B1 prodrug benfotiamine reduces AGE levels in experimental diabetes, and dialysis patients often suffer from vitamin B1 deficiency, we conducted two consecutive studies supplementing hemodialysis patients with benfotiamine. In both studies, genomic damage was measured as micronucleus frequency of PBLs before and at three time-points after initiation of benfotiamine supplementation. AGE-associated fluorescence in plasma, and in the second study additionally, the antioxidative capacity of plasma was analyzed. Benfotiamine significantly lowered the genomic damage of PBLs in hemodialysis patients of both studies independent of changes in plasma AGE levels. The second study gave a hint to the mechanism, as the antioxidative capacity of the plasma of the treated patients clearly increased, which might ameliorate the DNA damage.

  16. Pharmacokinetics of amikacin during hemodialysis and peritoneal dialysis

    DEFF Research Database (Denmark)

    Regeur, L; Colding, H; Jensen, H

    1977-01-01

    The pharmacokinetics of amikacin were examined in six bilaterally nephrectomized patients undergoing hemodialysis and in four patients with a minimal residual renal function undergoing peritoneal dialysis. The mean elimination half-life before the dialysis was 86.5 h in the anephric patients and 44...... renal function. During hemodialysis the half-life decreased to less than 10% (5.6 h) of the pretreatment value. The effectiveness of peritoneal dialysis was less as the half-life decreased to only about 30% (17.9 h) of the pretreatment value. During the dialyses a significant correlation between...... the half-life of amikacin and the decrease in blood urea and serum creatinine was demonstrated. The pharmacokinetic data were used to make dosage regimen recommendations for the treatment of patients undergoing intermittent hemodialysis or peritoneal dialysis....

  17. In situ measurement of flow characteristics of natural saline rock in loose zones for gas and saline solutions in given rock stress conditions. Final report; In-situ-Ermittlung von Stroemungskennwerten natuerlicher Salzgesteine in Auflockerungszonen gegenueber Gas und Salzloesungen unter den gegebenen Spannungsbedingungen im Gebirge. Abschlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Haefner, F.; Belohlavek, K.U.; Behr, A.; Foerster, S.; Pohl, A.

    2001-04-01

    A method and equipment were developed for measuring the extension of loose zones around worked areas in saline rock and for in situ measurement of very small permeabilities and porosities in these zones. The experiments are based on unsteady borehole logs with flowing gases or liquids with special multiple pack systems that enable measurements from 4 cm to 15 m from the cavern contour. The measurements were evaluated by a specially developed software with automatic parameter identification. Permeabilities were identified between 10{sup 14} m{sup 2} and the detection limit of 10{sup 24} m{sup 2} and effective porosities of less than 0.1% at experimental times of several minutes up to several days. The logs were made in 3 mines in Stassfurt rock salt at depths of 700 and 500 m with different geological and geomechanical boundary conditions, worked in different ways and for different periods of time (between a few days and 37 years). Some of the findings were validated by ultrasonic measurements. [German] Fuer die Ermittlung der Ausdehnung von Auflockerungszonen um bergmaennisch aufgefahrene Strecken/Hohlraeume im Salzgestein und zur In-situ-Bestimmung kleinster Permeabilitaeten und Porositaeten in diesen Bereichen wurde ein Verfahren und eine praktikable Versuchsausruestung entwickelt. Diese eignet sich auch fuer Frac-Untersuchungen. Basis der Versuchsdurchfuehrungen sind instationaere Bohrlochuntersuchungen mit Gasen oder Fluessigkeiten als Stroemungsfluid unter Einsatz spezieller Mehrfachpackersysteme. Damit sind Messungen ab 4 cm Abstand zur Hohlraumkontur bis zu 15 m moeglich. Die Versuchsauswertung erfolgt mittels einer speziell entwickelten Software mit automatischer Parameteridentifikation, die die instationaere Stroemung um die Versuchsbohrung raeumlich vollstaendig beschreibt. Permeabilitaeten wurden je nach Abstand zur Hohlraumkontur zwischen 10{sup -14} m{sup 2} und der Nachweisgrenze 10{sup -24} m{sup 2} und effektive Porositaeten bis <0,1% ermittelt, bei

  18. Medication adherence among adult patients on hemodialysis

    Directory of Open Access Journals (Sweden)

    Abdulmalik M Alkatheri

    2014-01-01

    Full Text Available Medication adherence was assessed in 89 patients on hemodialysis (HD at the King Abdul Aziz Medical City using an Arabic version of the Morisky Medication Adherence Scale (MASS-8. The results of the study revealed that 31.46% and 40.45% of the participants showed low and medium adherence, respectively, while 28.09% showed high medication adherence. Accordingly, 71.91% of the patients visiting the dialysis unit were considered medication non-adherent. While being of older age (P = 0.012, being married (P = 0.012 increased the level of adherence, being of medium level of education (P = 0.024 decreased adherence levels. On the other hand, gender, presence of a care-giver, number of members in the household and employment status seems to have no effect on the level of medication adherence. These results call upon the practitioners in HD units to develop intervention programs that can increase the level of medication adherence.

  19. Electrocardiographic manifestations of hyperkalemia in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Nemati Eghlim

    2010-01-01

    Full Text Available This study was performed to evaluate whether any electrocardiogram (ECG para-meter can predict the presence of hyperkalemia in patients on maintenance hemodialysis (HD. In January 2006, we conducted a cross-sectional study of 80 stable patients with end-stage renal disease from four university-based HD units of Tehran, Iran, receiving conventional thrice-weekly HD. Pre-HD serum electrolyte values and conventional 12-lead ECG were obtained from each pa-tient. Bivariate linear regression was used for assessing relationship of the study variables with hyperkalemia (K + > 5.2 mg/dL. Multivariable logistic regression was used for evaluating inde-pendent relationship between decreased T wave duration (≤ 170 ms and other variables. Bivariate correlation analysis showed a significant inverse correlation between serum potassium concentration and T wave duration (P < 0.05. None of the patients with serum potassium of ≥ 5.6 mg/dL had T wave duration > 200 ms. Multivariate logistic analysis, after adjustment for other factors, also showed a significant relationship between decreased T wave duration (≤ 170 ms and hyper-kalemia. We conclude that although hyperkalemia does not induce the usual ECG changes in HD patients, decreased T wave duration was found to be a good indicator of this lethal condition.

  20. Anxiety in Patients Treated with Hemodialysis.

    Science.gov (United States)

    Cohen, Scott D; Cukor, Daniel; Kimmel, Paul L

    2016-12-07

    Anxiety is a common yet frequently overlooked psychiatric symptom in patients with ESRD treated with hemodialysis (HD). Anxiety is characterized by disruptive feelings of uncertainty, dread, and fearfulness. A variety of common medical complaints may be manifestations of an anxiety disorder, including palpitations, tremors, indigestion, numbness/tingling, nervousness, shortness of breath, diaphoresis, and fear. It is essential for the clinician to rule out specific medical conditions, including cardiovascular, pulmonary, and neurologic diseases, before ascribing these symptoms to an anxiety disorder. In addition, there is considerable overlap between the symptoms of anxiety and those of depression and uremia. This psychiatric condition has a significant adverse impact on patients' perception of quality of life. Little is known regarding the prevalence and impact of anxiety disorders in patients with ESRD treated with HD; however, many of the seemingly irrational behaviors of patients, or behaviors which place them in conflict with staff and physicians, such as behavioral noncompliance, may be the expression of an underlying anxiety disorder. In this review, we present three clinical vignettes, highlighting the impact of anxiety disorders in patients with ESRD treated with HD. Copyright © 2016 by the American Society of Nephrology.

  1. Central Venous Occlusion in the Hemodialysis Patient.

    Science.gov (United States)

    Krishna, Vinay Narasimha; Eason, Joseph B; Allon, Michael

    2016-11-01

    Central venous stenosis (CVS) is encountered frequently among hemodialysis patients. Prior ipsilateral central venous catheterization and cardiac rhythm device insertions are common risk factors, but CVS can also occur in the absence of this history. Chronic CVS can cause thrombosis with partial or complete occlusion of the central vein at the site of stenosis. CVS is frequently asymptomatic and identified as an incidental finding during imaging studies. Symptomatic CVS presents most commonly as an upper- or lower-extremity edema ipsilateral to the CVS. Previously unsuspected CVS may become symptomatic after placement of an ipsilateral vascular access. The likelihood of symptomatic CVS may be affected by the central venous catheter (CVC) location; CVC side; duration of CVC dependence; type, location, and blood flow of the ipsilateral access; and extent of collateral veins. Venous angiography is the gold standard for diagnosis. Percutaneous transluminal angioplasty and stent placement can improve the stenosis and alleviate symptoms, but CVS typically recurs frequently, requiring repeated interventions. Refractory symptomatic CVS may require ligation of the ipsilateral vascular access. Because no available treatment option is curative, the goal should be to prevent CVS by minimizing catheters and central vein instrumentation in patients with chronic kidney disease and dialysis patients. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  2. Malnutrition predicting factors in hemodialysis patients.

    Science.gov (United States)

    Jahromi, Soodeh Razeghi; Hosseini, Saeed; Razeghi, Effat; Meysamie, Ali pasha; Sadrzadeh, Haleh

    2010-09-01

    Malnutrition is a predictor of increased mortality in chronic hemodialysis (HD) patients. Various factors may contribute to malnutrition in these patients including energy and protein intake, inflammation, and comorbidity. To determine the importance of these factors in malnutrition of chronic HD patients, we studied 112 chronic HD patients in two centers was evaluated with the Dialysis Malnutrition Score (DMS) and anthropometric and biochemical indices. Seventy six (67.8%) patients were classified as malnourished. According to DMS score, poor protein intake (r= -0.34, Penergy intake (r= - 0.18, Pmalnutrition in descending order of importance. Multiple regression analysis showed that only poor protein intake was the explanatory variable of anthropometric measurements decline including body mass index, triceps skin fold thick-ness, mid arm circumference, mid arm muscle circumference, fat free mass, fat mass, albumin, creatinine and transferrine. None of the mentioned factors predicted the decrease of biochemical markers. We conclude that the frequency of malnutrition is high in our population and poor protein intake is the primary contributing factor for this condition. Therefore, providing enough protein may be a simple and effective way in preventing malnutrition in these patients.

  3. Trace elements in renal disease and hemodialysis

    International Nuclear Information System (INIS)

    Miura, Yoshinori; Nakai, Keiko; Suwabe, Akira; Sera, Koichiro

    2002-01-01

    A number of considerations suggest that trace element disturbances might occur in patients with renal disease and in hemodialysis (HD) patients. Using particle induced X-ray emission, we demonstrated the relations between serum concentration, urinary excretion of the trace elements and creatinine clearance (Ccr) in randomized 50 patients. To estimate the effects of HD, we also observed the changes of these elements in serum and dialysis fluids during HD. Urinary silicon excretion decreased, and serum silicon concentration increased as Ccr decreased, with significant correlation (r=0.702, p<0.001 and r=0.676, p<0.0001, respectively). We also observed the increase of serum silicon, and the decrease of silicon in dialysis fluids during HD. These results suggested that reduced renal function and also dialysis contributed to silicon accumulation. Although serum selenium decreased significantly according to Ccr decrease (r=0.452, p<0.01), we could detect no change in urinary selenium excretion and no transfer during HD. Serum bromine and urinary excretion of bromine did not correlate to Ccr. However we observed a bromine transfer from the serum to the dialysis fluid that contributed to the serum bromine decrease in HD patients

  4. Blood leptin levels and erythropoietin requirement in Iranian hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Rahimi A

    2008-12-01

    Full Text Available "nBackground: Anemia is a common complication accompanied by high morbidity and mortality in hemodialysis patients. Considering the fact that the reduction of erythropoietin (EPO synthesis is the main cause of uremic anemia, receiving recombinant human erythropoietin (rHuEPO can improve the condition in these patients. Some of these hemodialysis patients, however, have acceptable hemoglobin levels without any need to EPO. Higher BMI, higher albumin and leptin plasma levels and longer durations of hemodialysis are possible factors contributing to the reduced need for rHuEPO in these patients. The present study is designed to asses the relationship between the plasma levels of leptin and the reduced EPO need. "nMethods: Fifty eligible hemodialysis patients with hemoglobin levels higher than 11 mg/dl were enrolled in the cross-sectional study. The information on age, sex, hemodialysis duration and the cause of renal dysfunction were extracted from the files. The baseline plasma levels of Leptin and albumin were measured. The patients BMI and the weekly need for rHuEPO were also calculated. "nResults: There was no correlation between the weekly need for rHuEPO and sex, BMI, the cause of renal dysfunction and the plasma levels of albumin and leptin; it, however, was related with age and the duration of dialysis. While age negatively influences the weekly need, the duration of dialysis has a positive effect on the need. "nConclusion: The plasma levels of leptin are not directly correlated with the required amounts of rHuEPO, indicating that leptin is not an effective factor in erythropoiesis. Conversely, older age and shorter hemodialysis durations are accompanied by reduced need for rHuEPO.

  5. Frequency of nursing care of vascular access in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Iman Taghizade Firoozjayi

    2016-03-01

    Full Text Available Background: Hemodialysis is a critical treatment method, which depends on the vascular access route. Lack of care for the vascular access route could diminish its efficiency in a short time. Regarding this, the present study aimed to evaluate the frequency of nursing care for vascular access route in the hemodialysis patients. Methods: This cross-sectional study was conducted on 20 nurses and 120 hemodialysis patients, who referred to the Hemodialysis Department of Shahid Beheshti Hospital, Babol, Iran, in 2015. The method of nursing care for vascular access route was evaluated using a researcher-made checklist. The data analysis was performed using the descriptive statistics in the SPSS version 16. Results: In total, 14 cases of nursing care were evaluated, in 100% of which all the caring steps, including wearing gloves and a mask, early bolus injections of heparin, washing the catheter tubing, frequent monitoring of blood pressure, rinsing the catheter tubing, returning the blood to the body after hemodialysis, and sterile covering of the puncture site, were observed. However, some of the other techniques, such as the care related to appropriate pump speed when starting the dialysis machine (81.66%, observance of the needle distance from fistula (75.83%, appropriate placement of catheter (75%, pressing the injection site (54.17%, blood pressure monitoring at the end of dialysis (50%, and change of the needle site between two sessions (27.5%, were not adhered to by the nurses. Conclusion: According to the results of this study, some of the nursing care steps, which are necessary in the beginning and end of the hemodialysis, were not accurately followed by the nurses. It is recommended that constant training courses be held for the nurses in this regard.

  6. [Evaluation of cardiac complications among chronic hemodialysis in Dakar].

    Science.gov (United States)

    Moustapha, Cissé Mouhamadou; Tall, Lemrabott Ahmed; Maria, Faye; Khodia, Fall; Moustapha, Faye; Fary, Ka El Hadji; Abdou, Niang; Boucar, Diouf

    2016-01-01

    Hemodialysis is the first extrarenal treatment method that allowed supporting patients in terminal chronic failure in Senegal since 1997. 25 years later, we conducted this study to determine the type and the prevalence of different cardiovascular complications and identify the main cardiovascular risk factors. It is a retrospective study of 4 years. 38 patients treated at least 6 months in hemodialysis and cardiovascular explorations with a front chest x-ray, electrocardiogram and cardiac ultrasound. All patients who have not started hemodialysis, treated less than 6 months in hemodialysis, treaties in peritoneal dialysis or having raised cardiovascular explorations were excluded. For each selected patient, we collected data epidemiological, clinical, paraclinical and evolutionary aspects of cardiovascular complications. 38 patients were included in this study. The average age was 52 years ± 12.85 and the sex ratio H/F of 1.53. Initial nephropathy was dominated by the néphroangiosclérose followed by diabetic nephropathy. Clinically the signs of appeal are marked by the effort dyspnea palpitations, chest pain and physically by the HTA, anemia. Cardiovascular complications were dominated by hypertrophy (LVH) left ventricular, rhythm type of arrhythmia disorders valvular leakage (mitral and tricuspid) and cerebral vascular accident (stroke). The average impact of LVH according the HTA is 81%, by sex of 78.26% for men and 60% for women. At the end of the study, 27 patients were pursuing hemodialysis and 11 had died 6 (54%) of cardiovascular cause. Hemodialysis is a common purification technique in Senegal and its complications remain especially dominated by abuses cardiovascular.

  7. NOAA Average Annual Salinity (3-Zone)

    Data.gov (United States)

    California Natural Resource Agency — The 3-Zone Average Annual Salinity Digital Geography is a digital spatial framework developed using geographic information system (GIS) technology. These salinity...

  8. Mapping the Salinity Gradient in a Microfluidic Device with Schlieren Imaging

    Directory of Open Access Journals (Sweden)

    Chen-li Sun

    2015-05-01

    Full Text Available This work presents the use of the schlieren imaging to quantify the salinity gradients in a microfluidic device. By partially blocking the back focal plane of the objective lens, the schlieren microscope produces an image with patterns that correspond to spatial derivative of refractive index in the specimen. Since salinity variation leads to change in refractive index, the fluid mixing of an aqueous salt solution of a known concentration and water in a T-microchannel is used to establish the relation between salinity gradients and grayscale readouts. This relation is then employed to map the salinity gradients in the target microfluidic device from the grayscale readouts of the corresponding micro-schlieren image. For saline solution with salinity close to that of the seawater, the grayscale readouts vary linearly with the salinity gradient, and the regression line is independent of the flow condition and the salinity of the injected solution. It is shown that the schlieren technique is well suited to quantify the salinity gradients in microfluidic devices, for it provides a spatially resolved, non-invasive, full-field measurement.

  9. A case of scrub typhus requiring maintenance hemodialysis

    Directory of Open Access Journals (Sweden)

    Dae-Yeon Kim

    2013-12-01

    Full Text Available Renal failure caused by scrub typhus is known to be reversible. In most cases, renal function is almost fully restored after appropriate antibiotic treatment. A 71-year-old man was diagnosed with scrub typhus complicated by renal failure. A renal biopsy revealed histopathologic findings consistent with acute tubulointerstitial nephritis. Renal function did not improve 18 months after discharge and the patient required continuous hemodialysis. Although severe renal failure requiring dialysis is a rare complication of scrub typhus, we describe a case of scrub typhus requiring maintenance hemodialysis. To the best of our knowledge, this is the first such report.

  10. Salinity controls on plant transpiration and soil water balance

    Science.gov (United States)

    Perri, S.; Molini, A.; Suweis, S. S.; Viola, F.; Entekhabi, D.

    2017-12-01

    Soil salinization and aridification represent a major threat for the food security and sustainable development of drylands. The two problems are deeply connected, and their interplay is expected to be further enhanced by climate change and projected population growth. Salt-affected land is currently estimated to cover around 1.1 Gha, and is particularly widespread in semi-arid to hyper-arid climates. Over 900 Mha of these saline/sodic soils are potentially available for crop or biomass production. Salt-tolerant plants have been recently proposed as valid solution to exploit or even remediate salinized soils. However the effects of salinity on evapotranspiration, soil water balance and the long-term salt mass balance in the soil, are still largely unexplored. In this contribution we analyze the feedback of evapotranspiration on soil salinization, with particular emphasis on the role of vegetation and plant salt-tolerance. The goal is to introduce a simple modeling framework able to shed some light on how (a) soil salinity controls plant transpiration, and (b) salinization itself is favored/impeded by different vegetation feedback. We introduce at this goal a spatially lumped stochastic model of soil moisture and salt mass dynamics averaged over the active soil depth, and accounting for the effect of salinity on evapotranspiration. Here, the limiting effect of salinity on ET is modeled through a simple plant response function depending on both salt concentration in the soil and plant salt-tolerance. The coupled soil moisture and salt mass balance is hence used to obtain the conditional steady-state probability density function (pdf) of soil moisture for given salt tolerance and salinization level, Our results show that salinity imposes a limit in the soil water balance and this limit depends on plant salt-tolerance mainly through the control of the leaching occurrence (tolerant plants exploit water more efficiently than the sensitive ones). We also analyzed the

  11. World Ocean Atlas 2005, Salinity

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — World Ocean Atlas 2005 (WOA05) is a set of objectively analyzed (1° grid) climatological fields of in situ temperature, salinity, dissolved oxygen, Apparent Oxygen...

  12. Genetic variation and plasticity of Plantago coronopus under saline conditions

    NARCIS (Netherlands)

    Smekens, Marret; Van Tienderen, P.H.

    2001-01-01

    Phenotypic plasticity may allow organisms to cope with variation in the environmental conditions they encounter in their natural habitats. Salt adaptation appears to be an excellent example of such a plastic response. Many plant species accumulate organic solutes in response to saline conditions.

  13. Genotypic variation in the response of tomato to salinity | Turhan ...

    African Journals Online (AJOL)

    In order to determine the predictive screening parameters that can be applied at early development stages of tomato plants, 18 tomato cultivars were grown in nutrient solution with 12 dS m-1 NaCl. The research was conducted in a completely randomized design with tree replications. The relationships among the salinity ...

  14. Extracting renewable energy from a salinity difference using a capacitor.

    Science.gov (United States)

    Brogioli, Doriano

    2009-07-31

    Completely renewable energy can be produced by using water solutions of different salinity, like river water and sea water. Many different methods are already known, but development is still at prototype stage. Here I report a novel method, based on electric double-layer capacitor technology. Two porous electrodes, immersed in the salt solution, constitute a capacitor. It is first charged, then the salt solution is brought into contact with fresh water. The electrostatic energy increases as the salt concentration of the solution is reduced due to diffusion. This device can be used to turn sources of salinity difference into completely renewable sources of energy. An experimental demonstration is given, and performances and possible improvements are discussed.

  15. Therapeutic effects of compound hypertonic saline on rats with sepsis

    Directory of Open Access Journals (Sweden)

    Fang Dong

    2014-09-01

    Full Text Available Sepsis is one of the major causes of death and is the biggest obstacle preventing improvement of the success rate in curing critical illnesses. Currently, isotonic solutions are used in fluid resuscitation technique. Several studies have shown that hypertonic saline applied in hemorrhagic shock can rapidly increase the plasma osmotic pressure, facilitate the rapid return of interstitial fluid into the blood vessels, and restore the effective circulating blood volume. Here, we established a rat model of sepsis by using the cecal ligation and puncture approach. We found that intravenous injection of hypertonic saline dextran (7.5% NaCl/6% dextran after cecal ligation and puncture can improve circulatory failure at the onset of sepsis. We found that the levels of tumor necrosis factor-α, interleukin-1β, interleukin-6 and intracellular adhesion molecule 1 levels in the lung tissue of cecal ligation and puncture rats treated with hypertonic saline dextran were significantly lower than the corresponding levels in the control group. We inferred that hypertonic saline dextran has a positive immunoregulatory effect and inhibits the overexpression of the inflammatory response in the treatment of sepsis. The percentage of neutrophils, lung myeloperoxidase activity, wet to dry weight ratio of lung tissues, histopathological changes in lung tissues, and indicators of arterial blood gas analysis was significantly better in the hypertonic saline dextran-treated group than in the other groups in this study. Hypertonic saline dextran-treated rats had significantly improved survival rates at 9 and 18 h compared to the control group. Our results suggest that hypertonic saline dextran plays a protective role in acute lung injury caused after cecal ligation and puncture. In conclusion, hypertonic/hyperoncotic solutions have beneficial therapeutic effects in the treatment of an animal model of sepsis.

  16. Perceived illness intrusion among patients on hemodialysis

    International Nuclear Information System (INIS)

    Bapat, Usha; Kedlaya, Prashanth G; Gokulnath

    2009-01-01

    Dialysis therapy is extremely stressful as it interferes with all spheres of daily activities of the patients. This study is aimed at understanding the perceived illness intrusion among patients on hemodialysis (HD) and to find the association between illness intrusion and patient demo-graphics as well as duration of dialysis. A cross sectional study involving 90 patients with chronic kidney disease (CKD) stage V, on HD was performed during the period from 2005 to 2006. The subjects included were above 18 years of age, willing, stable and on dialysis for at least two months. Patients with psychiatric co-morbidity were excluded. A semi-structured interview schedule covering sociodemographics and a 13 item illness intrusion checklist covering the various aspects of life was carried out. The study patients were asked to rate the illness intrusion and the extent. The data were analyzed statistically. The mean age of the subjects was 50.28 + - 13.69 years, males were predominant (85%), 73% were married, 50% belonged to Hindu religion, 25% had pre-degree education, 25% were employed and 22% were housewives. About 40% and 38% of the study patients belonged to middle and upper socio-economic strata respectively; 86% had urban background and lived in nuclear families. The mean duration on dialysis was 24 + - 29.6 months. All the subjects reported illness intrusion to a lesser or greater extent in various areas including: health (44%), work (70%) finance (55%), diet (50%) sexual life (38%) and psychological status (25%). Illness had not intruded in areas of relationship with spouse (67%), friends (76%), family (79%), social (40%) and religious functions (72%). Statistically significant association was noted between illness intrusion and occupation (P= 0.02). (author)

  17. Restless legs syndrome in patients on hemodialysis

    Directory of Open Access Journals (Sweden)

    Saleh Mohammad Yaser Salman

    2011-01-01

    Full Text Available Restless legs syndrome (RLS is common among dialysis patients, with a reported prevalence of 6-60%. The prevalence of RLS in Syrian patients on hemodialysis (HD is not known. The purpose of this study is to determine the prevalence of RLS in patients on regular HD, and to find the possible correlation between the presence of RLS and demographic, clinical, and biochemical factors. One hundred and twenty-three patients (male/female = 70/53, mean age = 41.95 ± 15.11 years on HD therapy at the Aleppo University Hospital were enrolled into the study. RLS was diagnosed based on criteria established by the International Restless Legs Syn-drome Study Group (IRLSSG. Data procured were compared between patients with and without RLS. Applying the IRLSSG criteria for the diagnosis, RLS was seen in 20.3% of the study pa-tients. No significant difference in age, gender, and intake of nicotine and caffeine was found between patients with and without the RLS. Similarly, there was no difference between the two groups in the duration of end-stage renal disease (ESRD, the period of dialysis dependence, dialysis adequacy, urea and creatinine levels, and the presence of anemia. The co-morbidities and the use of drugs also did not differ in the two groups. Our study suggests that the high prevalence of RLS among patients on HD requires careful attention and correct diagnosis can lead to better therapy and better quality of life. The pathogenesis of RLS is not clear and further studies are required to identify any possible cause as well as to discover the impact of this syndrome on sleep, quality of life, and possibly other complications such as cardiovasculare disease.

  18. Sodium setpoint and gradient in bicarbonate hemodialysis.

    Science.gov (United States)

    Basile, Carlo; Libutti, Pasquale; Lisi, Piero; Vernaglione, Luigi; Casucci, Francesco; Losurdo, Nicola; Teutonico, Annalisa; Lomonte, Carlo

    2013-01-01

    The demonstration of an individual osmolar setpoint in hemodialysis (HD) is crucial to individualize dialysate sodium concentrations. Furthermore, the diffusive gradient between plasma and dialysate sodium is important in the "fine tuning" of the intradialytic sodium mass balance (MB). The design of this study included part A: a retrospective analysis of predialysis plasma sodium concentrations extracted from a 6-year database in our HD population (147 prevalent white anuric patients); and part B: study of intradialytic sodium kinetics in 48 patients undergoing one 4-hour bicarbonate HD session. Direct potentiometry with an ion-selective electrode was used for sodium measurements. Study part A: the mean number of plasma sodium measurements per patient was 16.06 ± 14.03 over a mean follow-up of 3.55 ± 1.76 years. The mean of the averaged plasma sodium concentrations was 136.7 ± 2.1 mmol/L, with a low mean intraindividual coefficient of variation (1.39 ± 0.4). Study part B: mean predialysis and postdialysis plasma sodium concentrations were 135.8 ± 0.9 and 138.0 ± 0.9 mmol/L (p<0.001). Mean inlet dialyzer sodium concentration was 138.7 ± 1.1 mmol/L; the hourly diffusion concentration gradients showed a statistically significant transfer from dialysate to plasma (Wilks ? <0.0001). A statistically significant relationship was found between sodium MB and diffusion gradient (p<0.02), and between sodium MB and ultrafiltration volume (p<0.01). A relatively "fixed" and individual osmolar setpoint in HD patients was shown for the first time in a long-term follow-up. A dialysate sodium concentration of 140 mmol/L determined a dialysate to plasma sodium gradient.

  19. Food intake in patients on hemodialysis

    Directory of Open Access Journals (Sweden)

    Inaiana Marques Filizola Vaz

    2014-12-01

    Full Text Available Objective: To evaluate the intake of energy and nutrients by individuals on hemodialysis, following especific recommendations for this population and according to Food Guide for the Brazilian Population. Methods: A cross-sectional study, 118 adult patients, considered stable from, ten dialysis centers in Goiânia, Goiás. Dietary intake was estimated by six 24-hour recalls, and classified as adequate or inadequate, according to specific recommendations for individuals undergoing dialysis and that recommended for a healthy diet. A descriptive analysis was performed. Results: Average dietary intake of 2022.40 ± 283.70 kcal/day; 31.18 kcal/kg/day; 55.03 ± 4.20% carbohydrate; 30.23 ± 3.71% lipid, 1.18 ± 0.23 g protein/kg/day. Important prevalences of inadequacy were observed for the intake of calories (39.0%, protein (39.0% and other nutrients such as retinol (94.9%, saturated fat (87.3%, cholesterol (61,9%, iron (61.0%, potassium (60.2% and zinc (45.0%. Patients had a low intake of fruit food group (1.22 ± 0.89 servings and vegetables (1.76 ± 1.01 servings, dairy products (0.57 ± 0.43 servings and high intake of food group of oils and fats (3.45 ± 0.95 servings, sugars and sweets (1.55 ± 0.77 servings. Conclusion: Observed food consumption imbalance, characterized by excess of oils and fats, especially saturated oils and cholesterol, sugars and sweets, parallel to low intake of fruits and vegetables and dairy products. A considerable percentage of patients did not intake the minimum recommended of calories, protein, retinol, iron, zinc and potassium.

  20. Classification of bone scintigrams in hemodialysis patients

    International Nuclear Information System (INIS)

    Ishibashi, Kazunari; Miyamae, Tatsuya

    1985-01-01

    Bone scintigrams from a total of 75 hemodialysis patients using sup(99m)Tc-methylene-diphosphonate (MDP) were classified into two groups; Group I (56 patients) in which the uptake of the radioactivity appeared to be relatively high in the soft tissue and low in the bone, and Group II (19 patients) in which high uptake in the bone and low uptake in the soft tissue were observed. Patients in Group I were further classified into two subgroups; Group I sub(A) (articular type, 21 patients) which was characterized by relatively high uptake into the joint, and Group I sub(B) (reduction type, 35 patients) where uptake was faint in the whole region of the bone. The classification of patients in Group II was also performed; Group II sub(A) (spinal type, 14 patients) where high spinal uptake was observed, and Group II sub(B) (cranio-facial type, 5 patients) where high uptake into the cranio-facial region was observed. The results were compared with 146 subjects with normal bone scintigram in terms of the ratio of bone to soft tissue uptake (B/S ratio) for the cranial bone, jaw bone, lumbar vertebra and femoral bone, and the ratio of epiphysis to diaphysis uptake (E/D ratio) for the femoral bone. The B/S ratio was low in Group I and high in Group II for the bone studied, and the E/D ratio was markedly high in Group I sub(A). Histobiochemical examination indicated that patients in Group I sub(A) and Group II may have osteomalacia and secondary hyperparathyroidism, respectively. It was considered that the visual classification and semiquantitative study as described here were useful for evaluating the pathological condition of renal osteodystrophy. (author)

  1. [Pharmacokinetics of salazosulfapyridine in a hemodialysis patient].

    Science.gov (United States)

    Akiyama, Yuji; Fujimaki, Toshihisa; Sakurai, Yusei

    2003-06-01

    The patient was a 62-year-old female. Total gastrectomy was performed due to gastric ulcer in 1969. She was diagnosed as rheumatoid arthritis (RA) in 1985 and was developed to amyloidosis in 1991. She was started on hemodialysis (HD) for chronic renal failure in 1996. In 1998, her arthralgia was aggravated, and 100 mg/day of bucillamine was administered on the day of HD. Her arthralgia persisted, and switching to salazosulfapyridine (SASP) was considered. As there were no standards and no reports for the use of SASP in HD patients, we examined the pharmacokinetics of SASP and its metabolites, and compared our patient with the results of phase one study in normal subjects in Japan. In this case, the blood concentration of SASP was similar to that in healthy controls after single administration of 500 mg of SASP on the day of non-HD, while the concentration of sulfapyridine (SP) was higher than that in healthy donors. However, the blood concentrations of SASP, SP, and N4-acetyl-SP (AcSP) at 24 hours after administration were similar to those obtained in healthy men. SASP was not dialyzed, while about half of SP and AcSP, were dialyzed. In a five-day consecutive administration study also, the blood concentrations of these compounds on Day 5 were similar to those of phase one study, suggesting no accumulation. No adverse drug reaction was observed. As this case had the past history of total gastrectomy and amyloidosis, it is possible that this result is influenced by the factors. Therefore it is necessary to examine pharmacokinetics of SASP and its metabolites beforehand when administering this agent to other HD/RA patients.

  2. Perceived illness intrusion among patients on hemodialysis

    Directory of Open Access Journals (Sweden)

    Bapat Usha

    2009-01-01

    Full Text Available Dialysis therapy is extremely stressful as it interferes with all spheres of daily acti-vities of the patients. This study is aimed at understanding the perceived illness intrusion among pa-tients on hemodialysis (HD and to find the association between illness intrusion and patient demo-graphics as well as duration of dialysis. A cross sectional study involving 90 patients with chronic kidney disease (CKD stage V, on HD was performed during the period from 2005 to 2006. The subjects included were above 18 years of age, willing, stable and on dialysis for at least two months. Patients with psychiatric co-morbidity were excluded. A semi-structured interview schedule covering socio-demographics and a 13 item illness intrusion checklist covering the various aspects of life was ca-rried out. The study patients were asked to rate the illness intrusion and the extent. The data were ana-lyzed statistically. The mean age of the subjects was 50.28 ± 13.69 years, males were predominant (85%, 73% were married, 50% belonged to Hindu religion, 25% had pre-degree education, 25% were employed and 22% were housewives. About 40% and 38% of the study patients belonged to middle and upper socio-economic strata respectively; 86% had urban background and lived in nuclear fami-lies. The mean duration on dialysis was 24 ± 29.6 months. All the subjects reported illness intrusion to a lesser or greater extent in various areas including: health (44%, work (70% finance (55%, diet (50% sexual life (38% and psychological status (25%. Illness had not intruded in areas of rela-tionship with spouse (67%, friends (76%, family (79%, social (40% and religious functions (72%. Statistically significant association was noted between illness intrusion and occupation (P= 0.02.

  3. Classification of bone scintigrams in hemodialysis patients

    Energy Technology Data Exchange (ETDEWEB)

    Ishibashi, Kazunari; Miyamae, Tatsuya

    1985-03-01

    Bone scintigrams from a total of 75 hemodialysis patients using /sup 99m/Tc-methylene-diphosphonate (MDP) were classified into two groups; Group I (56 patients) in which the uptake of the radioactivity appeared to be relatively high in the soft tissue and low in the bone, and Group II (19 patients) in which high uptake in the bone and low uptake in the soft tissue were observed. Patients in Group I were further classified into two subgroups; Group I sub(A) (articular type, 21 patients) which was characterized by relatively high uptake into the joint, and Group I sub(B) (reduction type, 35 patients) where uptake was faint in the whole region of the bone. The classification of patients in Group II was also performed; Group II sub(A) (spinal type, 14 patients) where high spinal uptake was observed, and Group II sub(B) (cranio-facial type, 5 patients) where high uptake into the cranio-facial region was observed. The results were compared with 146 subjects with normal bone scintigram in terms of the ratio of bone to soft tissue uptake (B/S ratio) for the cranial bone, jaw bone, lumbar vertebra and femoral bone, and the ratio of epiphysis to diaphysis uptake (E/D ratio) for the femoral bone. The B/S ratio was low in Group I and high in Group II for the bone studied, and the E/D ratio was markedly high in Group I sub(A). Histobiochemical examination indicated that patients in Group I sub(A) and Group II may have osteomalacia and secondary hyperparathyroidism, respectively. It was considered that the visual classification and semiquantitative study as described here were useful for evaluating the pathological condition of renal osteodystrophy.

  4. Liver enzymes in patients with chronic kidney disease undergoing peritoneal dialysis and hemodialysis

    Directory of Open Access Journals (Sweden)

    Isabella Ramos de Oliveira Liberato

    2012-01-01

    Full Text Available OBJECTIVE: The present study was designed to analyze the serum levels of aspartate and alanine aminotransferases, gamma-glutamyl transferase, and the hematocrit in patients with chronic kidney disease who were undergoing peritoneal dialysis or hemodialysis. PATIENTS AND METHODS: Twenty patients on peritoneal dialysis and 40 on hemodialysis were assessed, and the patients were matched according to the length of time that they had been on dialysis. Blood samples were collected (both before and after the session for those on hemodialysis to measure the enzymes and the hematocrit. RESULTS: In the samples from the patients who were undergoing peritoneal dialysis, the aspartate and alanine aminotransferase levels were slightly higher compared with the samples collected from the patients before the hemodialysis session and slightly lower compared with the samples collected after the hemodialysis session. The levels of gamma-glutamyl transferase in the hemodialysis patients were slightly higher than the levels in the patients who were undergoing peritoneal dialysis. In addition, the levels of aminotransferases and gamma-glutamyl transferase that were collected before the hemodialysis session were significantly lower than the values collected after the session. The hematocrit levels were significantly lower in the patients who were on peritoneal dialysis compared with the patients on hemodialysis (both before and after the hemodialysis session, and the levels were also significantly lower before hemodialysis compared with after hemodialysis. CONCLUSION: The aminotransferase levels in the patients who were undergoing peritoneal dialysis were slightly higher compared with the samples collected before the hemodialysis session, whereas the aminotransferase levels were slightly lower compared with the samples collected after the session. The hematocrits and the aminotransferase and gamma-glutamyl transferase levels of the samples collected after the

  5. Numerical calculation of hemolysis levels in peripheral hemodialysis cannulas

    NARCIS (Netherlands)

    De Wachter, D; Verdonck, P

    Hemolysis in extracorporeal life support systems presents an underestimated problem. In this article, we investigate the hemolytic potential of peripheral hemodialysis cannulas numerically. An axisymmetrical finite element model of 3 cannula sizes was built (13G, 14G, and 16G) that was refined

  6. Vascular access complications and risk factors in hemodialysis ...

    African Journals Online (AJOL)

    Vascular access complications and risk factors in hemodialysis patients: A single center study. ... Stenosis was the most common risk factor for vascular failure as it occurred in (29%) of patients. ... Other risk factors for dialysis CRBSI include older age, low serum albumin, high BUN and decreasing the duration of dialysis.

  7. Acute effects of hemodialysis on salivary flow rate and composition

    NARCIS (Netherlands)

    Bots, C. P.; Brand, H. S.; Veerman, E. C. I.; Valentijn-Benz, M.; Henskens, Y. M. C.; Valentijn, R. M.; Vos, P. F.; Bijlsma, J. A.; ter Wee, P. M.; van Amerongen, B. M.; Nieuw Amerongen, A. V.

    2007-01-01

    To evaluate acute effects of hemodialysis (HD) on the salivary flow rate, pH and biochemical composition before, during and after completion of a dialysis session. Unstimulated whole saliva (UWS) and chewing-stimulated whole saliva (CH-SWS) were collected in 94 HD patients. Salivary flow rate, pH,

  8. Dental calculus formation in children and adolescents undergoing hemodialysis.

    Science.gov (United States)

    Martins, Carla; Siqueira, Walter Luiz; Oliveira, Elizabeth; Nicolau, José; Primo, Laura Guimarães

    2012-10-01

    This study aimed to determine whether dental calculus formation is really higher among patients with chronic kidney disease undergoing hemodialysis than among controls. Furthermore, the study evaluated correlations between dental calculus formation and dental plaque, variables that are related to renal disease and/or saliva composition. The Renal Group was composed of 30 patients undergoing hemodialysis, whereas the Healthy Group had 30 clinically healthy patients. Stimulated whole saliva and parotid saliva were collected. Salivary flow rate and calcium and phosphate concentrations were determined. In the Renal Group the saliva collection was carried out before and after a hemodialysis session. Patients from both groups received intraoral exams, oral hygiene instructions, and dental scaling. Three months later, the dental calculus was measured by the Volpe-Manhold method to determine the rate of dental calculus formation. The Renal Group presented a higher rate of dental calculus formation (p dental calculus formation and whole saliva flow rate in the Renal Group after a hemodialysis session (r = 0.44, p dental calculus was associated with phosphate concentration in whole saliva from the Renal Group (p dental calculus formation, probably due to salivary variables.

  9. Effect of hemodialysis on total antioxidant status of chronic renal ...

    African Journals Online (AJOL)

    Background: Renal failure is accompanied by oxidative stress, which is caused by enhanced production of reactive oxygen species and impaired antioxidant defense. Aim: To assess the effect of hemodialysis (by cellulose membrane dialyzer) on plasma total antioxidant status and lipid peroxidation of patients in chronic ...

  10. Sexual dysfunction in women with ESRD requiring hemodialysis

    NARCIS (Netherlands)

    Strippoli, G.F.; Vecchio, M.; Palmer, S.; De Berardis, G.; Craig, J.; Lucisano, G.; Johnson, D.; Pellegrini, F.; Nicolucci, A.; Sciancalepore, M.; Saglimbene, V.; Gargano, L.; Bonifati, C.; Ruospo, M.; Navaneethan, S.D.; Montinaro, V.; Stroumza, P.; Zsom, M.; Torok, M.; Celia, E.; Gelfman, R.; Bednarek-Skublewska, A.; Dulawa, J.; Graziano, G.; Gentile, G.; Ferrari, J.N.; Santoro, A.; Zucchelli, A.; Triolo, G.; Maffei, S.; Hegbrant, J.; Wollheim, C.; De Cosmo, S.; Manfreda, V.M.; Steiner, K.; et al.,

    2012-01-01

    BACKGROUND AND OBJECTIVES: The few existing studies of sexual dysfunction in women on hemodialysis are limited by small sample size. This large, cross-sectional study evaluated the prevalence and correlates of female sexual dysfunction in advanced kidney disease. DESIGN, SETTING, PARTICIPANTS,

  11. 21 CFR 876.5820 - Hemodialysis system and accessories.

    Science.gov (United States)

    2010-04-01

    ... system and accessories. (a) Identification. A hemodialysis system and accessories is a device that is used as an artificial kidney system for the treatment of patients with renal failure or toxemic... system, and accessories. Blood from a patient flows through the tubing of the extracorporeal blood system...

  12. Critical Evaluation of Blood Volume Measurements during Hemodialysis

    NARCIS (Netherlands)

    Dasselaar, Judith J.; van der Sande, Frank M.; Franssen, Casper F. M.

    2012-01-01

    Devices that continuously measure relative blood volume (RBV) changes during hemodialysis (HD) are increasingly used for the prevention of dialysis hypotension and fine-tuning of dry weight. However, RBV measurements are subject to various limitations. First, RBV devices provide information on

  13. Clinical and biochemical aspects of hemodialysis and hemodiafiltration

    NARCIS (Netherlands)

    den Hoedt, C.H.

    2012-01-01

    In hemodialysis (HD) clearance of uremic toxins occurs as a result of a concentration gradient between the blood and the dialysate, a process called diffusion. During hemodiafiltration (HDF), diffusion is combined with pressure driven fluid transport across the dialysis membrane, a process called

  14. Vascular access complications and risk factors in hemodialysis ...

    African Journals Online (AJOL)

    Tarek A. Ghonemy

    2015-08-18

    Aug 18, 2015 ... BMI were significant in patients with central blood infection (p < 0.008, <0.008 and <0.001 ... grafts) for hemodialysis over using the venous catheter as they ... were subjected to the following: thorough full history taking.

  15. Recurrent white thrombi formation in hemodialysis tubing: a case report.

    Science.gov (United States)

    Sathe, Kiran P; Yeo, Wee-Song; Liu, Isaac Desheng; Ekambaram, Sudha; Azar, Mohammed; Yap, Hui-Kim; Ng, Kar-Hui

    2015-01-15

    While the appearance of red clots in the dialyzer is a common phenomenon in every hemodialysis unit, the occurrence of white thrombi in the tubing is relatively rare. We describe an adolescent male with recurrent white thrombi formation in the hemodialysis tubing. This patient had chronic renal failure from focal segmental glomerulosclerosis, but was no longer nephrotic at the time of the thrombi formation. He had a history of recurrent thrombosis of his vascular access. However, no pro-thrombotic risk factors could be identified. White particulate matter, measuring 1 to 3mm in size, and adherent to the arterial and venous blood tubing lines was found during the rinse back of a hemodialysis session. This was associated with a 60% decrease in his platelet count. Light microscopic examination of the deposits revealed the presence of platelet aggregates. He subsequently developed thrombosis of his arteriovenous graft six hours later. The white thrombi recurred at the next dialysis session, as well as six months later. These episodes occurred regardless of the type of dialysis machine or tubing, and appeared to resolve with an increase in heparin dose. Recurrent white thrombi formation can occur in the hemodialysis tubing of a patient with no identifiable pro-thrombotic factors. The white thrombi may be a harbinger of arteriovenous graft thrombosis and may be prevented by an increase in heparin dose.

  16. Methotrexate for rheumatoid arthritis patients who are on hemodialysis.

    Science.gov (United States)

    Al-Hasani, Hasanein; Roussou, Euthalia

    2011-12-01

    Methotrexate (MTX) can be toxic to patients suffering from end stage renal disease (ESRD) on hemodialysis even at low doses. This increase in toxicity is more notable in terms of bone marrow suppression in the form of pancytopenia. Many methods of elimination including dialysis itself have been proven ineffective, and alternate treatments with anti-TNF alpha blockers can be considered.

  17. Percutaneous treatment of complications occurring during hemodialysis graft recanalization

    Energy Technology Data Exchange (ETDEWEB)

    Sofocleous, Constantinos T. E-mail: constant@pol.net; Schur, Israel; Koh, Elsie; Hinrichs, Clay; Cooper, Stanley G.; Welber, Adam; Brountzos, Elias; Kelekis, Dimitris

    2003-09-01

    Introduction/objective: To describe and evaluate percutaneous treatment methods of complications occurring during recanalization of thrombosed hemodialysis access grafts. Methods and materials: A retrospective review of 579 thrombosed hemodialysis access grafts revealed 48 complications occurring during urokinase thrombolysis (512) or mechanical thrombectomy (67). These include 12 venous or venous anastomotic ruptures not controlled by balloon tamponade, eight arterial emboli, 12 graft extravasations, seven small hematomas, four intragraft pseudointimal 'dissections', two incidents of pulmonary edema, one episode of intestinal angina, one procedural death, and one distant hematoma. Results: Twelve cases of post angioplasty ruptures were treated with uncovered stents of which 10 resulted in graft salvage allowing successful hemodialysis. All arterial emboli were retrieved by Fogarty or embolectomy balloons. The 10/12 graft extravasations were successfully treated by digital compression while the procedure was completed and the graft flow was restored. Dissections were treated with prolonged Percutaneous Trasluminal Angioplasty (PTA) balloon inflation. Overall technical success was 39/48 (81%). Kaplan-Meier Primary and secondary patency rates were 72 and 78% at 30, 62 and 73% at 90 and 36 and 67% at 180 days, respectively. Secondary patency rates remained over 50% at 1 year. There were no additional complications caused by these maneuvers. Discussions and conclusion: The majority of complications occurring during percutaneous thrombolysis/thrombectomy of thrombosed access grafts, can be treated at the same sitting allowing completion of the recanalization procedure and usage of the same access for hemodialysis.

  18. Mortality Risk for Women on Chronic Hemodialysis Differs by Age

    Directory of Open Access Journals (Sweden)

    Manish M Sood

    2014-06-01

    Full Text Available Background: Previous reports have demonstrated similar survival for men and women on hemodialysis, despite women's increased survival in the general population. Objectives: To examine the effect of age on mortality in women undergoing chronic hemodialysis. Design: A retrospective cohort study using an administrative data registry, the Canadian Organ Replacement Registry (CORR from Jan. 2001 and Dec. 2009. Setting: Canada. Patients: 28,971 (Women 11,792 (40.7%, Men 17,179 (59.3% incident chronic hemodialysis patients who survived greater than 90 days on dialysis. Measurements: All-cause mortality. Methods: Cox proportional hazards and competing risks models were employed to determine the independent association between sex, age and likelihood of all-cause mortality with renal transplantation as the competing outcome. Results: During the study period, 6060 (51.4% of women and 8650 (50.4% of men initiating dialysis died. Younger women experienced higher mortality (Age 85: Women 66%, Men 70.2%, HR 0.83 95% CI 0.71–0.97 compared to men. This relationship persisted after accounting for the competing risk of transplantation. Limitations: The cause of death was unknown. Conclusions: Women's survival on chronic hemodialysis varies by age compared to men with a significantly higher mortality in women younger than 45 years old and lower mortality in woman older than 75 years of age.

  19. Seroprevalence occurrence of viral hepatitis and HIV among hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Inass Mahmood Abid Kamal

    2018-05-01

    Full Text Available Background: Patients with chronic renal failure (CRF were on maintenance invasive hemodialysis (HD procedure. This procedure by itself affects immunity of the patients and became more susceptible to viral infections. Aim of the study: to investigate the occurrence of HBV, HCV and HIV infections in patients with hemodialysis. Patients and methods: A retrospective study of 430 end-stage renal failure patients, referred to hemodialysis department at XXXX Teaching Hospital, Baghdad-Iraq from January-2015 to January-2017. Patients were investigated for HBs-Ag using enzyme-labeled antigen test (Foresight-EIA-USA, HCV- Abs (IgG specific immunoglobulin using an HCV enzyme-labeled antigen test (Foresight-EIA-USAand anti - HIV Abs (IgG using enzyme-labeled antigen test (Foresight-EIA-USA. Results: The frequency of HBV infection in the first year was not significant between males (1.11% and females (0.00% (P = 0.295. About HCV also there are no significant differences between males (12.63% and females (9.31% (P = 0.347. After one year of follow up the frequencies of HBV and HCV were not significant between two sexes. Additionally, no any one of the patients had HIV infection. Conclusions: This study brings a light on that HBV and HCV were having the same frequencies in both genders and lower occurrence with time. Furthermore, HIV was not detected in those patients. Keywords: Virus, Hemodialysis, Infection

  20. [Home Daily Hemodialysis with NxStage System One: monocentric italian casistic results].

    Science.gov (United States)

    Brunati, Chiara; Cassaro, Franca; Cretti, Laura; Izzo, Michela; Pegoraro, Marisa; Negri, Daniela; Gervasi, Francesca; Colussi, Giacomo

    2017-09-28

    NxStage System One is a new dialytic technology based on easy setup, simplicity of use and reduced dimensions, which is increasingly in use worldwide for home hemodialysis treatments. The system utilizes a low amount of dialysate, usually 15-30 liters according to anthropometric patients' values. The dialysate is supplied at very low flux, generally about 1/3 of blood flow, in order to obtain an elevated saturation of dialysate for solutes. In these conditions the clearance of urea will be almost equal to dialysate flow rate. In order to achieve an obptimal weekly clearance evaluated by Std Kt/V the dialysis sessions are repeated six times a week. In this way a good control of blood voleme can be reached. In this paper we report our experience of treatment with NxStage System One in 12 patients from May 2011 to Dicember 2016. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  1. Enhanced hydrogen generation using a saline catholyte in a two chamber microbial electrolysis cell

    KAUST Repository

    Nam, Joo-Youn; Logan, Bruce E.

    2011-01-01

    sparged with CO2 or containing a phosphate buffer. The salinity of the catholyte achieved a high solution conductivity, and therefore the electrode spacing did not appreciably affect performance. The coulombic efficiency with the cathode placed near

  2. Assessment of the effect of salinity on the early growth stage of the ...

    African Journals Online (AJOL)

    SERVER

    2008-03-18

    Mar 18, 2008 ... The results showed that plant growth decreased proportionally with increasing ... Therefore, agriculturalists can assess growth rate changes caused by salinity using remote .... pH of all solutions was adjusted to 6. De-ionized ...

  3. Last Glacial Maximum Salinity Reconstruction

    Science.gov (United States)

    Homola, K.; Spivack, A. J.

    2016-12-01

    It has been previously demonstrated that salinity can be reconstructed from sediment porewater. The goal of our study is to reconstruct high precision salinity during the Last Glacial Maximum (LGM). Salinity is usually determined at high precision via conductivity, which requires a larger volume of water than can be extracted from a sediment core, or via chloride titration, which yields lower than ideal precision. It has been demonstrated for water column samples that high precision density measurements can be used to determine salinity at the precision of a conductivity measurement using the equation of state of seawater. However, water column seawater has a relatively constant composition, in contrast to porewater, where variations from standard seawater composition occur. These deviations, which affect the equation of state, must be corrected for through precise measurements of each ion's concentration and knowledge of apparent partial molar density in seawater. We have developed a density-based method for determining porewater salinity that requires only 5 mL of sample, achieving density precisions of 10-6 g/mL. We have applied this method to porewater samples extracted from long cores collected along a N-S transect across the western North Atlantic (R/V Knorr cruise KN223). Density was determined to a precision of 2.3x10-6 g/mL, which translates to salinity uncertainty of 0.002 gms/kg if the effect of differences in composition is well constrained. Concentrations of anions (Cl-, and SO4-2) and cations (Na+, Mg+, Ca+2, and K+) were measured. To correct salinities at the precision required to unravel LGM Meridional Overturning Circulation, our ion precisions must be better than 0.1% for SO4-/Cl- and Mg+/Na+, and 0.4% for Ca+/Na+, and K+/Na+. Alkalinity, pH and Dissolved Inorganic Carbon of the porewater were determined to precisions better than 4% when ratioed to Cl-, and used to calculate HCO3-, and CO3-2. Apparent partial molar densities in seawater were

  4. [Perinatal complications in patients with chronic renal insufficiency on hemodialysis].

    Science.gov (United States)

    Vázquez-Rodríguez, Juan Gustavo; del Angel-García, Guadalupe

    2010-09-01

    Pregnant patients with chronic renal insufficiency treated with hemodialysis experience adverse perinatal results. To compare perinatal complications of patients with chronic renal insufficiency undergoing hemodialysis who become pregnant vs. the complications of women with chronic renal insufficiency not undergoing dialysis but who then require dialysis during gestation. Transversal and retrospective study that included three patients with chronic renal insufficiency on chronic hemodialysis who became pregnant (group A) and three patients with chronic renal insufficiency without hemodialysis at the time of conception but who required dialysis during gestation (group B). Perinatal results were compared. Statistical analysis was performed with measures of central tendency and dispersion and Student t-test. Group A had 25 sessions vs. group B with 29 hemodialysis sessions (p = 0.88). Maternal complications were anemia 100% (six cases), Cesarean delivery 83.3% (group A 2 cases vs. group B 2 cases), preeclampsia 50% (group A 2 cases vs. group B 1 case), uncontrolled hypertension 50% (group A 2 cases vs. group B 1 case), preterm delivery 50% (group A 2 cases vs. group B 1 case), transfusion 33.3% (group A 2 cases), polyhydramnios 33.3% (group A 1 case vs. group B 1 case) and abortion 16.6% (group A 1 case). Fetal complications included fetal loss 16.6% (group A 1 case), neonatal mortality 33.3% (group A 1 cases vs. group B 1 case), prematurity 50% (group A2 cases vs. group B 1 case), fetal distress 50% (group A 1 case vs. group B 2 cases), respiratory failure 33.3% (group A 2 cases) and fetal growth restriction 16.6% (group A 1 case). Frequency of perinatal complications is elevated in both groups.

  5. Diagnostic discordance for hepatitis C virus infection in hemodialysis patients.

    Science.gov (United States)

    Kalantar-Zadeh, Kamyar; Miller, Loren G; Daar, Eric S

    2005-08-01

    Hepatitis C virus (HCV) infection is associated with an increase in proinflammatory cytokine levels. Similar changes are seen in maintenance hemodialysis patients with malnutrition-inflammation-cachexia syndrome (MICS), which is associated with poor clinical outcomes in this population. We hypothesized that HCV transcription-mediated amplification (TMA), a sensitive qualitative molecular test for HCV RNA, may identify maintenance hemodialysis patients with HCV infection not detected by means of antibody enzyme immunoassay (EIA), particularly in those with MICS. We evaluated HCV status in 314 maintenance hemodialysis patients by using HCV antibody EIA (version 2.0; Abbott Laboratories, Abbott Park, IL) and HCV TMA (Bayer Diagnostics Laboratories, Berkeley, CA). Twenty-five patients (8%) were EIA positive (EIA+)/TMA+; 4 patients (1%), EIA+/TMA negative (TMA-), and 22 patients (7%), EIA-/TMA+. In the 47 TMA+ patients, the sensitivity of EIA for HCV infection was only 53%. TMA+ patients had lower albumin levels and higher tumor necrosis factor alpha and serum glutamic oxaloacetic transaminase levels than TMA- patients. EIA+/TMA+ patients were more likely than EIA-/TMA+ or EIA-/TMA- patients to have hypoalbuminemia and higher iron and transaminase levels. Of all TMA+ patients, EIA- patients were more likely to have diabetes, be on dialysis therapy longer, and have lower liver enzyme levels and higher proinflammatory cytokine levels, including tumor necrosis factor alpha and interleukin 6. Maintenance hemodialysis patients infected with HCV according to TMA have clinical features suggestive of MICS. In this population, HCV EIA appears to have a low sensitivity for the identification of HCV infection, which may be caused by the confounding effect of MICS or other demographic or clinical factors. These apparently false-negative HCV antibody test results are seen in persons with a longer time on hemodialysis therapy, mirroring observations in other populations with serious

  6. TTV as A Risk Factor in Hemodialysis Process

    International Nuclear Information System (INIS)

    Ibrahim, I.M.

    2010-01-01

    The association of TTV (transfusion transmitted virus) with both cryptogenic chronic liver diseases and post-transfusion hepatitis has been reported. Hemodialysis patients are at high risk for viral hepatitis due to blood born viral agents. The few data available concerning TTV infection among hemodialysis patients shows a high prevalence. This study was conducted on one hundred patients with end-stage renal disease (ESRD). They were attending the hemodialysis (HD) unit of Naser institute for performing hemodialysis for the first time (as a control group) and the same patients after recurrent HD for at least six months of regular HD (as a HD patient group). Patients and controls were subjected to the following laboratory investigations; 1) TTV DNA detection by PCR. 2) HBs Ag by ELISA technique. 3) HCV Ab by ELISA technique. 4) Liver enzymes include ALT, AST and γGT. The study was done to detect TTV DNA by PCR in hemodialysis patients and to evaluate its clinical impacts, taking into account co-infection with other hepatitis viruses. The results of this work are:- 1- TTV is remarkably prevalent in HD patients. The prevalence of TTV infection in HD Egyptian patients was 45% and 9% in healthy volunteer from the same geographical area. 2- HCV was found to have highly significant association with HD patients while there was no association between HD patients and HBs Ag. 3- TTV infection was not found to be more prevalent in HD patients infected with HCV. 4- Abnormal liver enzymes were uncommon in HD patients infected with TTV alone, in contrast to patients with known hepatotropic viruses such as HCV. 5- TTV did not play a role in liver injury, but it might aggravate liver diseases caused by HCV.

  7. Short and long nightly hemodialysis in the United States.

    Science.gov (United States)

    Lockridge, Robert S; Pipkin, Mary

    2008-07-01

    When hemodialysis first started in the United States in the 1960s, a large percentage of patients performed their treatments at home. However, because of reimbursement issues, home hemodialysis (HHD) gradually succumbed to an in-center approach and eventually a mindset. Since the introduction of nightly HHD by Uldall and Pierratos in 1993, there has been a resurgence of interest in HHD. This paper describes the different types of home hemodialysis being performed as of December 31, 2007 in this country. Because neither the United States Renal Data System (USRDS) nor the End Stage Renal Disease (ESRD) Networks break down home dialysis into the different modalities, a provider questionnaire was sent out to 2 major providers, a number of mid-level providers and other providers known to do HHD. In addition, a questionnaire was sent out to 3 machine providers to obtain the number of patients using their machine for HHD as of December 31, 2007. The results showed that 91.7% of patients are dialyzing in-center, 7.3% are doing peritoneal dialysis, and 0.7% are doing HHD. Currently about 1% of ESRD patients in the United States are doing home hemodialysis. NxStage, however, has started 1000 patients in the past year on short-daily home hemodialysis. Patients are beginning to understand that there are better options than 3 times a week in-center dialysis. And as a result of the "HEMO Study," nephrologists now believe that longer and more frequent dialysis is a better therapy for ESRD patients. Therefore, promotion of HHD should become a priority for the renal community in the future.

  8. Optimal Wavelength Selection in Ultraviolet Spectroscopy for the Estimation of Toxin Reduction Ratio during Hemodialysis

    Directory of Open Access Journals (Sweden)

    Amir Ghanifar

    2016-06-01

    Full Text Available Introduction The concentration of substances, including urea, creatinine, and uric acid, can be used as an index to measure toxic uremic solutes in the blood during dialysis and interdialytic intervals. The on-line monitoring of toxin concentration allows for the clearance measurement of some low-molecular-weight solutes at any time during hemodialysis.The aim of this study was to determine the optimal wavelength for estimating the changes in urea, creatinine, and uric acid in dialysate, using ultraviolet (UV spectroscopy. Materials and Methods In this study, nine uremic patients were investigated, using on-line spectrophotometry. The on-line absorption measurements (UV radiation were performed with a spectrophotometer module, connected to the fluid outlet of the dialysis machine. Dialysate samples were obtained and analyzed, using standard biochemical methods. Optimal wavelengths for both creatinine and uric acid were selected by using a combination of genetic algorithms (GAs, i.e., GA-partial least squares (GA-PLS and interval partial least squares (iPLS. Results The Artifitial Neural Network (ANN sensitivity analysis determined the wavelengths of the UV band most suitable for estimating the concentration of creatinine and uric acid. The two optimal wavelengths were 242 and 252 nm for creatinine and 295 and 298 nm for uric acid. Conclusion It can be concluded that the reduction ratio of creatinine and uric acid (dialysis efficiency could be continuously monitored during hemodialysis by UV spectroscopy.Compared to the conventional method, which is particularly sensitive to the sampling technique and involves post-dialysis blood sampling, iterative measurements throughout the dialysis session can yield more reliable data.

  9. Incomplete turgor adjustment in Cladophora rupestrisunder fluctuating salinity regimes

    Science.gov (United States)

    Wiencke, Christian; Gorham, John; Tomos, Deri; Davenport, John

    1992-04-01

    Turgor pressure fluctuates strongly in Cladophora rupestrissubjected to low salinities and shows only a small tendency to readjust to the normal value in full seawater (incomplete turgor adjustment). This was revealed by direct turgor pressure measurements and by chemical analyses of osmotic solutes after exposure of upper and lower shore Cladophorato the different salinity regimes occurring in the intertidal zone or representing steady state osmotic acclimation. The main internal osmotic solutes were K +, Cl -, amino acids, NO 3-and glycine betaine. Na +, SO 42-and PO 43-were of less importance. The sum of the charges on the cations was similar to that for the anions. K +, Cl -and, to a lesser extent, amino acids were responsible for limited turgor pressure adjustment which did occur. The concentrations of the major osmotic solutes were influenced not only by salinity but also by light: those of amino acids and NO 3-were increased while those of K +and Cl -were decreased under illumination. Cladophorapopulations from the upper and lower shore differed in their ability to restore internal K +and Cl -levels on transfer to full seawater after long term exposure to low salinity. This may indicate ecotypic variation.

  10. Physiological and Biochemical Responses of Lavandula angustifolia to Salinity Under Mineral Foliar Application

    Science.gov (United States)

    Chrysargyris, Antonios; Michailidi, Evgenia; Tzortzakis, Nikos

    2018-01-01

    Saline water has been proposed as a solution to partially cover plant water demands due to scarcity of irrigation water in hot arid areas. Lavender (Lavandula angustifolia Mill.) plants were grown hydroponically under salinity (0–25–50–100 mM NaCl). The overcome of salinity stress was examined by K, Zn, and Si foliar application for the plant physiological and biochemical characteristics. The present study indicated that high (100 mM NaCl) salinity decreased plant growth, content of phenolics and antioxidant status and essential oil (EO) yield, while low-moderate salinity levels maintained the volatile oil profile in lavender. The integrated foliar application of K and Zn lighten the presumable detrimental effects of salinity in terms of fresh biomass, antioxidant capacity, and EO yield. Moderate salinity stress along with balanced concentration of K though foliar application changed the primary metabolites pathways in favor of major volatile oil constituents biosynthesis and therefore lavender plant has the potential for cultivation under prevalent semi-saline conditions. Zn and Si application, had lesser effects on the content of EO constituents, even though altered salinity induced changings. Our results have demonstrated that lavender growth/development and EO production may be affected by saline levels, whereas mechanisms for alteration of induced stress are of great significance considering the importance of the oil composition, as well. PMID:29731759

  11. Clinical Performance of a Salivary Amylase Activity Monitor During Hemodialysis Treatment

    Directory of Open Access Journals (Sweden)

    Masaru Shimazaki

    2008-01-01

    Full Text Available The hemodialysis procedure is thought to be a physical stressor in the majority of hemodialyzed patients. Previous studies suggest that elevated salivary amylase level may correlate with increased plasma norepinephrine level under psychological and physical stress conditions. In this study, we investigated biological stress reactivity during hemodialysis treatment using salivary amylase activity as a biomarker. Seven patients (male/female = 5/2, age:67.7+ /− 5.9 years who had been receiving regular 4 h hemodialysis were recruited. Salivary amylase activity was measured using a portable analyzer every hour during the hemodialysis session. Salivary amylase activity was shown to be relatively stable and constant throughout hemodialysis, whereas there were significant changes in systolic blood pressure and pulse rate associated with blood volume reduction. Our results show that hemodialysis treatment per se dose not affect salivary amylase activity.

  12. Depressive affect in incident hemodialysis patients

    Science.gov (United States)

    Larkin, John W; Wingard, Rebecca L; Jiao, Yue; Rosen, Sophia; Ma, Lin; Usvyat, Len A; Maddux, Franklin W

    2018-01-01

    Abstract Background The prevalence of depressive affect is not well defined in the incident hemodialysis (HD) population. We investigated the prevalence of and associated risk factors and hospitalization rates for depressive affect in incident HD patients. Methods We performed a prospective investigation using the Patient Health Questionnaire 2 (PHQ2) depressive affect assessment. From January to July of 2013 at 108 in-center clinics randomly selected across tertiles of baseline quality measures, we contacted 577 and 543 patients by telephone for depressive affect screening. PHQ2 test scores range from 0 to 6 (scores  ≥3 suggest the presence of depressive affect). The prevalence of depressive affect was measured at 1–30 and 121–150 days after initiating HD; depressive affect risk factors and hospitalization rates by depressive affect status at 1–30 days after starting HD were computed. Results Of 1120 contacted patients, 340 completed the PHQ2. In patients screened at 1–30 or 121–150 days after starting HD, depressive affect prevalence was 20.2% and 18.5%, respectively (unpaired t-test, P = 0.7). In 35 patients screened at both time points, there were trends for lower prevalence of depressive affect at the end of incident HD, with 20.0% and 5.7% of patients positive for depressive affect at 1–30 and 121–150 days, respectively (paired t-test, P = 0.1). Hospitalization rates were higher in patients with depressive affect during the first 30 days, exhibiting 1.5 more admissions (P < 0.001) and 10.5 additional hospital days (P = 0.008) per patient-year. Females were at higher risk for depressive affect at 1–30 days (P = 0.01). Conclusions The prevalence of depressive affect in HD patients is high throughout the incident period. Rates of hospital admissions and hospital days are increased in incident HD patients with depressive affect. PMID:29423211

  13. EVALUATION OF NUTRITIONAL STATUS IN HEMODIALYSIS PATIENTS

    Directory of Open Access Journals (Sweden)

    Amel Harzallah

    2016-08-01

    Full Text Available Malnutrition is a common problem among hemodialysis patients. This factor leads to increased morbidity and mortality. This study evaluates the nutritional status of patients on dialysis and analyses the various parameters used for assessing malnutrition. It is a cross-sectional study of 35 patients aged 18 years and up who have undergone dialysis three days a week for more than a year. The following were analysed: overall subjective assessment technique, Body Mass Index, anthropometric data and biological parameters (serum albumin, serum cholesterol, rate of alkaline reserves and C-reactive protein levels with a dietary three-day survey. Analysis of food survey data was performed using the software Bilnut. The patients’ average age was 46.7 years with a sex ratio of 1.18. Average waist size was 92.7±16.68 cm. Average arm circumference was 27.2±5.6 cm and average calf circumference was 32.03±5.87 cm. Malnutrition was found in 48% of cases according to SGA. Average BMI was 24.4 kg/m2. It was less than 23 Kg/m2 in 48% of cases. Average serum albumin concentration was 33.6 g/l and average CRP level was 6.16 mg/l. The average energy intake (Kcal/Kg/day was 30.87±11.92 the day of dialysis, 27.98±9.31 on a resting day and 29.93±9.42 on another day and the average protein intake (g/kg/day was 1.02±0.44 the day of dialysis, 0.94±0.36 a resting day and 1.04±0.36 on the other day. Malnutrition was frequent among our patients. The assessment of nutritional status in patients on dialysis requires simultaneous combination of several clinical, biologic and dietetic markers. Dietary management is mainly based on food survey regularly established.

  14. Productive use of saline lands

    International Nuclear Information System (INIS)

    2003-01-01

    Water is essential for life, and not least for agricultural activity. It interacts with solar energy to determine the climate of the globe, and its interaction with carbon dioxide inside a plant results in photosynthesis on which depends survival of all life. Much of the water available to man is used for agriculture and yet its usage has not been well managed. One result has been the build up of soil salinity. The Department of Technical Co-operation is sponsoring a programme, with technical support from the Department of Research and Isotopes, to make more productive use of salt-affected land and to limit future build up of salinity. (IAEA)

  15. Measuring pain in patients undergoing hemodialysis: a review of pain assessment tools

    OpenAIRE

    Upadhyay, Chandani; Cameron, Karen; Murphy, Laura; Battistella, Marisa

    2014-01-01

    Background Patients undergoing hemodialysis frequently report pain with multifactorial causes, not limited to that experienced directly from hemodialysis treatment. Their pain may be nociceptive, neuropathic, somatic or visceral in nature. Despite this, pain in this population remains under-recognized and under-treated. Although several tools have been used to measure pain in patients undergoing hemodialysis as reported in the literature, none of them have been validated specifically in this ...

  16. The relationship between spiritual well-being and stress coping strategies in hemodialysis patients

    OpenAIRE

    Zahra Taheri-Kharameh

    2016-01-01

    Background and Objectives: Spiritual well-being has been recognized as an important resource to cope with illness and life stresses. The aim of this study is to determine the Spiritual well-being status as well as stress coping strategies in hemodialysis patients. Methods: This descriptive-analysis study included 95 randomly selected patients undergoing treatments with hemodialysis in hemodialysis centers of Qom hospitals. Data collection instruments were the Spiritual Well-Being Scale an...

  17. Tolerance of Hordeum marinum accessions to O2 deficiency, salinity and these stresses combined

    Science.gov (United States)

    Malik, Al Imran; English, Jeremy Parker; Colmer, Timothy David

    2009-01-01

    Background and Aims When root-zone O2 deficiency occurs together with salinity, regulation of shoot ion concentrations is compromised even more than under salinity alone. Tolerance was evaluated amongst 34 accessions of Hordeum marinum, a wild species in the Triticeae, to combined salinity and root-zone O2 deficiency. Interest in H. marinum arises from the potential to use it as a donor for abiotic stress tolerance into wheat. Methods Two batches of 17 H. marinum accessions, from (1) the Nordic Gene Bank and (2) the wheat belt of Western Australia, were exposed to 0·2 or 200 mol m−3 NaCl in aerated or stagnant nutrient solution for 28–29 d. Wheat (Triticum aestivum) was included as a sensitive check species. Growth, root porosity, root radial O2 loss (ROL) and leaf ion (Na+, K+, Cl−) concentrations were determined. Key Results Owing to space constraints, this report is focused mainly on the accessions from the Nordic Gene Bank. The 17 accessions varied in tolerance; relative growth rate was reduced by 2–38 % in stagnant solution, by 8–42 % in saline solution (aerated) and by 39–71 % in stagnant plus saline treatment. When in stagnant solution, porosity of adventitious roots was 24–33 %; salinity decreased the root porosity in some accessions, but had no effect in others. Roots grown in stagnant solution formed a barrier to ROL, but variation existed amongst accessions in apparent barrier ‘strength’. Leaf Na+ concentration was 142–692 µmol g−1 d. wt for plants in saline solution (aerated), and only increased to 247–748 µmol g−1 d. wt in the stagnant plus saline treatment. Leaf Cl− also showed only small effects of stagnant plus saline treatment, compared with saline alone. In comparison with H. marinum, wheat was more adversely affected by each stress alone, and particularly when combined; growth reductions were greater, adventitious root porosity was 21 %, it lacked a barrier to ROL, leaf K+ declined to lower levels, and leaf Na+ and

  18. The effect of foot massage on night sleep quality in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    farhad Ariamanesh

    2015-05-01

    Full Text Available Background : Studies have shown, about 20 to 80 percent of hemodialysis patients have sleep problems that can lead to reduction of their quality of life. With regard to high number of hemodialysis patients in the present age, promoting the level of their health issues are deemed important. In this regared, the purpose of this research was to determine the effect of foot massage on night sleeping in hemodialysis patients. Materials and Methods: This experimental clinical trial design, was conducted on 80 hemodialysis patients, admitted to the hemodialysis wards of Shahid Rahimi and Shohada hospitals of Khorramabad city in 2014. Data gathering was done by Pittsburg questionnaire and Sleep Log, by which the sleep condition of the subjects was assessed before and after the night of massage therapy. The treatment was Stroke Foot Massage, carried out during dialysis for 10 minutes, three times a week, for four consecutive weeks. Results: Changes in the Pittsburg questionnaire score indicated that, using foot massage can improve sleep quality of hemodialysis patients and sleep hours increased and generally sleep condition was progressively improving each week than the week before (p<0/001. Conclusion: According to the results of this study, foot massage has a favorable impact on sleep quality in hemodialysis patients undergoing hemodialysis and can be applied and trained as a useful method to improve sleep quality of patients in hemodialysis wards.

  19. Hepatitis C Is Less Aggressive in Hemodialysis Patients than in Nonuremic Patients

    Science.gov (United States)

    Trevizoli, Jose Eduardo; de Paula Menezes, Raissa; Ribeiro Velasco, Lara Franciele; Amorim, Regina; de Carvalho, Mauro Birche; Mendes, Liliana Sampaio; Neto, Columbano Junqueira; de Deus Macedo, José Roberto; de Assis, Francisco; Neves, Rocha

    2008-01-01

    Background and objectives: The severity of liver disease among hepatitis C patients on hemodialysis is controversial. The aim of this study was to compare the clinical, biochemical, and liver histologic characteristics of hepatitis C virus (HCV) in hemodialysis patients and in those with normal renal function. Design, setting, participants, & measurements: A case-control study was carried out with 36 HCV patients on hemodialysis and 37 HCV patients with normal renal function matched for gender, age at infection, and estimated time of infection. Results: HCV patients on hemodialysis had lower levels of alanina aminotransferase and lower viral load. Hepatic fibrosis was significantly higher in the patients with normal renal function (73%) than in hemodialysis patients (47.2%, P < 0.025); the same was observed for inflammatory activity (control group 59.5% versus hemodialysis patients 27.7%, P = 0.003). In addition, the risk of tissue inflammation was four times lower in hemodialysis patients (odds ratio = 0.23, P < 0.004), and severe inflammatory activity on biopsy was the only independent risk factor for fibrosis (P < 0.001). Conclusions: The lower biochemical and inflammatory activities observed in hemodialysis patients suggest that hemodialysis and uremia may have a protective role against progression of the disease caused by HCV. PMID:18650408

  20. Doses de N e K no tomateiro sob estresse salino: I. Concentração de nutrientes no solo e na planta Doses of N and K in tomato under saline stress: I. Concentration of nutrients in the soil solution and plant

    Directory of Open Access Journals (Sweden)

    Flávio F. Blanco

    2008-02-01

    Full Text Available Em geral, culturas tolerantes à salinidade geralmente apresentam maiores teores foliares de certos nutrientes, sugerindo que a adubação em culturas sensíveis poderia elevar os teores desses nutrientes nas folhas, aumentando sua tolerância aos sais. Este trabalho teve o objetivo de estudar os efeitos do N e do K na condutividade elétrica, pH e concentração de nutrientes da solução do solo e nos teores de nutrientes e prolina nas folhas do tomateiro irrigado com água salina. Os tratamentos foram compostos da combinação de três níveis de N (7,5; 15,0 e 22,5 g por planta e de K (8, 16 e 24 gK2O por planta aplicados via fertirrigação por gotejamento, no esquema fatorial 3 x 3, com cinco repetições, sendo que à água de irrigação foram adicionados os sais cloreto de sódio e cloreto de cálcio, para obtenção de condutividade elétrica da água de 9,5 dS m-1. As concentrações de NO3 e K na solução do solo e de N e K nas folhas do tomateiro aumentaram com as doses de N e K mas não promoveram redução dos teores de Cl nem de Na nas folhas das plantas. O aumento do teor de prolina com as doses de K e a redução de Cl/N com as doses de N, sugerem que o aumento na adubação potássica e nitrogenada pode ser benéfico para o tomateiro sob condições de salinidade moderada.Crops tolerant to salinity generally present higher concentrations of some nutrients in the leaves, suggesting that the fertilization of sensitive crops could increase the contents of these nutrients in the leaves to increase the crop tolerance to salts. This work had the objective of studying the effects of N and K on electrical conductivity, pH and nutrient concentrations of soil solution and on concentration of nutrients and proline in the leaves of tomatos irrigated with saline water. The treatments were composed of the combination of three levels of N (7.5, 15.0 and 22.5 g per plant and K (8, 16 and 24 g K2O per plant applied by drip fertigation, in a 3

  1. Salt exclusion and mycorrhizal symbiosis increase tolerance to NaCl and CaCl2 salinity in ‘Siam Queen’ basil

    Science.gov (United States)

    A study was conducted to evaluate the effects of salinity on growth and nutrient uptake in basil (Ocimum basilicum L.). Plants were fertilized with a complete nutrient solution and exposed to no, low, or moderate levels of salinity from NaCl or CaCl2. Plants in the control and moderate salinity tre...

  2. Adipokines and nutritional status for patients on maintenance hemodialysis.

    Science.gov (United States)

    Małgorzewicz, S; Aleksandrowicz-Wrona, E; Owczarzak, A; Debska-Slizień, A; Rutkowski, B; Łysiak-Szydłowska, W

    2010-09-01

    The aim of this study was to investigate the serum concentration of adipokines, such as leptin, adiponectin, and resistin, and assess its relation to nutritional and inflammatory parameters in both overweight and normal weight patients on maintenance hemodialysis. A total of 36 hemodialysis patients (27 M, 9 F; mean age 55.3 +/- 12 yr.) were examined and 23 additional healthy volunteers were recruited as the control group. The concentrations of leptin, leptin receptor, adiponectin, resistin, IL-6, TNFa and CRP were measured by ELISA. Assessment of nutritional status was determined by the levels of albumin, BMI, percentage of body fat (%F), lean body mass (LBM), and Subjective Global Assessment Score (SGA). According to the SGA 7-points score and the albumin level, 20 patients were of good nutritional status (6-7 points), while 16 patients were mildly malnourished (4-5 points). The concentrations of CRP, resistin, adiponectin, and TNFa were statistically higher in hemodialysis patients than in the control group (p pound 0.05). The adiponectin level was inversely correlated with %F (R Spearman=-0.3; p pound 0.05). The level of leptin was positively correlated with %F as well as with BMI and SGA scores (R Spearman=0.4; p pound 0.05). Although there was no significant difference in the nutritional status between the nonoverweight (BMI 18.5-24.99) and overweight (BMI (3)25.0) groups of patients, in the nonoverweight group there were 12 patients (54.5%) with signs of mild malnutrition compared to 4 malnourished patients (28.5%) in the overweight group. Nonoverweight patients presented significantly lower leptin concentration (12.7 vs 27.8 ug/l) and higher adiponectin level (38.9 vs 32.5 ng/ml) when compared to overweight patients. The levels of IL-6 and TNFa were higher in the nonoverweight group of patients. Overweight patients also had shorter durations of stay in the hemodialysis program (30.5 vs. 87.6 months). The results of our study indicate that lean hemodialysis

  3. Exploring Protein Binding of Uremic Toxins in Patients with Different Stages of Chronic Kidney Disease and during Hemodialysis

    Directory of Open Access Journals (Sweden)

    Olivier Deltombe

    2015-09-01

    Full Text Available As protein binding of uremic toxins is not well understood, neither in chronic kidney disease (CKD progression, nor during a hemodialysis (HD session, we studied protein binding in two cross-sectional studies. Ninety-five CKD 2 to 5 patients and ten stable hemodialysis patients were included. Blood samples were taken either during the routine ambulatory visit (CKD patients or from blood inlet and outlet line during dialysis (HD patients. Total (CT and free concentrations were determined of p-cresylglucuronide (pCG, hippuric acid (HA, indole-3-acetic acid (IAA, indoxyl sulfate (IS and p-cresylsulfate (pCS, and their percentage protein binding (%PB was calculated. In CKD patients, %PB/CT resulted in a positive correlation (all p < 0.001 with renal function for all five uremic toxins. In HD patients, %PB was increased after 120 min of dialysis for HA and at the dialysis end for the stronger (IAA and the highly-bound (IS and pCS solutes. During one passage through the dialyzer at 120 min, %PB was increased for HA (borderline, IAA, IS and pCS. These findings explain why protein-bound solutes are difficult to remove by dialysis: a combination of the fact that (i only the free fraction can pass the filter and (ii the equilibrium, as it was pre-dialysis, cannot be restored during the dialysis session, as it is continuously disturbed.

  4. Desiccation-crack-induced salinization in deep clay sediment

    Directory of Open Access Journals (Sweden)

    S. Baram

    2013-04-01

    Full Text Available A study on water infiltration and solute transport in a clayey vadose zone underlying a dairy farm waste source was conducted to assess the impact of desiccation cracks on subsurface evaporation and salinization. The study is based on five years of continuous measurements of the temporal variation in the vadose zone water content and on the chemical and isotopic composition of the sediment and pore water in it. The isotopic composition of water stable isotopes (δ18O and δ2H in water and sediment samples, from the area where desiccation crack networks prevail, indicated subsurface evaporation down to ~ 3.5 m below land surface, and vertical and lateral preferential transport of water, following erratic preferential infiltration events. Chloride (Cl− concentrations in the vadose zone pore water substantially increased with depth, evidence of deep subsurface evaporation and down flushing of concentrated solutions from the evaporation zones during preferential infiltration events. These observations led to development of a desiccation-crack-induced salinization (DCIS conceptual model. DCIS suggests that thermally driven convective air flow in the desiccation cracks induces evaporation and salinization in relatively deep sections of the subsurface. This conceptual model supports previous conceptual models on vadose zone and groundwater salinization in fractured rock in arid environments and extends its validity to clayey soils in semi-arid environments.

  5. Osteoprotegerin and mortality in hemodialysis patients with cardiovascular disease

    DEFF Research Database (Denmark)

    Winther, Simon; Christensen, Jeppe Hagstrup; Flyvbjerg, Allan

    2013-01-01

    Abstract BACKGROUND: Patients treated with hemodialysis (HD) have an increased mortality, mainly caused by cardiovascular disease (CVD). Osteoprotegerin (OPG) is a glycoprotein involved in the regulation of the vascular calcification process. Previous studies have demonstrated that OPG.......08; in the adjusted analyses, the p-value for trend was 0.03. CONCLUSIONS: In a high-risk population of hemodialysis patients with previously documented cardiovascular disease, a high level of OPG was an independent risk marker of all-cause mortality....... is a prognostic marker of mortality. The aim of this study was to investigate if OPG was a prognostic marker of all-cause mortality in high-risk patients with end-stage renal disease and CVD. METHODS: We prospectively followed 206 HD patients with CVD. OPG was measured at baseline and the patients were followed...

  6. [Assessment of periodontal condition of kidney patients in hemodialysis].

    Science.gov (United States)

    Souza, Cláudia Régia Dias de; Libério, Silvana Amado; Guerra, Rosane Nassar Meireles; Monteiro, Silvio; Silveira, Ericka Janine Dantas da; Pereira, Antonio Luiz Amaral

    2005-01-01

    Thirty patients undergoing hemodialysis were evaluated for their periodontal condition through plaque, calculus and gingival indexes; PSR and IgA present in the saliva were also appraised in order to determine the periodontal condition of patients presenting chronic kidney disease. Results obtained demonstrated that in the studied group the plaque, calculus and gingival indexes were high. With regard to these patients' requirement to undergo periodontal treatment, most patients submitted to hemodialysis needed better oral hygiene, in addition to supra and sub gingival scraping and topic application of fluor (code 2). As to the IgA amount present in the saliva, only three patients showed a low density. Patients presenting chronic kidney disease disclosed a tendency for greater bacterial plaque concentration, high formation of dental calculus suggesting the need for periodontal treatment comprising supra and sub gingival scraping.

  7. Complication of Hemodialysis Access: A Case Report of Venous Hypertension

    Directory of Open Access Journals (Sweden)

    Sadegh Asadi

    2018-03-01

    Full Text Available Vascular access for dialysis is essential for these patients with end-stage renal disease, improvements in hemodialysis managment have lead to extended life expectancy. The creation and maintenance of hemoaccess occupies a significant portion of most vascular and general surgery practices.Venous hypertension due to arteriovenous fistula is usually secondary to venous outlet obstruction. Side to side proximal artery arteriovenous fistula serves as a certain cause of hemodialysis, but it is rarely reported as a peripheral venous hypertension cause. We are reporting a case with developed venous hypertension having dermal injuries in the arm. The patient underwent successful side-to-side radio cephalic fistula creation in the snuffbox a year ago.

  8. The Physician-Patient Working Alliance in Hemodialysis Treatment.

    Science.gov (United States)

    Fuertes, Jairo N; Rubinstein, Sofia; Reyes, Mariela; Iampornpipopchai, Pichet; Mujeeb, Shanza; Smith, Carroll R; Toporovsky, Arielle

    2017-01-01

    Over the past 20 years, the role of psychological and social factors, including the physician-patient working alliance, have emerged as integral components of medical care for patients with a myriad of health conditions. The current study examines a model comprised of psychological-interpersonal factors and the extent to which it explains patient satisfaction with and adherence to hemodialysis treatment. One hundred and seven adults with end-stage renal disease who were receiving regular outpatient hemodialysis participated in the study. Path analyses show that the physician-patient working alliance indirectly predicts patient adherence through patient satisfaction and patients' outcome expectations. The working alliance directly predicts patients' quality of life. It is concluded that consistent with previous research, the physician-patient working alliance is a significant factor in predicting key patient behaviors in medical care.

  9. Recurrent Hypoglycemia in a Hemodialysis Patient Related to Propoxyphene Treatment

    Directory of Open Access Journals (Sweden)

    Hui-Ting Lee

    2007-07-01

    Full Text Available There are various etiologies for hypoglycemia in patients with chronic renal failure, and its pathogenesis is complex. Concomitant use of medications is the most common cause. We report a rare case of an 82-year-old woman with type 2 diabetes mellitus in end-stage renal disease undergoing maintenance hemodialysis, who experienced recurrent symptomatic hypoglycemia during treatment with propoxyphene for pain relief. Hypoglycemia occurred simultaneously with elevated levels of serum immunoreactive insulin and C-peptide. After discontinuing propoxyphene, hypoglycemia mitigated and the level of insulin returned to normal range. Our case reminds us that propoxyphene-induced hypoglycemia should not be ignored, especially in hemodialysis patients with cold sweats, agitation and depressed consciousness.

  10. Direct cost of monitoring conventional hemodialysis conducted by nursing professionals.

    Science.gov (United States)

    Lima, Antônio Fernandes Costa

    2017-04-01

    to analyze the mean direct cost of conventional hemodialysis monitored by nursing professionals in three public teaching and research hospitals in the state of São Paulo, Brazil. this was a quantitative, explorative and descriptive investigation, based on a multiple case study approach. The mean direct cost was calculated by multiplying (clocked) time spent per procedure by the unit cost of direct labor. Values were calculated in Brazilian real (BRL). Hospital C presented the highest mean direct cost (BRL 184.52), 5.23 times greater than the value for Hospital A (BRL 35.29) and 3.91 times greater than Hospital B (BRL 47.22). the costing method used in this study can be reproduced at other dialysis centers to inform strategies aimed at efficient allocation of necessary human resources to successfully monitor conventional hemodialysis.

  11. Direct cost of monitoring conventional hemodialysis conducted by nursing professionals

    Directory of Open Access Journals (Sweden)

    Antônio Fernandes Costa Lima

    Full Text Available ABSTRACT Objective: to analyze the mean direct cost of conventional hemodialysis monitored by nursing professionals in three public teaching and research hospitals in the state of São Paulo, Brazil. Method: this was a quantitative, explorative and descriptive investigation, based on a multiple case study approach. The mean direct cost was calculated by multiplying (clocked time spent per procedure by the unit cost of direct labor. Values were calculated in Brazilian real (BRL. Results: Hospital C presented the highest mean direct cost (BRL 184.52, 5.23 times greater than the value for Hospital A (BRL 35.29 and 3.91 times greater than Hospital B (BRL 47.22. Conclusion: the costing method used in this study can be reproduced at other dialysis centers to inform strategies aimed at efficient allocation of necessary human resources to successfully monitor conventional hemodialysis.

  12. Hemodialysis and nutritional status in children: malnutrition and cachexia.

    Science.gov (United States)

    Fischbach, Michel; Dheu, Céline; Seuge, Laure; Orfanos, Nadia

    2009-01-01

    Malnutrition is a common state in chronic hemodialyzed children. More than malnutrition, which infers that dietary supplementation would be curative, cachexia, which implies loss of protein stores, are combined factors of impaired linear growth and reduced muscle mass in uremic patients. Adequate diet to prevent malnutrition is of major importance. But to avoid cachexia in children on chronic hemodialysis, the management of acidosis, inflammation, abnormal metabolic rate, and endocrine disturbances should not, be forgotten. Daily hemodialysis regimen using convective flow therapy and ultrapure dialysate, i.e., on line hemodiafiltration together with growth hormone therapy, appears as a hopeful strategy for the chronic dialyzed child to achieve catch-up growth, a parameter of optimal nutrition.

  13. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis

    DEFF Research Database (Denmark)

    Fellström, Bengt C; Jardine, Alan G; Schmieder, Roland E

    2009-01-01

    . Secondary end points included death from all causes and individual cardiac and vascular events. RESULTS: After 3 months, the mean reduction in low-density lipoprotein (LDL) cholesterol levels was 43% in patients receiving rosuvastatin, from a mean baseline level of 100 mg per deciliter (2.6 mmol per liter......BACKGROUND: Statins reduce the incidence of cardiovascular events in patients at high cardiovascular risk. However, a benefit of statins in such patients who are undergoing hemodialysis has not been proved. METHODS: We conducted an international, multicenter, randomized, double-blind, prospective...... trial involving 2776 patients, 50 to 80 years of age, who were undergoing maintenance hemodialysis. We randomly assigned patients to receive rosuvastatin, 10 mg daily, or placebo. The combined primary end point was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke...

  14. Frequent hemodialysis with NxStage system in pediatric patients receiving maintenance hemodialysis.

    Science.gov (United States)

    Goldstein, Stuart L; Silverstein, Douglas M; Leung, Jocelyn C; Feig, Daniel I; Soletsky, Beth; Knight, Cathy; Warady, Bradley A

    2008-01-01

    Recent evidence from adult hemodialysis (HD) patient studies reveal improved biochemical control and reported health-related quality of life after transition from conventional thrice weekly to daily home maintenance HD treatment. Published pediatric frequent dialysis experiences demonstrate similar improvement but all used conventional HD machines, which employ a treated municipal water supply, thereby frequently exposing patients to proinflammatory components. We report our pediatric experience with six-times-weekly HD using the NxStage system, which uses sterile dialysis fluid to provide dialysis in the home or center setting. Four patients (weight range 38-61.4 kg) completed the 16-week study. Patients exhibited progressive reductions in casual pretreatment systolic and diastolic blood pressures, discontinuation of antihypertensive medications, and decreased blood pressure load by ambulatory blood pressure monitoring. Mean serum phosphorus improved without change in phosphorus binder medication, and all three patients with a normalized protein catabolic rate 1.1 g/kg per day. Patients reported no adverse effects. Variable changes in proinflammatory cytokine levels were observed. We suggest that frequent HD with the NxStage system be considered for children who would benefit from home-based maintenance dialysis.

  15. The role of osmolality in saline fluid nebulization after tracheostomy: time for changing?

    Science.gov (United States)

    Wen, Zunjia; Wu, Chao; Cui, Feifei; Zhang, Haiying; Mei, Binbin; Shen, Meifen

    2016-12-09

    Saline fluid nebulization is highly recommend to combat the complications following tracheostomy, yet the understandings on the role of osmolality in saline solution for nebulization remain unclear. To investigate the biological changes in the early stage after tracheostomy, to verify the efficacy of saline fluid nebulization and explore the potential role of osmolality of saline nebulization after tracheostomy. Sprague-Dawley rats undergone tracheostomy were taken for study model, the sputum viscosity was detected by rotational viscometer, the expressions of TNF-α, AQP4 in bronchoalveolar lavage fluid were assessed by western blot analysis, and the histological changes in endothelium were evaluated by HE staining and scanning electron microscopy (SEM). Study results revealed that tracheostomy gave rise to the increase of sputum viscosity, TNF-α and AQP4 expression, mucosa and cilia damage, yet the saline fluid nebulization could significantly decrease the changes of those indicators, besides, the hypertonic, isotonic and hypertonic saline nebulization produced different efficacy. Osmolality plays an important role in the saline fluid nebulization after tracheostomy, and 3% saline fluid nebulization seems to be more beneficial, further studies on the role of osmolality in saline fluid nebulization are warranted.

  16. Recurrent symptomatic intraocular pressure spikes during hemodialysis in a patient with unilateral anterior uveitis

    Directory of Open Access Journals (Sweden)

    Lim Su-Ho

    2013-02-01

    Full Text Available Abstract Background The relationship between intraocular pressure (IOP changes and hemodialysis has been evaluated for several decades. However, no report on an IOP rise in uveitis patients during hemodialysis has been previously documented. This report describes the case of an uveitis patient with repetitive IOP spikes associated with severe ocular pain during hemodialysis sessions, which resolved after glaucoma filtering surgery. Case presentation A 47-year-old male with diabetes and hypertension had complained of recurrent ocular pain in the left eye during hemodialysis sessions. A slit-lamp examination showed diffuse corneal epithelial edema with several white keratic precipitates and inflammatory cells (Grade 3+ in the anterior chamber of the left eye. No visible neovascularization or synechiae were visible on the iris or angle. Topical glaucoma eye-drops and intravenous mannitol before hemodialysis did not prevent subsequent painful IOP spikes in the left eye. At the end of hemodialysis, IOP averaged ~40 mmHg. After trabeculectomy with mitomycin C in the left eye, his IOP stabilized in the low-teens (range, 10–14 mmHg and no painful IOP spikes occurred during hemodialysis over the first postoperative year. Conclusion We present a case of recurrent painful IOP spikes during hemodialysis in a patient with unilateral anterior uveitis unresponsive to conventional medical treatment prior to hemodialysis. To our knowledge, this is the first case report of repetitive symptomatic IOP rise during hemodialysis in an uveitic glaucoma patient. This case highlights the importance of the awareness of the possibility that IOP may rise intolerably during hemodialysis in uveitis patients with a compromised outflow facility.

  17. Serum alanine aminotransferase levels, hematocrit rate and body weight correlations before and after hemodialysis session

    Directory of Open Access Journals (Sweden)

    Edmundo Pessoa Lopes

    2009-01-01

    Full Text Available PURPOSE: To evaluate alanine aminotransferase levels before and after a hemodialysis session and to correlate these values with the hematocrit rate and weight loss during hemodialysis. PATIENTS AND METHODS: The serum alanine aminotransferase levels, hematocrit rate and body weight were measured and correlated before and after a single hemodialysis session for 146 patients with chronic renal failure. An receiver operating characteristic (ROC curve for the serum alanine aminotransferase levels collected before and after hemodialysis was plotted to identify hepatitis C virus-infected patients. RESULTS: The mean weight loss of the 146 patients during hemodialysis was 5.3% (p < 0.001. The mean alanine aminotransferase levels before and after hemodialysis were 18.8 and 23.9 IU/, respectively, denoting a significant 28.1% increase. An equally significant increase of 16.4% in the hematocrit rate also occurred after hemodialysis. The weight loss was inversely correlated with the rise in both the alanine aminotransferase level (r = 0.3; p < 0.001 and hematocrit rate (r = 0.5; p < 0.001. A direct correlation was found between the rise in alanine aminotransferase levels and the hematocrit during the hemodialysis session (r = 0.4; p < 0.001. Based on the ROC curve, the upper limit of the normal alanine aminotransferase level should be reduced by 40% relative to the upper limit of normal if the blood samples are collected before the hemodialysis session or by 60% if blood samples are collected after the session. CONCLUSION: In the present study, significant elevations in the serum alanine aminotransferase levels and hematocrit rates occurred in parallel to a reduction in body weight after the hemodialysis session. These findings suggest that one of the factors for low alanine aminotransferase levels prior to hemodialysis could be hemodilution in patients with chronic renal failure.

  18. Direct cost of monitoring conventional hemodialysis conducted by nursing professionals

    OpenAIRE

    Lima, Antônio Fernandes Costa

    2017-01-01

    ABSTRACT Objective: to analyze the mean direct cost of conventional hemodialysis monitored by nursing professionals in three public teaching and research hospitals in the state of São Paulo, Brazil. Method: this was a quantitative, explorative and descriptive investigation, based on a multiple case study approach. The mean direct cost was calculated by multiplying (clocked) time spent per procedure by the unit cost of direct labor. Values were calculated in Brazilian real (BRL). Results: H...

  19. Adherence to treatment and hospitalization risk in hemodialysis patients.

    Science.gov (United States)

    Vaiciuniene, Ruta; Kuzminskis, Vytautas; Ziginskiene, Edita; Skarupskiene, Inga; Bumblyte, Inga A

    2012-01-01

    The aim of this study was to evaluate whether adherence to treatment is associated with hospitalization risk in hemodialysis patients. We completed a cohort analysis of risk factors during 1 census month (November) and 1 year of follow-up during 5 consecutive years (2002-2006) in all end-stage renal disease patients hemodialyzed in the Kaunas region. During the census month, we collected data on noncompliance defined as (i) skipping of a hemodialysis (HD) session, (ii) shortening of 1 or more HD sessions, (iii) presence of hyperkalemia, (iv) presence of hyperphosphatemia, or (v) interdialytic weight gain (IDWG). In addition, data on age, sex, disability status, comorbidities, anemia control, malnutrition and inflammation, calcium-phosphorus metabolism and hospitalization rate were collected. Relative risk of hospitalization was estimated using Cox regression evaluating time to first hospitalization. We analyzed 559 patients for a total of 1,163 patient-years during the 5 years of the study. On multivariate analysis, adjusting for ischemic heart disease, diabetes mellitus, higher number of comorbid conditions, higher systolic blood pressure before dialysis, worse disability status, lower hemoglobin, albumin and urea before dialysis, the relative risk for hospitalization increased by 1.1 for every additional percentage point of IDWG and by 1.19 with each 1 mmol/L rise of serum phosphorus level. Skipping or shortening of hemodialysis sessions and serum potassium level were not associated with hospitalization. Higher IDWG and higher serum levels of phosphorus independently increased the relative risk of hospitalizations in hemodialysis patients. With skipped and shortened dialysis sessions, higher serum potassium level was not associated with hospitalization risk.

  20. Ultrasound Thrombolysis in Hemodialysis Access: In Vitro Investigation

    International Nuclear Information System (INIS)

    Wildberger, Joachim Ernst; Schmitz-Rode, Thomas; Haage, Patrick; Pfeffer, Joachim; Ruebben, Alexander; Guenther, Rolf W.

    2001-01-01

    Purpose: To evaluate the effectiveness of ultrasound thrombolysis in occluded hemodialysis access shunts using an in vitro model.Methods: Thrombosed hemodialysis accesses were simulated by clotted bovine blood in a flow model (silicone tubing; inner diameters 4, 6, and 9 mm). After retrograde and antegrade sheath placement (7 Fr), mechanical thrombolysis was performed using an ultrasound probe (Acolysis, Angiosonics, Morrisville, NC, USA). The tip of the device measured 2.2 mm in diameter. During sonication, the catheter was moved slowly back and forth using an over-the-wire system. Thirty complete occlusions [tubing diameters 4 mm (n = 12), 6 mm (n = 12), 9 mm (n = 6)] were treated. Initial thrombus weights were 3.5 (± 0.76) g, 7.7 (± 1.74) g, and 19.4 (± 2.27) g for the three diameters. Maximum sonication time was 15 min for each probe.Results: With this device, we were able to restore a continuous lumen in all 12 occluded 4∼mm silicone tubes. No wall-adherent thrombi remained after sonication for 3.5-9.6 min. In hemodialysis access models with diameters of 6 mm, thrombus fragments persisted in 25% (3/12 accesses). These were located in the medial portion of the access loop and near to the puncture sites. However, flow was re-established after 5.0-13.0 min of treatment in all settings. Mechanical dissolution of thrombus material failed in five of six access models with diameters of 9 mm, even though ultrasound energy was applied for the maximum of 15 min.Conclusion: In a clotted hemodialysis shunt model, successful ultrasound thrombolysis was limited to small access diameters and small amounts of thrombus

  1. Salivary function in patients with chronic renal failure undergoing hemodialysis

    International Nuclear Information System (INIS)

    Kaya, M.; Cermik, T.F.; Uestuen, F.; Sen, S.; Berkarda, S.

    2002-01-01

    The aim of this study was to evaluate the changes in salivary gland function in patients with chronic renal failure (CRF) undergoing hemodialysis. The group consisted of 23 patients with CRF (13 female, 10 male; mean age: 40±13 yr) and 14 healthy control subjects (mean age: 40±13 yr). All underwent dynamic salivary gland scintigraphy with gustatory stimulation. After intravenous administration of 99m Tc pertechnetate, first, perfusion images at 2 seconds per frame were acquired for 1 minute, then dynamic images at 1 minute per frame were acquired for 45 minutes. At 30 minutes after injection , 10 ml lemon juice was given for 15 minutes as a gustatory stimulus. We obtained time-activity curves derived from regions of interest centered over the four major salivary glands. The following functional indices were calculated for each gland: the time of maximum radioactivity (T max ) for the prestimulated period, the time of minimum radioactivity (T min ), as an indicator of velocity of secretion after stimulation, and the Lem E 5 % value as an indicator of the secretion function. When the patients with CRF undergoing hemodialysis were compared to the controls, there were statistically significant differences in T max , T min and Lem E 5 % values for bilateral parotid glands, and T min values for bilateral submandibular glands (p max and Lem E 5 % values for bilateral submandibular glands. There were also significant differences in T max and Lem E 5 % values for bilateral parotid glands between mild oral problems and severe oral problems in patients with CRF (undergoing hemodialysis). In this study, prolonged T max and T min values, and decreased Lem E 5 % values for parotid glands and prolonged T min values for submandibular glands on salivary scintigraphy pointed out decreased parenchymatous and excretory function in patients with CRF undergoing hemodialysis. (author)

  2. The Determinants of Hemoglobin Variability in Hemodialysis Patients

    OpenAIRE

    Tomanoski Vasilije; Gjorgjievska Gordana; Zvezdakovska Jasminka; Krecova Vasiliki; Andonoski Aleksandar; Nakovska Margarita; Muharemi Serjat; Kliseski Tode; Janakievska Pavlina; Ristoska Katerina; Veliu Ramazan; Vasileva Liljana; Jovanov Toni; Mehmedi-Veseli Kaltrina; Ferati Beane

    2016-01-01

    Introduction. Factors that have been reported to affect erythropoietin (EPO) responsiveness in hemodialysis (HD) patients include iron deficiency, chronic inflammation, secondary hyperparathyroidism, malnutrition and inadequate HD dose. The aim of the study was to analyze the deteminants of hemoglobin variability in HD patients. Methods. The study encompassed 526 patients (197 F and 329 M). According to HD vintage at the beginning of the study the patients were divided into two groups: group-...

  3. Anthropometric Indicators Predict Metabolic Syndrome Diagnosis in Maintenance Hemodialysis Patients.

    Science.gov (United States)

    Vogt, Barbara Perez; Ponce, Daniela; Caramori, Jacqueline Costa Teixeira

    2016-06-01

    Obesity has been considered the key in metabolic syndrome (MetS) development, and fat accumulation may be responsible for the occurrence of metabolic abnormalities in hemodialysis patients. The use of gold-standard methods to evaluate obesity is limited, and anthropometric measures may be the simplest methods. However, no study has investigated the association between anthropometric indexes and MetS in these patients. Therefore, the aim was to determine which anthropometric indexes had the best association and prediction for MetS in patients undergoing hemodialysis. Cross-sectional study that included patients older than 18 years, undergoing hemodialysis for at least 3 months. Patients with liver disease and cancer or those receiving corticosteroids or antiretroviral therapy were excluded. Diagnostic criteria from Harmonizing Metabolic Syndrome were used for the diagnosis of MetS. Anthropometric indexes evaluated were body mass index (BMI); percent standard of triceps skinfold thickness and of middle arm muscle circumference; waist circumference (WC); sagittal abdominal diameter; neck circumference; waist-to-hip, waist-to-thigh, and waist-to-height ratios; sagittal index; conicity index; and body fat percentage. Ninety-eight patients were included, 54.1% male, and mean age was 57.8 ± 12.9 years. The prevalence of MetS was 74.5%. Individuals with MetS had increased accumulation of abdominal fat and general obesity. Waist-to-height ratio was the variable independently associated with MetS diagnosis (odds ratio, 1.21; 95% confidence interval, 1.09-1.34; P < .01) and that better predicts MetS, followed by WC and BMI (area under the curve of 0.840, 0.836, and 0.798, respectively, P < .01). Waist-to-height ratio was the best anthropometric predictor of MetS in maintenance hemodialysis patients. © 2015 American Society for Parenteral and Enteral Nutrition.

  4. Exploring the opinion of hemodialysis patients about their dialysis unit

    OpenAIRE

    Ahmed Farouk Donia; Mohamed Ahmed Elhadedy; Hanzada Mohamed El-Maghrabi; Mohamed Hamed Abbas; Mohamed Ashraf Foda

    2015-01-01

    Hemodialysis (HD) patients are subjected to a number of physical and mental stresses. Physicians might be unaware of some of these problems. We assessed our patients′ opinion about the service provided at the dialysis unit. Our unit has 89 patients on HD. A questionnaire exploring our patients′ opinion relative to the service provided was prepared. The patients were asked to fill-in the questionnaire in a confidential manner. Questionnaires were then collected and examined while unaware of pa...

  5. Aldosterone and mortality in hemodialysis patients: role of volume overload.

    Science.gov (United States)

    Hung, Szu-Chun; Lin, Yao-Ping; Huang, Hsin-Lei; Pu, Hsiao-Fung; Tarng, Der-Cherng

    2013-01-01

    Elevated aldosterone is associated with increased mortality in the general population. In patients on dialysis, however, the association is reversed. This paradox may be explained by volume overload, which is associated with lower aldosterone and higher mortality. We evaluated the relationship between aldosterone and outcomes in a prospective cohort of 328 hemodialysis patients stratified by the presence or absence of volume overload (defined as extracellular water/total body water >48%, as measured with bioimpedance). Baseline plasma aldosterone was measured before dialysis and categorized as low (280 pg/mL). Overall, 36% (n = 119) of the hemodialysis patients had evidence of volume overload. Baseline aldosterone was significantly lower in the presence of volume overload than in its absence. During a median follow-up of 54 months, 83 deaths and 70 cardiovascular events occurred. Cox multivariate analysis showed that by using the low aldosterone as the reference, high aldosterone was inversely associated with decreased hazard ratios for mortality (0.49; 95% confidence interval, 0.25-0.76) and first cardiovascular event (0.70; 95% confidence interval, 0.33-0.78) in the presence of volume overload. In contrast, high aldosterone was associated with an increased risk for mortality (1.97; 95% confidence interval, 1.69-3.75) and first cardiovascular event (2.01; 95% confidence interval, 1.28-4.15) in the absence of volume overload. The inverse association of aldosterone with adverse outcomes in hemodialysis patients is due to the confounding effect of volume overload. These findings support treatment of hyperaldosteronemia in hemodialysis patients who have achieved strict volume control.

  6. Vascular access choice in incident hemodialysis patients: a decision analysis.

    Science.gov (United States)

    Drew, David A; Lok, Charmaine E; Cohen, Joshua T; Wagner, Martin; Tangri, Navdeep; Weiner, Daniel E

    2015-01-01

    Hemodialysis vascular access recommendations promote arteriovenous (AV) fistulas first; however, it may not be the best approach for all hemodialysis patients, because likelihood of successful fistula placement, procedure-related and subsequent costs, and patient survival modify the optimal access choice. We performed a decision analysis evaluating AV fistula, AV graft, and central venous catheter (CVC) strategies for patients initiating hemodialysis with a CVC, a scenario occurring in over 70% of United States dialysis patients. A decision tree model was constructed to reflect progression from hemodialysis initiation. Patients were classified into one of three vascular access choices: maintain CVC, attempt fistula, or attempt graft. We explicitly modeled probabilities of primary and secondary patency for each access type, with success modified by age, sex, and diabetes. Access-specific mortality was incorporated using preexisting cohort data, including terms for age, sex, and diabetes. Costs were ascertained from the 2010 USRDS report and Medicare for procedure costs. An AV fistula attempt strategy was found to be superior to AV grafts and CVCs in regard to mortality and cost for the majority of patient characteristic combinations, especially younger men without diabetes. Women with diabetes and elderly men with diabetes had similar outcomes, regardless of access type. Overall, the advantages of an AV fistula attempt strategy lessened considerably among older patients, particularly women with diabetes, reflecting the effect of lower AV fistula success rates and lower life expectancy. These results suggest that vascular access-related outcomes may be optimized by considering individual patient characteristics. Copyright © 2015 by the American Society of Nephrology.

  7. Individualized Anemia Management Reduces Hemoglobin Variability in Hemodialysis Patients

    OpenAIRE

    Gaweda, Adam E.; Aronoff, George R.; Jacobs, Alfred A.; Rai, Shesh N.; Brier, Michael E.

    2013-01-01

    One-size-fits-all protocol-based approaches to anemia management with erythropoiesis-stimulating agents (ESAs) may result in undesired patterns of hemoglobin variability. In this single-center, double-blind, randomized controlled trial, we tested the hypothesis that individualized dosing of ESA improves hemoglobin variability over a standard population-based approach. We enrolled 62 hemodialysis patients and followed them over a 12-month period. Patients were randomly assigned to receive ESA ...

  8. Vascular Function at Baseline in the Hemodialysis Fistula Maturation Study

    OpenAIRE

    Dember, Laura M.; Imrey, Peter B.; Duess, Mai?Ann; Hamburg, Naomi M.; Larive, Brett; Radeva, Milena; Himmelfarb, Jonathan; Kraiss, Larry W.; Kusek, John W.; Roy?Chaudhury, Prabir; Terry, Christi M.; Vazquez, Miguel A.; Vongpatanasin, Wanpen; Beck, Gerald J.; Vita, Joseph A.

    2016-01-01

    Background End?stage renal disease is accompanied by functional and structural vascular abnormalities. The objective of this study was to characterize vascular function in a large cohort of patients with end?stage renal disease, using noninvasive physiological measurements, and to correlate function with demographic and clinical factors. Methods and Results We analyzed cross?sectional baseline data from the Hemodialysis Fistula Maturation Study, a multicenter prospective observational cohort ...

  9. Hemodialysis Catheter Heat Transfer for Biofilm Prevention and Treatment.

    Science.gov (United States)

    Richardson, Ian P; Sturtevant, Rachael; Heung, Michael; Solomon, Michael J; Younger, John G; VanEpps, J Scott

    2016-01-01

    Central line-associated bloodstream infections (CLABSIs) are not easily treated, and many catheters (e.g., hemodialysis catheters) are not easily replaced. Biofilms (the source of infection) on catheter surfaces are notoriously difficult to eradicate. We have recently demonstrated that modest elevations of temperature lead to increased staphylococcal susceptibility to vancomycin and significantly soften the biofilm matrix. In this study, using a combination of microbiological, computational, and experimental studies, we demonstrate the efficacy, feasibility, and safety of using heat as an adjuvant treatment for infected hemodialysis catheters. Specifically, we show that treating with heat in the presence of antibiotics led to additive killing of Staphylococcus epidermidis with similar trends seen for Staphylococcus aureus and Klebsiella pneumoniae. The magnitude of temperature elevation required is relatively modest (45-50°C) and similar to that used as an adjuvant to traditional cancer therapy. Using a custom-designed benchtop model of a hemodialysis catheter, positioned with tip in the human vena cava as well as computational fluid dynamic simulations, we demonstrate that these temperature elevations are likely achievable in situ with minimal increased in overall blood temperature.

  10. The Adequacy of Phosphorus Binder Prescriptions Among American Hemodialysis Patients

    Science.gov (United States)

    Huml, Anne M.; Sullivan, Catherine M.; Leon, Janeen B.; Sehgal, Ashwini R.

    2013-01-01

    Because hemodialysis treatment has a limited ability to remove phosphorus, dialysis patients must restrict dietary phosphorus intake and use phosphorus binding medication. Among patients with restricted dietary phosphorus intake (1000 mg/d), phosphorus binders must bind about 250 mg of excess phosphorus per day and among patients with more typical phosphorus intake (1500 mg/d), binders must bind about 750 mg per day. To determine the phosphorus binding capacity of binder prescriptions among American hemodialysis patients, we undertook a cross-sectional study of a random sample of in-center chronic hemodialysis patients. We obtained data for one randomly selected patient from 244 facilities nationwide. About one-third of patients had hyperphosphatemia (serum phosphorus level > 5.5 mg/dL). Among the 224 patients prescribed binders, the mean phosphorus binding capacity was 256 mg/d (SD 143). 59% of prescriptions had insufficient binding capacity for restricted dietary phosphorus intake, and 100% had insufficient binding capacity for typical dietary phosphorus intake. Patients using two binders had a higher binding capacity than patients using one binder (451 vs. 236 mg/d, p phosphorus balance. Use of two binders results in higher binder capacity. Further work is needed to understand the impact of binder prescriptions on mineral balance and metabolism and to determine the value of substantially increasing binder prescriptions. PMID:23013171

  11. Bath salt intoxication causing acute kidney injury requiring hemodialysis.

    Science.gov (United States)

    Regunath, Hariharan; Ariyamuthu, Venkatesh Kumar; Dalal, Pranavkumar; Misra, Madhukar

    2012-10-01

    Traditional bath salts contain a combination of inorganic salts like Epsom salts, table salt, baking soda, sodium metaphosphate, and borax that have cleansing properties. Since 2010, there have been rising concerns about a new type of substance abuse in the name of "bath salts." They are beta-ketone amphetamine analogs and are derivates of cathinone, a naturally occurring amphetamine analog found in the "khat" plant (Catha edulis). Effects reported with intake included increased energy, empathy, openness, and increased libido. Serious adverse effects reported with intoxication included cardiac, psychiatric, and neurological signs and symptoms. Not much is known about the toxicology and metabolism of these compounds. They inhibit monoamine reuptake (dopamine, nor epinephrine, etc.) and act as central nervous system stimulants with high additive and abuse potential because of their clinical and biochemical similarities to effects from use of cocaine, amphetamine, and 3,4-methylenedioxy-N-methylamphetamine. Deaths associated with use of these compounds have also been reported. We report a case of acute kidney injury associated with the use of "bath salt" pills that improved with hemodialysis. © 2012 The Authors. Hemodialysis International © 2012 International Society for Hemodialysis.

  12. Sexual dysfunction in women with ESRD requiring hemodialysis.

    Science.gov (United States)

    Strippoli, Giovanni F M; Vecchio, Mariacristina; Palmer, Suetonia; De Berardis, Giorgia; Craig, Jonathan; Lucisano, Giuseppe; Johnson, David; Pellegrini, Fabio; Nicolucci, Antonio; Sciancalepore, Michela; Saglimbene, Valeria; Gargano, Letizia; Bonifati, Carmen; Ruospo, Marinella; Navaneethan, Sankar D; Montinaro, Vincenzo; Stroumza, Paul; Zsom, Marianna; Torok, Mariatta; Celia, Eduardo; Gelfman, Ruben; Bednarek-Skublewska, Anna; Dulawa, Jan; Graziano, Giusi; Gentile, Giorgio; Ferrari, Juan Nin; Santoro, Antonio; Zucchelli, Annalisa; Triolo, Giorgio; Maffei, Stefano; Hegbrant, Jörgen; Wollheim, Charlotta; De Cosmo, Salvatore; Manfreda, Valeria M

    2012-06-01

    The few existing studies of sexual dysfunction in women on hemodialysis are limited by small sample size. This large, cross-sectional study evaluated the prevalence and correlates of female sexual dysfunction in advanced kidney disease. DESIGN, SETTING, PARTICIPANTS, METHODS: A total of 1472 women with ESRD undergoing hemodialysis were recruited to a multinational, cross-sectional study conducted within a collaborative dialysis network in Europe and South America. Sexual dysfunction was identified by the Female Sexual Function Index. Correlates of self-reported sexual dysfunction were identified by regression analyses. Of the 1472 women, 659 completed questionnaires (45%). More than half (362 of 659 [55%]) lived with a partner, and 232 of 659 (35%) reported being sexually active. Of these 659 respondents, 555 (84%) reported sexual dysfunction. Women with a partner (282 of 362 [78%]) were less likely to report sexual dysfunction than those without a partner (273 of 297 [92%]) (Psymptoms, less education, menopause, diabetes, and diuretic therapy. Nearly all women who were not wait-listed for a kidney transplant and were living without a partner (249 of 260 [96%]) reported sexual dysfunction. More than half (128 of 232 [55%]) of sexually active women reported sexual dysfunction, associated with age, depressive symptoms, menopause, low serum albumin, and diuretic therapy. This descriptive study suggests most women on hemodialysis experience sexual problems. Additional research on the relevance of sexual dysfunction to symptom burden and quality of life in these women is needed.

  13. Quality of life on hemodialysis and inflammation: a descriptive analysis.

    Science.gov (United States)

    Bacci, M R; Adami, F; Figueiredo, F W S; Alves, B C A; da Veiga, G L; Fonseca, F L A

    2018-01-01

    Chronic kidney disease (CKD) is highly prevalent worldwide. Patients with CKD on hemodialysis are more likely to present behavioral changes and worse quality of life as a result of their routine and complications. They also have higher levels of cytokines. The aim of this study is to assess the relationship between the inflammatory profile and quality of life measured by KDOQL-SF36 in hemodialysis outpatients. Patients older than 21 years of age and on routine hemodialysis for at least 6 months with treatment on a regular weekly basis were included and their anthropometric parameters and serum inflammatory markers were evaluated. Thirty patients consented to participate. Homocysteine (Hcy) levels were correlated with worse glomerular filtration rate (GFR; P=0.003) and creatinine (P=0.002). IL-6 was not correlated with worse nutritional status taking into account body mass index (BMI; kg/m2; P=0.83). On the other hand, TNF-alpha was positively correlated with albumin (P=0.008), nutritional status by BMI (P=0.04), and nutritional status by arm circumference area (P=0.04). IL-6 was correlated with activity limitation (P=0.02) and Hcy with work status (P=0.04). Hcy was correlated with nutritional status and inflammatory markers. In this population, the majority of the sections in KDOQL-SF36 were not correlated with cytokines levels.

  14. Maintenance hemodialysis patients have high cumulative radiation exposure.

    LENUS (Irish Health Repository)

    Kinsella, Sinead M

    2010-10-01

    Hemodialysis is associated with an increased risk of neoplasms which may result, at least in part, from exposure to ionizing radiation associated with frequent radiographic procedures. In order to estimate the average radiation exposure of those on hemodialysis, we conducted a retrospective study of 100 patients in a university-based dialysis unit followed for a median of 3.4 years. The number and type of radiological procedures were obtained from a central radiology database, and the cumulative effective radiation dose was calculated using standardized, procedure-specific radiation levels. The median annual radiation dose was 6.9 millisieverts (mSv) per patient-year. However, 14 patients had an annual cumulative effective radiation dose over 20 mSv, the upper averaged annual limit for occupational exposure. The median total cumulative effective radiation dose per patient over the study period was 21.7 mSv, in which 13 patients had a total cumulative effective radiation dose over 75 mSv, a value reported to be associated with a 7% increased risk of cancer-related mortality. Two-thirds of the total cumulative effective radiation dose was due to CT scanning. The average radiation exposure was significantly associated with the cause of end-stage renal disease, history of ischemic heart disease, transplant waitlist status, number of in-patient hospital days over follow-up, and death during the study period. These results highlight the substantial exposure to ionizing radiation in hemodialysis patients.

  15. Intermittent hemodialysis in dogs with chronic kidney disease stage III

    Directory of Open Access Journals (Sweden)

    Alessandra Melchert

    2017-08-01

    Full Text Available ABSTRACT: Intermittent hemodialysis (IHD is a form of renal replacement that is used in veterinary medicine for cases involving drug removal, electrolyte imbalance, acute kidney injury, and chronic kidney disease (CKD. The aim of the present study was to verify the efficacy of IHD in dogs with CKD staged at grade III and to evaluate the effect of IHD on quality of life. Twelve dogs with CKD at stage III met the inclusion criteria and were divided equally into two groups. The control group (n=6 received only clinical treatment and intravenous fluid therapy, and the hemodialysis group (n=6 received clinical and IHD treatments. Blood samples were collected before and after treatments in both groups. We evaluated complications and clinical parameters of IHD every 30 minutes. Hemodialysis decreased serum urea, creatinine, and phosphorus. Despite the evident removal of nitrogen compounds, dialysis treatment did not increase survival time in these patients. The results of this study do not support the early use of dialysis in dogs with chronic kidney disease stage III.

  16. Prevalence of Secondary Hyper Parathyroidism in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    F Behzad

    2007-04-01

    Full Text Available Introduction: Osteodystrophy is one of the long term complications of chronic renal failure and is expressed in two forms;low turn over and high turn over. It is an important cause of morbidity in patients with renal failure and if diagnosed and managed properly, many problems of these patients can be resolved. In this study we evaluated the prevalence of hyperparathyroidism in hemodialysis patients and its correlation with different factors. Methods: This study was an analytic, observational study that was done by the cross- sectional method. We formatted a questionnaire for hemodialysis patients who were enrolled in the study over a period of 6 months. Fasting blood samples (5-10c.c were drawn to measure levels of PTH(parathyroid hormone ,calcium, phosphorous and alkaline phosphatase. Skull and wrist X-rays were also taken and the radiologist evaluated them with regards to hyperparathyroidism. Results: In the 80 patients studied, prevalence of hyperparathyroidism was 45% (36 patients. 44 patients were diabetics. Among different factors, hyperparathyroidism did not correlate with frequency and duration of dialysis, age, sex ,familial history, diabetes, hypertension , bone pains, muscle weakness, purities and level of calcium and phosphorous. But there was a significant relationship between hyperparathyroidism and alkaline phosphatase levels and radiological findings. Conclusion: We can use alkaline phosphatase levels and/or radiographic changes for evaluation of renal osteodystrophy in hemodialysis patients and prevent complications by early diagnosis and proper management.

  17. Bone Marrow Pathology Predicts Mortality in Chronic Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Cheng-Hao Weng

    2015-01-01

    Full Text Available Introduction. A bone marrow biopsy is a useful procedure for the diagnosis and staging of various hematologic and systemic diseases. The objective of this study was to investigate whether the findings of bone marrow studies can predict mortality in chronic hemodialysis patients. Methods. Seventy-eight end-stage renal disease patients on maintenance hemodialysis underwent bone marrow biopsies between 2000 and 2011, with the most common indication being unexplained anemia followed by unexplained leukocytosis and leukopenia. Results. The survivors had a higher incidence of abnormal megakaryocyte distribution P=0.001, band and segmented cells P=0.021, and lymphoid cells P=0.029 than the nonsurvivors. The overall mortality rate was 38.5% (30/78, and the most common cause of mortality was sepsis (83.3% followed by respiratory failure (10%. In multivariate Cox regression analysis, both decreased (OR 3.714, 95% CI 1.671–8.253, P=0.001 and absent (OR 9.751, 95% CI 2.030–45.115, P=0.004 megakaryocyte distribution (normal megakaryocyte distribution as the reference group, as well as myeloid/erythroid ratio (OR 1.054, CI 1.012–1.098, P=0.011, were predictive of mortality. Conclusion. The results of a bone marrow biopsy can be used to assess the pathology, and, in addition, myeloid/erythroid ratio and abnormal megakaryocyte distribution can predict mortality in chronic hemodialysis patients.

  18. [Medication adherence of 65 patients in hemodialysis in Togo].

    Science.gov (United States)

    Sabi, K A; Noto-Kadou-Kaza, B; Amekoudi, Y E; Tsevi, M C; Sylla, F; Kossidze, K; Gnionsahe, D A

    2014-01-01

    The aim of this study was to assess adherence in people on hemodialysis and determine the factors of poor adherence. This cross-sectional study took place throughout the month of September, 2012, in the hemodialysis center of the Sylvanus Olympio University Hospital, the only such center in Togo. The study included 65 patients, with a mean age of 49.5 years (range: 22 to 77 years), more often men (sex ratio: 1.82) and married (74 %). More than half (58%) had completed secondary education, while 73% belonged to the least advantaged socioeconomic class; 61 (94%) had health insurance, and 57% had been on dialysis for 1 to 4 years. The compliance rate was 11%. The main factors associated with good adherence were marital status (p = 0.0339) and the patient's general health status (p = 0.001). Treatment fatigue (p = 0.0347), forgetfulness (p = 0.0001), dosage forms and drug characteristics (p = 0.0198) were all factors of noncompliance. Therapeutic non-compliance was proportional to the number of drugs prescribed (p = 0.4263). Adherence in hemodialysis patients in Togo is very poor.

  19. Effect of hemodialysis on intraocular lens power calculation.

    Science.gov (United States)

    Çalışkan, Sinan; Çelikay, Osman; Biçer, Tolga; Aylı, Mehmet Deniz; Gürdal, Canan

    2016-01-01

    To evaluate changes in ocular biometric parameters after hemodialysis (HD) in patients with end-stage renal disease (ESRD). Forty eyes of 40 patients undergoing HD were included in this cross-sectional study. Keratometry (K) readings, white-to-white (WTW) distance, central corneal thickness (CCT), anterior chamber depth (ACD), pupil diameter, lens thickness (LT), axial length (AL), and intraocular lens (IOL) power calculation were measured with Lenstar LS 900 (Haag Streit AG, Koeniz, Switzerland) before and after hemodialysis. Intraocular pressure (IOP) was measured with a non-contact tonometer (Tonopachy NT-530P, Nidek Co., LTD, Tokyo, Japan). Main outcomes were changes in biometric parameters after HD. Reliability of the measurements (intraclass correlation coefficients (ICCs)) and the effect size (Cohen's d) were also calculated. Mean difference in AL before and after HD was -0.041 ± 0.022 mm with ICCs > 0.90 (p  0.90 (p = 0.041 and Cohen's d = 0.20). Hemodialysis had no significant effect on K readings, WTW distance, CCT, ACD, LT, or IOP. Axial length and pupil diameter increase after HD with small effect size, while HD does not significantly affect IOL power calculations.

  20. Relationships between appetite and quality of life in hemodialysis patients.

    Science.gov (United States)

    Zabel, Rachel; Ash, Susan; King, Neil; Juffs, Philip; Bauer, Judith

    2012-08-01

    The aim of this paper was to investigate the association between appetite and kidney-disease specific quality of life in maintenance hemodialysis patients. Quality of life (QoL) was measured using the kidney disease quality of life survey. Appetite was measured using self-reported categories and a visual analog scale. Other nutritional parameters included Patient-Generated Subjective Global Assessment (PGSGA), dietary intake, body mass index and biochemical markers C-reactive protein and albumin. Even in this well nourished sample (n=62) of hemodialysis patients, PGSGA score (r=-0.629), subjective hunger sensations (r=0.420) and body mass index (r=-0.409) were all significantly associated with the physical health domain of QoL. As self-reported appetite declined, QoL was significantly lower in nine domains which were mostly in the SF36 component and covered social functioning and physical domains. Appetite and other nutritional parameters were not as strongly associated with the Mental Health domain and Kidney Disease Component Summary Domains. Nutritional parameters, especially PGSGA score and appetite, appear to be important components of the physical health domain of QoL. As even small reductions in nutritional status were associated with significantly lower QoL scores, monitoring appetite and nutritional status is an important component of care for hemodialysis patients. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Seroprevalence occurrence of viral hepatitis and HIV among hemodialysis patients.

    Science.gov (United States)

    Kamal, Inass Mahmood Abid; Mahdi, Batool Mutar

    2018-05-01

    Patients with chronic renal failure (CRF) were on maintenance invasive hemodialysis (HD) procedure. This procedure by itself affects immunity of the patients and became more susceptible to viral infections. to investigate the occurrence of HBV, HCV and HIV infections in patients with hemodialysis. A retrospective study of 430 end-stage renal failure patients, referred to hemodialysis department at XXXX Teaching Hospital, Baghdad-Iraq from January-2015 to January-2017. Patients were investigated for HBs-Ag using enzyme-labeled antigen test (Foresight-EIA-USA), HCV- Abs (IgG) specific immunoglobulin using an HCV enzyme-labeled antigen test (Foresight-EIA-USA)and anti - HIV Abs (IgG) using enzyme-labeled antigen test (Foresight-EIA-USA). The frequency of HBV infection in the first year was not significant between males (1.11%) and females (0.00%) (P = 0.295). About HCV also there are no significant differences between males (12.63%) and females (9.31%) (P = 0.347). After one year of follow up the frequencies of HBV and HCV were not significant between two sexes. Additionally, no any one of the patients had HIV infection. This study brings a light on that HBV and HCV were having the same frequencies in both genders and lower occurrence with time. Furthermore, HIV was not detected in those patients.

  2. [The history of home hemodialysis and its likely revival].

    Science.gov (United States)

    Ralli, Chiara; Imperiali, Patrizio; Duranti, Ennio

    2016-01-01

    The home extracorporeal hemodialysis, which aroused a great interest in the past, has not kept its promises due to the complexity and expectations for family involvement in treatment management. In the United States NxStage One portable system was proposed and designed for home use. In this work we describe, starting from the history of home hemodialysis, the method with NxStage system by comparing it with the conventional HD in 5 patients. The dialysis efficiency was similar between the two treatments, even if home hemodialysis showed a reduction in serum urea, creatinine and phosphorus. At the same time phosphate binders use decreased with an increase in serum calcium while hemoglobin increased reducing doses of erythropoietin. The method was successful in the training of the patients and their partners during hospital training and at home. Patients have shown great enthusiasm at the beginning and during the therapy, which is developed around the users personal needs, being able to decide at its own times during 24 hours according to personal needs, in addition to faster recovery after the dialysis. This method certainly improved the patients' wellness and increased their autonomy.

  3. Idiopathic erythrocytosis in a patient on chronic hemodialysis

    Directory of Open Access Journals (Sweden)

    Dong Hyun Lee

    2015-03-01

    Full Text Available A 78-year-old man on hemodialysis presented to our hospital with erythrocytosis. He had started hemodialysis 4 years previously, with a hemoglobin level of 9.8 g/dL, and was administered erythropoiesis stimulating agents and ferrous sulfate. Two years previously, his hemoglobin level increased to 14.5 g/dL and the treatment for anemia was discontinued. He continued hemodialysis thrice weekly; however, the hemoglobin level had increased to 17.0 g/dL at the time of presenting to our hospital. His serum erythropoietin level was 31.4 mIU/mL (range, 3.7–31.5 mIU/mL, carboxyhemoglobin level was 0.6% (range, 0–1.5%, and oxygen saturation in ambient air was 95.4%. The JAK2 V617F mutation was not observed and other bone marrow abnormalities were not identified. The patient was diagnosed with bladder cancer and a transurethral resection was performed. Eight months after the treatment of bladder cancer, his hemoglobin level was 15.1 g/dL, and he was diagnosed with idiopathic erythrocytosis.

  4. Saline water irrigation for crop production

    Energy Technology Data Exchange (ETDEWEB)

    Khan, A R [Directorate of Water Management Research, Indian Council of Agricultural Research (ICAR), Walmi Complex, P.O. - Phulwari Sharif, Patna (India); [Abdus Salam International Centre for Theoretical Physics, Trieste (Italy); Singh, S S; Singh, S R [Directorate of Water Management Research, Indian Council of Agricultural Research (ICAR), Walmi Complex, P.O. - Phulwari Sharif, Patna (India)

    2001-05-01

    Salinity is one of agriculture's most complex production problems. Excessive salts from irrigation water or high water tables can severely limit crop production. Years of saline water irrigation on poorly drained soils can eventually make economic crop production impossible. About 10% of all land are affected by salinity problems. They occur in every continent in different proportions, more frequently in arid and semi-arid areas. This paper discusses a range of problems related to use of saline water for crop irrigation.

  5. Saline water irrigation for crop production

    International Nuclear Information System (INIS)

    Khan, A.R.; Singh, S.S.; Singh, S.R.

    2001-05-01

    Salinity is one of agriculture's most complex production problems. Excessive salts from irrigation water or high water tables can severely limit crop production. Years of saline water irrigation on poorly drained soils can eventually make economic crop production impossible. About 10% of all land are affected by salinity problems. They occur in every continent in different proportions, more frequently in arid and semi-arid areas. This paper discusses a range of problems related to use of saline water for crop irrigation

  6. A global algorithm for estimating Absolute Salinity

    Science.gov (United States)

    McDougall, T. J.; Jackett, D. R.; Millero, F. J.; Pawlowicz, R.; Barker, P. M.

    2012-12-01

    The International Thermodynamic Equation of Seawater - 2010 has defined the thermodynamic properties of seawater in terms of a new salinity variable, Absolute Salinity, which takes into account the spatial variation of the composition of seawater. Absolute Salinity more accurately reflects the effects of the dissolved material in seawater on the thermodynamic properties (particularly density) than does Practical Salinity. When a seawater sample has standard composition (i.e. the ratios of the constituents of sea salt are the same as those of surface water of the North Atlantic), Practical Salinity can be used to accurately evaluate the thermodynamic properties of seawater. When seawater is not of standard composition, Practical Salinity alone is not sufficient and the Absolute Salinity Anomaly needs to be estimated; this anomaly is as large as 0.025 g kg-1 in the northernmost North Pacific. Here we provide an algorithm for estimating Absolute Salinity Anomaly for any location (x, y, p) in the world ocean. To develop this algorithm, we used the Absolute Salinity Anomaly that is found by comparing the density calculated from Practical Salinity to the density measured in the laboratory. These estimates of Absolute Salinity Anomaly however are limited to the number of available observations (namely 811). In order to provide a practical method that can be used at any location in the world ocean, we take advantage of approximate relationships between Absolute Salinity Anomaly and silicate concentrations (which are available globally).

  7. 40 CFR 230.25 - Salinity gradients.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Salinity gradients. 230.25 Section 230.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING SECTION 404(b... Physical and Chemical Characteristics of the Aquatic Ecosystem § 230.25 Salinity gradients. (a) Salinity...

  8. Salinity: Electrical conductivity and total dissolved solids

    Science.gov (United States)

    The measurement of soil salinity is a quantification of the total salts present in the liquid portion of the soil. Soil salinity is important in agriculture because salinity reduces crop yields by reducing the osmotic potential making it more difficult for the plant to extract water, by causing spe...

  9. Ion dynamics in cationic lipid bilayer systems in saline solutions

    DEFF Research Database (Denmark)

    Miettinen, Markus S; Gurtovenko, Andrey A; Vattulainen, Ilpo

    2009-01-01

    Positively charged lipid bilayer systems are a promising class of nonviral vectors for safe and efficient gene and drug delivery. Detailed understanding of these systems is therefore not only of fundamental but also of practical biomedical interest. Here, we study bilayers comprising a binary...... are concluded to be interesting for the physics of the whole membrane, especially considering its interaction dynamics with charged macromolecular surfaces....

  10. Geographical Variations in Blood Pressure Level and Seasonality in Hemodialysis Patients

    NARCIS (Netherlands)

    Duranton, Flore; Kramer, Anneke; Szwarc, Ilan; Bieber, Brian; Gayrard, Nathalie; Jover, Bernard; Vetromile, Fernando; Massy, Ziad A.; Combe, Christian; Tentori, Francesca; Jager, Kitty J.; Servel, Marie-Françoise; Argilés, Àngel

    2018-01-01

    Seasons and climate influence the regulation of blood pressure (BP) in the general population and in hemodialysis patients. It is unknown whether this phenomenon varies across the world. Our objective was to estimate BP seasonality in hemodialysis patients from different geographical locations.

  11. Markers of bone pain in the hemodialysis patients with renal insufficiency

    International Nuclear Information System (INIS)

    Oka, Fumitoshi; Sagawa, Hitoshi; Yabe, Kinji

    1988-01-01

    The patients receiving maintenance hemodialysis were divided into two groups in the absence and the presence of bone pain and investigated the markers of bone pain in these patients. These results suggested that the duration of receiving hemodialysis, serum contrations of alkaline phosphatase, osteocalcin and parathyroid hormone became to be the markers of bone pain. (author)

  12. Coping with Treatment-Related Stress: Effects on Patient Adherence in Hemodialysis.

    Science.gov (United States)

    Christensen, Alan J.; And Others

    1995-01-01

    Examines the relation of coping to adherence among 57 hemodialysis patients. As predicted, coping efforts involving planful problem solving were associated with more favorable adherence when used in response to stressors involving a relatively controllable aspect of the hemodialysis context. For less controllable stressors, coping efforts…

  13. [Auto-dialysis: an 11-year experience of a hemodialysis center in France].

    Science.gov (United States)

    Montagnac, R; Schillinger, F

    1996-03-30

    Report 11 years of experience with self-managed hemodialysis in patients medically apt for extra-hospital dialysis and living close enough to small outpatient hemodialysis units to become totally self-sufficient. Among the 276 patients with chronic renal failure managed at the hemodialysis center at the Troyes hospital during the 11-year study period from 1984 through 1994, self-managed hemodialysis at small outpatient units was initiated in 127 (46%). None of these 127 patients required medical assistance or specific care during dialysis sessions. At initial hospital admission, only 60/127 (47%) were totally self-sufficient: 52 (41%) were later graft recipients; and 21 (16.5%) had to return to the hospital for a medical or surgical condition incompatible with extra-hospital care but all of these 21 patients remained self-sufficient. Extra-hospital hemodialysis in units close to the patients residence offers patients a better quality of life, even when medical assistance is required. All patients who require hemodialysis can thus be treated at lower cost without compromising quality of treatment. Perfect self-sufficiency may not be a goal in itself, but self-managed hemodialysis can be a very useful technique for patients without major medical problems. Continuing contact with the organizing hemodialysis center guarantees the safety of the system.

  14. Relationship between instantaneous wave-free ratio and fractional flow reserve in patients receiving hemodialysis.

    Science.gov (United States)

    Morioka, Yuta; Arashi, Hiroyuki; Otsuki, Hisao; Yamaguchi, Junichi; Hagiwara, Nobuhisa

    2017-06-22

    Instantaneous wave-free ratio (iFR) is a vasodilator-free index and is reported to have a good correlation with fractional flow reserve (FFR). Hemodialysis patients exhibit left ventricular hypertrophy, reduced arterial compliance, and impaired microcirculation. Such a coronary flow condition in these patients may influence the relationship between iFR and FFR. This study assessed the impact of hemodialysis on the relationship between iFR and FFR. The study enrolled 196 patients with 265 stenoses who underwent assessment via iFR, FFR assessment, and right heart catheterization. A good correlation between iFR and FFR was observed in hemodialysis patients. iFR in the hemodialysis group was significantly lower than in the non-hemodialysis group (0.81 ± 0.13 vs. 0.86 ± 0.13, p = 0.005), although no significant difference was found in FFR and percentage diameter stenosis. An iFR value of 0.84 was found to be equivalent to an FFR value of 0.8 in hemodialysis patients, which was lower than the standard predictive iFR range for ischemia. Vasodilator-free assessment by iFR could be beneficial in evaluating intermediate coronary stenosis in patients receiving hemodialysis. However, the threshold for iFR abnormality needs adjustment in hemodialysis patients, and larger clinical trials are required to confirm the results in this specific subset.

  15. Hormone profiles and their relation with menstrual cycles in patients undergoing hemodialysis

    Directory of Open Access Journals (Sweden)

    Deniz Cemgil Arıkan

    2011-03-01

    Full Text Available Objective: To investigate the etiology of menstrual disorders among patients undergoing hemodialysis due to chronic renal failure by assessing menstrual history, serum hormone levels, and other biochemical factors. Material and methods: Thirty patients undergoing hemodialysis and 30 healthy women at reproductive age were enrolled in our study. Demographic characteristics, hormonal and biochemical data, and sonographically measured endometrial thickness values of the subjects were compared. In addition, the present and the pre-hemodialysis menstrual pattern of the patients undergoing hemodialysis were recorded. The hormonal, hematological, and biochemical data of the patients were compared according to their menstrual patterns. Results: No statistical significance was seen between age, BMI, gravida, parity, abortion, and curettage among groups (p>0.05. Hemoglobin and hematocrit levels were significantly lower in the hemodialysis group than in the control (p0.05. Mean serum LH and prolactin levels were significantly higher in the hemodialysis group compared to the control (p0.05. Serum LH and prolactin levels were higher, and serum FSH, estradiol and TSH levels were lower in patients who developed amenorrhea after hemodialysis treatment when compared to non-amenorrheic subjects. However, these differences were not statistically significant (p>0.05. Discussion: The most important factor in the etiology of menstrual disorders seen in chronic renal failure patients was high serum LH and prolactin levels. Hemodialysis is a successful treatment that extends life expectancy and ameliorates the hypothalamo-pituitary-ovarian axis in chronic renal failure patients.

  16. Serum leptin level and its significance in chronic renal failure hemodialysis patients

    International Nuclear Information System (INIS)

    Zhang Yong; You Yuping; Chen Weizhen; Mo Congjian

    2003-01-01

    To study serum leptin level in chronic renal failure (CRF) hemodialysis patients and the relationship between serum leptin level and residue renal function, body composition, and indices of malnutrition, 31 end-stage CRF hemodialysis patients and 38 healthy people were enrolled. Serum leptin levels were detected by radioimmunoassay. BMI, %Fat and LBM were measured by bioelectrical impedance analysis device. Alb, Chol, Hgb, BUN, SCr and Ccr of the patients were also examined. Results showed that Serum leptin level in end-stage CRF hemodialysis patients was markedly higher than that in healthy controls (P 0.05). Conclusion: Hyperleptinemia existed in end-stage CRF hemodialysis patients and might cause the loss of LBM. The leptin level was not correlated with residue renal function, but it could reflect the fat content. However, serum leptin did not play a significant role in protein malnutrition in end-stage CRF hemodialysis patients

  17. Intermittent hemodialysis is superior to continuous veno-venous hemodialysis/hemodiafiltration to eliminate methanol and formate during treatment for methanol poisoning

    Czech Academy of Sciences Publication Activity Database

    Zakharov, S.; Pelclová, D.; Navrátil, Tomáš; Běláček, J.; Kurcová, I.; Komzák, O.; Šálek, T.; Latta, J.; Turek, R.; Boček, R.; Kučera, C.; Hubáček, J. A.; Fenclová, Z.; Petřík, V.; Čermák, M.; Hovda, K. E.

    2014-01-01

    Roč. 86, č. 1 (2014), s. 199-207 ISSN 0085-2538 Institutional support: RVO:61388955 Keywords : Intermittent hemodialysis * hemodiafiltration * methanol poisonings Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 8.563, year: 2014

  18. Contributions of myocardial scintigraphy in coronary heart disease in chronic hemodialysis: A prospective study of 52 cases

    International Nuclear Information System (INIS)

    Souli, Jihene

    2007-01-01

    We propose in this work to assess the prevalence of cardiovascular risk factors in the chronic hemodialysis as well as diagnostic and prognostic performance of myocardial SPECT. We conducted a prospective study over a period of 5 years (1999-2004) assemble 52 chronic hemodialysis patients, 73 pour cent were treated at the hemodialysis unit of the principal Hospital Military - Tunis and 27 pour cent the hemodialysis unit of the polyclinic CNSS El Khadhra. The conventional periodic hemodialysis bicarbonate was the dialysis technique used in all our patients.

  19. In-center hemodialysis attendance: patient perceptions of risks, barriers, and recommendations.

    Science.gov (United States)

    Chenitz, Kara B; Fernando, Michael; Shea, Judy A

    2014-04-01

    Missed hemodialysis treatments lead to increased morbidity and mortality in the end-stage renal disease population. Little is known about why patients have difficulty attending their scheduled in-center dialysis treatments. Semistructured interviews with 15 adherent and 15 nonadherent hemodialysis patients were conducted to determine patients' attitudes about dialysis, health beliefs and risk perception regarding missed treatments, barriers and facilitators to hemodialysis attendance, and recommendations to improve the system to facilitate dialysis attendance. Average time on dialysis was 2.5 years for the nonadherent group and 7.3 years in the adherent group. In both groups, patients felt that dialysis is life-saving and a necessity. A substantial number of patients in both groups understood that missing hemodialysis treatments is dangerous and several patients could clearly communicate the risk of skipping. The most common barriers to hemodialysis were inadequate or unreliable transportation (mentioned in both groups) and a lack of motivation to get to dialysis or that dialysis is not a priority (typically mentioned by the nonadherent group). Facilitators to hemodialysis attendance included explanations from the health care team regarding the risk of skipping and relationships with other dialysis patients. Patient recommendations to improve dialysis attendance included continued education about the risk of poor attendance and more accessible transportation. Patients did not feel that home dialysis would improve adherence. Hemodialysis patients must adhere to a complex and burdensome regimen. Through the elucidation of barriers and facilitators to hemodialysis attendance and through specific patient recommendations, at least three interventions may be further investigated to improve hemodialysis attendance: Improvement of the transportation system, education and supportive encouragement from the health care team, and peer support mentorship. © 2014 International

  20. Effect of Hemodialysis on Left and Right Ventricular Volume and Function

    International Nuclear Information System (INIS)

    Han, Jin Suk; Koh, Chang Soon

    1985-01-01

    With the improvement of hemodialysis, the course of thc discase in patient with endstage renal disease has been clearly improved. Nevertheless, among several shortcomings to our present mode of renal replacement therapy, cardiovascular complications have been the leading cause of morbidity and mortality. Several factors such as anemia, arteriovenous shunting of blood, intermittent extracorporeal circulation and hypertension may be contributing. But little is known about the quantitative cardiac hemodynamic characteristics occurred during hemodialysis. The purpose of this study is to observe the sequential hemodynamic changes before, during and after the hemodialysis and to investigate: reliable parameters in the detection of ventricular dysfunction. In the present study, equilibrium radionuclide cardiac angiography was performed and left and right ventricular volume indices, ejection phase indices of both ventricular, performance were measured in the 16 stable patients with chronic renal failure treated with maintenance hemodialysis sequentially i.e. before, during (carly and late phase) and after the hemodialysis. The results obtained were as follows; 1) The indices of the left ventricular function were not changed during the hemodialysis but increased after the hemodialysis. 2) The indices of the right ventricular function(EF, SVI) were significantly decreased in the early phase (15, 30 minutes after starting extracorporeal circulation) but recovered after the hemodialysis, 3) The ratio of right ventricular to left ventricular ejection fraction was significantly decreased in the early phase and the lung volume indices were significantly increased at the same phase. As a conclusion, hemodialysis improves left ventricular function maybe du to increased contractility, and effects on the right ventricular function maybe due to the increased lung volume in the early phase of hemodialysis.

  1. Effect of Hemodialysis on Left and Right Ventricular Volume and Function

    Energy Technology Data Exchange (ETDEWEB)

    Han, Jin Suk; Koh, Chang Soon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1985-09-15

    With the improvement of hemodialysis, the course of thc discase in patient with endstage renal disease has been clearly improved. Nevertheless, among several shortcomings to our present mode of renal replacement therapy, cardiovascular complications have been the leading cause of morbidity and mortality. Several factors such as anemia, arteriovenous shunting of blood, intermittent extracorporeal circulation and hypertension may be contributing. But little is known about the quantitative cardiac hemodynamic characteristics occurred during hemodialysis. The purpose of this study is to observe the sequential hemodynamic changes before, during and after the hemodialysis and to investigate: reliable parameters in the detection of ventricular dysfunction. In the present study, equilibrium radionuclide cardiac angiography was performed and left and right ventricular volume indices, ejection phase indices of both ventricular, performance were measured in the 16 stable patients with chronic renal failure treated with maintenance hemodialysis sequentially i.e. before, during (carly and late phase) and after the hemodialysis. The results obtained were as follows; 1) The indices of the left ventricular function were not changed during the hemodialysis but increased after the hemodialysis. 2) The indices of the right ventricular function(EF, SVI) were significantly decreased in the early phase (15, 30 minutes after starting extracorporeal circulation) but recovered after the hemodialysis, 3) The ratio of right ventricular to left ventricular ejection fraction was significantly decreased in the early phase and the lung volume indices were significantly increased at the same phase. As a conclusion, hemodialysis improves left ventricular function maybe du to increased contractility, and effects on the right ventricular function maybe due to the increased lung volume in the early phase of hemodialysis.

  2. Infusion of hypertonic saline (7.5% NaCl) causes minor immunological changes in normovolaemic women

    DEFF Research Database (Denmark)

    Petersen, Jens Aage Kølsen; Nielsen, J O D; Bendtzen, K

    2004-01-01

    Haemorrhagic shock is treated effectively by infusion of hypertonic saline/colloid solutions. Furthermore, previous studies found hypertonicity to affect immune responses in animals and in human blood cell cultures. It is unknown, however, whether hypertonic saline infusion affects immune responses...

  3. Comprehensive phenotypic analysis of rice (Oryza sativa) response to salinity stress

    KAUST Repository

    Pires, Inês S.

    2015-07-22

    Increase in soil salinity levels is becoming a major cause of crop yield losses worldwide. Rice (Oryza sativa) is the most salt-sensitive cereal crop, and many studies have focused on rice salinity tolerance, but a global understanding of this crop\\'s response to salinity is still lacking. We systematically analyzed phenotypic data previously collected for 56 rice genotypes to assess the extent to which rice uses three known salinity tolerance mechanisms: shoot-ion independent tolerance (or osmotic tolerance), ion exclusion, and tissue tolerance. In general, our analyses of different phenotypic traits agree with results of previous rice salinity tolerance studies. However, we also established that the three salinity tolerance mechanisms mentioned earlier appear among rice genotypes and that none of them is predominant. Against the pervasive view in the literature that the K+/Na+ ratio is the most important trait in salinity tolerance, we found that the K+ concentration was not significantly affected by salt stress in rice, which puts in question the importance of K+/Na+ when analyzing rice salt stress response. Not only do our results contribute to improve our global understanding of salt stress response in an important crop, but we also use our results together with an extensive literature research to highlight some issues commonly observed in salinity stress tolerance studies and to propose solutions for future experiments.

  4. Multimodal flow visualization and optimization of pneumatic blood pump for sorbent hemodialysis system.

    Science.gov (United States)

    Shu, Fangjun; Parks, Robert; Maholtz, John; Ash, Steven; Antaki, James F

    2009-04-01

    Renal Solutions Allient Sorbent Hemodialysis System utilizes a two-chambered pneumatic pump (Pulsar Blood Pump, Renal Solutions, Inc., Warrendale, PA, USA) to avoid limitations associated with peristaltic pumping systems. Single-needle access is enabled by counter-pulsing the two pump chambers, thereby obviating compliance chambers or blood reservoirs. Each chamber propels 20 cc per pulse of 3 s (dual access) or 6 s (single access) duration, corresponding to a peak Reynolds number of approximately 8000 (based on inlet velocity and chamber diameter). A multimodal series of flow visualization studies (tracer particle, dye washout, and dye erosion) was conducted on a sequence of pump designs with varying port locations and diaphragms to improve the geometry with respect to risk of thrombogenesis. Experiments were conducted in a simplified flow loop using occluders to simulate flow resistance induced by tubing and dialyzer. Tracer visualization revealed flow patterns and qualitatively indicated turbulence intensity. Dye washout identified dwell volume and areas of flow stagnation for each design. Dye erosion results indicated the effectiveness and homogeneity of surface washing. Compared to a centered inlet which resulted in a fluid jet that produced two counter-rotating vortices, a tangential inlet introduced a single vortex, and kept the flow laminar. It also provided better surface washing on the pump inner surface. However, a tangential outlet did not present as much benefit as expected. On the contrary, it created a sharp defection to the flow when transiting from filling to ejection.

  5. Plant aquaporins: new perspectives on water and nutrient uptake in saline environment.

    Science.gov (United States)

    del Martínez-Ballesta, M C; Silva, C; López-Berenguer, C; Cabañero, F J; Carvajal, M

    2006-09-01

    The mechanisms of salt stress and tolerance have been targets for genetic engineering, focusing on ion transport and compartmentation, synthesis of compatible solutes (osmolytes and osmoprotectants) and oxidative protection. In this review, we consider the integrated response to salinity with respect to water uptake, involving aquaporin functionality. Therefore, we have concentrated on how salinity can be alleviated, in part, if a perfect knowledge of water uptake and transport for each particular crop and set of conditions is available.

  6. Methylenetetrahy-drofolate Reductase Gene Polymorphism in Patients Receiving Hemodialysis

    Directory of Open Access Journals (Sweden)

    Ermina Kiseljaković

    2010-04-01

    Full Text Available Methylenetetrahydrofolate Reductase (MTHFR is key enzyme in metabolism of homocysteine. Homozygotes for mutation (TT genotype have hyperhomocysteinemia, risk factor for atherosclerosis development. The aim of the study was to find out distribution of genotype frequencies of C677T MTHFR among patients on maintenance hemodialysis. Possible association of alleles and genotypes of C677T polymorphism of the MTHFR gene with age of onset, duration of dialysis and cause of kidney failure was studied also. Cross-sectional study includes 80 patients from Clinic of Hemodialysis KUCS in Sarajevo. In order to perform genotyping, isolated DNA was analyzed by RFLP-PCR and gel-electrophoresis. From total of 80 patients, 42.5% (n=24 were female, 57.5% (n=46 were male, mean age 54.59±1.78 years and duration of dialysis 79.92±6.32 months. Genotype distribution was: CC 51.2% (n=41, CT 37.5% (n=30 and TT 11.2% (n=9. Patients with wild-type genotype have longer duration of dialysis in month (87.1 ± 63.93 comparing to TT genotype patients (67.06 ± 39.3, with no statistical significance. T allele frequency was significantly higher in group of vascular and congenital cause of kidney failure (Pearson X2 =6.049, P<0.05 comparing to inflammation etiology group. Genotype distribution results are within the results other studies in Europe. Obtained results indicate that C677T polymorphism is not associated with onset, duration and cause of kidney failure in our hemodialysis population. There is an association of T allele of the MTHFR gene and vascular and congenital cause kidney failure.

  7. Residual urine output and postoperative mortality in maintenance hemodialysis patients.

    Science.gov (United States)

    Lin, Yu-Feng; Wu, Vin-Cent; Ko, Wen-Je; Chen, Yih-Sharng; Chen, Yung-Ming; Li, Wen-Yi; Chou, Nai-Kuan; Chao, Anne; Huang, Tao-Min; Chang, Fan-Chi; Chen, Shih-I; Shiao, Chih-Chung; Wang, Wei-Jie; Tsai, Hung-Bin; Tsai, Pi-Ru; Hu, Fu-Chang; Wu, Kwan-Dun

    2009-09-01

    The relationship between residual urine output and postoperative survival in maintenance hemodialysis patients is unknown. To explore the relationship between amount of urine before surgery and postoperative mortality and differences between postoperative nonanuria and anuria in maintenance hemodialysis patients. A total of 109 maintenance hemodialysis patients underwent major operations. Anuria was defined as urine output <30 mL in the 8 hours before the first session of postoperative dialysis. Propensity scores for postoperative anuria were developed. Postoperative residual urine output was 159.2 mL/8 h (SD, 115.1) in 33 patients; 76 patients were anuric. Preoperative residual urine output and adequate perioperative blood transfusion were positively related to postoperative urine output. Propensity-adjusted 30-day mortality was associated with postoperative anuria (odds ratio [OR], 4.56; 95% confidence interval [CI], 1.16-17.96; P = .03), prior stroke (OR, 4.46; 95% CI, 1.43-13.89; P = .01) and higher disease severity (OR, 1.10; 95% CI, 1.00-1.21; P = .049) at the first postoperative dialysis. OR of 30-day mortality was 5.38 for nonanuria to anuria vs nonanuria to nonanuria (P = .03) and 5.13 for preoperative anuria vs nonanuria to nonanuria (P = .01). By Kaplan-Meier analysis, 30-day mortality differed significantly among patients for nonanuria to nonanuria, anuria, and nonanuria to anuria (log rank, P = .045). Patients with preoperative nonanuria and postoperative anuria had higher mortality than did patients with no anuria before and after surgery and patients with anuria before surgery. Postoperative residual urine output is an important surrogate marker for disease severity.

  8. Bioimpedance-Guided Fluid Management in Hemodialysis Patients

    Science.gov (United States)

    Arias-Guillén, Marta; Wabel, Peter; Fontseré, Néstor; Carrera, Montserrat; Campistol, José Maria; Maduell, Francisco

    2013-01-01

    Summary Background and objectives Achieving and maintaining optimal fluid status remains a major challenge in hemodialysis therapy. The aim of this interventional study was to assess the feasibility and clinical consequences of active fluid management guided by bioimpedance spectroscopy in chronic hemodialysis patients. Design, setting, participants, & measurements Fluid status was optimized prospectively in 55 chronic hemodialysis patients over 3 months (November 2011 to February 2012). Predialysis fluid overload was measured weekly using the Fresenius Body Composition Monitor. Time-averaged fluid overload was calculated as the average between pre- and postdialysis fluid overload. The study aimed to bring the time-averaged fluid overload of all patients into a target range of 0.5±0.75 L within the first month and maintain optimal fluid status until study end. Postweight was adjusted weekly according to a predefined protocol. Results Time-averaged fluid overload in the complete study cohort was 0.9±1.6 L at baseline and 0.6±1.1 L at study end. Time-averaged fluid overload decreased by −1.20±1.32 L (P<0.01) in the fluid-overloaded group (n=17), remained unchanged in the normovolemic group (n=26, P=0.59), and increased by 0.59±0.76 L (P=0.02) in the dehydrated group (n=12). Every 1 L change in fluid overload was accompanied by a 9.9 mmHg/L change in predialysis systolic BP (r=0.55, P<0.001). At study end, 76% of all patients were either on time-averaged fluid overload target or at least closer to target than at study start. The number of intradialytic symptoms did not change significantly in any of the subgroups. Conclusions Active fluid management guided by bioimpedance spectroscopy was associated with an improvement in overall fluid status and BP. PMID:23949235

  9. Burnout Syndrome Among Hemodialysis and Peritoneal Dialysis Nurses.

    Science.gov (United States)

    Karakoc, Ayten; Yilmaz, Murvet; Alcalar, Nilufer; Esen, Bennur; Kayabasi, Hasan; Sit, Dede

    2016-11-01

    Burnout, a syndrome with 3 dimensions of emotional exhaustion, depersonalization, and reduction of personal accomplishment, is very common among hemodialysis nurses, while data are scarce regarding the prevalence of burnout syndrome (BS) among peritoneal dialysis (PD) nurses. This study aimed to assess and compare demographic and professional characteristics and burnout levels in hemodialysis and PD nurses, and to investigate factors that increase the level of burnout in dialysis nurses. A total of 171 nurses from 44 dialysis centers in Turkey were included in a cross-sectional survey study. Data were collected using a questionnaire defining the social and demographic characteristics and working conditions of the nurses as well as the Maslach Burnout Inventory for assessment of burnout level. There was no significant difference in the level of burnout between the hemodialysis and PD nurses groups. Emotional exhaustion and depersonalization scores were higher among the shift workers, nurses who had problems in interactions with the other team members, and those who wanted to leave the unit, as well as the nurses who would not attend training programs. In addition, male sex, younger age, limited working experience, more than 50 hours of working per week, and working in dialysis not by choice were associated with higher depersonalization scores. Personal accomplishment score was lower among the younger nurses who had problems in their interactions with the doctors, who would not regularly attend training programs, and who felt being medically inadequate. Improving working conditions and relations among colleagues, and also providing further dialysis education are necessary for minimizing burnout syndrome. Burnout reduction programs should mainly focus on younger professionals.

  10. The spectrum of bone disease in Jordanian hemodialysis patients

    International Nuclear Information System (INIS)

    Younes, Nidal A.; Al-Mansour, M.; Sroujieh, Ahmad S.; Wahbeh, A.; Ailabouni, W.; Hamzah, Y.; Mahafzah, W.

    2006-01-01

    To evaluate the spectrum of mineral abnormalities and bone disease (BD) in hemodialysis patients at Jordan University Hospital (JUH), Amman, Jordan. A cross-sectional study was conducted among 63 patients (38 males and 25 females), mean age 44.19 years (range 17-76 years), with chronic kidney disease (CKD) on regular hemodialysis at JUH between November 2004 and April 2005. All patients have undergone complete blood count, chemistry profile, alkaline phosphatase, serum albumin, intact parathyroid hormone (iPTH) and plain x-rays. Bone disorders were identified in 45 patients on x-rays (70%). Osteopenia was found in 43 patients (68.3%), subperiosteal resorption in 24 patients (38.3%) and metastatic calcification in 22 patients (35%). Hypocalcemia was found in 28.6% and hypercalcemia in 7.9%. All patients were taking calcium carbonate, and 55.5% of patients were on vitamin D supplements. The calcium levels in 63.5% and the phosphorus levels in 50.8% of patients were within the recommended guidelines of the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI). Serum i-PTH level was above 300 pg/ml high turnover bone disease in 24.6% of patients, 21.3% had iPTH of 150-300 pg/ml target, and 44.3% had i-PTH levels below 100 pg/mL suggesting a dynamic bone disease. Patients with severe bone disease had a statistically significant higher iPTH levels (p<0.005). Bone disease and mineral abnormalities are common in hemodialysis patients at JUH. Earlier detection of bone disease and better overall management strategy may reduce the frequency and severity of bone disease in CKD patients in Jordan. (author)

  11. Nontraditional factors influencing the quality of life of hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Diana-Cristina Varela

    2014-06-01

    Full Text Available Introduction: The prevalence of CKD patients in advanced stages with dialysis requirement continues to grow. A goal for the medical team, the patient and their caregivers is to provide a treatment that offers an impact on the prognosis and quality of life (QOL. Methods: In 100 patients with CKD on hemodialysis, randomized assigned, the quality of life by SF-36 was assessed, it was evaluated the functional capacity using the Karnofsky, ability to perform basic tasks of daily life through the index Barthel, presence of depression using the Beck test, family functioning through family APGAR, cognitive state through Minimental and presence of comorbidities using the Charlson index correlated with the sum of physical components (PCS and mental components (MCS of the SF-36 in patients in two renal units in Medellín and Bogotá, Colombia. Results: A decrease in QOL in the physical components (PCS Mental components (MCS regarding the general population. A significant correlation between low PCS and diabetes mellitus (-16 p=0.008 95% CI 2.49 was found. Low MCS showed relation with PTH (p=0.046 95% CI 0.000-0.014, Karnofsky index (p=0.034 95% CI 0.244 to 5.984 and Beck depression test (p=0.000 95% CI -13.606 to 6.253. Conclusions: The QOL of hemodialysis patients is affected with more impact on PCS, there is significant relationship between MCS with functional status and depression. To improve QOL in hemodialysis patients, non traditionally-measured variables should be measured and monitored and the therapeutic focus should be optimized addressed to physical rehabilitation, nutritional, functional and psychological state.

  12. Assessment of adequacy of hemodialysis dose at a Palestinian hospital

    Directory of Open Access Journals (Sweden)

    Heba Adas

    2014-01-01

    Full Text Available Adequacy of hemodialysis improves patient survival, quality of life and biochemical outcomes and minimizes disease complications and hospitalizations. This study was an observational cross-sectional study that was conducted in July 2012. Blood tests, weight and blood pressure were measured before and after hemodialysis. Single-pool Kt/V and urea reduction ratio (URR were calculated. The targets based on the National Kidney Foundation Disease Outcomes Quality Initiative (KDOQI Clinical Practice Guidelines were Kt/V ≥ 1.2 and URR ≥ 65%. Of the 64 patients, 41 (64.1% were males. The mean age of the patients was 58.13 ± 17.2 years. The mean body mass index (BMI was 25.04 ± 5.01 kg/m 2 . The mean Kt/V and URR were 1.06 ± 0.05 and 54.4 ± 19.3, respectively. There was no significant difference between men and women (1.06 ± 0.47 versus 1.04 ± 0.55, P = 0.863 and (54.7 ± 19.59 versus 53.81 ± 19.17, P = 0.296. Only 25 (39.1% patients achieved the Kt/V goal and only 22 (34.4% had target URR, and there was no significant association between hemodialysis adequacy and any of the variables such as sex, age, presence of chronic diseases or BMI. Serum potassium levels post-dialysis were significantly lower in patients who reached the target Kt/V (mean = 3.44 ± 0.48 versus 3.88 ± 0.48, P = 0.001. Most patients were inadequately dialyzed and a large percentage of the patients did not attain the targets. Attempts to achieve the desired goals are necessary. It is important to calculate Kt/V or URR and individualize the dialysis doses for each patient.

  13. Metabolic Syndrome and Physical Activity in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    derya atik

    2014-06-01

    Full Text Available Purpose: This descriptive study was carried out to reveal the level of physical activity in patients who receive hemodialysis due to chronic kidney failure and to identify its relationship with the prevalence of metabolic syndrome (MetS. Material and method: The study was conducted with 55 patients at the hemodialysis units of Alanya State Hospital and Private Alanya Anadolu Hospital between 10 and 30 June 2013. The study data were collected using the National Cholesterol Education Program, the Adult Treatment Panel III (NCEP-ATP III, a data collection form containing Metabolic Syndrome Diagnosis Criteria, and the International Physical Activity Questionnaire (IPAQ. The data were analyzed using arithmetic mean +/- standard deviation (SD, number and percentage distributions, independent sample t test, crosstabs, One Way Anova, and Pearson and #8217;s Correlation Analysis. Conclusion and suggestions: It was found that 41.8% of the patients were between 50 and 65 years of age, the majority of them were male (58.2%, hemodialysis had been administered to 69.1% of them for at least 36 months, and 50.9% of them met three and more of the MetS criteria. There was no statistically significant relationship between MetS and physical activity levels, but the length of physical activity was longer in those who did not meet the MetS diagnosis criteria (p>0.05. An increase in sedentary time raised the MetS criteria (p<0.05. Conclusion: Nearly 1/2 of the patients were at risk of MetS. Physical activity level being statistically ineffective on MetS can be associated with low physical activity level and longer sedentary time. It can be said that being completely sedentary increases BMI and therefore MetS. The study can be repeated on different samples and the results can be compared. [J Contemp Med 2014; 4(2.000: 69-75

  14. Cutaneous manifestations in patients with chronic renal failure on hemodialysis

    Directory of Open Access Journals (Sweden)

    Udayakumar P

    2006-01-01

    Full Text Available Background: Chronic renal failure (CRF presents with an array of cutaneous manifestations. Newer changes are being described since the advent of hemodialysis, which prolongs the life expectancy, giving time for these changes to manifest. Aim: The aim of this study was to evaluate the prevalence of dermatologic problems among patients with chronic renal failure (CRF undergoing hemodialysis. Methods: One hundred patients with CRF on hemodialysis were examined for cutaneous changes. Results: Eighty-two per cent patients complained of some skin problem. However, on examination, all patients had at least one skin lesion attributable to CRF. The most prevalent finding was xerosis (79%, followed by pallor (60%, pruritus (53% and cutaneous pigmentation (43%. Other cutaneous manifestations included Kyrle′s disease (21%; fungal (30%, bacterial (13% and viral (12% infections; uremic frost (3%; purpura (9%; gynecomastia (1%; and dermatitis (2%. The nail changes included half and half nail (21%, koilonychia (18%, onychomycosis (19%, subungual hyperkeratosis (12%, onycholysis (10%, splinter hemorrhages (5%, Mees′ lines (7%, Muehrcke′s lines (5% and Beau′s lines (2%. Hair changes included sparse body hair (30%, sparse scalp hair (11% and brittle and lusterless hair (16%. Oral changes included macroglossia with teeth markings (35%, xerostomia (31%, ulcerative stomatitis (29%, angular cheilitis (12% and uremic breath (8%. Some rare manifestations of CRF like uremic frost, gynecomastia and pseudo-Kaposi′s sarcoma were also observed. Conclusions: CRF is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. The commonest are xerosis and pruritus and the early recognition of cutaneous signs can relieve suffering and decrease morbidity.

  15. BODY COMPOSITION IN HEMODIALYSIS AND PERITONEAL DIALYSIS PATIENTS

    Directory of Open Access Journals (Sweden)

    Nam Ho Kim

    2012-06-01

    Full Text Available Bioimpedance analysis is a reliable technique for determining post dialysis target weight. Using this technique, we can understand body fluid status easier and conveniently. Moreover this technique can be used for check nutrition status and nutritional status of dialysis patients. We compared the body fluid status and nutrition status between hemodialysis (HD patients and peritoneal dialysis (PD patients by BCM (Body composition monitor technique. We studied 48 (30 males and 18 females PD patients, 21 (10 males and 11 females HD patients. Body composition monitoring (BCM, Fesenitus Medical Care, Germany was used as a tool for the analysis of bioimpedance. Extracellular water, Total body water, Intracellular water, Overhydration, E/I, Lean tissue mass, Fat Tissue mass was measured and those results were compared between two groups. HD patients were more hydrated than PD patients (61.9% vs. 35.4% and nutritional status such as LTI was poorer than peritoneal dialysis patients (11.7±1.7 vs. 15.3±2.6. Although total body water is more abundant in peritoneal patients (29.4±5.5L vs. 35.9±6.2L, Extracellular water and intracellular water ratio was relatively higher in Hemodialysis patients (E/I 0.98±0.13 vs. 0.87±0.12. The nutrition status was better in PD patients by comparing the percent of lean tissue mass (LTM% between two groups (LTM% 52.1±10.6% vs. 66.8±11.3. In conclusions, Hemodialysis patients were more hydrated with poorer nutrition status than peritoneal dialysis patients, but, due to the significant difference of age between two groups, further study should be required.

  16. [Pulmonary hypertension in hemodialysis patients: Prevalence and associated factors].

    Science.gov (United States)

    Reque, Javier; Quiroga, Borja; Ruiz, Caridad; Villaverde, Maria Teresa; Vega, Almudena; Abad, Soraya; Panizo, Nayara; López-Gómez, J Manuel

    2016-02-19

    Pulmonary hypertension (PH) is a progressive disorder that can be caused by several underlying conditions or an intrinsic alteration of the pulmonary vasculature. Chronic increased pressure in the pulmonary vasculature leads to changes in the architecture of the vessels that can perpetuate PH and produce right ventricular dysfunction. These structural and functional alterations can decrease survival and quality of life of patients on hemodialysis; however, there is a lack of evidence about this problem in this population. The aim of this study is to establish the prevalence of PH in patients on hemodialysis and its association with specific factors related to this patient population. We included 202 prevalent patients on hemodialysis for at least 6 months and who were clinically stable. We collected demographic data, routine laboratory parameters and data of 2D Doppler-echocardiography. PH was defined as a systolic pulmonary artery pressure (SPAP) estimated by Doppler ultrasound above 35mmHg. Hydration status was assessed by determining the plasma concentration of N-terminal pro brain natriuretic peptide (Nt-proBNP). PH prevalence was 37.1% (75 patients). The average SPAP in the entire study population was 32±12mmHg and in the group with PH it was 45±11mmHg. We found a direct and statistically significant correlation between the presence of PH and age (P=.001), time on renal replacement therapy (P=.04), the presence of systolic dysfunction (P=.007), diastolic dysfunction (P= 01), mitral valve disease (P=.01) and double mitral and aortic disease (P=.007). Volume overload was closely associated with PH, as demonstrated by the correlation between the SPAP and Nt-proBNP levels (P=.001). We conclude that prevalence of PH in hemodialysis patients is high. And one of the most important associated factors is volume overload. More studies are needed to establish the impact of PH on morbidity and mortality of patients and to assess whether a better volume control improves

  17. Central Venous Disease in Hemodialysis Patients: An Update

    Energy Technology Data Exchange (ETDEWEB)

    Modabber, Milad, E-mail: mmodabber@gmail.com [McMaster University, Michael G. DeGroote School of Medicine (Canada); Kundu, Sanjoy [Scarborough Hospital and Scarborough Vascular Ultrasound, The Vein Institute of Toronto (Canada)

    2013-08-01

    Central venous occlusive disease (CVD) is a common concern among the hemodialysis patient population, with the potential to cause significant morbidity. Endovascular management of CVD, comprising percutaneous balloon angioplasty and bare-metal stenting, has been established as a safe alternative to open surgical treatment. However, these available treatments have poor long-term patency, requiring close surveillance and multiple repeat interventions. Recently, covered stents have been proposed and their efficacy assessed for the treatment of recalcitrant central venous stenosis and obstruction. Moreover, newly proposed algorithms for the surgical management of CVD warrant consideration. Here, we seek to provide an updated review of the current literature on the various treatment modalities for CVD.

  18. Infliximab treatment in a patient with rheumatoid arthritis on hemodialysis.

    Science.gov (United States)

    Singh, Ranju; Cuchacovich, Raquel; Huang, Wenqun; Espinoza, Luis R

    2002-03-01

    We describe a 60-year-old woman with active rheumatoid arthritis (RA) and endstage renal disease secondary to hypertensive nephrosclerosis undergoing hemodialysis. She had tried multiple antirheumatic medications; however, their usefulness was limited due to toxic side effects or lack of efficacy. She was then treated with chimeric antitumor necrosis factor monoclonal antibody (infliximab), which resulted in immediate improvement in clinical and laboratory measures. After about 2 years of therapy, no side effects have been observed. This report expands the spectrum of infliximab to include RA patients with renal insufficiency.

  19. Vascular access for hemodialysis. Patency rates and results of revision.

    Science.gov (United States)

    Palder, S B; Kirkman, R L; Whittemore, A D; Hakim, R M; Lazarus, J M; Tilney, N L

    1985-08-01

    Over a 4-year interval, 324 arteriovenous conduits were created in 256 patients with end-stage renal disease as access for chronic hemodialysis. These included 154 Cimino fistulae, 163 polytetrafluoroethylene (PTFE) grafts, and seven miscellaneous grafts. Satisfactory patency rates were demonstrated for as long as 4 years for both Cimino fistulae and PTFE grafts by life-table analysis. Failures of Cimino fistulae usually occurred early in the postoperative period, secondary to attempts to use inadequate veins. Thrombosis caused the majority of PTFE graft failures and was generally the result of venous stenosis. Correction of such venous stenosis is mandatory to restore graft patency and can result in prolonged graft survival.

  20. Contribuição de solutos orgânicos e inorgânicos no ajustamento osmótico de pinhão-manso submetido à salinidade Contribution of organic and inorganic solutes to osmotic adjustment of physic nut under salinity

    Directory of Open Access Journals (Sweden)

    Evandro Nascimento da Silva

    2009-05-01

    Full Text Available O objetivo deste trabalho foi avaliar a acumulação de solutos orgânicos e inorgânicos e suas contribuições para o ajustamento osmótico de folhas de pinhão-manso (Jatropha curcas L. submetido à salinidade. O experimento foi conduzido em delineamento experimental inteiramente casualizado, com cinco tratamentos (0, 25, 50, 75 e 100 mmol L-1 de NaCl e quatro repetições. As plantas foram cultivadas hidroponicamente em casa de vegetação, em condições controladas de fotoperíodo (12 horas, temperatura (média de 28ºC e umidade relativa do ar (média de 65%, com radiação fotossinteticamente ativa máxima média de 700 µmol m-1 s-1. O potencial osmótico das folhas decresceu progressivamente e variou de -0,84 a -2,05 MPa, enquanto o conteúdo relativo de água aumentou nos tratamentos com 75 e 100 mmol L-1. Os íons Na+ e Cl- foram os mais importantes, em termos quantitativos, e contribuíram com cerca de 52 e 20%, respectivamente, para o ajustamento osmótico das folhas de plantas tratadas com NaCl. A contribuição do K+ decresceu de modo acentuado e foi de 17 e 5% nos tratamentos com 25 e 100 mmol L-1 de NaCl. A contribuição média dos solutos orgânicos, açúcares, aminoácidos, glicina betaína e prolina, foi de 5,5, 6, 4 e 0,03%, respectivamente. As folhas de pinhão-manso ajustam-se osmoticamente em presença de salinidade, e mantêm bom nível de hidratação, principalmente por meio da acumulação de Na+ e Cl-. A glicina betaína tem papel quantitativo mais importante do que a prolina no ajustamento osmótico, tanto em presença quanto em ausência de salinidade.The objectives of this work were to evaluate the organic and inorganic solutes accumulation and measure their contribution to the osmotic adjustment of physic nut (Jatropha curcas L. leaves under salinity. The experiment was carried out using a completely randomized design with five treatments (0, 25, 50, 75, and 100 mmol L-1 of NaCl and four replications. Plants

  1. Echocardiographic study of cardiac dysfunction in patients of chronic kidney disease on hemodialysis

    International Nuclear Information System (INIS)

    Arshi, S.; Butt, G.U.D.; Mian, F.A.

    2016-01-01

    Objective: The objective of this study was to see echocardiographic findings of cardiac dysfunction in patients of chronic kidney disease (CKD) on hemodialysis. Study Design: Comparative cross sectional study. Place and Duration of Study: Department of nephrology, Pakistan Institute of Medical Sciences. Islamabad from September 2014 to February 2015. Patients and Methods: One hundred patients of either gender were included in this study. Fifty patients of chronic kidney disease stage V on hemodialysis were taken for echocardiography and fifty were normal. Echocardiography was done for cardiac dysfunction. Systolic function was measured by ejection fraction (EF) and fractional shortening (FS). Diastolic function was measured by E/A ratio. Results: Out of 100 patients included in the study, 50 patients were on hemodialysis and 50 were control. Left ventricular end systolic and end diastolic volumes were higher in patients on hemodialysis than controls as well as left atrial enlargement and inter ventricular septum which was statistically significant. Ejection fraction, although normal and fractional shortening decreased in patients on hemodialysis (p<0.05). Diastolic dysfunction was present in 36 patients on hemodialysis, while absent in the control group. Conclusion: Patients with chronic kidney disease on hemodialysis have higher prevalence of cardiac dysfunction. (author)

  2. N-terminal pro brain natriuretic peptide as a cardiac biomarker in Japanese hemodialysis patients.

    Science.gov (United States)

    Shimizu, Minako; Doi, Shigehiro; Nakashima, Ayumu; Naito, Takayuki; Masaki, Takao

    2018-03-01

    This study examined the clinical significance of N-terminal pro brain natriuretic peptide level as a cardiac marker in Japanese hemodialysis patients. This was a multicenter cross-sectional study involving 1428 Japanese hemodialysis patients. Ultrasonic cardiography data at post-hemodialysis were obtained from 395 patients. We examined whether serum N-terminal pro brain natriuretic peptide levels were associated with cardiac parameters and assessed cut-off values and investigated factors associated with a reduced ratio of N-terminal pro brain natriuretic peptide levels pre- and post-hemodialysis. Multivariate logistic regression analysis showed that pre- and post-hemodialysis N-terminal pro brain natriuretic peptide levels were associated with left ventricular hypertrophy on electrocardiogram (odds ratio: 3.10; p N-terminal pro brain natriuretic peptide levels were also significantly associated with ejection fraction on urine chorionic gonadotrophin (ultrasonic cardiography; odds ratio: 35.83; p N-terminal pro brain natriuretic peptide reduction ratio during a hemodialysis session correlated with Kt/V, membrane area, membrane type, modality, body weight gain ratio, treatment time, and ultrafiltration rate with multiple linear regression ( R: 0.53; p N-terminal pro brain natriuretic peptide are associated with the presence of left ventricular hypertrophy in this population. The post-hemodialysis N-terminal pro brain natriuretic peptide level is a useful marker for systolic dysfunction.

  3. Interventions to improve hemodialysis adherence: a systematic review of randomized-controlled trials.

    Science.gov (United States)

    Matteson, Michelle L; Russell, Cynthia

    2010-10-01

    Over 485,000 people in the United States have chronic kidney disease, a progressive kidney disease that may lead to hemodialysis. Hemodialysis involves a complex regimen of treatment, medication, fluid, and diet management. In 2005, over 312,000 patients were undergoing hemodialysis in the United States. Dialysis nonadherence rates range from 8.5% to 86%. Dialysis therapy treatment nonadherence, including treatment, medication, fluid, and diet nonadherence, significantly increases the risk of morbidity and mortality. The purpose of this paper is to systematically review randomized-controlled trial intervention studies designed to increase treatment, medication, fluid, and diet adherence in adult hemodialysis patients. A search of Cumulative Index of Nursing and Allied Health Literature (CINAHL) (1982 to May 2008), MEDLINE (1950 to May 2008), PsycINFO (1806 to May 2008), and all Evidence-Based Medicine (EBM) Reviews (Cochran DSR, ACP Journal Club, DARE, and CCTR) was conducted to identify randomized-controlled studies that tested the efficacy of interventions to improve adherence in adult hemodialysis patients. Eight randomized-controlled trials met criteria for inclusion. Six of the 8 studies found statistically significant improvement in adherence with the intervention. Of these 6 intervention studies, all studies had a cognitive component, with 3 studies utilizing cognitive/behavioral intervention strategies. Based on this systematic review, interventions utilizing a cognitive or cognitive/behavioral component appear to show the most promise for future study. © 2010 The Authors. Hemodialysis International © 2010 International Society for Hemodialysis.

  4. Survival with Three-Times Weekly In-Center Nocturnal Versus Conventional Hemodialysis

    Science.gov (United States)

    Xu, Jianglin; Suri, Rita S.; Nesrallah, Gihad; Lindsay, Robert; Garg, Amit X.; Lester, Keith; Ofsthun, Norma; Lazarus, Michael; Hakim, Raymond M.

    2012-01-01

    Whether the duration of hemodialysis treatments improves outcomes remains controversial. Here, we evaluated survival and clinical changes associated with converting from conventional hemodialysis (mean=3.75 h/treatment) to in-center nocturnal hemodialysis (mean=7.85 h/treatment). All 959 consecutive patients who initiated nocturnal hemodialysis for the first time in 77 Fresenius Medical Care facilities during 2006 and 2007 were eligible. We used Cox models to compare risk for mortality during 2 years of follow-up in a 1:3 propensity score–matched cohort of 746 nocturnal and 2062 control patients on conventional hemodialysis. Two-year mortality was 19% among nocturnal hemodialysis patients compared with 27% among conventional patients. Nocturnal hemodialysis associated with a 25% reduction in the risk for death after adjustment for age, body mass index, and dialysis vintage (hazard ratio=0.75, 95% confidence interval=0.61–0.91, P=0.004). With respect to clinical features, interdialytic weight gain, albumin, hemoglobin, dialysis dose, and calcium increased on nocturnal therapy, whereas postdialysis weight, predialysis systolic blood pressure, ultrafiltration rate, phosphorus, and white blood cell count declined (all P<0.001). In summary, notwithstanding the possibility of residual selection bias, conversion to treatment with nocturnal hemodialysis associates with favorable clinical features, laboratory biomarkers, and improved survival compared with propensity score–matched controls. The potential impact of extended treatment time on clinical outcomes while maintaining a three times per week hemodialysis schedule requires evaluation in future clinical trials. PMID:22362905

  5. Coastal hazards and groundwater salinization on low coral islands.

    Science.gov (United States)

    Terry, James P.; Chui, T. F. May

    2016-04-01

    Remote oceanic communities living on low-lying coral islands (atolls) without surface water rely for their survival on the continuing viability of fragile groundwater resources. These exist in the form of fresh groundwater lenses (FGLs) that develop naturally within the porous coral sand and gravel substrate. Coastal hazards such as inundation by high-energy waves driven by storms and continuing sea-level rise (SLR) are among many possible threats to viable FGL size and quality on atolls. Yet, not much is known about the combined effects of wave washover during powerful storms and SLR on different sizes of coral island, nor conversely how island size influences lens resilience against damage. This study investigates FGL damage by salinization (and resilience) caused by such coastal hazards using a modelling approach. Numerical modelling is carried out to generate steady-state FGL configurations at three chosen island sizes (400, 600 and 800 m widths). Steady-state solutions reveal how FGL dimensions are related in a non-linear manner to coral island size, such that smaller islands develop much more restricted lenses than larger islands. A 40 cm SLR scenario is then imposed. This is followed by transient simulations to examine storm-induced wave washover and subsequent FGL responses to saline damage over a 1 year period. Smaller FGLs display greater potential for disturbance by SLR, while larger and more robust FGLs tend to show more resilience. Further results produce a somewhat counterintuitive finding: in the post-SLR condition, FGL vulnerability to washover salinization may actually be reduced, owing to the thinner layer of unsaturated substrate lying above the water table into which saline water can infiltrate during a storm event. Nonetheless, combined washover and SLR impacts imply overall that advancing groundwater salinization may lead to some coral islands becoming uninhabitable long before they are completely submerged by sea-level rise, thereby calling

  6. Estuarine turbidity, flushing, salinity, and circulation

    Science.gov (United States)

    Pritchard, D. W.

    1972-01-01

    The effects of estuarine turbidity, flushing, salinity, and circulation on the ecology of the Chesapeake Bay are discussed. The sources of fresh water, the variations in salinity, and the circulation patterns created by temperature and salinity changes are analyzed. The application of remote sensors for long term observation of water temperatures is described. The sources of sediment and the biological effects resulting from increased sediments and siltation are identified.

  7. ( Phaseolus vulgaris L. ) seedlings to salinity stress

    African Journals Online (AJOL)

    The effect of salinity stress on five cultivars of common bean: Bassbeer, Beladi, Giza 3, HRS 516 and RO21 were evaluated on a sand/peat medium with different salinity levels (0, 50 and 100 mM NaCl) applied 3 weeks after germination for duration of 10 days. Salinity had adverse effects not only on the biomass yield and ...

  8. A global algorithm for estimating Absolute Salinity

    Directory of Open Access Journals (Sweden)

    T. J. McDougall

    2012-12-01

    Full Text Available The International Thermodynamic Equation of Seawater – 2010 has defined the thermodynamic properties of seawater in terms of a new salinity variable, Absolute Salinity, which takes into account the spatial variation of the composition of seawater. Absolute Salinity more accurately reflects the effects of the dissolved material in seawater on the thermodynamic properties (particularly density than does Practical Salinity.

    When a seawater sample has standard composition (i.e. the ratios of the constituents of sea salt are the same as those of surface water of the North Atlantic, Practical Salinity can be used to accurately evaluate the thermodynamic properties of seawater. When seawater is not of standard composition, Practical Salinity alone is not sufficient and the Absolute Salinity Anomaly needs to be estimated; this anomaly is as large as 0.025 g kg−1 in the northernmost North Pacific. Here we provide an algorithm for estimating Absolute Salinity Anomaly for any location (x, y, p in the world ocean.

    To develop this algorithm, we used the Absolute Salinity Anomaly that is found by comparing the density calculated from Practical Salinity to the density measured in the laboratory. These estimates of Absolute Salinity Anomaly however are limited to the number of available observations (namely 811. In order to provide a practical method that can be used at any location in the world ocean, we take advantage of approximate relationships between Absolute Salinity Anomaly and silicate concentrations (which are available globally.

  9. Advances in measuring ocean salinity with an optical sensor

    International Nuclear Information System (INIS)

    Menn, M Le; De Bougrenet de la Tocnaye, J L; Grosso, P; Delauney, L; Podeur, C; Brault, P; Guillerme, O

    2011-01-01

    Absolute salinity measurement of seawater has become a key issue in thermodynamic models of the oceans. One of the most direct ways is to measure the seawater refractive index which is related to density and can therefore be related to the absolute salinity. Recent advances in high resolution position sensitive devices enable us to take advantage of small beam deviation measurements using refractometers. This paper assesses the advantages of such technology with respect to the current state-of-the-art technology. In particular, we present the resolution dependence on refractive index variations and derive the limits of such a solution for designing seawater sensors well suited for coastal and deep-sea applications. Particular attention has been paid to investigate the impact of environmental parameters, such as temperature and pressure, on an optical sensor, and ways to mitigate or compensate them have been suggested here. The sensor has been successfully tested in a pressure tank and in open oceans 2000 m deep

  10. Omega-3 intake in people with epilepsy under regular hemodialysis program: here to stay

    Directory of Open Access Journals (Sweden)

    Carla Alessandra Scorza

    2013-07-01

    Full Text Available Among the many risk factors suggested for sudden unexpected death in epilepsy (SUDEP, higher frequency of seizures is a very consistent issue. Furthermore, it has been established that hemodialysis-associated seizure is a complication of the dialysis procedure. Thus, since a possible relation between cardiovascular abnormalities and SUDEP among patients with chronic renal insufficiency in regular hemodialysis program should not be neglected, we propose in this paper that omega-3 fatty acids offer opportunities for prevention of sudden cardiac death or improved treatment in people with epilepsy under the regular hemodialysis program.

  11. Comparison of cardiovascular risk factors in maintenance hemodialysis patients based on phase angle of bioimpedance analysis

    Science.gov (United States)

    Muzasti, R. A.; Lubis, H. R.

    2018-03-01

    Mortality and morbidity rate, especially from cardiovascular disease in hemodialysis patients in Indonesia is still quite high. One of indicator to assess the predictive value of mortality is the phase angle (PhA) of bioimpedance analysis (BIA) scan examination. Determining the comparison of BMI and laboratory data as cardiovascular risk factors in hemodialysis patients based on PhA.A cross-sectional analytical study was done on 155 outpatientsin RasyidaRenal Hospital, Medan in 2016. Patients were two groups, namely PhAcardiovascular risk factors of hemodialysis patients were determined by age, BMI, and hemoglobin.

  12. Complementary Therapies for Pain Among Individuals Receiving Hemodialysis: A Systematic Review.

    Science.gov (United States)

    Zins, Savannah; Gross, Cynthia R; Huff, Edwin D; Hooke, Mary Catherine

    2018-01-01

    Pain is a major problem for individuals undergoing hemodialysis and can lead to decreased quality of life when ineffectively managed. Pain is often reported as burdensome; thus, nurses must learn effective, nonpharmacological adjuncts to help care for symptomatic patients. The purpose of this review was to identify non-pharmacologic complementary therapies and evaluate their effectiveness in minimizing pain among individuals undergoing hemodialysis. Multiple complementary interventions were identified, and several reduced pain, but evidence is qualified by limitations in study methods. Complementary therapies have the potential to reduce pain among individuals undergoing hemodialysis; however, more research is needed. Copyright© by the American Nephrology Nurses Association.

  13. The effect of hemodialysis on balance measurements and risk of fall.

    Science.gov (United States)

    Erken, Ertugrul; Ozelsancak, Ruya; Sahin, Safak; Yılmaz, Emine Ece; Torun, Dilek; Leblebici, Berrin; Kuyucu, Yunus Emre; Sezer, Siren

    2016-10-01

    Patients with end-stage renal disease (ESRD) have increased risk of falls and fall-related complications. Other than aging and factors related to chronic kidney disease, treatment of hemodialysis may also contribute to this increased risk. The aim of this study was to demonstrate the impairment of balance after a session of hemodialysis with a quantitative assessment and reveal an increased fall risk that would possibly be related to treatment of hemodialysis for patients on maintenance hemodialysis. Fifty-six patients with ESRD on chronic hemodialysis program and 53 healthy individuals were involved in this study. Fall Index percentages were calculated, and fall risk categories were determined for all patients and healthy controls using Tetrax posturography device (Sunlight Medical Ltd Israel). The patient group was evaluated twice for balance, before and after a routine session of hemodialysis. Fall Index scores of healthy controls were lower than that of ESRD patients (p = 0.001). In the patient group, we found the mean Fall Index to be significantly higher at the post-dialysis assessment compared to the pre-dialysis assessment (p = 0.003). The number of patients with high risk of falling also increased at the post-dialysis assessment yet the difference did not reach significance. Fall Index was correlated with the increase in age only at the pre-dialysis balance measurement (p = 0.038). Patients with better dialysis adequacy had significantly lower Fall Index scores than the others at the pre-dialysis balance measurement (p = 0.004). The difference was not significant at the post-dialysis measurement. In the current study, we evaluated the balance of ESRD patients before and after a routine session of hemodialysis treatment. This is the first study to investigate the effect of hemodialysis on balance, using an electronic posturographic balance system. We found the Fall Index score to be significantly higher after hemodialysis, indicating a negative

  14. Salinity Temperature and Roughness Remote Scanner (STARRS)

    Data.gov (United States)

    Federal Laboratory Consortium — FUNCTION: Provides spatially continuous high-resolution surface salinity imagery in a synoptic manner from small aircraft. Its output complements data collected from...

  15. Mapping spatial variability of soil salinity in a coastal paddy field based on electromagnetic sensors.

    Science.gov (United States)

    Guo, Yan; Huang, Jingyi; Shi, Zhou; Li, Hongyi

    2015-01-01

    In coastal China, there is an urgent need to increase land area for agricultural production and urban development, where there is a rapid growing population. One solution is land reclamation from coastal tidelands, but soil salinization is problematic. As such, it is very important to characterize and map the within-field variability of soil salinity in space and time. Conventional methods are often time-consuming, expensive, labor-intensive, and unpractical. Fortunately, proximal sensing has become an important technology in characterizing within-field spatial variability. In this study, we employed the EM38 to study spatial variability of soil salinity in a coastal paddy field. Significant correlation relationship between ECa and EC1:5 (i.e. r >0.9) allowed us to use EM38 data to characterize the spatial variability of soil salinity. Geostatistical methods were used to determine the horizontal spatio-temporal variability of soil salinity over three consecutive years. The study found that the distribution of salinity was heterogeneous and the leaching of salts was more significant in the edges of the study field. By inverting the EM38 data using a Quasi-3D inversion algorithm, the vertical spatio-temporal variability of soil salinity was determined and the leaching of salts over time was easily identified. The methodology of this study can be used as guidance for researchers interested in understanding soil salinity development as well as land managers aiming for effective soil salinity monitoring and management practices. In order to better characterize the variations in soil salinity to a deeper soil profile, the deeper mode of EM38 (i.e., EM38v) as well as other EMI instruments (e.g. DUALEM-421) can be incorporated to conduct Quasi-3D inversions for deeper soil profiles.

  16. Mapping spatial variability of soil salinity in a coastal paddy field based on electromagnetic sensors.

    Directory of Open Access Journals (Sweden)

    Yan Guo

    Full Text Available In coastal China, there is an urgent need to increase land area for agricultural production and urban development, where there is a rapid growing population. One solution is land reclamation from coastal tidelands, but soil salinization is problematic. As such, it is very important to characterize and map the within-field variability of soil salinity in space and time. Conventional methods are often time-consuming, expensive, labor-intensive, and unpractical. Fortunately, proximal sensing has become an important technology in characterizing within-field spatial variability. In this study, we employed the EM38 to study spatial variability of soil salinity in a coastal paddy field. Significant correlation relationship between ECa and EC1:5 (i.e. r >0.9 allowed us to use EM38 data to characterize the spatial variability of soil salinity. Geostatistical methods were used to determine the horizontal spatio-temporal variability of soil salinity over three consecutive years. The study found that the distribution of salinity was heterogeneous and the leaching of salts was more significant in the edges of the study field. By inverting the EM38 data using a Quasi-3D inversion algorithm, the vertical spatio-temporal variability of soil salinity was determined and the leaching of salts over time was easily identified. The methodology of this study can be used as guidance for researchers interested in understanding soil salinity development as well as land managers aiming for effective soil salinity monitoring and management practices. In order to better characterize the variations in soil salinity to a deeper soil profile, the deeper mode of EM38 (i.e., EM38v as well as other EMI instruments (e.g. DUALEM-421 can be incorporated to conduct Quasi-3D inversions for deeper soil profiles.

  17. Seasonal induced changes in spinach rhizosphere microbial community structure with varying salinity and drought.

    Science.gov (United States)

    Mark Ibekwe, A; Ors, Selda; Ferreira, Jorge F S; Liu, Xuan; Suarez, Donald L

    2017-02-01

    Salinity is a common problem under irrigated agriculture, especially in low rainfall and high evaporative demand areas of southwestern United States and other semi-arid regions around the world. However, studies on salinity effects on soil microbial communities are relatively few while the effects of irrigation-induced salinity on soil chemical and physical properties and plant growth are well documented. In this study, we examined the effects of salinity, temperature, and temporal variability on soil and rhizosphere microbial communities in sand tanks irrigated with prepared solutions designed to simulate saline wastewater. Three sets of experiments with spinach (Spinacia oleracea L., cv. Racoon) were conducted under saline water during different time periods (early winter, late spring, and early summer). Bacterial 16S V4 rDNA region was amplified utilizing fusion primers designed against the surrounding conserved regions using MiSeq® Illumina sequencing platform. Across the two sample types, bacteria were relatively dominant among three phyla-the Proteobacteria, Cyanobacteria, and Bacteroidetes-accounted for 77.1% of taxa detected in the rhizosphere, while Proteobacteria, Bacteroidetes, and Actinobacteria accounted for 55.1% of taxa detected in soil. The results were analyzed using UniFrac coupled with principal coordinate analysis (PCoA) to compare diversity, abundance, community structure, and specific bacterial groups in soil and rhizosphere samples. Permutational analysis of variance (PERMANOVA) analysis showed that soil temperature (P=0.001), rhizosphere temperature (P=0.001), rhizosphere salinity (P=0.032), and evapotranspiration (P=0.002) significantly affected beta diversity of soil and rhizosphere microbial communities. Furthermore, salinity had marginal effects (P=0.078) on soil beta diversity. However, temporal variability differentially affected rhizosphere microbial communities irrigated with saline wastewater. Therefore, microbial communities in

  18. Reinforcement of spinal anesthesia by epidural injection of saline: a comparison of hyperbaric and isobaric tetracaine.

    Science.gov (United States)

    Yamazaki, Y; Mimura, M; Hazama, K; Namiki, A

    2000-04-25

    An epidural injection of saline was reported to extend spinal anesthesia because of a volume effect. The aim of this study was to evaluate the influence of the baricity of spinal local anesthetics upon the extension of spinal anesthesia by epidural injection of saline. Forty patients undergoing elective lower-limb surgery were randomly allocated to four groups of 10 patients each. Group A received no epidural injection after the spinal administration of hyperbaric tetracaine (dissolved in 10% glucose). Group B received an epidural injection of 8 ml of physiological saline 20 min after spinal hyperbaric tetracaine. Group C received no epidural injection after spinal isobaric tetracaine (dissolved in physiological saline). Group D received an epidural injection of 8 ml of saline 20 min after spinal isobaric tetracaine. The level of analgesia was examined by the pinprick method at 5-min intervals. The levels of analgesia 20 min after spinal anesthesia were significantly higher in hyperbaric groups than in isobaric groups [T5 (T2-L2) vs. T7 (T3-12)]. After epidural injection of saline, the levels of analgesia in groups B and D were significantly higher than in groups A and C. The segmental increases after epidural saline injection were 2 (0-3) in group B and 2 (1-7) in group D. Sensation in the sacral area remained 20 min after spinal block in one patient in group D; however, it disappeared after epidural saline injection. In this study, 8 ml of epidural saline extended spinal analgesia. However, there was no difference between the augmenting effect in isobaric and hyperbaric spinal anesthesia. We conclude that the reinforcement of spinal anesthesia by epidural injection of saline is not affected by the baricity of the spinal anesthetic solution used.

  19. Mapping Spatial Variability of Soil Salinity in a Coastal Paddy Field Based on Electromagnetic Sensors

    Science.gov (United States)

    Guo, Yan; Huang, Jingyi; Shi, Zhou; Li, Hongyi

    2015-01-01

    In coastal China, there is an urgent need to increase land area for agricultural production and urban development, where there is a rapid growing population. One solution is land reclamation from coastal tidelands, but soil salinization is problematic. As such, it is very important to characterize and map the within-field variability of soil salinity in space and time. Conventional methods are often time-consuming, expensive, labor-intensive, and unpractical. Fortunately, proximal sensing has become an important technology in characterizing within-field spatial variability. In this study, we employed the EM38 to study spatial variability of soil salinity in a coastal paddy field. Significant correlation relationship between ECa and EC1:5 (i.e. r >0.9) allowed us to use EM38 data to characterize the spatial variability of soil salinity. Geostatistical methods were used to determine the horizontal spatio-temporal variability of soil salinity over three consecutive years. The study found that the distribution of salinity was heterogeneous and the leaching of salts was more significant in the edges of the study field. By inverting the EM38 data using a Quasi-3D inversion algorithm, the vertical spatio-temporal variability of soil salinity was determined and the leaching of salts over time was easily identified. The methodology of this study can be used as guidance for researchers interested in understanding soil salinity development as well as land managers aiming for effective soil salinity monitoring and management practices. In order to better characterize the variations in soil salinity to a deeper soil profile, the deeper mode of EM38 (i.e., EM38v) as well as other EMI instruments (e.g. DUALEM-421) can be incorporated to conduct Quasi-3D inversions for deeper soil profiles. PMID:26020969

  20. Practical salinity management for leachate irrigation to poplar trees.

    Science.gov (United States)

    Smesrud, Jason K; Duvendack, George D; Obereiner, James M; Jordahl, James L; Madison, Mark F

    2012-01-01

    fifteen year record of monitoring and operational data are presented that can be used by others in managing irrigation of saline water to poplar trees. When salinity is carefully managed, tree systems can help to provide sustainable leachate management solutions for landfills.

  1. Organic matter and salinity modify cadmium soil (phyto)availability.

    Science.gov (United States)

    Filipović, Lana; Romić, Marija; Romić, Davor; Filipović, Vilim; Ondrašek, Gabrijel

    2018-01-01

    Although Cd availability depends on its total concentration in soil, it is ultimately defined by the processes which control its mobility, transformations and soil solution speciation. Cd mobility between different soil fractions can be significantly affected by certain pedovariables such as soil organic matter (SOM; over formation of metal-organic complexes) and/or soil salinity (over formation of metal-inorganic complexes). Phytoavailable Cd fraction may be described as the proportion of the available Cd in soil which is actually accessible by roots and available for plant uptake. Therefore, in a greenhouse pot experiment Cd availability was observed in the rhizosphere of faba bean exposed to different levels of SOM, NaCl salinity (50 and 100mM) and Cd contamination (5 and 10mgkg -1 ). Cd availability in soil does not linearly follow its total concentration. Still, increasing soil Cd concentration may lead to increased Cd phytoavailability if the proportion of Cd 2+ pool in soil solution is enhanced. Reduced Cd (phyto)availability by raised SOM was found, along with increased proportion of Cd-DOC complexes in soil solution. Data suggest decreased Cd soil (phyto)availability with the application of salts. NaCl salinity affected Cd speciation in soil solution by promoting the formation of CdCl n 2-n complexes. Results possibly suggest that increased Cd mobility in soil does not result in its increased availability if soil adsorption capacity for Cd has not been exceeded. Accordingly, chloro-complex possibly operated just as a Cd carrier between different soil fractions and resulted only in transfer between solid phases and not in increased (phyto)availability. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Saline catholytes as alternatives to phosphate buffers in microbial fuel cells

    KAUST Repository

    Ahn, Yongtae; Logan, Bruce E.

    2013-01-01

    Highly saline solutions were examined as alternatives to chemical buffers in microbial fuel cells (MFCs). The performance of two-chamber MFCs with different concentrations of saline solutions in the cathode chamber was compared to those with a buffered catholyte (50mM PBS). The use of a NaCl catholyte improved the CE to 43-60% (28% with no membrane) due to a reduction in oxygen transfer into the anolyte. The saline catholyte also reduced the membrane and solution resistance to 23Ω (41Ω without a membrane). The maximum power density of 491mW/m2 (240mM NaCl) was only 17% less than the MFC with 50mM PBS. The decrease in power output with highest salinity was due to reduced proton transfer due to the ion exchange membrane, and pH changes in the two solutions. These results show that MFC performance can be improved by using a saline catholyte without pH control. © 2013 Elsevier Ltd.

  3. Saline catholytes as alternatives to phosphate buffers in microbial fuel cells

    KAUST Repository

    Ahn, Yongtae

    2013-03-01

    Highly saline solutions were examined as alternatives to chemical buffers in microbial fuel cells (MFCs). The performance of two-chamber MFCs with different concentrations of saline solutions in the cathode chamber was compared to those with a buffered catholyte (50mM PBS). The use of a NaCl catholyte improved the CE to 43-60% (28% with no membrane) due to a reduction in oxygen transfer into the anolyte. The saline catholyte also reduced the membrane and solution resistance to 23Ω (41Ω without a membrane). The maximum power density of 491mW/m2 (240mM NaCl) was only 17% less than the MFC with 50mM PBS. The decrease in power output with highest salinity was due to reduced proton transfer due to the ion exchange membrane, and pH changes in the two solutions. These results show that MFC performance can be improved by using a saline catholyte without pH control. © 2013 Elsevier Ltd.

  4. Valsalva maneuver procedures in the diagnosis of right-to-left shunt by contrast-enhanced transcranial doppler using agitated saline solution with blood as a contrast agent Manobra de Valsalva no diagnóstico de embolia paradoxal pelo doppler transcraniano contrastado com o uso de solução salina agitada associada a sangue como meio de contraste

    Directory of Open Access Journals (Sweden)

    Marcos Christiano Lange

    2010-06-01

    Full Text Available OBJECTIVE: To compare two different timings for the performance of the Valsalva maneuver (VM using an infusion of agitated saline solution with blood as contrast agent (CA to right-to-left shunt (RLS screening. METHOD: 42 patients were submitted to a standardized contrast-enhanced transcranial doppler (cTCD to screen for right-to-left shunt (RLS. cTCD technique was done with two different moments of the VM: [1] the CA injection during the VM (CAduringVM test; [2] the CA injection before the VM (CApreVM test. RESULTS: Positive MCA tests were observed in 47 (56% CAduringVM tests and in 50 (59.5% CApreVM tests, p=0.64. There was an almost perfect agreement for the positive tests between the CAduringVM and CApreVM test, r s=0.829 (95% CI 0.61-1.00, pOBJETIVO: Comparar dois momentos diferentes da manobra de Valsalva (MV com o uso de solução salina com sangue como meio de contraste (MC para investigação de embolia paradoxal (EP. MÉTODO: 42 pacientes foram submetidos a protocolo padronizado de DTCc com a MV em dois momentos diferentes: [1] injeção do MC durante a MV (teste ACduranteMV; [2] injeção de MC antes da MV (teste ACpreMV. RESULTADOS: Exames positivos foram observados em 47 (56% ACMs testes ACduranteMV e 50 (59.5% testes ACpreMV, p=0.64. Houve uma correlação quase perfeita entre ambos os testes, r s=0.829 (95% CI 0.61-1.00, p<0.001. CONCLUSÃO: O presente estudo demonstra que não existe diferença significativa na positividade de EP pelo DTCc quando são comparados dois momentos diferentes da MV.

  5. Radiology of the kidneys in patients under maintenance hemodialysis

    International Nuclear Information System (INIS)

    Bahner, M.L.; Kaick, G. van; Bommer, J.; Sommerer, C.

    1999-01-01

    The kidneys of patients with chronic renal failure undergoing maintenance hemodialysis may show different variances or complications. Most common are secondarily acquired renal cysts, which my be found in as many as 92% of patients after 8 years of hemodialysis. Single (in 12.5% of patients) or multiple (8.3%) cysts with bleeding are common; additionally, hematuria or ruptured cysts may be found. Bleeding into cysts is more common in patients with autosomal dominant polycystic kidney disease. Due to the decreasing urinary production development of kidney stones is very uncommon, but calcification in or around cysts can be found in 71% of patients. Kidney tumors occur 41 times more often in patients with chronic renal failure than in patients without kidney disease. We detected tumors in 4.2% of our patients on long-term dialysis. Diagnostic differentiation of the relatively slow growing and fairly late metastasizing malignant tumors from adenomas is not possible. Nevertheless, we screen our patients every 3-4 years. Computed tomography is superior to ultrasonography for this purpose, because ultrasonography lacks the necessary sensitivity in this group of patients. (orig.) [de

  6. Vascular and valvular calcifications in chronic hemodialysis patients

    Directory of Open Access Journals (Sweden)

    María Elena Bruzzone

    2014-12-01

    Full Text Available Introduction: Vascular and valvular calcifications are a frequent complication in dialyzed patients and are connected to an increased morbi-mortality. Many radiological methods (TAC multiple slices and with electrons emission have been used to investigate the presence of vascular calcifications in this population, but only few works have been focused on simple radiology. Objectives: The objectives of this work are to evaluate vascular calcifications by means of Kauppila index in hemodialysis prevalent patients, identify linked risk factors and determine their association with heart valves calcification. Methods: 95 stable patients under hemodialysis were surveyed during a period of 6 months longer. Abdominal Rx simple profile were performed on all patients to evaluate calcification of abdominal aorta by Kauppila index and twodimensional echocardiogram to detect valvular calcifications. Data were collected about sex, age, diabetes, Hypertension, tabaquism, dislipemia and bone-mineral metabolism. Results: 64.5% of the patients showed vascular calcifications. Average Kauppila index was 6.25. Age and time on dialysis correlated with vascular calcifications. In 31.6 % of individuals valvular calcifications were found, which presented significant association with diabetes and Kauppila Index. Conclusions: Vascular and valvular calcifications were frequent in the surveyed population. Kauppila index correlated with age, time on dialysis and valvular calcifications. Heart valves calcification was associated with diabetes.

  7. 25-Hydroxyvitamin D response to cholecalciferol supplementation in hemodialysis.

    Science.gov (United States)

    Armas, Laura A G; Andukuri, Radha; Barger-Lux, Janet; Heaney, Robert P; Lund, Richard

    2012-09-01

    Recent understanding of extrarenal production of calcitriol has led to the exploration of native vitamin D treatment in dialysis patients. This paper reports the pharmacokinetics of 25-hydroxyvitamin D response to 10,333 IU cholecalciferol given weekly in subjects on chronic dialysis. This randomized, double-blind, placebo-controlled trial of 15 weeks of oral cholecalciferol in subjects with stage 5 CKD requiring maintenance hemodialysis was conducted from November of 2007 to March of 2010. The time course of serum 25-hydroxyvitamin D was measured over the course of treatment. Additionally, blood was drawn at baseline and last visit for calcium, phosphorus, calcitriol, and parathyroid hormone levels. The median (interquartile range) baseline 25-hydroxyvitamin D level was 13.3 (11.1-16.2) ng/ml for the treatment group and 15.2 (10.7-19.9) ng/ml for the placebo group. 25-hydroxyvitamin D steady state levels rose by 23.6 (19.2-29.9) ng/ml in the treatment group, and there was no change in the placebo group. Calcitriol levels also increased significantly in the treatment group. There were no significant changes in levels of calcium, albumin, phosphorus, and parathyroid hormone in either group. Cholecalciferol (10,333 IU) given weekly in patients on chronic hemodialysis produces a steady state in 25-hydroxyvitamin D of approximately 24 ng/ml.

  8. Calcium absorption response to cholecalciferol supplementation in hemodialysis.

    Science.gov (United States)

    Armas, Laura A G; Zena, Mohsen; Lund, Richard; Heaney, Robert P

    2013-06-01

    Recent understanding of extrarenal production of calcitriol has led to the use of more vitamin D supplementation in CKD populations. This paper reports the effect of cholecalciferol supplementation on calcium absorption. Paired calcium absorption tests were done before and after 12-13 weeks of 20,000 IU weekly cholecalciferol supplementation in 30 participants with stage 5 CKD on hemodialysis. The study was conducted from April to December of 2011. Calcium absorption was tested with a standardized meal containing 300 mg calcium carbonate intrinsically labeled with (45)Ca; 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were measured. 25-Hydroxyvitamin D rose from 14.2 ng/ml (11.5-18.5) at baseline to 49.3 ng/ml (42.3-58.1) at the end of the study (P<0.001). 1,25-Dihydroxyvitamin D rose from 15.1 (10.5-18.8) pg/ml at baseline to 20.5 (17.0-24.7) pg/ml at the end of the study (P<0.001). The median baseline calcium absorption was 12% (7%-17%) and 12% (7%-16%) at the end of study. Patients with stage 5 CKD on hemodialysis had very low calcium absorption values at baseline, and cholecalciferol supplementation that raised 25(OH)D levels to 50 ng/ml had no effect on calcium absorption.

  9. Habitual coffee consumption enhances attention and vigilance in hemodialysis patients.

    Science.gov (United States)

    Nikić, Petar M; Andrić, Branislav R; Stojimirović, Biljana B; Trbojevic-Stanković, Jasna; Bukumirić, Zoran

    2014-01-01

    Coffee drinking is the main source of caffeine intake among adult population in the western world. It has been reported that low to moderate caffeine intake has beneficial effect on alertness and cognitive functions in healthy subjects. The aim of this study is to evaluate the impact of habitual coffee consumption on cognitive function in hemodialysis patients. In a cross-sectional study, 86 patients from a single-dialysis centre underwent assessment by the Montreal Cognitive Assessment tool and evaluation for symptoms of fatigue, mood, and sleep disorders by well-validated questionnaires. The habitual coffee use and the average daily caffeine intake were estimated by participants' response to a dietary questionnaire. Sixty-seven subjects (78%) consumed black coffee daily, mostly in low to moderate dose. Cognitive impairment was found in three-quarters of tested patients. Normal mental performance was more often in habitual coffee users (25% versus 16%). Regular coffee drinkers achieved higher mean scores on all tested cognitive domains, but a significant positive correlation was found only for items that measure attention and concentration (P = 0.024). Moderate caffeine intake by habitual coffee consumption could have beneficial impact on cognitive function in hemodialysis patients due to selective enhancement of attention and vigilance.

  10. [Assessment and follow up of diabetic patients in hemodialysis].

    Science.gov (United States)

    Sanhueza, María Eugenia; Cotera, Alejandro; Elgueta, Leticia; López S, Gloria; Loncon, Patricia; Macan, Fernando; Pérez, Francisco; Cavada, Gabriel; Alvo, Miriam

    2008-03-01

    Despite a better management of the variables that influence the development of diabetic nephropathy there is a progressive increase in the prevalence of terminal renal failure among diabetics, whose cause is not clear. To study in a group of patients in hemodialysis, the quality of diabetes control previous to the entry to dialysis, their physical condition and their evolution. Diabetic patients with at least three months of hemodialysis answered a questionnaire about diabetes control quality previous to dialysis and had physical and laboratory assessment. They were followed for at least four years thereafter. Fifty seven patients aged 62+/-11 years were studied. Eighty four percent had some degree of disability. Eighty seven percent had high blood pressure and 73% had to enter dialysis as an emergency. Mean glycosilated hemoglobin was 7.7% and 58% had a dialysis dose with a Kt/Vofless than 1.2. Fifty eight percent died during follow up. No relationship between mortality and age, blood pressure, glycosilated hemoglobin of Kt/V, was observed. There is an inadequate management of blood glucose and blood pressure of diabetic patients before entry to dialysis. They are referred inverted exclamation markate to the nephrologist, the dialysis dose is insufficient and they have a high mortality.

  11. The new standard of fluids for hemodialysis in Japan.

    Science.gov (United States)

    Kawanishi, Hideki; Masakane, Ikuto; Tomo, Tadashi

    2009-01-01

    The standard of fluids for hemodialysis is being evaluated by the International Organization for Standardization (ISO), and will be decided within a few years. In 2008, the Japanese Society for Dialysis Therapy (JSDT) proposed the standard of fluids for hemodialysis by taking the draft ISO standard into consideration and the circumstances in Japan. It was characteristically a standard for Japan, where the central dialysis fluid delivery system (CDDS) is routinely used. In addition, the therapeutic application of each dialysis fluid is clarified. Since high-performance dialyzers are frequently employed in Japan, the standard recommends that ultrapure dialysis fluid be used for all dialysis modalities at all dialysis facilities. It also recommends that the dialysis equipment safety management committee at each facility validate the microbiological qualities of online-prepared substitution fluid, making the responsibility of the dialysis facility clear. This standard is more rigid than those of other countries, and is expected to contribute to improvements in the survival outcome of dialysis patients. (c) 2009 S. Karger AG, Basel.

  12. Therapeutic efficacy of different Hemodialysis prescriptions in canine azotemia

    Directory of Open Access Journals (Sweden)

    Ekta Atul Thakkar

    2014-12-01

    Full Text Available Aim: The aim was to determine therapeutic efficacy of different Hemodialysis prescriptions in canine azotemia. Materials and Methods: Patients (n=9 with acute onset of renal dysfunction or chronic patients with superimposed acute factor (component or patients with known chronic nature of the disease were dialyzed with Fresenius 4008S hemodialysis machine after jugular catheterization. Patients were randomly divided into two groups, one group (n=3 was dialyzed every day and second (n=4 was dialyzed on alternate days. The patients were evaluated for following parameters to compare the efficacy of the dialysis prescription: Urea reduction ratio (URR, creatinine reduction ratio (CRR, Kt/V, time averaged concentration of urea (TAC urea. Result and Discussion: Increasing both dialysis frequency and duration is the superior dialysis schedule. Patient dialyzed every day with total processed blood volume 1.79 L/Kg for 4 h 26 min/session had the lowest TAC of 36.82 mg/dl, thereby was considered it as a better prescription.

  13. Adherence to phosphate binders in hemodialysis patients: prevalence and determinants.

    Science.gov (United States)

    Van Camp, Yoleen P M; Vrijens, Bernard; Abraham, Ivo; Van Rompaey, Bart; Elseviers, Monique M

    2014-12-01

    Phosphate control is a crucial treatment goal in end-stage renal disease, but poor patient adherence to phosphate binder therapy remains a challenge. This study aimed to estimate the extent of phosphate binder adherence in hemodialysis patients and to identify potential determinants. Phosphate binder adherence was measured blindly in 135 hemodialysis patients for 2 months using the medication event monitoring system. Patient data, gathered at inclusion through medical records, ad hoc questionnaires and the short form (SF)-36 health survey, included: (1) demographics, (2) perceived side-effects, belief in benefit, self-reported adherence to the therapy, (3) knowledge about phosphate binder therapy, (4) social support, and (5) quality of life (SF-36). Phosphatemia data was collected from charts. 'Being adherent' was defined as missing adherent' as missing adherent. Over the entire 8-week period, 22 % of patients were totally adherent. Mean phosphatemia levels were 0.55 mg/dl lower in adherent than nonadherent patients (4.76 vs. 5.31 mg/dl). Determinants for being totally adherent were living with a partner, higher social support (both were interrelated) and higher physical quality of life. Experiencing intake-related inconvenience negatively affected adherence. The social support and quality of life physical score explained 26 % of the variance in adherence. Phosphate binder nonadherence remains a major problem. Interventions should aim, at least, to improve social support. With few associated factors found and yet low adherence, an individualized approach seems indicated.

  14. [Adherence to pharmacological treatment in adult patients undergoing hemodialysis].

    Science.gov (United States)

    Sgnaolin, Vanessa; Figueiredo, Ana Elizabeth Prado Lima

    2012-06-01

    Adherence to treatment in patients on hemodialysis is not a simple process. Strategies to promote adherence will meet the need for improvements in the process of orientation concerning the disease and its pharmacological treatment. To identify compliance with pharmacological treatment of patients on hemodialysis and the main factors related to it we used the Adherence Scale. Observational, descriptive and cross-sectional study. Interviews were conducted to collect socioeconomic, pharmacological data, as well as those regarding self-reported adherence to drug. Out of the 65 participants, 55.4% showed non-compliance. The mean number of drugs used was 4.1 ± 2.5 (self-report) and 6.2 ± 3.0 (prescription). Statistical analysis showed significant differences concerning compliance at different ages (> 60 years are more adherent). A significant proportion of patients have difficulty to comply with treatment and the main factor was forgetfulness. Regarding age, elderly patients are more adherent to treatment. The low level of knowledge about the used drugs may be one of the reasons for the lack of adherence, and the patient's orientation process by a team of multiprofessionals involved in assisting is a strategy to promote adherence.

  15. Habitual Coffee Consumption Enhances Attention and Vigilance in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Petar M. Nikić

    2014-01-01

    Full Text Available Objective. Coffee drinking is the main source of caffeine intake among adult population in the western world. It has been reported that low to moderate caffeine intake has beneficial effect on alertness and cognitive functions in healthy subjects. The aim of this study is to evaluate the impact of habitual coffee consumption on cognitive function in hemodialysis patients. Methods. In a cross-sectional study, 86 patients from a single-dialysis centre underwent assessment by the Montreal Cognitive Assessment tool and evaluation for symptoms of fatigue, mood, and sleep disorders by well-validated questionnaires. The habitual coffee use and the average daily caffeine intake were estimated by participants’ response to a dietary questionnaire. Results. Sixty-seven subjects (78% consumed black coffee daily, mostly in low to moderate dose. Cognitive impairment was found in three-quarters of tested patients. Normal mental performance was more often in habitual coffee users (25% versus 16%. Regular coffee drinkers achieved higher mean scores on all tested cognitive domains, but a significant positive correlation was found only for items that measure attention and concentration (P=0.024. Conclusions. Moderate caffeine intake by habitual coffee consumption could have beneficial impact on cognitive function in hemodialysis patients due to selective enhancement of attention and vigilance.

  16. Cardiovascular impact in patients undergoing maintenance hemodialysis: Clinical management considerations.

    Science.gov (United States)

    Chirakarnjanakorn, Srisakul; Navaneethan, Sankar D; Francis, Gary S; Tang, W H Wilson

    2017-04-01

    Patients undergoing maintenance hemodialysis develop both structural and functional cardiovascular abnormalities. Despite improvement of dialysis technology, cardiovascular mortality of this population remains high. The pathophysiological mechanisms of these changes are complex and not well understood. It has been postulated that several non-traditional, uremic-related risk factors, especially the long-term uremic state, which may affect the cardiovascular system. There are many cardiovascular changes that occur in chronic kidney disease including left ventricular hypertrophy, myocardial fibrosis, microvascular disease, accelerated atherosclerosis and arteriosclerosis. These structural and functional changes in patients receiving chronic dialysis make them more susceptible to myocardial ischemia. Hemodialysis itself may adversely affect the cardiovascular system due to non-physiologic fluid removal, leading to hemodynamic instability and initiation of systemic inflammation. In the past decade there has been growing awareness that pathophysiological mechanisms cause cardiovascular dysfunction in patients on chronic dialysis, and there are now pharmacological and non-pharmacological therapies that may improve the poor quality of life and high mortality rate that these patients experience. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Spironolactone in chronic hemodialysis patients improves cardiac function

    International Nuclear Information System (INIS)

    Taheri, Shahram; Mortazavi, Mojhgan; Shahidi Shahrzad; Seirafian, Shiva; Pourmoghadas, Ali; Garakyaraghi, Mohammad; Eshaghian, Afrooz; Ghassami, Maryam

    2009-01-01

    We performed this study to assess whether low dose spironolactone could be administered in hemodialysis (HD) patients with moderate to severe heart failure to improve cardiovascular function and reduce hospitalization without inducing hyperkalemia. We enrolled 16 chronic HD patients with moderate to severe heart failure and left ventricle ejection fraction :5 45%. In a double blinded randomized placebo controlled study, one group of 8 patients received 25 mg of spironolactone after each dialysis session within six months, and the rest received a placebo. Echocardiography was performed on all the patients to assess ejection fraction and left ventricular mass during 12 hours after completion of hemodialysis at the beginning and the end of study. Serum potassium was measured predialysis every 4 weeks. The mean ejection fraction increased significantly more in spironolactone group during the study period than in the placebo group (6.2 + - 1.64 vs. 0.83 + - 4.9, P0.046). The mean left ventricular mass decreased in the spironolactone group, but increased significantly in the placebo group during the period (-8.4 + - 4.72 vs. 3 + -7.97. 95%, P= 0.021). The incidence of hyperkalemia was not significantly increased in the study or controlled groups. In conclusion, we found in this study that administration of spironolactone in chronic HD patients with moderate to severe heart failure substantially improved their cardiac function and decreases left ventricular mass without development of significant hyperkalemia. (author)

  18. Nonoxidized, biologically active parathyroid hormone determines mortality in hemodialysis patients

    DEFF Research Database (Denmark)

    Tepel, Martin; Armbruster, Franz Paul; Grön, Hans Jürgen

    2013-01-01

    Background: It was shown that nonoxidized PTH (n-oxPTH) is bioactive, whereas the oxidation of PTH results in a loss of biological activity. Methods: In this study we analyzed the association of n-oxPTH on mortality in hemodialysis patients using a recently developed assay system. Results......: Hemodialysis patients (224 men, 116 women) had a median age of 66 years. One hundred seventy patients (50%) died during the follow-up period of 5 years. Median n-oxPTH levels were higher in survivors (7.2 ng/L) compared with deceased patients (5.0 ng/L; P = .002). Survival analysis showed an increased survival...... in the highest n-oxPTH tertile compared with the lowest n-oxPTH tertile (χ(2), 14.3; P = .0008). Median survival was 1702 days in the highest n-oxPTH tertile, whereas it was only 453 days in the lowest n-oxPTH tertile. Multivariable-adjusted Cox regression showed that higher age increased odds for death, whereas...

  19. Seroprevalence occurrence of viral hepatitis and HIV among hemodialysis patients

    Science.gov (United States)

    Kamal, Inass Mahmood; Mutar Mahdi, Batool

    2018-05-01

    Background: Patients with chronic renal failure (CRF) were on maintenance invasive haemodialysis (HD) procedure. This procedure by itself affects immunity of the patients and became more susceptible to viral infections. Aim of the study: to investigate the occurrence of HBV, HCV and HIV infections in patients with hemodialysis. Patients and methods: A retrospective study of 430 end-stage renal failure patients, referred to hemodialysis department at Al-Kindy Teaching Hospital, Baghdad-Iraq from Junuary-2015 to Junuary-2017. Patients were investigated for HBs-Ag using enzyme-labeled antigen test (Foresight-EIA-USA ), HCV- Abs (IgG) specific immunoglobulin using a HCV enzyme-labeled antigen test (Foresight-EIA-USA) and anti HIV Abs (IgG) using enzyme-labeled antigen test (Foresight-EIA-USA). Results: The frequency of HBV infection in the first year was not significant between males (1.11%) and females (0.00%)(P = 0.295). About HCV also there are no significant differences between males (12.63%) and females (9.31%)(P = 0.347). After one year of follow up the frequencies of HBV and HCV were not significant between two sexes. Additionally, no any one of the patients had HIV infection. Conclusions: This study brings a light on that HBV and HCV were having the same frequencies in both genders and lower occurrence with time. Furthermore, HIV was not detected in those patients.

  20. New-onset diabetes after hemodialysis initiation: impact on survival.

    Science.gov (United States)

    Salifu, Moro O; Abbott, Kevin C; Aytug, Serhat; Hayat, Amir; Haria, Dhiren M; Shah, Syed; Friedman, Eli A; Delano, Barbara G; McFarlane, Samy I; Hurst, Frank P; Flom, Peter L; Jindal, Rahul M

    2010-01-01

    The incidence of new-onset diabetes after initiation of hemodialysis (NODAD) and its impact on survival is not known. We used data from the United States Renal Data System (USRDS) from January 2000 to December 2001, with at least 3 years of follow-up for this study. Patients aged 18-80 years were included. NODAD was defined as two Medicare institutional claims for diabetes in patients with no history of diabetes prior to starting hemodialysis (HD). Incidence (per 1,000 patient-years), prevalence (%) and hazard ratios for mortality in patients with NODAD were calculated. There were 59,340 incident patients with no history of diabetes prior to starting HD, of which 3,853 met criteria for NODAD. The overall incidence and prevalence of NODAD were 20 per 1,000 patient-years and 7.6%, respectively. In a cohort of 444 patients without diabetes and documented glycosylated hemoglobin A1c, diabetes after initiation of HD. NODAD was associated with a significantly increased risk of death as compared to non-diabetes patients (hazard ratio 1.20, 95% confidence interval 1.14-1.25). The USRDS showed a high incidence of NODAD, associated with significantly higher mortality compared to those who did not develop NODAD. The mechanism of NODAD needs to be explored further in experimental and clinical studies. 2010 S. Karger AG, Basel.

  1. Physical Activity in Hemodialysis Patients Measured by Triaxial Accelerometer

    Directory of Open Access Journals (Sweden)

    Edimar Pedrosa Gomes

    2015-01-01

    Full Text Available Different factors can contribute to a sedentary lifestyle among hemodialysis (HD patients, including the period they spend on dialysis. The aim of this study was to evaluate characteristics of physical activities in daily life in this population by using an accurate triaxial accelerometer and to correlate these characteristics with physiological variables. Nineteen HD patients were evaluated using the DynaPort accelerometer and compared to nineteen control individuals, regarding the time spent in different activities and positions of daily life and the number of steps taken. HD patients were more sedentary than control individuals, spending less time walking or standing and spending more time lying down. The sedentary behavior was more pronounced on dialysis days. According to the number of steps taken per day, 47.4% of hemodialysis patients were classified as sedentary against 10.5% in control group. Hemoglobin level, lower extremity muscle strength, and physical functioning of SF-36 questionnaire correlated significantly with the walking time and active time. Looking accurately at the patterns of activity in daily life, HDs patients are more sedentary, especially on dialysis days. These patients should be motivated to enhance the physical activity.

  2. Nutritional profile of hemodialysis patients concerning treatment time

    Directory of Open Access Journals (Sweden)

    Livia de Almeida Alvarenga

    Full Text Available Abstract Introduction: The mortality of the population with chronic kidney disease (CKD on hemodialysis (HD is very high and the protein-energy malnutrition stands out as one of the most common consequences in relation to this condition. Objective: To evaluate the association between time of hemodialysis and nutritional parameters of patients. Methods: It is a cross-sectional study with secondary data, developed of the University Hospital of the Federal University of Juiz de Fora (HU/UFJF. This study was approved by the Research Ethics Committee (Nº 1.233.142, a total of 36 patients. The medical records and collected data were analyzed for anthropometric markers, biochemical and diet, considering two groups: HD time less than three and greater than or equal to three years. Results: There was reduction of mass of somatic protein with increased duration of HD. In relation to food intake was observed that in patients with increased duration of dialysis, an increase in average consumption of protein / kg of weight, calories, phosphorus and potassium, with a significant difference from the mean protein intake / kg (p = 0.04 and phosphorus (p = 0.045. Increasing HD time has altered body composition of patients, indicating a decline in the nutritional status of these individuals. Conclusion: HD patients are a risk group for protein-energy malnutrition, where HD time interferes with the nutritional status and food profile of the patient. The group HD time greater than or equal to 3 years presented worsening nutritional status.

  3. Cerebral microbleeds and intracerebral hemorrhages in patients on maintenance hemodialysis

    International Nuclear Information System (INIS)

    Watanabe, Akira

    2006-01-01

    Cerebrovascular diseases are important causes of death in patients on maintenance hemodialysis. Recently, it has become clear that the presence of cerebral microbleeds (MBs) on T2 * -weighted magnetic resonance imaging (MRI) is closely related to intracerebral hemorrhages. This study investigated the incidence of MBs in chronic dialysis patients and prospective hemorrhagic complications of chronic dialysis patients with old intracerebral hemorrhages. Eighty patients (34 males, 46 females) with chronic renal failure, whose mean age was 62.9±11.4 years, were examined by MRI. The mean duration of hemodialysis was 7.8±6.3 years. MBs were found in 28 patients (35%) by T2 * -weighted MRI. Old intracerebral hemorrhages were seen in seven of the patients, and MBs were found in five (71%) of these seven patients. The frequency of old intracerebral hemorrhages was significantly higher in patients with MBs than in those without (p=0.048), and the numbers of MBs were significantly larger in patients with old intracerebral hemorrhages than in those without (p=0.0065). Three of the seven patients with old intracerebral hemorrhages had new hemorrhagic complications (two intracerebral hemorrhages and one cerebral microbleed) within a year. These intracerebral hemorrhages occurred in areas without MBs on the first T2 * -weighted MRI. T2 * -weighted MRI is useful for the detection of MBs, which may be a predictor of intracerebral hemorrhage. When a patient has a large number of MBs and old intracerebral hemorrhages, the risk of intracerebral hemorrhage undoubtedly increases. (author)

  4. Prolonged hypophosphatemia following parathyroidectomy in chronic hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Eda Altun

    2015-01-01

    Full Text Available Secondary hyperparathyroidism (SHPT is a common problem in patients with end-stage renal disease. In cases with severe and resistant SHPT, surgical parathyroidectomy (PTX is recommended. Hungry bone syndrome (HBS following surgical PTX is most often associated with hypocalcemia and hypophosphatemia. The mechanisms for the HBS are not clear, and a method for its prevention has not been established. We present three hemodialysis patients with persistant hypophosphatemia after PTX. In our parathyroidectomized patients, hypocalcemia could be corrected with calcium and vitamin D treatment, but hypophosphatemia continued for eight months in one patient and in two other patients until the last visit (10 and 2 months, respectively. Predisposing factors such as old age, diabetes mellitus and parathyroid adenoma were not found in our patients. All three patients were younger (<35 years old and anuric. Hemodialysis durations were seven, three and two years. In summary, HBS presented with hypocalcemia, and especially hypophosphatemia cannot be developed uncommonly and may persist for a long time following PTX in HD patients.

  5. Slow nocturnal home hemodialysis (SNHHD)--one year later.

    Science.gov (United States)

    Ouwendyk, M; Pierratos, A; Francoeur, R; Wallace, L; Sit, W; Vas, S

    1996-01-01

    High costs and overcrowding of dialysis centres are leading to a global crisis in health care provision. We are developing slow nocturnal home hemodialysis (SNHHD) in which patients dialyze for eight to 10 hours during sleep five to seven nights per week. Vascular access is by means of the Cook silastic jugular catheter. Special precautions are taken to prevent accidental disconnection and air embolism. Dialysis functions are remotely monitored on computer via a modem by trained staff. Five patients have completed five to seven weeks of training and have been successfully performing SNHHD single-handedly (three out of five patients live alone) for 14, 14, 11, 10 and four months respectively. All have discontinued their phosphate binders and increased dietary phosphate intake. Compared with conventional hemodialysis (CHD) results, average pre-dialysis urea and creatinine levels are remarkably reduced to 9.6 mmol/l and 486 umol/l respectively. The average cumulative weekly Kt/V for CHD is 5.0 as compared to 7.7 while on SNHHD. Four out of five patients report sleeping soundly and experience greatly increased energy and stamina. Their days are entirely free. Repeated in-situ re-use of the dialyzer and blood lines will reduce the patient's work and make SNHHD a very inexpensive modality. SNHHD appears to be a widely applicable treatment with many advantages to both the patient and the health care system.

  6. [Mobile single-pass batch hemodialysis system in intensive care medicine. Reduction of costs and workload in renal replacement therapy].

    Science.gov (United States)

    Hopf, H-B; Hochscherf, M; Jehmlich, M; Leischik, M; Ritter, J

    2007-07-01

    This paper describes the introduction of a single-pass batch hemodialysis system for renal replacement therapy in a 14 bed intensive care unit. The goals were to reduce the workload of intensive care unit physicians using an alternative and simpler method compared to continuous veno-venous hemodiafiltration (CVVHDF) and to reduce the costs of hemofiltrate solutions (80,650 EUR per year in our clinic in 2005). We describe and evaluate the process of implementation of the system as well as the achieved and prospective savings. We conclude that a close cooperation of all participants (physicians, nurses, economists, technicians) of a hospital can achieve substantial benefits for patients and employees as well as reduce the economic burden of a hospital.

  7. [Blood detoxification using superparamagnetic nanoparticles (magnetic hemodialysis)].

    Science.gov (United States)

    Ciochină, Al D; Untu, Alina; Iacob, Gh

    2010-01-01

    The authors present an experimental study realized in order to simulate blood detoxification with the help of supermagnetic nanoparticles. The particles used are red oxide nanoparticles which are considered to be equivalent from a magnetic susceptibility and dynamic diameter point of view to the complex structures of magnetite nanoparticles. Two types of custom HGMS matrices have been used--a threaded one and a micro-spheres one. For testing red oxide particles have been purposefully created to have a lower magnetic susceptibility than magnetite or iron-carbon particles used in other experimental studies. Different concentrations of iron oxide, glycerine and water have been prepared, creating a 3.5 cP viscosity (equivalent to the one of the blood); the concentrations of the prepared solutions varied between 0.16 mg/mL and 2 mg/mL, with the background magnetic field value ranging from 0.25 T to 0.9 T, in order to observer the effectiveness of filtering at different intensities. The efficiency of HGMS filtering in experimental conditions was almost completely successful (99.99%) in all experimental conditions, both with the threaded and micro-spheres matrices. The high gradient magnetic separation system of nanoparticles has maximum efficiency and has the potential of being implemented in a medical blood detoxification device.

  8. Effect of vitamin C supplementation on lipid profile, serum uric acid, and ascorbic acid in children on hemodialysis.

    Science.gov (United States)

    El Mashad, Ghada Mohamed; ElSayed, Hanan M; Nosair, Nahla A

    2016-01-01

    Children with end-stage renal disease (ESRD) suffer from dyslipidemia and hyperuricemia that might play a causal role in the progression of cardiovascular disease (CVD). The aim of the study is to assess the effects of Vitamin C supplementation on uric acid, ascorbic acid, and serum lipid levels among children on hemodialysis (HD). This prospective study was conducted in the pediatric nephrology unit at Menoufia University Hospital. The study included a total of 60 children with ESRD on maintenance HD therapy. They were divided into two groups: Group I (supplemented group, n = 30) received intravenous Vitamin C supplementation and Group II (control, n = 30) received placebo (intravenous saline) for three months. The results are shown as a mean ± standard deviation. Statistical evaluation was performed by SPSS software (version 11.5) using paired t-test. After supplementation with Vitamin C, the serum Vitamin C and high-density lipoprotein levels increased significantly with a significant reduction in the levels of serum uric acid, cholesterol, low-density lipoproteins, and triglyceride at the end of the study period. No significant changes were observed in the control group. Vitamin C can serve as a useful urate lowering medicine in HD patients to avoid complications of hyperuricemia. Furthermore, it had favorable effects on the lipid profile. This improvement can be considered as a preventive strategy in the progression of CVD in HD patients. Vitamin C supplementation improves ascorbic acid deficiency in these patients.

  9. Effect of vitamin C supplementation on lipid profile, serum uric acid, and ascorbic acid in children on hemodialysis

    Directory of Open Access Journals (Sweden)

    Ghada Mohamed El Mashad

    2016-01-01

    Full Text Available Children with end-stage renal disease (ESRD suffer from dyslipidemia and hyperuricemia that might play a causal role in the progression of cardiovascular disease (CVD. The aim of the study is to assess the effects of Vitamin C supplementation on uric acid, ascorbic acid, and serum lipid levels among children on hemodialysis (HD. This prospective study was conducted in the pediatric nephrology unit at Menoufia University Hospital. The study included a total of 60 children with ESRD on maintenance HD therapy. They were divided into two groups: Group I (supplemented group, n = 30 received intravenous Vitamin C supplementation and Group II (control, n = 30 received placebo (intravenous saline for three months. The results are shown as a mean ± standard deviation. Statistical evaluation was performed by SPSS software (version 11.5 using paired t-test. After supplementation with Vitamin C, the serum Vitamin C and high-density lipoprotein levels increased significantly with a significant reduction in the levels of serum uric acid, cholesterol, low-density lipoproteins, and triglyceride at the end of the study period. No significant changes were observed in the control group. Vitamin C can serve as a useful urate lowering medicine in HD patients to avoid complications of hyperuricemia. Furthermore, it had favorable effects on the lipid profile. This improvement can be considered as a preventive strategy in the progression of CVD in HD patients. Vitamin C supplementation improves ascorbic acid deficiency in these patients.

  10. Clinical impact of a combined therapy of peritoneal dialysis and hemodialysis.

    Science.gov (United States)

    Matsuo, N; Yokoyama, K; Maruyama, Y; Ueda, Y; Yoshida, H; Tanno, Y; Yamamoto, R; Terawaki, H; Ikeda, M; Hanaoka, K; Yamamoto, H; Ogura, M; Watanabe, S; Kimura, Y; Hosoya, T

    2010-09-01

    Although peritoneal dialysis (PD) is recommended as the first-line treatment for end-stage renal disease, limitations exist to achieving good clinical status when the residual renal function (RRF) has declined. Combined therapy with PD and hemodialysis (HD) is the treatment of choice for patients who cannot control body fluid status and/or cannot obtain adequate solute removal by PD alone. The aim of this study was to evaluate the clinical efficacy of this combined therapy. In this retrospective study, 53 patients on PD and diagnosed with underdialysis and/or overhydration with declining RRF were recruited. Parameters of volume control, uremic solute removal, anemia, and predictors for encapsulating peritoneal sclerosis (EPS) were compared before and 1 year after combined therapy. The patients' hydration status improved significantly with reductions in atrial natriuretic peptide and blood pressure. Serum creatinine and beta2 microglobulin also decreased significantly. The hemoglobin level increased remarkably from 8.2 ± 1.6 to 10.7 ± 1.2 g/dl (p < 0.01) and the reticulocyte count also increased significantly, even though at the same time the dose of recombinant human erythropoietin decreased significantly. The dialysate to plasma creatinine ratio obtained from the fast peritoneal equilibration test (PET) decreased significantly from 0.65 ± 0.11 to 0.59 ± 0.13, and the level of interleukin 6 in PET drainage also significantly decreased. Furthermore, serum C-reactive protein and fibrinogen decreased significantly. Combined therapy with PD and HD is an effective way to control fluid status and to correct inadequate solute removal, leading to improvement in inflammation, peritoneal function and anemia.

  11. Metabolic Fingerprinting to Assess the Impact of Salinity on Carotenoid Content in Developing Tomato Fruits

    Directory of Open Access Journals (Sweden)

    Lieven Van Meulebroek

    2016-05-01

    Full Text Available As the presence of health-promoting substances has become a significant aspect of tomato fruit appreciation, this study investigated nutrient solution salinity as a tool to enhance carotenoid accumulation in cherry tomato fruit (Solanum lycopersicum L. cv. Juanita. Hereby, a key objective was to uncover the underlying mechanisms of carotenoid metabolism, moving away from typical black box research strategies. To this end, a greenhouse experiment with five salinity treatments (ranging from 2.0 to 5.0 decisiemens (dS m−1 was carried out and a metabolomic fingerprinting approach was applied to obtain valuable insights on the complicated interactions between salinity treatments, environmental conditions, and the plant’s genetic background. Hereby, several hundreds of metabolites were attributed a role in the plant’s salinity response (at the fruit level, whereby the overall impact turned out to be highly depending on the developmental stage. In addition, 46 of these metabolites embraced a dual significance as they were ascribed a prominent role in carotenoid metabolism as well. Based on the specific mediating actions of the retained metabolites, it could be determined that altered salinity had only marginal potential to enhance carotenoid accumulation in the concerned tomato fruit cultivar. This study invigorates the usefulness of metabolomics in modern agriculture, for instance in modeling tomato fruit quality. Moreover, the metabolome changes that were caused by the different salinity levels may enclose valuable information towards other salinity-related plant processes as well.

  12. Characterizing the continuously acquired cardiovascular time series during hemodialysis, using median hybrid filter preprocessing noise reduction

    Directory of Open Access Journals (Sweden)

    Wilson S

    2015-01-01

    Full Text Available Scott Wilson,1,2 Andrea Bowyer,3 Stephen B Harrap4 1Department of Renal Medicine, The Alfred Hospital, 2Baker IDI, Melbourne, 3Department of Anaesthesia, Royal Melbourne Hospital, 4University of Melbourne, Parkville, VIC, Australia Abstract: The clinical characterization of cardiovascular dynamics during hemodialysis (HD has important pathophysiological implications in terms of diagnostic, cardiovascular risk assessment, and treatment efficacy perspectives. Currently the diagnosis of significant intradialytic systolic blood pressure (SBP changes among HD patients is imprecise and opportunistic, reliant upon the presence of hypotensive symptoms in conjunction with coincident but isolated noninvasive brachial cuff blood pressure (NIBP readings. Considering hemodynamic variables as a time series makes a continuous recording approach more desirable than intermittent measures; however, in the clinical environment, the data signal is susceptible to corruption due to both impulsive and Gaussian-type noise. Signal preprocessing is an attractive solution to this problem. Prospectively collected continuous noninvasive SBP data over the short-break intradialytic period in ten patients was preprocessed using a novel median hybrid filter (MHF algorithm and compared with 50 time-coincident pairs of intradialytic NIBP measures from routine HD practice. The median hybrid preprocessing technique for continuously acquired cardiovascular data yielded a dynamic regression without significant noise and artifact, suitable for high-level profiling of time-dependent SBP behavior. Signal accuracy is highly comparable with standard NIBP measurement, with the added clinical benefit of dynamic real-time hemodynamic information. Keywords: continuous monitoring, blood pressure

  13. Characterizing the continuously acquired cardiovascular time series during hemodialysis, using median hybrid filter preprocessing noise reduction.

    Science.gov (United States)

    Wilson, Scott; Bowyer, Andrea; Harrap, Stephen B

    2015-01-01

    The clinical characterization of cardiovascular dynamics during hemodialysis (HD) has important pathophysiological implications in terms of diagnostic, cardiovascular risk assessment, and treatment efficacy perspectives. Currently the diagnosis of significant intradialytic systolic blood pressure (SBP) changes among HD patients is imprecise and opportunistic, reliant upon the presence of hypotensive symptoms in conjunction with coincident but isolated noninvasive brachial cuff blood pressure (NIBP) readings. Considering hemodynamic variables as a time series makes a continuous recording approach more desirable than intermittent measures; however, in the clinical environment, the data signal is susceptible to corruption due to both impulsive and Gaussian-type noise. Signal preprocessing is an attractive solution to this problem. Prospectively collected continuous noninvasive SBP data over the short-break intradialytic period in ten patients was preprocessed using a novel median hybrid filter (MHF) algorithm and compared with 50 time-coincident pairs of intradialytic NIBP measures from routine HD practice. The median hybrid preprocessing technique for continuously acquired cardiovascular data yielded a dynamic regression without significant noise and artifact, suitable for high-level profiling of time-dependent SBP behavior. Signal accuracy is highly comparable with standard NIBP measurement, with the added clinical benefit of dynamic real-time hemodynamic information.

  14. Saline water irrigation of quinoa and chickpea

    DEFF Research Database (Denmark)

    Hirich, A.; Jelloul, A.; Choukr-Allah, R.

    2014-01-01

    A pot experiment was conducted in the south of Morocco to evaluate the response of chickpea and quinoa to different irrigation water salinity treatments (1, 4, 7 and 10 dS m-1 for chickpea and 1, 10, 20 and 30 dS m-1 for quinoa). Increasing salinity affected significantly (P

  15. Decline of the world's saline lakes

    Science.gov (United States)

    Wayne A. Wurtsbaugh; Craig Miller; Sarah E. Null; R. Justin DeRose; Peter Wilcock; Maura Hahnenberger; Frank Howe; Johnnie Moore

    2017-01-01

    Many of the world’s saline lakes are shrinking at alarming rates, reducing waterbird habitat and economic benefits while threatening human health. Saline lakes are long-term basin-wide integrators of climatic conditions that shrink and grow with natural climatic variation. In contrast, water withdrawals for human use exert a sustained reduction in lake inflows and...

  16. Estimation of salinity power potential in India

    Digital Repository Service at National Institute of Oceanography (India)

    Das, V.K.; RamaRaju, D.V.

    Salinity gradient as a source of energy has much potential, but this has been recognized only recently. The energy density of this source is equivalent to about 250 m water head for a salinity difference of 35 ppt. This source exists...

  17. Health-related quality of life in a sample of iranian patients on hemodialysis

    DEFF Research Database (Denmark)

    Pakpour, Amir H.; Saffari, Mohsen; Yekaninejad, Mir Saeed

    2010-01-01

    were included using a convenience sampling approach in a cross-sectional study. Data collection was performed using a Persian translation of the Short Form-36 questionnaire in combination with demographic and clinically related questions. The collected data were analyzed using a logistic regression......INTRODUCTION: This study evaluated the health-related quality of life (HRQOL) in a sample of Iranian patients undergoing maintenance hemodialysis. The data were compared with the HRQOL for the Iranian general population. MATERIALS AND METHODS: Two-hundred and fifty patients undergoing hemodialysis...... the fact that patients undergoing hemodialysis suffer from poor HRQOL. In comparison with data from other studies from Asian and European countries, this sample of Iranian patients on hemodialysis had a lower HRQOL, a discrepancy that might be due to differences in life style, socioeconomic status...

  18. Chronic obstructive pulmonary disease in patients with end-stage kidney disease on hemodialysis

    DEFF Research Database (Denmark)

    Plesner, Louis L; Warming, Peder E; Nielsen, Ture L

    2016-01-01

    The objectives of this study were to assess the prevalence of chronic obstructive pulmonary disease (COPD) in hemodialysis patients with spirometry and to examine the effects of fluid removal by hemodialysis on lung volumes. Patients ≥18 years at two Danish hemodialysis centers were included....... Forced expiratory volume in one second (FEV1 ), forced vital capacity (FVC), and FEV1 /FVC ratio were measured with spirometry before and after hemodialysis. The diagnosis of COPD was based on both the GOLD criteria and the lower limit of normal criteria. There were 372 patients in treatment at the two...... centers, 255 patients (69%) completed spirometry before dialysis and 242 of these (65%) repeated the test after. In the initial test, 117 subjects (46%) had airflow limitation indicative of COPD with GOLD criteria and 103 subjects (40.4%) with lower limit of normal criteria; COPD was previously diagnosed...

  19. Evaluation of pulmonary function in renal transplant recipients and chronic renal failure patients undergoing maintenance hemodialysis

    Directory of Open Access Journals (Sweden)

    Mohamed E. Abdalla

    2013-01-01

    Conclusion: There is impairment of lung function in patients with CRF undergoing hemodialysis. The main changes are small airway obstruction, reduction in carbon monoxide transfer and diminished 6MWT that were not completely improved in the kidney transplant patients.

  20. Depression and quality of life in patients on long term hemodialysis ...

    African Journals Online (AJOL)

    Depression and quality of life in patients on long term hemodialysis at a national ... Quality of Life instrument were used to assess depression and quality of life. ... Haemodialysis patients who obtained low scores on quality of life measures ...

  1. Korean clinical practice guidelines for preventing the transmission of infections in hemodialysis facilities

    Directory of Open Access Journals (Sweden)

    Hayne Cho Park

    2018-03-01

    Full Text Available Patients receiving hemodialysis are vulnerable to infectious diseases due to their impaired immunity and high risk of exposure to pathogens. To protect patients, staff, and visitors from potential infections, each hemodialysis unit should establish and follow standard infection control and prevention measures. Therefore, clinical practice guidelines were developed by a working group of nephrologists and infection control specialists to provide evidence-based guidance for dialysis physicians and nurses, with the aim of preventing infection transmission and controlling infection sources in hemodialysis facilities. The areas of infection control covered by these guidelines include standard precautions, isolation strategies, vascular access, water treatment, cleaning/disinfecting/sterilizing, and vaccination. This special report summarizes the key recommendations from the Korean clinical practice guidelines for preventing the transmission of infections in hemodialysis facilities.

  2. 21 CFR 876.5600 - Sorbent regenerated dialysate delivery system for hemodialysis.

    Science.gov (United States)

    2010-04-01

    ... dialyzer. The device is used with the extracorporeal blood system and the dialyzer of the hemodialysis... dialysate conditions. The sorbent cartridge may include absorbent, ion exchange and catalytic materials. (b...

  3. [Quality assurance and certification of a hemodialysis unit according to the ISO-9001-2000 standards].

    Science.gov (United States)

    Arenas, M D; Gil, M T; Egea, J J; Sirvent, A E; Giménez, A

    2003-01-01

    We report the experience of three hemodialysis centers registered with the ISO 9001-2000 standard, regarding the development of a quality measure system and providing an analysis of this system and its advantages and disadvantages.

  4. Do laboratory salinity tolerances of freshwater animals correspond with their field salinity?

    International Nuclear Information System (INIS)

    Kefford, Ben J.; Papas, Phil J.; Metzeling, Leon; Nugegoda, Dayanthi

    2004-01-01

    The degree to which laboratory derived measures of salinity tolerance reflect the field distributions of freshwater biota is uncertain. In this paper we compare laboratory-derived acute salinity tolerance (LC 50 values) of freshwater macroinvertebrates (range 5.5-76 mS/cm) and fish (range 2.7-82 mS/cm) from southeastern Australia with the salinity from which they have been collected in the field. Only 4% of the macroinvertebrates were collected at salinity levels substantially higher than their 72-h LC 50 obtained from directly transferring animals from low salinity water to the water they were tested (direct transfer LC 50 ). This LC 50 value was correlated with the maximum salinity at which a species had been collected. For common macroinvertebrates, the maximum field salinity was approximated by the direct transfer 72-h LC 50 . For adult freshwater fish, 21% of species were collected at salinities substantially greater than their acute direct transfer LC 50 and there was a weak relationship between these two variables. Although there was a weak correlation between the direct transfer LC 50 of early life stages of freshwater fish and the maximum field salinity, 58% of the field distribution were in higher than their LC 50 values. In contrast, LC 50 determined from experiments that acclimated adult fish to higher salinity (slow acclimation) provided a better indication of the field distribution: with only one fish species (7%) being in conflict with their maximum field salinity and a strong positive relationship between these variables. This study shows that laboratory measures of acute salinity tolerance can reflect the maximum salinity that macroinvertebrate and fish species inhabit and are consistent with some anecdotal observations from other studies. - Acute laboratory salinity tolerances relate to maximum salinity where organisms occur in nature

  5. Do laboratory salinity tolerances of freshwater animals correspond with their field salinity?

    Energy Technology Data Exchange (ETDEWEB)

    Kefford, Ben J.; Papas, Phil J.; Metzeling, Leon; Nugegoda, Dayanthi

    2004-06-01

    The degree to which laboratory derived measures of salinity tolerance reflect the field distributions of freshwater biota is uncertain. In this paper we compare laboratory-derived acute salinity tolerance (LC{sub 50} values) of freshwater macroinvertebrates (range 5.5-76 mS/cm) and fish (range 2.7-82 mS/cm) from southeastern Australia with the salinity from which they have been collected in the field. Only 4% of the macroinvertebrates were collected at salinity levels substantially higher than their 72-h LC{sub 50} obtained from directly transferring animals from low salinity water to the water they were tested (direct transfer LC{sub 50}). This LC{sub 50} value was correlated with the maximum salinity at which a species had been collected. For common macroinvertebrates, the maximum field salinity was approximated by the direct transfer 72-h LC{sub 50}. For adult freshwater fish, 21% of species were collected at salinities substantially greater than their acute direct transfer LC{sub 50} and there was a weak relationship between these two variables. Although there was a weak correlation between the direct transfer LC{sub 50} of early life stages of freshwater fish and the maximum field salinity, 58% of the field distribution were in higher than their LC{sub 50} values. In contrast, LC{sub 50} determined from experiments that acclimated adult fish to higher salinity (slow acclimation) provided a better indication of the field distribution: with only one fish species (7%) being in conflict with their maximum field salinity and a strong positive relationship between these variables. This study shows that laboratory measures of acute salinity tolerance can reflect the maximum salinity that macroinvertebrate and fish species inhabit and are consistent with some anecdotal observations from other studies. - Acute laboratory salinity tolerances relate to maximum salinity where organisms occur in nature.

  6. Tea (Camellia sinensis (L.) Kuntze) leaf compost ameliorates the adverse effects of salinity on growth of cluster beans (Cyamopsis tetragonoloba L.)

    International Nuclear Information System (INIS)

    Saeed, R.; Shah, P.; Jahan, B.

    2016-01-01

    The pot experiment was carried out to evaluate the effect of tea compost on plant growth under salinity. Plants were grown in clay pots filled with sandy loam soil and irrigated by saline water (0, 50 and 100mM NaCl) with and without tea compost amendments. Soil evapotranspiration (ET), vegetative and reproductive growth and biochemical parameters were studied in this experiment. ET rate was increased with increasing salinity, whereas, it decreased with application of tea compost under all salinity. Vegetative (shoot height, number of leaves, fresh and dry biomass) and reproductive (number of seeds per plant) growth significantly decline under increasing salinity levels. Tea compost treatment helped in improving all these parameters. Total photosynthetic pigments (chlorophyll a, b, carotenoids and total chlorophyll content) showed reduction under raising salinity levels, while betterment was recorded with application of tea compost. Organic solutes (soluble sugars, proteins, free amino acids and phenolic content) increased with increasing salinity (50-100mM NaCl). Increased soluble sugars were found with tea compost treatment under non-saline control and decreased in salinity. Soluble proteins, amino acids and phenolic content increased with application of tea compost under both control and salinity. It is concluded that tea compost treatment is found to cope with salinity stress and improve plant growth and biochemical parameters by diluting the hazardous effects of salinity. (author)

  7. Hemodialysis knowledge and medical adherence in African Americans diagnosed with end stage renal disease: results of an educational intervention.

    Science.gov (United States)

    Wells, Janie R

    2011-01-01

    The purpose of this three-group quasi-experimental re